What this thread is missing is Obamas promise that everyone could keep their doctor, keep their plans and reduce their cost. The latest count is Obama said that in public 28X. Talk about "liar in chief." He's worse than Trump with the truth
1
Not even close. Mostly false or worse: Obama - 26%. Trump - 70%. If lying were a basketball game, Trump beats Obama 70 to 26, a ridiculous blowout.
http://www.politifact.com/personalities/barackobama/ http://www.politifact.com/personalities/donald-trump/
http://www.politifact.com/personalities/barackobama/ http://www.politifact.com/personalities/donald-trump/
3
Politifact are a bunch of leftist hacks who always find Republicans supposedly "lie" more than Democrats.
2
The dichotemy in incomes in USA of rich with poor has parallels everywhere in its society: 'best medical practice' with 'no available care'; 'maximum profit' with 'minimum consideration'; 'ideals of equality' with 'ethnic preference'; 'ethos of civic responsibility' with 'self-dealing populism'; 'religious faith' with 'military expansion'; 'patriotism' with 'entitlement'; etc.
I was in Canada when the Social Insurance Act was first implemented. Canada was simply less Janus-faced than USA was. Viet Nam war was on then, and USA was dealing with its own social reforms in the face of that. Still, there was a lot of doubt in BC & Alberta about whether 'socialized medicine' would bankrupt Canada.
What was the cost of inclusiveness, 45 years or so later? Today, average cost of a home in Vancouver, Canada's most expensive city is C$864,556. Average cost of a home in Saratoga, CA (Apple HQ) is C$3,308,152. Average cost in the least expensive communities are C$159,370 (Fredricton, NB), vs C$86,356 (Detroit, MI). Average income in Canada is C$78K (vs ~C$72K in USA). According to Commonwealth Fund, Canada delivers a weighted average of slightly better healthcare at half the cost, based on around 12 parameters (including access), and 33% of Americans surveyed reported going without needed care because of expense in 2016 (down from 37% in 2013), at the bottom of 11 countries surveyed. Hard to find an American humble enough to accept average health care, though.
I was in Canada when the Social Insurance Act was first implemented. Canada was simply less Janus-faced than USA was. Viet Nam war was on then, and USA was dealing with its own social reforms in the face of that. Still, there was a lot of doubt in BC & Alberta about whether 'socialized medicine' would bankrupt Canada.
What was the cost of inclusiveness, 45 years or so later? Today, average cost of a home in Vancouver, Canada's most expensive city is C$864,556. Average cost of a home in Saratoga, CA (Apple HQ) is C$3,308,152. Average cost in the least expensive communities are C$159,370 (Fredricton, NB), vs C$86,356 (Detroit, MI). Average income in Canada is C$78K (vs ~C$72K in USA). According to Commonwealth Fund, Canada delivers a weighted average of slightly better healthcare at half the cost, based on around 12 parameters (including access), and 33% of Americans surveyed reported going without needed care because of expense in 2016 (down from 37% in 2013), at the bottom of 11 countries surveyed. Hard to find an American humble enough to accept average health care, though.
5
It's like Levi's: hard to find an American humble enough to say they wear a size 8, so Levi's just renames them size 6 and sells a boatload.
Rich or poor, American healthcare as it stands today is sub-par.
Rich or poor, American healthcare as it stands today is sub-par.
2
What value do insurance companies add to the goal of providing health care, other than writing checks (or their electronic equivalent) to those who actually provide health care? What value is to ever come from those gullible to take those advertised courses in "Medical Coding" (that's billing code, not software code)?
A single payer health care system, in some form, would be a real, rare case of "Cheaper, Better, Faster", getting all three.
A single payer health care system, in some form, would be a real, rare case of "Cheaper, Better, Faster", getting all three.
3
We're No 46!
"It’s remarkable how low America places in health care efficiency: among the 48 countries included in the Bloomberg study, the U.S. ranks 46th, outpacing just Serbia and Brazil. Once that sinks in, try this one on for size: the U.S. ranks worse than China, Algeria, and Iran."
http://www.huffingtonpost.com/2013/08/29/most-efficient-healthcare_n_382...
Imagine how much better we could do, if we replaced our Lobbyocracy with a better form of government and had universal healthcare.
"It’s remarkable how low America places in health care efficiency: among the 48 countries included in the Bloomberg study, the U.S. ranks 46th, outpacing just Serbia and Brazil. Once that sinks in, try this one on for size: the U.S. ranks worse than China, Algeria, and Iran."
http://www.huffingtonpost.com/2013/08/29/most-efficient-healthcare_n_382...
Imagine how much better we could do, if we replaced our Lobbyocracy with a better form of government and had universal healthcare.
7
What is the purpose of insurance?
A common thread seems to be a lack of agreement as to what insurance is.
As part of financial literacy, I propose teaching the concepts of expected value and the role of insurance to control variability.
Some consider insurance to be a free lunch. Some look at insurance as a waste of money.
I have asked insurance salespeople the question. What is the purpose of insurance. So far, the responses, to me, are nonsense. When asked about deductables, the response from insurance agnets is nonsense in my point of view.
Why are insurance companies sponsor Flo, the liazard, the distraught parent as spokespersons? Cecause they can sell the idea of "cheap" insurance and ignore education on what risk reduction involves.
Why are insurance companies allowed, even encouraged, to ignore the role of education in reducing unexpected costs?
Does camera enforcement really make roads safer? If so, why haven't insurance premiums decreased?
A common thread seems to be a lack of agreement as to what insurance is.
As part of financial literacy, I propose teaching the concepts of expected value and the role of insurance to control variability.
Some consider insurance to be a free lunch. Some look at insurance as a waste of money.
I have asked insurance salespeople the question. What is the purpose of insurance. So far, the responses, to me, are nonsense. When asked about deductables, the response from insurance agnets is nonsense in my point of view.
Why are insurance companies sponsor Flo, the liazard, the distraught parent as spokespersons? Cecause they can sell the idea of "cheap" insurance and ignore education on what risk reduction involves.
Why are insurance companies allowed, even encouraged, to ignore the role of education in reducing unexpected costs?
Does camera enforcement really make roads safer? If so, why haven't insurance premiums decreased?
1
The right-wing republican mafiosi have done everything they could do to destroy Obamacare from its inception and then like mob killers on the witness stand they turn around and proclaim that Obamacare is "self-destructing."
They make Satan look like an ingenue.
They make Satan look like an ingenue.
4
Why aren't Obamacare supporters, especially Democratic politicians, nailing Trump and Congressional Republicans for undermining Obamacare? Imagine advertisements along the lines of:
"Are your health insurance premiums soaring? Are insurers pulling out? Blame President Trump and his crew for deliberately undermining the symstem. Call your Congressman and Senator today!"
"Are your health insurance premiums soaring? Are insurers pulling out? Blame President Trump and his crew for deliberately undermining the symstem. Call your Congressman and Senator today!"
2
This is nothing more than Trump wanting to destroy everything Obama to please his base. If the President really cared about America and Americans, he would fix it. Remember it is only high Premiums that people object to. If Trump is what he says he is, a business genius, then fix it, don't destroy it.
3
The only thing he's a genius at is going bankrupt and not paying the people with whom he contracted to do the work he wanted to have done. If that's what they teach at his fancy college, it should be shut down. So should he.
2
Health care is just one of many issues that Trump wants to reverse to make America Great Again. Soon we will be back to the Jim Crow era and white rule.
3
I think the article is testimony to what matters to the US business-run government and the media who obfuscate the clear fact that single payer is the humane, affordable alternative: profits. Are the parasitic health insurance companies—a middle man that isn't even needed—getting high enough profits off of the suffering and needs of Americans? This is the question asked, rather than, "why do we need health insurance companies when we could have a single payer system?"
2
I am on medicare and also have medigap insurance. For a total of about $600 per month, my insurance so far has literally paid for everything. No deductible. No nothing. So I can't complain. I wish every American could get my type of insurance, but then the increased tax burden might be unconscionable. I was in Denmark and spoke to a person who had "free" healthcare. It was "free" alright, but they paid a much higher tax rate than I paid. So, no thanks.
Conversely, my daughter and her husband pay more for their insurance under Obamacare than they do for their mortgage. Not only have their premiums gone up dramatically, but the deductibles are so high that the insurance, except for a great catastrophe, is almost useless. It is essentially a 'junk" plan as proponents of Obamacare used to call some plans, even though it is one of the better existing plans and costs multiples of so called"junk" plans before Obamacare. Last year, they had to pay $30,000 out of pocket for needed eye surgery. My daughter's husband is self employed, so their options are limited.
For my daughter's family, Obamacare is severely broken, and they will pay even more. Yet, our politicians can't/won't fix it. And, sorry Democrats, you are part of the problem too. You never seriously initiated a fix, and now would be more than happy to see the dysfunctional Republicans fail so you could hold it against them. Both parties seek political upmanship, while our system remains broken.
Conversely, my daughter and her husband pay more for their insurance under Obamacare than they do for their mortgage. Not only have their premiums gone up dramatically, but the deductibles are so high that the insurance, except for a great catastrophe, is almost useless. It is essentially a 'junk" plan as proponents of Obamacare used to call some plans, even though it is one of the better existing plans and costs multiples of so called"junk" plans before Obamacare. Last year, they had to pay $30,000 out of pocket for needed eye surgery. My daughter's husband is self employed, so their options are limited.
For my daughter's family, Obamacare is severely broken, and they will pay even more. Yet, our politicians can't/won't fix it. And, sorry Democrats, you are part of the problem too. You never seriously initiated a fix, and now would be more than happy to see the dysfunctional Republicans fail so you could hold it against them. Both parties seek political upmanship, while our system remains broken.
4
Lucky you! I have your same coverage exactly, but no doctor (primary care) here is accepting patients with Medicare.
1
As a stockholder in both hospitals corporations and health insurance companies, they have done well by me. It is working and the kinks were being worked out. But Trump refuses to believe this. It has helped many of my friends and their kids.
2
Aaron - sorry to point this out but all sanctuary city means is this. Federal law, precludes local law enforcement from doing federal law enforcement work. Identifying and detaining illegal aliens is strictly and ICE job.
Keep in mind, that Kelly and Trump have not put any investment into making sure that visitors arriving on legitimate visas leave on time. ZIP!! This category of illegal is ~ 50% of illegal alien population - just not from Mexico, Central or South America.
Why do you think that is? Why do you think no President - Republican or Democrat - have been similarly indifferent to legal visitors who just overstay their visas!
Keep in mind, that Kelly and Trump have not put any investment into making sure that visitors arriving on legitimate visas leave on time. ZIP!! This category of illegal is ~ 50% of illegal alien population - just not from Mexico, Central or South America.
Why do you think that is? Why do you think no President - Republican or Democrat - have been similarly indifferent to legal visitors who just overstay their visas!
1
Sorry Kathryn, you are totally wrong. Local law enforcement chooses not to cooperate with ICE. Because of your internal and external biases you choose to state untruths. This is why our AG has threatened to withhold funds to sanctuary cities. Local and Federal law enforcement should be COOPERATING. A little teamwork goes a long way.
1
The Obama administration kept insurance providers in the Affordable Care Act market by transferring money from the Treasury to cover their losses, but Trump doesn’t have the option of continuing the payments. A federal court has ruled the transfer of funds from the treasury is unconstitutional. District Court Judge Rosemary Collyer ruled that the Constitution says "No Money shall be drawn from the Treasury, but in Consequence of Appropriations made by Law.” She said “Paying [those] reimbursements without an appropriation thus violates the Constitution. Congress is the only source for such an appropriation, and no public money can be spent without one." Judge Collyer granted an abeyance to give Congress them time to repeal and replace the ACA, but their efforts have proven unsuccessful. Unless the House votes to appropriate the funds, Judge Collyer’s ruling will go into effect.
2
As usual, the republican version of events cherry-picks only the right-wing pleasantries:
"US District Judge Rosemary M. Collyer, appointed by George W. Bush, has ruled that the cost-sharing program is unconstitutional for spending money that has not been specifically provided by an act of Congress, but concluded that Congress had in fact authorized that program to be created. The judge also found that Congress had provided authority to cover the spending for the tax credits to consumers who use them to help afford health coverage.[3] The judge enjoined further cost-sharing payments, but stayed the order pending appeal, which is currently before the United States Court of Appeals for the District of Columbia Circuit."
"On December 5, 2016, the United States Court of Appeals for the District of Columbia Circuit stayed further proceedings in the case at the request of the House of Representatives." --Wikipedia
"US District Judge Rosemary M. Collyer, appointed by George W. Bush, has ruled that the cost-sharing program is unconstitutional for spending money that has not been specifically provided by an act of Congress, but concluded that Congress had in fact authorized that program to be created. The judge also found that Congress had provided authority to cover the spending for the tax credits to consumers who use them to help afford health coverage.[3] The judge enjoined further cost-sharing payments, but stayed the order pending appeal, which is currently before the United States Court of Appeals for the District of Columbia Circuit."
"On December 5, 2016, the United States Court of Appeals for the District of Columbia Circuit stayed further proceedings in the case at the request of the House of Representatives." --Wikipedia
2
Or, return to healthcare as a nonprofit enterprise by law. That was the situation before Republican President Nixon signed the law to change healthcare to a for profit business.
3
Just 12% of Americans support the Senate Republican healthcare law that was recently defeated by one vote. Just as Republicans have spent 7 years complaining about the Affordable Health Care Act yet developing NOTHING to replace it, they continue with this practice.
Instead of developing a health care policy that will be a better alternative to Obama Care, Congressional Republicans have temporarily shelved their two competing plans developed under Paul Ryan and Mitch McConnell. Republicans are betting that before the 2018 elections, there will be a personnel change in the Senate that will result in a 50/50 tie for the repeal of Obama Care. At that point Mike Pence will step in and cast the deciding vote to repeal the Affordable Health Care Act - even with no viable alternative proposed by the Republican majority in Congress. The other tact will be to deliberately take no action to improve the existing health care act so that it will fail.
This is not leadership. It is cowardliness. Rather than act as self-proclaimed "compassionate conservative", these reactionary conservatives are "men" who run in fear from Donald Trump and the far right extreme of the Republican party.
"Men" is in quotation marks because none of these people meet the definition of men as they would like us to perceive, but also to acknowledge the courage and leadership of Susan Collins, Lisa Murkowski and John McCain.
Instead of developing a health care policy that will be a better alternative to Obama Care, Congressional Republicans have temporarily shelved their two competing plans developed under Paul Ryan and Mitch McConnell. Republicans are betting that before the 2018 elections, there will be a personnel change in the Senate that will result in a 50/50 tie for the repeal of Obama Care. At that point Mike Pence will step in and cast the deciding vote to repeal the Affordable Health Care Act - even with no viable alternative proposed by the Republican majority in Congress. The other tact will be to deliberately take no action to improve the existing health care act so that it will fail.
This is not leadership. It is cowardliness. Rather than act as self-proclaimed "compassionate conservative", these reactionary conservatives are "men" who run in fear from Donald Trump and the far right extreme of the Republican party.
"Men" is in quotation marks because none of these people meet the definition of men as they would like us to perceive, but also to acknowledge the courage and leadership of Susan Collins, Lisa Murkowski and John McCain.
3
Actually medicare overhead load is 5% not 0.5%. But still much lower than ACA limit of 20% for private insurers. Pre ACA some insurers were running 50% of premiums on overhead.
2
One thing to consider is how states treat their citizens. In republican run states like North Carolina, Mississippi, Texas as examples they state run services agressively discriminate against their citizens who are not light skinned or affluent.
Letting states control it guarantees that US citizens will be damaged by racism and religious bigotry. Sad but true.
In Texas a family with parents and one child, if the income is more than ~ $3010/yr for an adult that adult is ineligible for Texas Medicaid. The child if under one is eligible even if household income is $20,000.00/yr.
Think about that - married couple with Household income of $20K the working adults get no help at all. And coverage for children drops fast as the costs of children increases.
Letting states control it guarantees that US citizens will be damaged by racism and religious bigotry. Sad but true.
In Texas a family with parents and one child, if the income is more than ~ $3010/yr for an adult that adult is ineligible for Texas Medicaid. The child if under one is eligible even if household income is $20,000.00/yr.
Think about that - married couple with Household income of $20K the working adults get no help at all. And coverage for children drops fast as the costs of children increases.
2
Politicians, mostly Republicans, provided cover for the entire health care system over the past 40 years while the system slowly imploded. By the time the nation realized how broken it was it was too late. The Clintons tried to make a play for single payer but the insurance companies were too powerful at that point to allow the federal government to make any changes. It wasn’t until Obama and the Democratic congress took RomneyCare nation-wide that we now have an ongoing, national conversation about healthcare.
This conversation is good for our health!
It took decades for health insurance companies, doctors, hospitals, drug companies and big pharma to get hooked on their incomes rising faster than inflation. But like an addict hooked on crack, we need to nurse the health care system back to reality in steps. I don’t believe we can realistically go cold turkey with a single payer system right away. For example, people who are heavily invested in the system like newly graduated docs with huge medical school loans, investors in public health companies, and everyone who works in the health insurance industry, will need some sort of bailout if we move in the direction of single payer and regulating costs.
This is a huge and complex problem that can be fixed - but it will take time. But keep talking about it! Don’t let the politicians and health care industry interests hijack the narrative!
This conversation is good for our health!
It took decades for health insurance companies, doctors, hospitals, drug companies and big pharma to get hooked on their incomes rising faster than inflation. But like an addict hooked on crack, we need to nurse the health care system back to reality in steps. I don’t believe we can realistically go cold turkey with a single payer system right away. For example, people who are heavily invested in the system like newly graduated docs with huge medical school loans, investors in public health companies, and everyone who works in the health insurance industry, will need some sort of bailout if we move in the direction of single payer and regulating costs.
This is a huge and complex problem that can be fixed - but it will take time. But keep talking about it! Don’t let the politicians and health care industry interests hijack the narrative!
1
This article paints false equivalences for the unsuspecting reader who simply laps up conclusions presented by the Times:
1) "...have helped push many insurers’ stocks to record highs." If you're comparing stock prices pre-ACA, it was a period of time when all stocks had cratered following the market crash. The ACA didn't propel insurers' stock to all-time highs, the market recovery did.
2) The insurers that stayed in the individual market have come to realize that the individual market was more like Medicaid than the employer business." Try talking to actual medical providers and doctors who refuse to see Medicaid patients since reimbursement rates are so low that they don't even cover the salaries of back-office staff required to file convoluted paperwork to obtain reimbursement. This is hardly good news.
3) "...many insurance companies still participating have cut losses sharply." Cutting losses isn't success in the business world. Try writing a story when it's just breaking even. That these companies still haven't managed to break-even in over 6 years is a testament to the flaws of the ACA while the Democrats rested on their laurels with "nothing to see here" attitude.
1) "...have helped push many insurers’ stocks to record highs." If you're comparing stock prices pre-ACA, it was a period of time when all stocks had cratered following the market crash. The ACA didn't propel insurers' stock to all-time highs, the market recovery did.
2) The insurers that stayed in the individual market have come to realize that the individual market was more like Medicaid than the employer business." Try talking to actual medical providers and doctors who refuse to see Medicaid patients since reimbursement rates are so low that they don't even cover the salaries of back-office staff required to file convoluted paperwork to obtain reimbursement. This is hardly good news.
3) "...many insurance companies still participating have cut losses sharply." Cutting losses isn't success in the business world. Try writing a story when it's just breaking even. That these companies still haven't managed to break-even in over 6 years is a testament to the flaws of the ACA while the Democrats rested on their laurels with "nothing to see here" attitude.
6
Despite all the sabotage by Trump and Republicans ACA is working. Had the other 19 Red Taker states expanded Medicaid it would be better. Paying insurers losses in Risk Corridors without grousing every year would be better still.
We pay 100% of insurers losses in farmers revenue guarantee insurance program as well as other insurer subsidies that benefits 1.6 million rich farmers. McConnell and company see that as an investment.
Paying insurers losses and other subsidies benefitting 12-13 million working poor ought to be An equally important investment in worker productivity and reduced hospital ER losses. Actually it would be a better investment.
We pay 100% of insurers losses in farmers revenue guarantee insurance program as well as other insurer subsidies that benefits 1.6 million rich farmers. McConnell and company see that as an investment.
Paying insurers losses and other subsidies benefitting 12-13 million working poor ought to be An equally important investment in worker productivity and reduced hospital ER losses. Actually it would be a better investment.
1
Kathryn, it's not working for all. Middle class families premiums and deductibles are unaffordable. Have you not read about that for the last 7 years or are you just cherry picking issues that make the other side look bad???? BTW I've asked the Times, on multiple occasions to educate all of us on single payer as well as individual states managing health care for their populations. Finally while all of this is going on there is no serious discussion on wellness...
1
Our ACA insurance with subsidies is good for our family and we would keep it even if the premium rises by 20 % or more in 2018. All the talk about Obamacare being a disaster or a nightmare is all political hype. The President keeps harping that it is collapsing is also partisan grandstand. If it was so why would millions opt for Obamacare?
As per Kaiser family research all the counties in US are covered. Of course there are people at higher income levels who face high deductibles. This and other problems can be solved if party in power makes effort to do that instead of wasting time and efforts on the "outdated" slogan Repeal & replace. Ultimately of course we would have to introduce a bi-partisan single payer system similar to the best of European model as in Switzerland.
As per Kaiser family research all the counties in US are covered. Of course there are people at higher income levels who face high deductibles. This and other problems can be solved if party in power makes effort to do that instead of wasting time and efforts on the "outdated" slogan Repeal & replace. Ultimately of course we would have to introduce a bi-partisan single payer system similar to the best of European model as in Switzerland.
4
And, the states with the biggest issues for coverage are ~ 90% in Red Taker states that refused to expand Medicaid. Their refusal not only guaranteed constituents continued poor health but high Hospital ER losses.
3
It's sad that health insurance companies are loosing money from Trump's actions. But they could save some by not purchasing advertising and not giving excessive bonuses to high ranking officers.
1
If the Dems ever return to the White House and control the Hill, then Medicare should be implemented as our national healthcare program. The millions presently being wasted, and the millions in profits made by insurerss, as well as healthcare providers should be enough for our politicians to realize it is time for a change. Yesterday, the insurers are crying wolf incurring millions of losses, dropping coverage cause they can't make double digit profits, dropping medical coverage, and guess what they are saying now: oh, we are making great profits, it is all kicking in, the dots are starting to connect, we will definitely return to the exchanges and offer 2018 medical plans. Additionally, the billions Trump will pass on to the insurers will only add more profits. Only in America can you find the number of suckers, called the middle class, that allow this to happen.
Try - federal employee healthcare for all - a single payer system. Or DOD Tricare for Life a single payer system. Or VA - a single payer system. Actually federal Employee is a good prospect as it is designed to cover everything from prenatal and pediatric to elderly.
Think about it.
Think about it.
Since money is the bottom line for the insurers, I hope they will try to stop this egomaniac, his coterie and the Republicans to give up their unsuccessful, multiple attempts attempts to repeal Obamacare. Money and personal health talk and they act. More power to the insurers and Trump's supporters who realize that repealing Obamacare could be their death knell.
1
Everyone has an opinion which I respect. Many espouse "single payer" as if it is some magic bullet that can cure all of our health care coverage woes. The NYT can do everyone a tremendous service by actually educating the country on single payer, how would it work, cost, transition time, transition recommendations, physician pay etc. Tjey should also publish single payer compared to individual states managing their own states.
1
This is hilarious: Obamneycare was supposed to be capping the insurers' add-on at 25%, i.e. limiting them to taking 20% of the nation's healthcare budget to run their marble columns, executive jets, golf-club memberships and what-not.
(The Social Security Administration costs 0.5% of throughput to run all the databases, security, entitlement enforcement, and cutting the checks. The Canadian health care payment systems cost 0.5% of throughput to run all the databases, security, entitlement enforcement, and cutting the checks. Who knew private enterprise could do the same thing for only forty times as much?)
Reminds me of when the Socialists brought in Provincially-paid health insurance, i.e. Single Payer, in Saskatchewan. (This is socialised insurance; it is not "socialised medicine.") Suddenly it seemed doctors' incomes jumped 50%.
"That's assuming they were reporting their incomes accurately in the past," remarked the Socialist leader, Baptist Minister Rev. Tommy Douglas. Dryly.
(The Social Security Administration costs 0.5% of throughput to run all the databases, security, entitlement enforcement, and cutting the checks. The Canadian health care payment systems cost 0.5% of throughput to run all the databases, security, entitlement enforcement, and cutting the checks. Who knew private enterprise could do the same thing for only forty times as much?)
Reminds me of when the Socialists brought in Provincially-paid health insurance, i.e. Single Payer, in Saskatchewan. (This is socialised insurance; it is not "socialised medicine.") Suddenly it seemed doctors' incomes jumped 50%.
"That's assuming they were reporting their incomes accurately in the past," remarked the Socialist leader, Baptist Minister Rev. Tommy Douglas. Dryly.
We could have a state-of-the-art healthcare system like other major Western countries and many smaller ones as well, if we were willing to do what is necessary to achieve single payer coverage.
If healthcare is a right rather than a privilege, then all Americans deserve access to dental, vision, mental health and physical health care regardless of ability to pay.
Instead, Mr. Trump and his cronies have chosen to do whatever they can to destabilize the current system, the ACA, for their own ends rather than doing what is good for all Americans.
A racist agenda to erase Mr. Obama's legacy is more important to them than the Americans whom they supposedly serve. Unfortunately, many Americans believe they are right in this pursuit, being racists and white supremacists themselves or otherwise ignorant of their own best interests.
If Trump, et. al., are successful in the end, these same people will be among the greatest sufferers, including those who believe that "the community" should provide for the sick and elderly out of the goodness of their hearts whether they have the necessary training or not. They fail to understand that America is a large community where money can be used to provide specialized services. I hope they can learn this without coming to harm themselves.
If healthcare is a right rather than a privilege, then all Americans deserve access to dental, vision, mental health and physical health care regardless of ability to pay.
Instead, Mr. Trump and his cronies have chosen to do whatever they can to destabilize the current system, the ACA, for their own ends rather than doing what is good for all Americans.
A racist agenda to erase Mr. Obama's legacy is more important to them than the Americans whom they supposedly serve. Unfortunately, many Americans believe they are right in this pursuit, being racists and white supremacists themselves or otherwise ignorant of their own best interests.
If Trump, et. al., are successful in the end, these same people will be among the greatest sufferers, including those who believe that "the community" should provide for the sick and elderly out of the goodness of their hearts whether they have the necessary training or not. They fail to understand that America is a large community where money can be used to provide specialized services. I hope they can learn this without coming to harm themselves.
2
if it said TRUMP CARE... it would be the greatest thing since canned bread
Medicare and Medicaid have gone through dozens of major revisions since becoming law in 1965.
For the past several years, GOP members of Congress have done everything in their power to do absolutely nothing to close the ACA loopholes.
They're not simply obstructionists. They are incompetent.
Isn't anyone else tired of hearing this is all President Obama's fault?
For the past several years, GOP members of Congress have done everything in their power to do absolutely nothing to close the ACA loopholes.
They're not simply obstructionists. They are incompetent.
Isn't anyone else tired of hearing this is all President Obama's fault?
2
Nope
For every undocumented immigrant worker who self deports- their host state or current sanctuary city will provide medical insurance to a legal, uninsured resident. That way, we'll solve the immigration and healthcare problem in one swoop.
1
ObamaCare is still a Bad Joke. It i the insurance industry support act. We the taxpayer are subsidizing insurance companies with TAX dollars to insure them a profit. It so mind boggling so many liberals support this nonsense except that it has Obama's name on it. We do NOT need greedy insurance companies we need SINGLE payer health care in America.
1
The parts that are bad are the ones that the Democrats included trying to placate the opposing republicans. The subsidies to greedy insurance companies were included (based on Richard Nixon's proposal from 45 years ago) in order to bribe them (ala the republican model for most industries) from opposing. Should have just passed a single-payer government plan from the get-go. There would have been no more wailing and gnashing of teeth by the right than there has been when a plan that was tailored to their desires was passed, and labeled Obamacare.
1
@Dave. Give me a break, the republicans were never involved in the creation of Obamacare. The only collusion that took place were the special carve out deals made between Obama and the senators from Nebraska and Louisiana. Remember the Nebraska kickback and the Louisiana purchase. So please spare all of us on your incorrect assessment of the ACA no negotiations with republicans.
This is a nice, feel good article that pretends ObamaCare is working. I'm a physician working in the trenches, and what I see:
-75% of the newly insured since 2010 are new Medicaid patients, and most physicians do not participate in this program b/c the reimbursement is so abysmal. So these folks are still filling up ERs b/c they can't get a physician appointment. Worthless "insurance" card.
-the other 25% of the newly insured have such high deductibles (most popular ACA bronze plan carries a $6,000 individual deductible) that either they can't afford to see a provider and don't go, or they just don't pay the doctor b/c they don't have the $ to pay the deductible.
ObamaCare is and will continue to be a failure, hiding behind a politically popular slogan: "More people have insurance under the ACA."
-75% of the newly insured since 2010 are new Medicaid patients, and most physicians do not participate in this program b/c the reimbursement is so abysmal. So these folks are still filling up ERs b/c they can't get a physician appointment. Worthless "insurance" card.
-the other 25% of the newly insured have such high deductibles (most popular ACA bronze plan carries a $6,000 individual deductible) that either they can't afford to see a provider and don't go, or they just don't pay the doctor b/c they don't have the $ to pay the deductible.
ObamaCare is and will continue to be a failure, hiding behind a politically popular slogan: "More people have insurance under the ACA."
4
So, accept the reimbursement offered for Medicaid. Those physicians who do don't seem to be going hungry or homeless. Greed never improved the world.
The most popular ACA plans are the silver, not the bronze.
The most popular ACA plans are the silver, not the bronze.
2
Dave, are you a doctor? Do you have even a clue what costs they have? There is a reason so many will not accept medicaid. The Times always sugar coats Obamacare and it willfully misleads it's readers. You can actively see the results just by reading the comments here. So many are uninformed or ill-informed. The Times prefers to keep its readers in the dark about the problems with Obamacare, and they prefer to constantly implicate Republicans and Trump instead of putting the blame where it rightfully belongs- the dishonest Democrats and Obama who lied and jammed this through. Never does the Times mention how Medicaid costs are out of control and the threat it poses to state budgets and the federal budget.
1
The weakest link of ACA has been the volatility of the individual insurance market. Long before ACA, the individual (as well as small and medium business) health insurance markets were unstable and experienced double digit increases. Without a pool of insureds to spread the risk, a single bad health experience would cause your next premium to sky rocket.
The solution exists in President Clinton’s proposed “Alliances” or risk (not high risk) pools linked either by geographic boundaries or other clusters. His proposal stated: "Users would choose plans offered by regional health alliances to be established by each state. These alliances would purchase insurance coverage for the state's residents and could set fees for doctors who charge per procedure." (https://www.congress.gov/.../103rd.../house-bill/3600/text)
Before Obamacare, individuals and small businesses in Washington and Alaska experienced annual rate increases for 20 - 40% hikes. The largest insurer of individuals had kept individual rate in the single digits by subsidizing those insureds using reserve funds for years. By 2008 could not responsibly continue to do so.
As outrageous as those hikes sound state insurance departments’ analysis showed the rates were justified to cover costs of medical advances and patient demand.
Given the current high public support for continued access to coverage via ACA, we can (and should) use this part of Clinton's proposal a bi-partisan fix to ACA.
The solution exists in President Clinton’s proposed “Alliances” or risk (not high risk) pools linked either by geographic boundaries or other clusters. His proposal stated: "Users would choose plans offered by regional health alliances to be established by each state. These alliances would purchase insurance coverage for the state's residents and could set fees for doctors who charge per procedure." (https://www.congress.gov/.../103rd.../house-bill/3600/text)
Before Obamacare, individuals and small businesses in Washington and Alaska experienced annual rate increases for 20 - 40% hikes. The largest insurer of individuals had kept individual rate in the single digits by subsidizing those insureds using reserve funds for years. By 2008 could not responsibly continue to do so.
As outrageous as those hikes sound state insurance departments’ analysis showed the rates were justified to cover costs of medical advances and patient demand.
Given the current high public support for continued access to coverage via ACA, we can (and should) use this part of Clinton's proposal a bi-partisan fix to ACA.
1
The shareholders shouldn't be anywhere in an equation of health of a population. Single Payer is the only ethical solution.
4
We are 19 trillion dollars in debt and subsidizing insurance companies and that is good news?
5
We are 19 trillion dollars in debt, and trump and company is trying to increase the bloated military budget by 60% while cutting the budgets of the agencies that provide real services to real Americans, our environment, and ecological support system.
4
"Despite anxiety over the Affordable Care Act’s stability, many insurance companies still participating have cut losses sharply. Some are starting to prosper."
So they don't need Obama's subsidies anymore?
So they don't need Obama's subsidies anymore?
3
My individual policy under Obamacare increased 300% in the time I had it, because the first policy was cancelled due to its "unprofitability", and that's what their next most comparable policy cost. The following year, I had to switch companies to keep my providers "in network", for a slightly higher rate. I'm already at the limit of what I can afford, so I predict that for next year, with the increases the NYT is reporting, dozens will be dropping out entirely, or settling for a plan that covers much less, with huge deductibles, basically making it unusable.
It's time for single-payer for all, some true basic reforms of our health care system (controlling costs) and putting the insurance gougers out of business. No one seems to ask why Americans have to pay through the nose for care that every other western country (with far lower GDPs) are able to receive as a nationally funded mandate, where citizens can live without fear of losing their homes to medical expenses.
It's time for single-payer for all, some true basic reforms of our health care system (controlling costs) and putting the insurance gougers out of business. No one seems to ask why Americans have to pay through the nose for care that every other western country (with far lower GDPs) are able to receive as a nationally funded mandate, where citizens can live without fear of losing their homes to medical expenses.
12
Because some others are making HUGE profit for your health care system.....BTW here is the map showing the countries with a universal system in place; take note that USA is similar to Africa and China in this matter, amazing, isn't!!!:
https://images.search.yahoo.com/yhs/search;_ylt=A0LEVvDhBaNZvxsAgFkPxQt....
https://images.search.yahoo.com/yhs/search;_ylt=A0LEVvDhBaNZvxsAgFkPxQt....
And your household AGI is high enough that there are no subsidies? Did your state expand medicaid?
Before retirement my employer offered an HMO, a PPO and a fee for service plan. The first was least expensive and Fee for Service most expensive. Subsidized premium, $325 out of pocket and max deductible/could pay of $2250 taxes as a co-pay per visit. I did not have to pay all $2250 out of pocket before getting any benefit either.
But, the first two would never provide their list of who was in their networks until after sign up closed. Never in all of 20 years before I retired. I heard more than one colleague grousing that their preferred Dr. was not in network. And the monthly premiums were under $300/mo for families and the colleagues were $80K and up for household income. For an extra 50 or 100 they could have had certainty about everything - just could not get past that extra $50-100 per month.
Before retirement my employer offered an HMO, a PPO and a fee for service plan. The first was least expensive and Fee for Service most expensive. Subsidized premium, $325 out of pocket and max deductible/could pay of $2250 taxes as a co-pay per visit. I did not have to pay all $2250 out of pocket before getting any benefit either.
But, the first two would never provide their list of who was in their networks until after sign up closed. Never in all of 20 years before I retired. I heard more than one colleague grousing that their preferred Dr. was not in network. And the monthly premiums were under $300/mo for families and the colleagues were $80K and up for household income. For an extra 50 or 100 they could have had certainty about everything - just could not get past that extra $50-100 per month.
If Obama and the democrats would have done this right in the first place we would not be in the mess we are in. The Republicans would have zero leverage to change anything.
Instead health care now is in such limbo with our schizophrenic presidents tweets and ramblings creating anxiety and uncertainty in an already ever evolving marketplace.
With the return of lawmakers in September I predict nothing changes with Obamacare. It will be years of chaos in regards to healthcare for Americans.
I love my employer provided healthcare but I would not wish what's out there on anybody.
Instead health care now is in such limbo with our schizophrenic presidents tweets and ramblings creating anxiety and uncertainty in an already ever evolving marketplace.
With the return of lawmakers in September I predict nothing changes with Obamacare. It will be years of chaos in regards to healthcare for Americans.
I love my employer provided healthcare but I would not wish what's out there on anybody.
2
They did what they could get through Congress, in case no one recalls. It was touch and go all the way with various Senators and House members demanding this or that and killing the public option because it might hurt the insurance industry headquartered in their states.
13
They tried.....but the GOP blocks the law and made a lot of amendments to affect the good working of the system which , like others complicated matters, shall not be amend without taking time to understand the impacts.
The GOP , as usual , stop the Democrats to help people.
The GOP , as usual , stop the Democrats to help people.
2
They tailored it to the perceived desires of the republicans and to the insurance companies to get it passed. Still no republicans voted for it. Should have been single-payer from the get-go. There would have been no more carping and fighting than there has been anyway.
blah, blah blah!! when is someone going to write about the ever increasing cost of medical care and drugs and why the US is paying substantially more than the other 37 industrial nation in healthcare costs. Oh you state this but not why and how we could reduce costs, a good analysis at this period of time why costs keep rising or how the CEO's aren't loosing a cent.
Before 2010 and before ACA there use to be lengthy talks about reducing cost of drugs, medical equipment, medical services, administrative costs. But not anymore because those oligarchs don't want their paid for politicians and analysis to do so.
Before 2010 and before ACA there use to be lengthy talks about reducing cost of drugs, medical equipment, medical services, administrative costs. But not anymore because those oligarchs don't want their paid for politicians and analysis to do so.
10
@Julie
You just answered your own question. That's exactly why :)
You just answered your own question. That's exactly why :)
I wish we could buy insurance against stupid government. Surely actuaries can assess the risk and peg premiums to electoral outcomes. That way, voters would have a better idea of the relative costs of campaign promises.
5
Dear Republicans,
You had better hope that Obamacare stabilizes and continues. Because if it fails, that pretty much guarantees that universal healthcare will be the next step.
On second thought, I support Medicare for All. So go ahead, GOP. Continue to sabotage the ACA. Throw us in that briar patch.
You had better hope that Obamacare stabilizes and continues. Because if it fails, that pretty much guarantees that universal healthcare will be the next step.
On second thought, I support Medicare for All. So go ahead, GOP. Continue to sabotage the ACA. Throw us in that briar patch.
8
Up here in Canada we have Medicare. It's paid for indirectly through taxes, but it pays our medical bills without our paying for them. In the US, you have a health care that is controlled by the HMO's, Doctors, and Big (and little) Insurance. It's no wonder there is such chaos in the US. Of course, the big golden-haired schnook has a lot to do with the chaos.
I just don't understand how People of the USA let the aforementioned bloodsuckers get away with bleeding you dry. In Europe, Scandinavia, and in Canada there are government health plans that take care of their population, and without sending their citizens to the poor house.
In the USA, it's "let's squeeze every drop of blood from those sick suckers"!
I just don't understand how People of the USA let the aforementioned bloodsuckers get away with bleeding you dry. In Europe, Scandinavia, and in Canada there are government health plans that take care of their population, and without sending their citizens to the poor house.
In the USA, it's "let's squeeze every drop of blood from those sick suckers"!
36
Answer his.
Why do so many Canadians comes to the United States to get medical care if things were so good where you live.
My answer.
It isn't as good as you suggest.
You get to have a health care system that only works for people who do not have a condition that needs immediate attentions
Your system isn't perfect and neither is it in the USA.
From this article it is established unlike many articles I have read in the Times the insurance companies lost money.
They were therefore not bloodsuckers.
If ACA failed it wasn't because of them.
Why do so many Canadians comes to the United States to get medical care if things were so good where you live.
My answer.
It isn't as good as you suggest.
You get to have a health care system that only works for people who do not have a condition that needs immediate attentions
Your system isn't perfect and neither is it in the USA.
From this article it is established unlike many articles I have read in the Times the insurance companies lost money.
They were therefore not bloodsuckers.
If ACA failed it wasn't because of them.
4
Stone,
Answer me this: Why do so many Americans buy their drugs and also travel to Canada for care? It's absurd to suggest that Canadians are coming to the United States in search of health care. It's the other way around.
I can go to Canada and see a doctor for $140 or less out of pocket. Even with employer provided insurance, that's cheaper than I can do it in the United States, by the time I'm finished with copays and lab tests and unnecessary procedures that I neither want nor request. While I'm in Canada, I can get my prescriptions filled for a fraction of what I pay in the United States.
Who are these people who are traveling from Canada to the United States for medical care? My guess is, they are largely rich people who can afford boutique care. Which makes an abundant amount of sense, because you pretty much have to be rich to afford medical care here.
Answer me this: Why do so many Americans buy their drugs and also travel to Canada for care? It's absurd to suggest that Canadians are coming to the United States in search of health care. It's the other way around.
I can go to Canada and see a doctor for $140 or less out of pocket. Even with employer provided insurance, that's cheaper than I can do it in the United States, by the time I'm finished with copays and lab tests and unnecessary procedures that I neither want nor request. While I'm in Canada, I can get my prescriptions filled for a fraction of what I pay in the United States.
Who are these people who are traveling from Canada to the United States for medical care? My guess is, they are largely rich people who can afford boutique care. Which makes an abundant amount of sense, because you pretty much have to be rich to afford medical care here.
13
Stone,
Canadians go to the nearest hospital, and they go where there are specialised services. This means that on the Prairies we tend to use hospitals in the US Middle West. Large numbers of Canadians winter over in Florida. They tend to be old folks, and they use American hospitals. These are still paid for by the Canadian system.
In the great population centers, Toronto, Montreal, and the cities of the coasts, Canada's health care system runs very profitably on medical tourism, mostly from the United States.
Canadians go to the nearest hospital, and they go where there are specialised services. This means that on the Prairies we tend to use hospitals in the US Middle West. Large numbers of Canadians winter over in Florida. They tend to be old folks, and they use American hospitals. These are still paid for by the Canadian system.
In the great population centers, Toronto, Montreal, and the cities of the coasts, Canada's health care system runs very profitably on medical tourism, mostly from the United States.
Imagine if Republican's had spent the past 8 years helping to improve Obamacare instead of trying to destroy it for purely political motivation? At this point we might even have had the beginnings of a reasonably acceptable healthcare system and also likely we would not have had Donald Trump as President.
I can't help but be reminded that Republicans also exploited attacks on the Civil Rights Legislation of the 60's that might have helped end once and for all the great stain on America of slavery and segregation with their "Southern Strategy" purely for the purpose of gaining power. The rise of rightwing extremism now reaching to the very highest office in the land is a direct consequence of their actions.
When you think about it there really is something evil in all this.
I can't help but be reminded that Republicans also exploited attacks on the Civil Rights Legislation of the 60's that might have helped end once and for all the great stain on America of slavery and segregation with their "Southern Strategy" purely for the purpose of gaining power. The rise of rightwing extremism now reaching to the very highest office in the land is a direct consequence of their actions.
When you think about it there really is something evil in all this.
17
I would love Medicare for all. But how do we as a country pay for it.
Medicare is currently funded through payroll tax that both the employer and employee pay. And if you are self employed you pay the full amount. It is then further funded by Medicare premiums paid to the federal government by those over 65. In addition most folks benefiting from Medicare purchase a supplement plan.
The point here, there is nothing free about our current Medicare system. I am self employed so from my net income I pay the full Medicare tax. I do not receive an ACA subsidy for the cost of my medical insurance. I would be happy to take the $10,000 a year I currently pay for my insurance and apply it to the cost of a stable Medicare for all plan. But how many others out there are willing to do that.
How many in this country who benefit from an employer provided medical insurance benefit are willing to give that up for an increase in their payroll tax. And remember, that employer provided benefit is a pre-tax benefit to both the employer and employee.
Medicare is currently funded through payroll tax that both the employer and employee pay. And if you are self employed you pay the full amount. It is then further funded by Medicare premiums paid to the federal government by those over 65. In addition most folks benefiting from Medicare purchase a supplement plan.
The point here, there is nothing free about our current Medicare system. I am self employed so from my net income I pay the full Medicare tax. I do not receive an ACA subsidy for the cost of my medical insurance. I would be happy to take the $10,000 a year I currently pay for my insurance and apply it to the cost of a stable Medicare for all plan. But how many others out there are willing to do that.
How many in this country who benefit from an employer provided medical insurance benefit are willing to give that up for an increase in their payroll tax. And remember, that employer provided benefit is a pre-tax benefit to both the employer and employee.
6
Considering a Medicare for all plan would costs roughly 1/3rd less that the private system we have now, I'm sure most people would be willing to move 2/3rds of the money they pay for private insurance to Medicare and pocket the rest.
No more premiums, co pays, provider networks, co-insurance, fear of going bankrupt due to medical expenses, etc
No more premiums, co pays, provider networks, co-insurance, fear of going bankrupt due to medical expenses, etc
2
See Canada, Europe, UK, et al.
It works. We just have to want it to. So far, we don't.
The biggest mistake made in creating the ACA was in attempting to make it acceptable to republicans. The President and the Democrats in Congress compromised without the republicans even being willing to negotiate. The result was a plan that the republicans had actually originally proposed, but now opposed. The plan traces originally to Richard Nixon, though his was more far reaching.
We need Medicare for all, a single-payer system.
It works. We just have to want it to. So far, we don't.
The biggest mistake made in creating the ACA was in attempting to make it acceptable to republicans. The President and the Democrats in Congress compromised without the republicans even being willing to negotiate. The result was a plan that the republicans had actually originally proposed, but now opposed. The plan traces originally to Richard Nixon, though his was more far reaching.
We need Medicare for all, a single-payer system.
3
The secret is in the lower cost per person in the single payer system. The govt as the only payer has significantly more bargaining power for services. The U.S. pays way more per person for a significantly lower life expectancy. It's beyond insane.
5
If premiums are going up and providers and insurance companies are going down there is trouble in River City. The ACA needs major fixing. Hopefully both parties will make face-saving political concessions to save the law and provide desperately needed affordable coverage to all. The difficulty is not as great as the lack of political will and courage to address it.
Insurance companies are responsible for the high cost of healthcare. I have spine disease and was being charged over $545 a month for Blue Cross way before the Affordable Care Act. That was only half the cost as the state payed half the premium for my special plan provided to California's pre-existing patients. Every year I was paying more with less coverage. Now PPO insurance hardly exists. Plans have to provide minimal health services but they limit us to small networks of doctors like HMO's did. Thank God Obama was able to get us some protections. Unfortunately he allowed the GOP to make amendments. Republican leaders wanted premiums and co pays added to "keep people off the couch". They are convinced that if we don't have to pay big, common people will abuse the right to healthcare. Obama always said this was only a start to changes needed. If he had been supported by congress we would have universal healthcare. Our country spends more on healthcare per person than countries who provide universal coverage. We need to allow insurance companies to compete accross state lines. If marketing boundary's were lifted it would bring down costs.
1
I guess you didn't read the fine print.
That was Obama who put that in place.
That was Obama who put that in place.
I wouldn't worry too much about the insurance companies. They are ALWAYS making a huge profit.
5
Amid the hype about the ACA's imminent collapse, insurers are beginning to realize that the government subsidies will most likely not be cancelled and that there is a good chance that both sides will work to repair and improve the law. It is ironic that the adolescent in the White House didn't recognize this outcome and support the effort. Apparently the obsession with erasing everything associated with President Obama is so strong that doing what is logical and right for the American people never crosses his mind.
2
American Health Insurers made unprecedented earning gains under the ACA , from 2009 to 2015
Have a look at the graph
https://www.nytimes.com/2017/08/26/health/obamacare-market-insurance.html
It shows the pretax earning of America's five largest health insurers increased from $ 15 Billion in 2009 to $ 25 Billion in 2015 . (The insurance companies were "bought off" in the writing of the ACA, to avoid a repeat of the "Harry and Louise" campaign that send the Clinton plan into the dust bin of history)
So why the outcry now ?
Because, the object of a for profit health insurance company is to maximize profit, not service to customers.
The reform is equally clear, run the health insurances companies as tightly government regulated non-for-profit companies, as does, to quote The Economist, "a obscure Republic called Germany that had Universal Health Insurances for 134 years"
https://www.economist.com/news/finance-and-economics/21679475-regulation...
Have a look at the graph
https://www.nytimes.com/2017/08/26/health/obamacare-market-insurance.html
It shows the pretax earning of America's five largest health insurers increased from $ 15 Billion in 2009 to $ 25 Billion in 2015 . (The insurance companies were "bought off" in the writing of the ACA, to avoid a repeat of the "Harry and Louise" campaign that send the Clinton plan into the dust bin of history)
So why the outcry now ?
Because, the object of a for profit health insurance company is to maximize profit, not service to customers.
The reform is equally clear, run the health insurances companies as tightly government regulated non-for-profit companies, as does, to quote The Economist, "a obscure Republic called Germany that had Universal Health Insurances for 134 years"
https://www.economist.com/news/finance-and-economics/21679475-regulation...
3
Democrats do cater to some money pools. Health insurers are one such group.
It is not Obamacare. It is not the ACA. It is the American health care system. Language matters.
2
For myself, call it whatever you want. However, in the end, you Americans are being blood-sucked to death by Big Pharma, Big Insurance, Big HMO's, and doctors.
9
First, insurance companies do not lose money. Rate-payers are charged for any losses. Always have.
Second, the GOP at the state level worked to make sure it would fail if they could manage it. The congressional GOP had 151 amendments accepted as part of the final bill and all were meant to make the odds work against having it succeed.
Had the AFA been allowed to go ahead on its own original proposal, there would have been no problem.
Now if someone just had the guts to take on the pill industry, America just might have acceptable health insurance.
Second, the GOP at the state level worked to make sure it would fail if they could manage it. The congressional GOP had 151 amendments accepted as part of the final bill and all were meant to make the odds work against having it succeed.
Had the AFA been allowed to go ahead on its own original proposal, there would have been no problem.
Now if someone just had the guts to take on the pill industry, America just might have acceptable health insurance.
8
What nonsense - most insurance rates are controlled by the government. It`s easy for an insurance company to lose money.
3
So, that's why they stay in business, to find an easy way to lose money? Most seem to be fairly profitable, though their accounting methods may find ways to make it look otherwise for tax and regulatory purposes.
I'm for Medicare for all. I think the best approach would be to add a public option to ACA to allow people to voluntarily join, in particular low wage/uninsured citizens at first. In addition, it would buy time for Medicare to increase staffing, establish procedures & infrastructure, etc... to manage what's sure to be increasing demands on the agency.
Insurance companies most likely move to a supplemental form of health coverage vs primary. Another consideration is giving time for insurance companies to adjust to loss of revenue which will lead to huge loss of jobs (which most likely be somewhat off-set by Medicare build-up).
Insurance companies most likely move to a supplemental form of health coverage vs primary. Another consideration is giving time for insurance companies to adjust to loss of revenue which will lead to huge loss of jobs (which most likely be somewhat off-set by Medicare build-up).
6
Corporate welfare has to end somewhere, why not with health insurance? A REAL government by the people and for the people would provide a national single-payer healthcare plan. Insurers sell insurance plans for homes and vehicles and life; they don't have to go out of business entirely, but they have created an unfair system of picking and choosing: providing healthcare policies for those with little risk and leaving those who need coverage most to fend for themselves—leading to unpaid hospital and doctor bills, a substantial group of unhealthy chronically ill individuals, personal/family bankruptcy, and, ultimately the taxpayer.
If our spineless, shameful government will not give us a national one-payer healthcare plan, then it/they should "govern" the insurers. If insurers want to sell health insurance anywhere within the USA, they should be required to sell it everywhere, to anyone who wants it, at the same price they sell it to everyone else—with slight variances allowable for geographical areas with higher cost-of-living levels. No pre-existing condition exclusions allowed—that risk exists is the reason insurance came into being. No unreasonable deductibles. No insurance plans that aren't worth the paper they're written on.
We must not accept anything less from our government. Businesses that require welfare must be allowed to simply dissolve. Our government for us. It is not for businesses.
If our spineless, shameful government will not give us a national one-payer healthcare plan, then it/they should "govern" the insurers. If insurers want to sell health insurance anywhere within the USA, they should be required to sell it everywhere, to anyone who wants it, at the same price they sell it to everyone else—with slight variances allowable for geographical areas with higher cost-of-living levels. No pre-existing condition exclusions allowed—that risk exists is the reason insurance came into being. No unreasonable deductibles. No insurance plans that aren't worth the paper they're written on.
We must not accept anything less from our government. Businesses that require welfare must be allowed to simply dissolve. Our government for us. It is not for businesses.
10
In 1965 Medicare was projected to cost $9 billion by 1990. Despite the promises by politicians the actual cost was $67 billion. Obamacare is no different despite his promise below. Everyone wants free government programs but someone has to pay for them. Ask yourself how much more are you willing to contribute out of your weekly paycheck to fund someone else's healthcare coverage.
Finally, let me discuss an issue that is a great concern to me, to members of this chamber, and to the public -- and that's how we pay for this plan.
And here's what you need to know. First, I will not sign a plan that adds one dime to our deficits -- either now or in the future. (Applause.) I will not sign it if it adds one dime to the deficit, now or in the future, period. And to prove that I'm serious, there will be a provision in this plan that requires us to come forward with more spending cuts if the savings we promised don't materialize. (Applause.) Now, part of the reason I faced a trillion-dollar deficit when I walked in the door of the White House is because too many initiatives over the last decade were not paid for -- from the Iraq war to tax breaks for the wealthy. (Applause.) I will not make that same mistake with health care.
Finally, let me discuss an issue that is a great concern to me, to members of this chamber, and to the public -- and that's how we pay for this plan.
And here's what you need to know. First, I will not sign a plan that adds one dime to our deficits -- either now or in the future. (Applause.) I will not sign it if it adds one dime to the deficit, now or in the future, period. And to prove that I'm serious, there will be a provision in this plan that requires us to come forward with more spending cuts if the savings we promised don't materialize. (Applause.) Now, part of the reason I faced a trillion-dollar deficit when I walked in the door of the White House is because too many initiatives over the last decade were not paid for -- from the Iraq war to tax breaks for the wealthy. (Applause.) I will not make that same mistake with health care.
1
good luck, I hope you have a long healthy life, you could have peace and happiness if you give up the part of thinking everyone is out to get your money.
1
First, if you're so worried about deficits, how about cutting the disgusting amount given to the defense industry in the U.S.? That alone would pay for all of our health insurance plus probably give a check for $20k to every American each year.
Second, let me point out something about your sentence "Ask yourself how much more are you willing to contribute out of your weekly paycheck to fund someone else's healthcare coverage."
That is exactly what insurance is. It's called actuarial science. Everyone pays in and you benefit when you need it. That's why it's called insurance. Been that way for decades, if not hundreds of years. Learn some facts; knowledge is power.
Second, let me point out something about your sentence "Ask yourself how much more are you willing to contribute out of your weekly paycheck to fund someone else's healthcare coverage."
That is exactly what insurance is. It's called actuarial science. Everyone pays in and you benefit when you need it. That's why it's called insurance. Been that way for decades, if not hundreds of years. Learn some facts; knowledge is power.
4
Well, Don: don't give yourself or the wealthy their tax breaks!!!
3
"The health law has also provided insurers, including major players, with another opportunity to make money: "
And here you have it. Profit is the real reason health companies (or any corporations- We have Boeing up here, so I know.) do anything. Profit has made our system the most expensive on earth.
Profit has improved health care immeasurably, though. The World Health Organization rates is as on a par with Morocco. The first world and their mostly public systems are better, but Morocco, look out! We are going to pass you!
It would be funny, but people are dying because we have a lousy health system. To be sure, ACA made it better but a foundation built on beach sand is going to be wobbly, always.
And here you have it. Profit is the real reason health companies (or any corporations- We have Boeing up here, so I know.) do anything. Profit has made our system the most expensive on earth.
Profit has improved health care immeasurably, though. The World Health Organization rates is as on a par with Morocco. The first world and their mostly public systems are better, but Morocco, look out! We are going to pass you!
It would be funny, but people are dying because we have a lousy health system. To be sure, ACA made it better but a foundation built on beach sand is going to be wobbly, always.
4
I am lucky I live in NY. I had hepatitis C and have no income because I take care of my ailing father full time (night and day.) I got Medicare and was treated and cured. As a byproduct crippling arthritis went away completely. It wasn't cheap but healthcare for me that would have even offered hope to be covered for a new expensive procedure like that would likely have cost me $1,200+ on the individual market, a sum that would have required I make a lot of money. Without the ACA I would be dying.
Every other country in the world seems to have a more sensible system thought the ACA is a great step forward. The ACA is working. Why is our country so incapable of coming together and realizing that the government of the people, by the people, for the people is worth supporting?
Every other country in the world seems to have a more sensible system thought the ACA is a great step forward. The ACA is working. Why is our country so incapable of coming together and realizing that the government of the people, by the people, for the people is worth supporting?
9
The US operates on the theory that only desperation motivation causes people to want to work in the US.
1
The underlying problem still remains....healthcare industry is an oxymoron, and we are so inundated with capitalism that it is destroying us as a people and has given the profit chasers an open run. You cannot serve the god of wealth and the people at the same time. I believe in capitalism, the entrepreneur, and hard work earns a living. But I also believe that in the very Latin/Greek origins of the word "Democracy", concern and the will of the people should prevail. We have sold 'the people' down the river, while investors and Wall Street flourish. Marketing and advertising are king, and the heck with truth and honor. We can't keep using band-aids to stop the bleeding out of our country's values. To fund an already inflated military at the expense of a healthy citizenry is obscene. And the greater obscenity is that almost half of American voters supported a part and/or presidential candidate who do not even have their constituents' best interests at heart. It is all about money (i.e., power), my friends. And we have allowed it to happen. I still hold out hope for a "Medicare" for all solution that works well in other countries. But I also recognize the "what benefits me and my 'choices' is where most Americans stand. Too bad. I don't think I will see our citizens and our country get the healthy care they need in my lifetime.
9
If they can, insurance companies should sue the Trump administration for playing stupid games preventing the companies from being able to count on the rules.
And where are the Democrats? Ceding the conversation to the word weasels as usual.
And where are the Democrats? Ceding the conversation to the word weasels as usual.
6
Re: "The healthier business outlook has been achieved at a big cost to consumers."
What a big fat surprise that is...
What a big fat surprise that is...
2
It's difficult to trust anything republicans in Washington say about the ACA. They say it's failing, in a death spiral, etc. "We need to repeal it." I don't recall hearing anything about replacing the ACA during the Obama years. It appears they've begun to accept that taking healthcare access away isn't popular. Remember those death panels they cooked up in 2009-10? Grassley was my senator then. It still gets my blood boiling recalling his lie about killing "grandma." Republican politicians have no shame!
Trump WILL cut off those subsidies! The great need for a wall on our southern border will be his excuse. He has no interest in anything that doesn't profit him either financially or personally. Not even his base is all that important to him. He's certainly lied to them and has managed to keep them from figuring it out.
Is there is any possibility that those who lose their health insurance because the subsidies disappear have standing to sue Trump or the federal government because of it's actions? Some of us will die when the subsidies are gone or when the ACA is finally repealed. Some of us will die slowly, like diabetics. We'll go to the ER often. But, that's no substitute for insulin or other meds/supplies. Think about this! You simply do NOT provide medical care access to people for 4 years then yank it away. Most aren't going to eligible for medicaid.
Repbs could have worked with dems to fix the ACA. Instead they starved & neglected it, then said IT failed.
Trump WILL cut off those subsidies! The great need for a wall on our southern border will be his excuse. He has no interest in anything that doesn't profit him either financially or personally. Not even his base is all that important to him. He's certainly lied to them and has managed to keep them from figuring it out.
Is there is any possibility that those who lose their health insurance because the subsidies disappear have standing to sue Trump or the federal government because of it's actions? Some of us will die when the subsidies are gone or when the ACA is finally repealed. Some of us will die slowly, like diabetics. We'll go to the ER often. But, that's no substitute for insulin or other meds/supplies. Think about this! You simply do NOT provide medical care access to people for 4 years then yank it away. Most aren't going to eligible for medicaid.
Repbs could have worked with dems to fix the ACA. Instead they starved & neglected it, then said IT failed.
3
No it was Democrats and Obama that lied from the beginning. The times refuses to this day to admit they lied while everyday now it is the Republicans and Trumps fault this program is going to fail despite the Times routine dishonesty about it.
3
Reed: Nice plug you gave Jareds brother Joshua, co founder of Oscar Health Care( would venture capitalists have thrown hundreds of millions at him without his connections?), was that the purpose of the article, it said little else we didn't already know, and emphasized just how much all branches of this charming first family are attempting to profit from their high profile, and momentarily at least, powerful connections. Between Jared brother Joshua's Health Care entanglement, sister Nicole pitching visas for cash to Chinese investors, Ivanka peddeling her Made in China schmatas and Jared running around the world playing King Solomon in the M.E. with his buddy Bibi and borrowing tens of millions from "unusual" Israeli sources( The Steinmetz Group) they have created quite a "brand" for themselves. As a matter of fact this article begs only one question, why are we allowing such blatant corruption with in an already corrupt institution?
6
This spotty coverage problem exists in the US because only the US is dishonest enough to enlist insurance companies as defacto tax collectors.
4
The health insurance market is not "fixable." Demand is unpredictable, supply is inelastic, and costs to health consumers are unknowable. This is not a market; it's a scam. Single-payer for all.
8
The basic system is simple....whether you are healthy or not, young or old, rich or poor....you are covered by decent health care. For those who can pay ....the choice is simple....you take up health insurance or, if you choose not to,you are taxed a slightly higher tax rate. In Australia, a 65 year old single person , who wants top insurance will pay approximately $US120 per month.....and can choose to pay a deductible,of say, $US500/$1.000 for any hospital stay. If you choose not to have health insurance you pay a small percent more of tax.
The system also covers free medical insurance to those who do not meet the economic means test. Prescriptions are so much cheaper than both USA & even Canada and again heavily subsidized by the Government for those who can't afford it.
The system also covers free medical insurance to those who do not meet the economic means test. Prescriptions are so much cheaper than both USA & even Canada and again heavily subsidized by the Government for those who can't afford it.
1
Among the major problems in the entire health care discussion is the belief that health care is a right, not privilege. This is NOT the functioning belief in our Congress, especially the republicans, who are under the influence of the insurance and pharmaceutical lobbyists. The philosophy that we are all in this together, "One Nation" is lost on those that believe only the rich are worthy. Greed and power, over compassion, particularly from the current administration and his party, is shameful.
3
Single payer for all.
6
Republicans and Trump's policies involving healthcare will take us back to where we were before the ACA. The insurances companies business model is not covering people with pre-existing conditions and life time caps. Why would anyone want to pay for a health insurance policy that doesn't cover the condition you have? Having insurance companies involved in healthcare is ridiculous. They are for profit entities and could care less about your wellness or medical condition. Their concern is their bottom line.
There should be no debate about universal healthcare. It should be a fact of life. People suffer while the insurance industry's lobbyists maneuver for more power to make money off of the elderly and infirm.
The entire affair is a disgrace.
Let's see what happens when Trump's supporters are dropping like flies because they can't afford healthcare. Republicans will then claim that everyone has "access" and it's all Obama's fault if no one can afford the astronomical cost of this access to healthcare designed only for those who can afford it.
Pathetic.
There should be no debate about universal healthcare. It should be a fact of life. People suffer while the insurance industry's lobbyists maneuver for more power to make money off of the elderly and infirm.
The entire affair is a disgrace.
Let's see what happens when Trump's supporters are dropping like flies because they can't afford healthcare. Republicans will then claim that everyone has "access" and it's all Obama's fault if no one can afford the astronomical cost of this access to healthcare designed only for those who can afford it.
Pathetic.
2
It's hard to feel sorry for these insurance companies when you see how much they pay their administrators. Millions that could go to helping Americans get healthier. Talk about sick!
4
The US healthcare system is a money making scam. We are being lied to by rich corporations.
8
Have you all seen the stock charts of the health insurers? At all time highs in price and valuation multiples, and they've been rallying for 9 years straight off the ACA which has been their biggest growth driver by far! Unfortunately, the ACA, which every insurer initially feared, was quickly turned into a new profit center due to its massive expansion of Medicaid. Because seniors were already covered under Medicare, most new Medicaid enrollees were younger and healthy, and consequentially, extremely profitable, since they tended not to get sick much, and the stupid government has been overpaying the insurers for this lesser risk for nearly a decade now! So why have some insurers pulled out of select markets? Because the risk pool has worsened, meaning nearly everyone elgible is enrolled and the bottom of the barrel of risk has been scraped, and all that are left are the unfortunate souls who get sick frequently - and are hence unprofitable. They still deserve coverage, yet perversely the insurers, already printing money at a record clip, back off at the slightest hint of risk. Its disgusting. Where's the morality? Its a good reason why the Medical Loss Ratio should be federally regulated. And then our traditional premiums go up 30% every year - so the companies can buy back their own stock hand over fist, then hike our deductibles, dwindle our coverage benefits, and fight our routine claims. American Health Insurers, you are a vile, corrupt industry.
1
In America a company's primary responsibility is to its shareholders to make the greatest profit possible. It's a popular ism any way.
So why should we be surprised, in a for-profit industry like health care, that huge medical insurance companies are making hay?
Nobody has an extra hundred thousand lying around to cover unseen "occurrences". And even if they did, they likely wouldn't be shopping around for the best price if they had a heart attack.
So basically, they have you over a barrel. Another popular ism.
So why should we be surprised, in a for-profit industry like health care, that huge medical insurance companies are making hay?
Nobody has an extra hundred thousand lying around to cover unseen "occurrences". And even if they did, they likely wouldn't be shopping around for the best price if they had a heart attack.
So basically, they have you over a barrel. Another popular ism.
2
I don't believe you told us why some companies are now making a profit.
"Companies in a position to offer low-cost plans have thrived" does not tell us why they are in that position. Regarding Centene, you said it was their "experience." For Oscar Health you say, "sensing a more promising future, it plans to enter three more states." For NC Blue Cross a simple: "..is strong enough to scale back rate increases."
Not a very good analysis. You give us no real insights into why this is happening. No facts to indicate if it is just chance or random events.
Is it only the expansion of Medicaid, which you say is "another opportunity to make money."
My Point: I'm wondering if any new concepts are working to improve the health of people, treat chronic conditions, change people's behavior, have doctors work together, educate people? Some real meaningful change.
You give us no clues. A bit of fluff I'm sorry to say.
"Companies in a position to offer low-cost plans have thrived" does not tell us why they are in that position. Regarding Centene, you said it was their "experience." For Oscar Health you say, "sensing a more promising future, it plans to enter three more states." For NC Blue Cross a simple: "..is strong enough to scale back rate increases."
Not a very good analysis. You give us no real insights into why this is happening. No facts to indicate if it is just chance or random events.
Is it only the expansion of Medicaid, which you say is "another opportunity to make money."
My Point: I'm wondering if any new concepts are working to improve the health of people, treat chronic conditions, change people's behavior, have doctors work together, educate people? Some real meaningful change.
You give us no clues. A bit of fluff I'm sorry to say.
2
And I might add this from an editorial today in this newspaper:
"The United States spends much more on medical care than other rich countries, like Britain, Australia and the Netherlands, according to a recent Commonwealth Fund report, yet its citizens live shorter lives and suffer from more illnesses and injuries than people in other industrialized nations."
Exactly my point. Has anything happened to improve the outrageous costs of US health care or it weaker outcomes? Has any improvement occurred for the patient? Never mind why health care companies are doing better! I need a drug for an eye disease and for one shot on one day my health care company was billed $11,000. Yes, eleven thousand dollars. That is preposterous.
"The United States spends much more on medical care than other rich countries, like Britain, Australia and the Netherlands, according to a recent Commonwealth Fund report, yet its citizens live shorter lives and suffer from more illnesses and injuries than people in other industrialized nations."
Exactly my point. Has anything happened to improve the outrageous costs of US health care or it weaker outcomes? Has any improvement occurred for the patient? Never mind why health care companies are doing better! I need a drug for an eye disease and for one shot on one day my health care company was billed $11,000. Yes, eleven thousand dollars. That is preposterous.
2
It's no surprise that congress excluded itself from the ACA.
Rate increases in the double digits, insurers leaving markets, and the healthy hipsters forgoing coverage. The funding formula and market restrictions don't work. At what point will they realize the healthy cannot keep paying these prices for essentially catastrophe coverage.
Rate increases in the double digits, insurers leaving markets, and the healthy hipsters forgoing coverage. The funding formula and market restrictions don't work. At what point will they realize the healthy cannot keep paying these prices for essentially catastrophe coverage.
1
Congress did NOT exclude itself from the ACA.....it's just that they get big subsidies...but they have to get their insurance on the DC exchange.
1
Its all very confusing. The ACA was structured to be funded by ever increasing premiums and deductibles. Why all the angst?
I'm baffled when I read these articles. NY Times journalists inevitably gloss over the very real problem in the individual market post-ACA - the increasing number of solidly middle class Americans who simply cannot afford to buy insurance anymore for themselves or their families.
Last year the off-exchange, unsubsidized portion of the individual market shrunk by 29%. What did these people do? Did they turn to short term options in desperation as I did as the cost of premiums and deductibles soared? (For me it was roughly $700-$900 per month with a $6500-$7500 deductible.)
I am far less worried about "uncertainty" in the individual market than I am about the basic structural problem of the ACA and it's disgraceful Faustian bargain with its insurance company masters. I don't think the people like me who cheered the law's passage, thinking it would bring insurance to the uninsured and make what we thought was costly insurance better, ever dreamed how it would play out.
I read one comment about letting Americans buy into the Federal Insurance program and if you ask people to pay that's a lot more attractive option than asking them to pay, as we do now, steep prices for the equivalent of Medicaid.
Last year the off-exchange, unsubsidized portion of the individual market shrunk by 29%. What did these people do? Did they turn to short term options in desperation as I did as the cost of premiums and deductibles soared? (For me it was roughly $700-$900 per month with a $6500-$7500 deductible.)
I am far less worried about "uncertainty" in the individual market than I am about the basic structural problem of the ACA and it's disgraceful Faustian bargain with its insurance company masters. I don't think the people like me who cheered the law's passage, thinking it would bring insurance to the uninsured and make what we thought was costly insurance better, ever dreamed how it would play out.
I read one comment about letting Americans buy into the Federal Insurance program and if you ask people to pay that's a lot more attractive option than asking them to pay, as we do now, steep prices for the equivalent of Medicaid.
2
We'll never have a Medicare-for-all system in the US, because the government must protect the insurance industry. Changing from our current system, even gradually, would wreck havoc on our economy. Markets would plunge and millions of insurance industry workers would lose their jobs. One entire sector of the economy cannot be made to just disappear without horrible repercussions. We are stuck with the system we have for a very long time to come. Republicans want to end the ACA, which means health insurance will go back to being the sole responsibility of employers. If an employer doesn't provide insurance, workers will not have insurance. That was the system for years and years, and that's what we'll see again. But, we won't be moving to Medicare-for-all. It sounds good, but would be disastrous.
1
The ACA was structured to enhance the insurance industry's participation.
Furthermore, part of required additional funding was to be covered by increasing premiums and deductibles. Why the change in direction now? Do not understand the angst.
Furthermore, part of required additional funding was to be covered by increasing premiums and deductibles. Why the change in direction now? Do not understand the angst.
You're wrong. Here's why.
When a majority of people who vote favor something, it happens. Health care is no different. We are reaching the point where advocating Medicare for everyone is a political plus for politicians. It would actually help our economy, because billions of dollars that are now being flushed down the drain on wasteful and inefficient practices would, presumably, go toward something more productive. As for millions of people being thrown out of work, I couldn't care less. They'll find jobs doing something else, just as factory workers and loggers were forced to find jobs doing something else. Would those jobs pay as much? Likely not, and again, I don't care. Millions of people in this nation have lost their jobs due to changes in our economy, and then they got a double whammy when lower wages paired with astronomical health care costs pushed them into poverty and bankruptcy. At least the millions of people who lose their jobs when we all get Medicare will be able to go to the doctor.
When a majority of people who vote favor something, it happens. Health care is no different. We are reaching the point where advocating Medicare for everyone is a political plus for politicians. It would actually help our economy, because billions of dollars that are now being flushed down the drain on wasteful and inefficient practices would, presumably, go toward something more productive. As for millions of people being thrown out of work, I couldn't care less. They'll find jobs doing something else, just as factory workers and loggers were forced to find jobs doing something else. Would those jobs pay as much? Likely not, and again, I don't care. Millions of people in this nation have lost their jobs due to changes in our economy, and then they got a double whammy when lower wages paired with astronomical health care costs pushed them into poverty and bankruptcy. At least the millions of people who lose their jobs when we all get Medicare will be able to go to the doctor.
3
May be. More likely a good number of the better doctors will opt out and serve private insurance patients. Wait times will exceed 6 months for many.
"Although people with incomes low enough to qualify for federal subsidies were shielded from the brunt of the steep increases, the high prices prompted Republicans to blame the law for plans that were out of many people's reach."
What does this sentence even mean? ACA and the rest of our health care system--calling it a system is silly--is nothing more than smoke and mirrors. Who, really, believes that insurance companies are going bust? It''s a disaster, and a predictable one. Premiums are going up by 8.5 percent in a single year and the premise of the story is there's cause for hope?
Polls show that half of Americans now support Medicare for everyone, or some version thereof. Let's build on that instead of monkeying around with attempting to rescue ACA, which any first-year economics student can tell you can never possibly work.
Medicare for everyone. It's inevitable. Let's do it now.
What does this sentence even mean? ACA and the rest of our health care system--calling it a system is silly--is nothing more than smoke and mirrors. Who, really, believes that insurance companies are going bust? It''s a disaster, and a predictable one. Premiums are going up by 8.5 percent in a single year and the premise of the story is there's cause for hope?
Polls show that half of Americans now support Medicare for everyone, or some version thereof. Let's build on that instead of monkeying around with attempting to rescue ACA, which any first-year economics student can tell you can never possibly work.
Medicare for everyone. It's inevitable. Let's do it now.
12
Excellent point. The rate increases will only get worse over time.
2
Rate increases were built into the ACA from the git go. Why the change in direction now. Of course the real costs were camouflaged but every thoughtful person knew that.
You ask what the following sentence means: "Although people with incomes low enough to qualify for federal subsidies were shielded from the brunt of the steep increases, the high prices prompted Republicans to blame the law for plans that were out of many people's reach."
It means the Republicans are lying about healthcare, again. Without the Obamacare subsidies there would be a real danger of a market meltdown, a so-called death spiral: prices are high enough to force people out of the market which leads the insurance companies to raise prices yet higher etc.
What's missing from the coverage is a look at the history of insurance premiums, this is not the first time we've seen large increases, what doeas the overall historical picture look like.
If prices keep going up at such a rate your pessimism would be warranted but what evidence is there that that's what going to happen?
As for your supposed first year economics student...I know of at least one Nobel Prize winning economist who thinks the ACA is quite workable!
It means the Republicans are lying about healthcare, again. Without the Obamacare subsidies there would be a real danger of a market meltdown, a so-called death spiral: prices are high enough to force people out of the market which leads the insurance companies to raise prices yet higher etc.
What's missing from the coverage is a look at the history of insurance premiums, this is not the first time we've seen large increases, what doeas the overall historical picture look like.
If prices keep going up at such a rate your pessimism would be warranted but what evidence is there that that's what going to happen?
As for your supposed first year economics student...I know of at least one Nobel Prize winning economist who thinks the ACA is quite workable!
This article for me almost seems like a marketing advertisement for Insurers. Egads.
Can the NYT's please, please please get off of their pro-insurance stance for just once and write an article on the economic mechanics of a Medicare for All system. Preferably comparing and examining how Canada and/or other developed countries have been successfully running their health systems- for YEARS. We'd appreciate it.
Can the NYT's please, please please get off of their pro-insurance stance for just once and write an article on the economic mechanics of a Medicare for All system. Preferably comparing and examining how Canada and/or other developed countries have been successfully running their health systems- for YEARS. We'd appreciate it.
13
Or you could do a little research your own self and take a look at the system in Holland, which has universal coverage without a single payer system.
How do they do it? Stringent regulation of insurance companies along with generous subsidies from the government for folks who couldn't afford health insurance on their own. That might sound a little bit familiar, let's call it Obamacare On Steroids.
Implementing a single payer system in the US would run into the fact that many tens of millions of Americans currently get their health insurance from their employer. So we'd be forcing them off their current coverage onto a new, untested system. Just calling it Medicare For All doesn't change the fact that it would be a basically new system. Where would the money come from, I mean exactly where would the money come from?
How do they do it? Stringent regulation of insurance companies along with generous subsidies from the government for folks who couldn't afford health insurance on their own. That might sound a little bit familiar, let's call it Obamacare On Steroids.
Implementing a single payer system in the US would run into the fact that many tens of millions of Americans currently get their health insurance from their employer. So we'd be forcing them off their current coverage onto a new, untested system. Just calling it Medicare For All doesn't change the fact that it would be a basically new system. Where would the money come from, I mean exactly where would the money come from?
2
CEO compensation averaging $14,000,000. Sometimes, e.g. United Health Care, annual CEO comp soars to $205,000,000. They don't re-invent the wheel.
They don't cure disease. Their brokers often take 30% of premiums on group or industry policies sold. Aetna can still pay Mark Bertolini $15,000,000 a year. We're having a little trouble figuring out why supply chain, pharmaceutical, hospital/snf chain, and insurance execs rake in so much of our money and, until Obama, didn't have to actually cover treatment for diseases or still don't have to allow any qualified and willing provider to be 'in-network'. Only ones subsidizing this system of over-paid paper pushers are patients, providers of care/physicians, tax-payers. SINGLE PAYER UNIVERSAL HEALTHCARE. FOR ALL. Re-train the newly unemployed execs and their vast bureaucracies to work in the call centers in India or the Philippines where care is currently 'managed.' Maybe they could be pay per minute tele-entertainers. Tell jokes. Sing. Talk to lonely people. Or people let down by their system. Something useful.
They don't cure disease. Their brokers often take 30% of premiums on group or industry policies sold. Aetna can still pay Mark Bertolini $15,000,000 a year. We're having a little trouble figuring out why supply chain, pharmaceutical, hospital/snf chain, and insurance execs rake in so much of our money and, until Obama, didn't have to actually cover treatment for diseases or still don't have to allow any qualified and willing provider to be 'in-network'. Only ones subsidizing this system of over-paid paper pushers are patients, providers of care/physicians, tax-payers. SINGLE PAYER UNIVERSAL HEALTHCARE. FOR ALL. Re-train the newly unemployed execs and their vast bureaucracies to work in the call centers in India or the Philippines where care is currently 'managed.' Maybe they could be pay per minute tele-entertainers. Tell jokes. Sing. Talk to lonely people. Or people let down by their system. Something useful.
25
The Republicans destroyed and sabotaged the health coops that served as a governor and control on price gouging by the private for profit companies. Monthly payments are still significantly less that we can recall paying providers like Oxford Health Plans back in the 90s. So there's been a vast improvement, both in numbers of patients covered and in cost. But, in comments here one reads primarily people complaining about paying more in a field absent the health coops, without understanding how it got that way: Republican hate and lies versus Democratic lack of spine and the ability to speak simply about a complicated problem.
33
I am often astounded at just how far out of touch mainstream America is as regards ACA. If they will remember correctly insurance premiums and health care costs were growing at an average of 30% per year in 2008. Those costs were growing an yet some 35 million people were not even allowed to be a part of that system. It bears repeating 35 million were not allowed to participate.
Flash forward to 2017. Over 18 million of the "uninsurables" are now insured, rates do not go up 30% every year and yet the biggest complaint we get is that the old method, the exclusionary one, represented free market principles and that market based ACA which allows all to be consumers is a government takeover.
Finally, regarding this "free market" principle that is supposed to apply. What is the market for selling policies to people who are so sick that whomever sells the policy will lose 100 times the premiums in benefits? The market would say there is no market for such policies. And this is where free markets and health care diverge. There is no profit in taking care of the sickest and the poorest among us. Period, end of story...
Flash forward to 2017. Over 18 million of the "uninsurables" are now insured, rates do not go up 30% every year and yet the biggest complaint we get is that the old method, the exclusionary one, represented free market principles and that market based ACA which allows all to be consumers is a government takeover.
Finally, regarding this "free market" principle that is supposed to apply. What is the market for selling policies to people who are so sick that whomever sells the policy will lose 100 times the premiums in benefits? The market would say there is no market for such policies. And this is where free markets and health care diverge. There is no profit in taking care of the sickest and the poorest among us. Period, end of story...
30
Simple. Too bad that our government is so profoundly dysfunctional and so much of our populous can't understand facts like you do.
This is a classic ACA math mistake that you are making if you are considering the additional Medicaid enrolled that the state governors added as " insureds" because the only thing that makes them "insureds" is that doctors and hospitals know now that they will be getting reimbursed by the federal government through increasing federal deficits. They aren't paying the $1600 a month I pay for my family- they are glomming on the free Medicaid through their state legislators and then bitching about income inequality!
When is the discussion going to shift from the cost of insurance to the cost of the care provided? Isn't that at the root of the problem?
15
Honestly, are we subsidizing healthcare or the insurance companies? The insurance companies are the problem.
38
open up the federal employee health insurance plan to everyone. it's a win-win situation. health insurance companies get more money and premiums are low. Without the government paying half, I would be paying $400 A month. In the single payer market , my premium would be $1600 A month. Only difference is now I have a $500 deductible and it's the same insurance company. they have a choice of different plans from hmos to ppos.
9
Let me get this straight. Despite substantial government subsidies and a government-enforced mandate to purchase their product, we're supposed to believe that getting at least ONE insurer in every market is a sign of improvement?
Double digit increases, reduction in the quality of the product, and monopolistic pricing? What could be worse? Oh yeah... a tax penalty for not purchasing the product. This isn't a public policy, it's criminal racketeering enforced by the DOJ.
Americans wanted health care, they got overpriced, high deductible insurance. We should just endow our representatives so there is no confusion. The "Honorable Blue Cross Blues Shield Senator from New York".
Double digit increases, reduction in the quality of the product, and monopolistic pricing? What could be worse? Oh yeah... a tax penalty for not purchasing the product. This isn't a public policy, it's criminal racketeering enforced by the DOJ.
Americans wanted health care, they got overpriced, high deductible insurance. We should just endow our representatives so there is no confusion. The "Honorable Blue Cross Blues Shield Senator from New York".
18
Let me get another thing straight. Are you being critical of the Republican party of the Obama years for their hand in the weakening of the ACA in the first place (yes, the Democratic party had full control for Obama's first two years, but Obama, unlike his successor, actually worked hard for political consensus)? Or are you being critical of the train wreck of a Republican adminstration we have now for their irresponsible, destructive talk of sabotage of the ACA?
And herein lies the Achille's heel of subsidized health care: funding it.
3
Insurance companies are being used as tax collectors by a system that lies about anything to avoid confessing it is a hidden tax.
Tom, stop it.
Cost is only an Achilles heel in the sense that Santa Claus is a wealthy entrepreneur on the left coast.
It looks like you dearly love your talking points, but how about these:
We pay more than anybody for health care, and add the cost of health insurance on top of that, which doesn't bother you?
We get second rate health outcomes and worse, even the very richest of us. That doesn't bother you either?
We pay a trillion dollars every year to a health insurance industry that creates nothing, that contributes nothing, that conducts the rationing you guys usually go to after the outrageous cost scare tactic, but they ration care on the basis of their own profit. Perverse incentive, yes?
By the time you add up the cost of health care, of deductibles, of overpriced medicines and devices, of the lower salaries you all get to allow your employers to "pay" for your employer provided insurance, and the premiums you pay, you have pretty much covered the cost of a single payer plan. And got better, easier, more responsive care in the process. What's not to like?
Oh, yeah, its the "everybody is covered no matter what" part, right?
Cost is only an Achilles heel in the sense that Santa Claus is a wealthy entrepreneur on the left coast.
It looks like you dearly love your talking points, but how about these:
We pay more than anybody for health care, and add the cost of health insurance on top of that, which doesn't bother you?
We get second rate health outcomes and worse, even the very richest of us. That doesn't bother you either?
We pay a trillion dollars every year to a health insurance industry that creates nothing, that contributes nothing, that conducts the rationing you guys usually go to after the outrageous cost scare tactic, but they ration care on the basis of their own profit. Perverse incentive, yes?
By the time you add up the cost of health care, of deductibles, of overpriced medicines and devices, of the lower salaries you all get to allow your employers to "pay" for your employer provided insurance, and the premiums you pay, you have pretty much covered the cost of a single payer plan. And got better, easier, more responsive care in the process. What's not to like?
Oh, yeah, its the "everybody is covered no matter what" part, right?
Maybe it's the everybody is taxed part that bothers them.
The fiscal health of insurance companies is more important than the health and well being of Americans is indicative of the sad state of the USA.
Insurance companies add ZERO to the health care system. They are an excuse to steal money from both "We the People" and the US Gov.
Polls have shown that 70%+ of "We the People" want a single payer system. The only reason we do not have what the rest of the western world has is I & C (incompetence & corruption) on both sides of the isle.
PS: There is no such thing as "health insurance". You cannot insure against a dead certainty. Therefore health insurance is bogus.
Insurance companies add ZERO to the health care system. They are an excuse to steal money from both "We the People" and the US Gov.
Polls have shown that 70%+ of "We the People" want a single payer system. The only reason we do not have what the rest of the western world has is I & C (incompetence & corruption) on both sides of the isle.
PS: There is no such thing as "health insurance". You cannot insure against a dead certainty. Therefore health insurance is bogus.
36
I was ok until I got to the paragraph about Joshua Kushner, Jared's brother, in the healthcare insurance business.
My God, these Trump people and their affiliates are everywhere! Even controlling, literally, people's health.
My God, these Trump people and their affiliates are everywhere! Even controlling, literally, people's health.
48
The whole Washington racket swirls around the sale of captive consumers to rentiers.
Aetna says it lost more than $900 million on the exchanges...then why is their EPS up more than 300% since the ACA was enacted...
26
Very good question! At least the insurance companies must pay out some 80% or more in actual claims. I think part of the corporate "loss" is due to not scamming so many businesses and people.
6
If the Democrats had any intelligence they would be pushing for Medicare for all. Then maybe they would win back the House and Senate. It seems like a "no-brainer" to me.
31
They are, Susan. Unfortunately, there are not enough of them to make it happen.
But the Democrats are no less allies of large health-insurance corporations than are the Republicans.
1
Are you ready to pay a 16% VAT for it?
Pop Quiz Time!
Take one male bovine creature, add grass...Result:
A) The 7+-year Republican posturing about the ACA;
B) The health insurance industry's excuses for why it can't make money under the rules of the ACA;
C) Pretty much any argument purporting to explain why Medicare for all won't work;
D) Fertilizer;
E) A no-no for the Comments sidebar
F) All of the above.
Extra Credit:
Which of the above responses (excluding "F") is a positive benefit for the country?
Take one male bovine creature, add grass...Result:
A) The 7+-year Republican posturing about the ACA;
B) The health insurance industry's excuses for why it can't make money under the rules of the ACA;
C) Pretty much any argument purporting to explain why Medicare for all won't work;
D) Fertilizer;
E) A no-no for the Comments sidebar
F) All of the above.
Extra Credit:
Which of the above responses (excluding "F") is a positive benefit for the country?
7
I don't know of a more dysfunctional system and industry than US healthcare. My wife was charged over $300/hour for a service that ultimately proved not to have been covered by her reputable employer's otherwise reputable employer-provided insurance company. When she reluctantly informed the provider of her need to stop, they offered to bill her at $90/visit instead, the rate they offer to individuals who are paying out of pocket. So, uhm, what exactly is the true cost of this service: $90/HR, $300/HR, or something else entirely?
This "system" is a joke, and Americans are the butt of it. We introduce and self-impose inefficiencies in this system and keep tap-dancing around the obvious, logical solution right in front of us and demonstrated by Scandinavian countries that have been successfully doing it for years: universal healthcare under a single payer. Enough already.
This "system" is a joke, and Americans are the butt of it. We introduce and self-impose inefficiencies in this system and keep tap-dancing around the obvious, logical solution right in front of us and demonstrated by Scandinavian countries that have been successfully doing it for years: universal healthcare under a single payer. Enough already.
172
Thank you Jeff, I'm deeply disturbed AND sorry for wife's distressing incident!
2
My Aunt when working as a judge in Vermont experienced exactly the same issue in court. The doctor's office was suing for $3,500 but billed people that were not insured and had to pay out of pocket $900. Needless to say, I think, they settled the case for $900.
The lack of published price lists for medical services is one of the most glaring examples of unequally protective law in this nation of credulous juveniles.
Trump's most radical lies are about Obamacare and most elected GOP officeholders know he is lying yet they do and say nothing. Republican Senators Murkowski, Collins and McCain showed all of them what integrity looks like. As Trump's life long racism - he was the named defendant in numerous housing discrimination cases in the 1960s- becomes more apparent to voters, GOP leaders SHOULD become less willing to cooperate with him.
Trump is actively working to sabotage Obamacare because he really has no concern for others outside of his own family. His words during the campaign have been the opposite of his actions as President. If the 62 million people who voted for Trump are paying attention AND GOP leaders forcefully correct Trump's lies we have a chance that the Trump Presidency will last ONLY four years.
Trump is actively working to sabotage Obamacare because he really has no concern for others outside of his own family. His words during the campaign have been the opposite of his actions as President. If the 62 million people who voted for Trump are paying attention AND GOP leaders forcefully correct Trump's lies we have a chance that the Trump Presidency will last ONLY four years.
14
There are more lies than truths told about US public policies.
The hard truth is that only 5% of Americans are driving the country forward on any given day. The rest are along for the ride. Obviously, said 5% should have access to primo medical care while any plan that introduces mediocrity into the system is unwise.
3
Putting others out of work pays well until the hatchet swings for you.
The question is do we care for our fellow citizens or not? Medicare for all.
21
BJ
You're certainly right about that.
There is a follow-up question that also matters: Wouldn't you like to have better health care and save a ton of money, too?
Because that what your answer, Medicare for all, or any other well-designed single payer system would do.
You're certainly right about that.
There is a follow-up question that also matters: Wouldn't you like to have better health care and save a ton of money, too?
Because that what your answer, Medicare for all, or any other well-designed single payer system would do.
17
Without triage, no universal set of health care coverage is affordable. Unreasonable individual demands for extreme services can bankrupt any system.
3
I'd like to see fewer dollars in the military and more in healthcare. We have the money since the military wastes 20-25% of their budget.
2
Healthcare should be for patients, not for profit. Let's make Improved and Expanded Medicare for All, HR 676, the law of the land. There will soon be a bill on the Senate side as well. Everybody in, nobody out!
37
So, the insurers underpriced their product to get the business. Then it cost more than anticipated.
When risk-averse, for profit companies with little experience of start ups became involved in a massive start up like this, the result was predictable: folks who had been shut out of health care for years decided to use what they'd purchsed. Yes, many were sicker than expected.
Higher consumer demand should and could have been built into their business model. But, the risk averse are rarely entrepreneurs.
Some Silicon Valley entrepreneurs would have been useful.
When risk-averse, for profit companies with little experience of start ups became involved in a massive start up like this, the result was predictable: folks who had been shut out of health care for years decided to use what they'd purchsed. Yes, many were sicker than expected.
Higher consumer demand should and could have been built into their business model. But, the risk averse are rarely entrepreneurs.
Some Silicon Valley entrepreneurs would have been useful.
11
dd
And doing away with health insurance completely would have been most useful of all.
Why sustain an industry which contributes virtually nothing to the economy, offers no innovation or leadership, which exists purely to ration health care to enhance its own profit?
And which diverts a trillion dollars every year from the actual provision of care.
Entrepreneurism in the insurance field is focused solely on the financial side: creating deceptive new financial tools, lobbying to exclude more and more conditions and diagnoses from coverage, finding ways to held blameless for serious, even fatal decisions.
Entrepreneurs come in many varieties, not all of them in it simply for the big bucks. We need innovation on behalf of patients, not executives and investors alone.
Lucky for us, Canada and others have done the heavy lifting for us. Now we just need to get Republicans off our backs.
And doing away with health insurance completely would have been most useful of all.
Why sustain an industry which contributes virtually nothing to the economy, offers no innovation or leadership, which exists purely to ration health care to enhance its own profit?
And which diverts a trillion dollars every year from the actual provision of care.
Entrepreneurism in the insurance field is focused solely on the financial side: creating deceptive new financial tools, lobbying to exclude more and more conditions and diagnoses from coverage, finding ways to held blameless for serious, even fatal decisions.
Entrepreneurs come in many varieties, not all of them in it simply for the big bucks. We need innovation on behalf of patients, not executives and investors alone.
Lucky for us, Canada and others have done the heavy lifting for us. Now we just need to get Republicans off our backs.
19
Also important to note: most medical practices must have one or more insurance clerks to encode the procedures for billing, sort out insurance carriers, track outgoing bills and incoming payments. With single payer, a lot of that "overhead" goes away. Voila! Less expensive medical care.
5
What about the doctor's offices? They have it just as bad if not worse. The doctor is worried as much about malpractice and billing as the patient if not more.
The early losses by insurers underscored the backlog of medical needs by the newly insured Americans. With that backlog increasingly satisfied, this can be a good business while offering much needed care.
17
This must be a centerpiece of Dems efforts going forward to make sure this kind of news and results are spread to every voter.
The US electorate could use some positive news about what can work instead of harping on the negative.
Thank you again, President Obama!
The US electorate could use some positive news about what can work instead of harping on the negative.
Thank you again, President Obama!
32
It's only positive news if you're not one of the unfortunate people paying the full price. Perhaps you skipped over the paragraph on rate increases.
Universal Medicare for all as basic coverage makes more sense.
Universal Medicare for all as basic coverage makes more sense.
The very premise of the healthcare bill trump keeps pushing is an out and out lie. The ACA, "Obamacare" is not collapsing. It is not failing. Whatever difficulties the program is having is entirely due to deliberate brazen GOP sabotage efforts- both by refusing the Medicare expansion, and by destabilizing the insurance markets through Trump's threats, and the AHCA legislation.
37
Is it not curious that "success" is measured by an insurance company's black ink rather than a smoothly functioning health care system that does not impoverish or addict it's citizens? Or, is this too clear a view for the blurry-eyed that populate pontificating newsrooms?
59
Hemmings: This is how capitalism works. Don't like profit as the metric of success, change the economic model.
1
That is exactly what many are suggesting. Healthcare should be a right, not a privilege. The US functions differently and at vastly higher cost per capita than any other healthcare system and it has only recently made a serious attempt to make it work for all and not just the rich or those employed by large corporations that build the high cost of healthcare into their bottom lines creating two 'classes' of people.
Henry, based on your posts here over several years, you could benefit from some mental health attention.
Here in the Netherlands we have great healthcare. Basic healthcare insurance is mandatory and covers the larger part of all medical care. Premiums for basic care are not dependent on a person’s income, and support is offered to those having trouble paying these basic premiums. Pre-existing conditions do not affect the ability to obtain basic coverage and exclusion is forbidden by law. Total cost of healthcare is rising, but that is largely due to an aging population (post-war baby boom) and advances in treatment possibilities and technology. I work at one of the largest healthcare insurers, which is not aimed at profits (all profits flow back to consumer premiums). I think a big problem in the US lies in the cost of medical treatment, trickling down the system. The cost of treatments in the Netherlands is much, much lower compared to the cost of those exact treatments in the US.
105
Thanks for sharing that. So many European countries are ahead of us in taking care of people sensibly - and using a single payer system. Capitalism in the US has actually gone to an extreme and we are killing our own people as we feed the insurance company profits. The salaries alone that they take out of health care are stunning while we put hundreds of families a year into bankruptcy over health needs. It is a disgrace and the strategy of cutting more people out of the system to increase 'profits' as Trumpcare would do is ridiculous.
17
Until 2006 all healthcare in the Netherlands was organized and controlled by a single government regulated organization. In the end, this turned out to be inefficient and expensive due to a lack of incentives for healthcare providers to provide better quality care, work more efficient and contain costs. Since 2006 we have a (regulated) system with several private health care insurers to improve on those shortcomings. The difference with traditional insurers, who’s main goal is to maximize profits for shareholders, is that our healthcare profits flow back into the system. Massive profits for healthcare insurers not flowing back to healthcare are virtually non-existent, as an insurer you’d be out of business within a year. No system is perfect, but this works pretty well for us.
3
If insurance companies have been setting their prices to protect themselves against worst case scenarios, it is to be expected that they would do well if these scenarios do not materialize. By producing the uncertainty that drives up prices, Trump can create evidence that the system is too expensive. Murdering your parents and then claiming benefits as an orphan is exactly the sort of business strategy Trump admires.
25
And that is exactly what Trump wants to achieve. Line the pockets of the insurers.
12
Really can't believe that's what you think is going on; " Trump lining the pockets of the insurers." From day one of Obamacare, the insurers have been making out like bandits. I live in Minnesota, home for United Healthcare. They are doing fantastic in terms of profitability and growth. The same could be said for all major health insurers. So to lay this at Trumps feet is disingenuous. The ACA did not address drug costs, wellness and still left many of citizens w/o insurance. The middle class was pounded with astronomical premiums and co-pays. Everyone has a solution with many advocating single payer. Some suggest let individual states manage the health of their own citizens. Here in Minnesota we have unbelievably great healthcare and with a little increase in taxes it would be easy to subsidize the remaining who are without healthcare. Each state managing its own healthcare costs , a much smaller business model which is easier to manage and execute on rather than than Washington managing it all. Once coverage is not an issue everyone can move on to what is just as important which is wellness.
2
Of course United Healthcare is doing well. They have a long-term contract with the federal government to provide coverage for ALL military families active and retired. (Tricare). They know they will get their money. Too bad they won't use profits from that contract to help other sectors of their business.
1
Universal health insurance , single payer , with accessibility and affordability for every American is the only answer to this MESS .
Improve the ACA with steps towards Universal Coverage , like in most other industrialized countries.
Improve the ACA with steps towards Universal Coverage , like in most other industrialized countries.
74
I don't believe that health insurers suddenly discovered that the ACA market is "more like Medicaid" than employer group plans. Second, the health insurance companies should welcome fewer competitors in each market since it brings them more customers, premium dollars, and greater negotiating clout with physicians, hospitals, and pharma suppliers. Stabilizing anticipated insurance revenues, insured costs, and available health networks will improve how well the system works.
3
Single payer is still the best option but, as long as insurance companies can cherry pick who they insure, either through company plans or by establishing very narrow networks, this system will not work.
As stated, insurance companies are making billions of dollars, but they insist on putting our nations most disadvantaged people, those on individual plans, on a separate P&L line. If they put all people together, they would still make decent profits. This is the greed of our current capitalist system at work.
As stated, insurance companies are making billions of dollars, but they insist on putting our nations most disadvantaged people, those on individual plans, on a separate P&L line. If they put all people together, they would still make decent profits. This is the greed of our current capitalist system at work.
30
So, bottom line, individuals who aren't covered at work are still at the mercy of insurance companies and their profit strategies, always waiting to hear if we can keep our plans and our doctors or if the company that insures us this year will be gone next year. Oh, and waiting to hear how much our premiums will go up. There should be no place in our healthcare system for private insurers who come and go and raise their premiums more than the cost of living each year. No workers I know get 20-30% raises in one year. Stability, in coverage, providers and pricing, is essential for consumers of health insurance, especially those with chronic illness. How to get stability? Obviously, the private sector cannot do it. Government has to. All who cannot get coverage through employers should be able to buy into a public insurance plan, with premiums based on income. Simple as that.
61
Great news that the Insurance Companies don't need these taxpayer funded subsidies. Now to eliminate subsidies for the so-called "poor". You know, the families which work off the books, receive a boatload of Government handouts (Welfare, Food Stamps, Section 8 vouchers, etc) yet want free healthcare through Medicaid/Federal Exchange subsidies paid for by financially stressed middle-class taxpayers.
8
Anyone who "works off the books" makes incredibly little per hour--there is zero to protect them in the marketplace since they officially don't exist, and their employers take advantage of that. Of course everyone who can read realizes that people only qualify for any type of welfare for a limited time now. Even food stamps are being limited, by so-called "people" such as yourself. Since you are supposedly in NY, you know how expensive it is to live there. Section 8 vouchers become ever harder to get as well, plus many landlords refuse to take them. But employers want the poor--so they can receive more profit and pay fewer dollars in wages. And now in addition to needing to eat, and have a place to sleep, the poor even need health care too. Employers should support this--if the poor die, they will have a hard time finding anyone else to work for what they want to pay. By the way, the subsidies are not paid for by financially-stressed middle-class taxpayers as much as they are used by them. Many middle-class people have sunk downward as wages continue to stagnate. That leaves the wealthy, who can well afford to pay their fair share but would like to avoid it. From the sound of your post, that is probably you, "John Smith."
64
"It is very wonderful to me, the ease with which one arranges the abundance of others."
J Austen, "Mansfield Park"
J Austen, "Mansfield Park"
6
The issue is what is a " fair share" and why is it greedy for me to want to keep more of the hard earned money that I got out of bed to work for but not greedy for you when you want to take more of my money to pay for people who in many cases have money for tattoos but not for health insurance?
I am sorry that the last country that was potentially uncovered by private insurance businesses occurred. This is a missed opportunity to allow those of use who would like to choose to purchase a public insurance company an option. It would have been great to move forward and allow Medicare or Medicaid to expand there and have a sliding scale buy-in.
Maybe a bill will be introduced this session to expand our freedoms in health care and to decrease the marketing, 30% administrative and CEO costs.
Maybe next time.....
Maybe a bill will be introduced this session to expand our freedoms in health care and to decrease the marketing, 30% administrative and CEO costs.
Maybe next time.....
6
Dear NYTimes,
Will you please write an article about single payer? Your readers need to know the facts. Please include studies that tell just how easy it would be to enact health care for all. And include the list of countries that already have great health care.
Thank you.
Will you please write an article about single payer? Your readers need to know the facts. Please include studies that tell just how easy it would be to enact health care for all. And include the list of countries that already have great health care.
Thank you.
279
And please include details about how those countries' plans are structured. Tell readers that Australians pay a 2percent payroll tax for theirs.
Thanks for pushing for the elephant in the room. Yes, NY Times, we need a REAL healthcare debate, not a conversation about whether a parasitic group of insurance companies that should be dissolved and possibly prosecuted are making enough profits from human need, suffering and pain.
Dear NYT: Please publish info re contacting Canadian $.
I just looked at the Air Canada Site: $229 r/t to Montreal. Non-stop. 90 minutes or so. We can take an early flight to Montreal, go see a doc, pay the non-Canadian rate (very reasonable to this American), have a lovely lunch, and come back at the end of the day (did I mention 90 minutes--visiting my mother in NJ takes longer via NJ transit). I pay $580 a month for worthless insurance. For the same $, I can see a lovely doctor in Canada, not use the poor door, and probably see the doctor for more than 15 secs. I don't need to live there--I just need to visit doctors who actually value being medical doctors.
I just looked at the Air Canada Site: $229 r/t to Montreal. Non-stop. 90 minutes or so. We can take an early flight to Montreal, go see a doc, pay the non-Canadian rate (very reasonable to this American), have a lovely lunch, and come back at the end of the day (did I mention 90 minutes--visiting my mother in NJ takes longer via NJ transit). I pay $580 a month for worthless insurance. For the same $, I can see a lovely doctor in Canada, not use the poor door, and probably see the doctor for more than 15 secs. I don't need to live there--I just need to visit doctors who actually value being medical doctors.
145
Unfortunately this is not a practical solution for the working poor!
3
Sharon: I coudnt agree more, when you do have insurance the experience of going to a Dr. these days is shall we say "not what it used to be". First of all, to renew many prescriptions you must go monthly because A.C.A. only allows thirty day supplies for many drugs especially those reclassified shortly after the A.C.A., this is time consuming for everyone but the Insurance company with their sole purpose of collecting as much money as possible and paying out as little as possible accomplished through a blizzard of paperwork and an atmosphere of continual harassment. We do not need private insurance companies, they know it, we know it and the government knows it, the insurance industry admitted as much when there was the possibility of single payer, they and the drug companies said they could not compete with a government run plan. So why do we allow them to continue to gouge us and continue to give us some of the worst care among developed nations at twice the price? Our bought and paid for politicians and the army of lobbyists employed by big pharma and big insurance. Our health care system, absurd tort system, Wall Streets tentacles in every phase of it from the hospitals themselves to the physicians practices have produced the most expensive, most profitable for all involved and the worst care in recent history: B.T.W. Sharon we have looked into moving to Canada, but tens of millions of Asians beat us to the punch, it's now unaffordable.
2
Sharon: earlier you said you earned a good income, so perhaps traveling to Canada and paying $229 for a flight (which must be booked in advance) is a workable idea for SOME non-threatening medical issues.
But what if you have an emergency? Or they find something like cancer that requires long term care? Can you fly up there twice a week?
And since you must pay something, plus $229 for airfare, plus renting a car or taxi from the airport, plus parking (back home), plus lunch -- and if you need tests, perhaps overnight stay -- in most cases, you could afford to see a US doctor. Trying calling a few independent practitioners, and asking if they give a discount for cash upfront. Most will do this. They'd rather get cash than deal with insurance, which pays very late.
This also works at the dentist. Try it.
As expat says though: these things only work if you are relatively wealthy. No working class or poor person can afford to fly to Canada for a sprained ankle or even a broken ankle. No poor person can pay cash to get a low cost US office visit either.
But what if you have an emergency? Or they find something like cancer that requires long term care? Can you fly up there twice a week?
And since you must pay something, plus $229 for airfare, plus renting a car or taxi from the airport, plus parking (back home), plus lunch -- and if you need tests, perhaps overnight stay -- in most cases, you could afford to see a US doctor. Trying calling a few independent practitioners, and asking if they give a discount for cash upfront. Most will do this. They'd rather get cash than deal with insurance, which pays very late.
This also works at the dentist. Try it.
As expat says though: these things only work if you are relatively wealthy. No working class or poor person can afford to fly to Canada for a sprained ankle or even a broken ankle. No poor person can pay cash to get a low cost US office visit either.
Yet another excellent and well researched article.
It appears some eagerly predict failure of insurers, but with that bill collapsing in the lap of Republican senators, life goes on and insurers pick up the pace. No one I know has ridiculous rates. Since it's the law, those subsidies must be paid.
I am still struck by the fact this president and Republicans were willing to take away healthcare from millions. That Rose Garden celebration? The bill hadn't even passed the Senate!
Former President Barack Obama wrote an article in the New England Journal of Medicine as to how to fix the Affordable Care Act, published Jan. 27, 2017. Now that was a guy who understood policy. You can sense the urgency since it appeared a week after his successor's inauguration.
http://www.nejm.org/doi/pdf/10.1056/NEJMp1616577
It appears some eagerly predict failure of insurers, but with that bill collapsing in the lap of Republican senators, life goes on and insurers pick up the pace. No one I know has ridiculous rates. Since it's the law, those subsidies must be paid.
I am still struck by the fact this president and Republicans were willing to take away healthcare from millions. That Rose Garden celebration? The bill hadn't even passed the Senate!
Former President Barack Obama wrote an article in the New England Journal of Medicine as to how to fix the Affordable Care Act, published Jan. 27, 2017. Now that was a guy who understood policy. You can sense the urgency since it appeared a week after his successor's inauguration.
http://www.nejm.org/doi/pdf/10.1056/NEJMp1616577
42
Joanne, thank you for this link!
4
Joanne, the article is grossly lacking in depth. It blindly ignores the double dight rare increases and exiting of insurers from select markets.
It fails to discuss the benefits of a single payer system or the inability of Medicare to negotiate with big pharma. Avoiders the question of Where will the funds come from to pay for the subsidies? The ACA needs to be overhauled not flushed. Middle class Americans are being squeezed mercilessly by the cost of healthcare. Obama care in its present form is not the solution. It's no wonder congress excluded itself from it.
It fails to discuss the benefits of a single payer system or the inability of Medicare to negotiate with big pharma. Avoiders the question of Where will the funds come from to pay for the subsidies? The ACA needs to be overhauled not flushed. Middle class Americans are being squeezed mercilessly by the cost of healthcare. Obama care in its present form is not the solution. It's no wonder congress excluded itself from it.
Perhaps if the federal government had told Northwell that they could not participate in Medicare reimbursements if they allowed CareConnect to fail, perhaps they might have worked a little harder at it. That's not to excuse the trump administration for needlessly roiling the markets just because they could.
6
Don't cry for insurers--especially CareConnect--Dowling made tremendous profits and now he pulls out.
I have zero sympathy for doctors at this point. Insurance is becoming a Ponzi scheme--when the CEO can't make more money than the insured put in, they pull out of the market. How is this at all related to health care.
Care Connect pays doctors in its system 1/4 to 1/2 of what they bill. So when a doctor bills $2000, Cc pays $500.
If the doctor negotiated directly with me, I could pay that too. But w/out insurance, they would charge me $2000 and if I go bankrupt, too bad.
Heartless doctors. As ye sow, so ye reap.
Here is an article from Crain's about how Dowling is the highest compensated exec. Health care means denial of services Otherwise, you can't make a buck.
This is insane.
Thanks to you Mr. Dowling, I am now liberated from the burden of paying $580/ month. I am liberated from going to Northshore and using the poor door and sitting in an unhygienic, poorly ventilated, crowded, noisy waiting area.
http://www.crainsnewyork.com/article/20160413/HEALTH_CARE/160419958/new-...
I have zero sympathy for doctors at this point. Insurance is becoming a Ponzi scheme--when the CEO can't make more money than the insured put in, they pull out of the market. How is this at all related to health care.
Care Connect pays doctors in its system 1/4 to 1/2 of what they bill. So when a doctor bills $2000, Cc pays $500.
If the doctor negotiated directly with me, I could pay that too. But w/out insurance, they would charge me $2000 and if I go bankrupt, too bad.
Heartless doctors. As ye sow, so ye reap.
Here is an article from Crain's about how Dowling is the highest compensated exec. Health care means denial of services Otherwise, you can't make a buck.
This is insane.
Thanks to you Mr. Dowling, I am now liberated from the burden of paying $580/ month. I am liberated from going to Northshore and using the poor door and sitting in an unhygienic, poorly ventilated, crowded, noisy waiting area.
http://www.crainsnewyork.com/article/20160413/HEALTH_CARE/160419958/new-...
16
All we have learned from the so-called flaws in the ACA is that insurance companies, if required to cover everyone and treat them fairly, can't rake in as much money as they want.
The popular features of supposedly detested Obamacare are, you will note, the "government interference" bits - coverage for pre-existing conditions and for children to age 26, subsidies and exchanges.
The least-popular element happens to be the ONE that is an absolute must if we want to have universal coverage in a for-profit system - the individual mandate. Insurers simply can't make enough money to induce them to stay in the market, without it.
The solution would be pretty glaring were it not for the 8 years of GOP obstruction, obfuscation and flat-out lies.
Any attempt to fix the ACA should include a public option. If private insurers find they're unable to compete, it will prove a point about the for-profit model.
The popular features of supposedly detested Obamacare are, you will note, the "government interference" bits - coverage for pre-existing conditions and for children to age 26, subsidies and exchanges.
The least-popular element happens to be the ONE that is an absolute must if we want to have universal coverage in a for-profit system - the individual mandate. Insurers simply can't make enough money to induce them to stay in the market, without it.
The solution would be pretty glaring were it not for the 8 years of GOP obstruction, obfuscation and flat-out lies.
Any attempt to fix the ACA should include a public option. If private insurers find they're unable to compete, it will prove a point about the for-profit model.
30
This feels like rearranging the deck chairs on the Titanic.
The people covered and using the ACA is between 22 million (NYTimes) and 26 million (Kaiser) - about 8% of the population. This leaves 28 million people, 8.7%, that are not covered (7 million for refusal to insure, thus they incur the tax and 21 million in the Unknown category). A comprehensive, nationally-mandated, Federal Health approach that leave 1 in 11 uninsured (plus all the illegal immigrants) has to be classed a failure.
I am all for single-payer, but not if it involves insurance companies and the current Health Infrastructure. Hospitals should be like public Universities with public money building and staffing them and that includes Doctors, who should be paid on salary, not piece-work. This is the only way to drive out the obscene amounts of money that are wasted on insurance and all the insane bookkeeping that goes into costing every single aspirin as a "drug delivered."
All of the "Medicare for all" proposals simply attempt to use the existing fee for service model. Given that the average cost per person is $18,000+ on Medicare Vs. $10,000 for less than 65 insurance, it's not much of a bargain.
The delivery model of Health Care needs to change if we're to have any sort of meaningful cost reform - until that happens, we'll always be playing the game of cost-shifting to someone else and paying much higher costs than everyone else in the world.
The people covered and using the ACA is between 22 million (NYTimes) and 26 million (Kaiser) - about 8% of the population. This leaves 28 million people, 8.7%, that are not covered (7 million for refusal to insure, thus they incur the tax and 21 million in the Unknown category). A comprehensive, nationally-mandated, Federal Health approach that leave 1 in 11 uninsured (plus all the illegal immigrants) has to be classed a failure.
I am all for single-payer, but not if it involves insurance companies and the current Health Infrastructure. Hospitals should be like public Universities with public money building and staffing them and that includes Doctors, who should be paid on salary, not piece-work. This is the only way to drive out the obscene amounts of money that are wasted on insurance and all the insane bookkeeping that goes into costing every single aspirin as a "drug delivered."
All of the "Medicare for all" proposals simply attempt to use the existing fee for service model. Given that the average cost per person is $18,000+ on Medicare Vs. $10,000 for less than 65 insurance, it's not much of a bargain.
The delivery model of Health Care needs to change if we're to have any sort of meaningful cost reform - until that happens, we'll always be playing the game of cost-shifting to someone else and paying much higher costs than everyone else in the world.
21
Americans on Medicare are, on average, less healthy than younger people. It's called aging. Comparing average costs as you do misses this vital fact.
18
You're kidding, right? Like Universities? Evidently you haven't been reading the news about the debt people are coming out of college with these days.
6
Single payer by definition means the insurance companies are not involved.
Medicare patients on average consume 3x the medical care than those who are under 65, so Medicare is a bargain compared to private insurance.
Whether you pay doctors a fixed salary, per patient, or per service - and there are advantages and disadvantages to each model, doctors' fees are a small proportion of health care costs, especially if you do not include labs and diagnostics done in the office. In fact, many primary care offices would lose money without the charges due to labs and diagnostics. In the long run, compensating physicians so they do not have an incentive to order tests or send patients to consultants - which includes tort reform, would save money for the system.
Medicare patients on average consume 3x the medical care than those who are under 65, so Medicare is a bargain compared to private insurance.
Whether you pay doctors a fixed salary, per patient, or per service - and there are advantages and disadvantages to each model, doctors' fees are a small proportion of health care costs, especially if you do not include labs and diagnostics done in the office. In fact, many primary care offices would lose money without the charges due to labs and diagnostics. In the long run, compensating physicians so they do not have an incentive to order tests or send patients to consultants - which includes tort reform, would save money for the system.
2
Anthem, up 196%
Aetna, up 353%
Cigna, up 384%
Humana, up 406%
United Health, up 465%
That's how the share values have fared for the 5 largest health insurers since the ACA went into effect in March, 2010.
Do they look like they're struggling?
For reference, the S&P500 rose 110% during that same period.
Aetna, up 353%
Cigna, up 384%
Humana, up 406%
United Health, up 465%
That's how the share values have fared for the 5 largest health insurers since the ACA went into effect in March, 2010.
Do they look like they're struggling?
For reference, the S&P500 rose 110% during that same period.
113
If this is so their shareholders would revolt against them leaving the ACA, since you credit the ACA for these profits. Please explain!
Thanks for the facts which were not included in the article. Appreciate your research and sharing thereof.
4
Dave... oh and by the way. I did NOT "credit" the ACA for these profits. Please re-read my post. I simply pointed out the facts regarding their share prices. The ACA certainly seems not to have done those prices much harm, given their amazing increases relative to the overall stock market.
I wish I had had the foresight to buy healthcare stock back when the ACA went into effect.
I wish I had had the foresight to buy healthcare stock back when the ACA went into effect.
4
Insurance company lobbyists were deeply involved in writing the ACA, which was barely different than the plan schemed up by Republicans and their big insurance friends in the 90's. They insisted on the mandate, made sure there was no public option plan and eliminated everything that would force down cost.
If these companies are actually losing money, the fault lies not with the ACA but with their own incompetence and excessive greed. The best thing that could happen would be for them to fail.
If these companies are actually losing money, the fault lies not with the ACA but with their own incompetence and excessive greed. The best thing that could happen would be for them to fail.
21
Minnesota offers state plans with no-cost or low-cost premiums. Here is its premium table.
https://edocs.dhs.state.mn.us/lfserver/Public/DHS-4139A-ENG
If You Qualify
You will be able to get medical services at little cost to you.
Medical Assistance does not require you to pay a monthly premium. Members have small co-pays for some services, usually $1 - $3. This is called cost sharing.
MinnesotaCare does require you to pay a monthly premium, and it is based on your income. Members have small co-pays. The MinnesotaCare Premium Estimator Table (PDF) will help you estimate your premium amount.
If You Don't Qualify
If you do not qualify for Medical Assistance or MinnesotaCare, but meet one or more of the criteria listed below, we will submit your application to your county agency.
Need help paying for long-term care or nursing home services
Are over age 65
Are a person with a disability
Need help paying for Medicare
https://edocs.dhs.state.mn.us/lfserver/Public/DHS-4139A-ENG
If You Qualify
You will be able to get medical services at little cost to you.
Medical Assistance does not require you to pay a monthly premium. Members have small co-pays for some services, usually $1 - $3. This is called cost sharing.
MinnesotaCare does require you to pay a monthly premium, and it is based on your income. Members have small co-pays. The MinnesotaCare Premium Estimator Table (PDF) will help you estimate your premium amount.
If You Don't Qualify
If you do not qualify for Medical Assistance or MinnesotaCare, but meet one or more of the criteria listed below, we will submit your application to your county agency.
Need help paying for long-term care or nursing home services
Are over age 65
Are a person with a disability
Need help paying for Medicare
10
Like the Swedish influence in the great state of Minnesota!!
1
Insurance company prosperity is what Obamacare was all about. That part was guaranteed. Claiming it was affordable health care was always a fairy tale, at best. That the Republican plan was worse isn't a surprise, but Obamacare made as much sense as the Maginot Line.
10
It is called incrementalism in policy circles and it is painful to watch, because it never allows us to get what citizens need in a timely fashion. I will be dead before we get affordable insurance, if ever.
2
I am confident that the insurance companies will ultimately have a profitable ACA business if the law is not changed. All they need to do is keep pushing through large prices increases to their captive market, who are the buyers who get almost all their costs paid by ACA premium subsidies and cost-sharing. In the past they have had a substantial number of "healthy" buyers generating high revenues/low costs, thereby holding premiums down for the entire single risk pool. This puts the companies at risk because it is hard to estimate how fast the healthy buyers will drop out of the market. The healthy buyers, particularly the unsubsidized ones, are dropping out rapidly. The time will come when they are essentially all gone, and the individual market will consist only of high cost/high subsidy buyers. The role of the insurance companies then will be to efficiently recirculate government money. The non-monetary cost will be millions of people without insurance.
3
"Among the hardest hit are those who do not qualify for subsidies to help with premiums or out-of-pocket costs, which rise along with rate increases. Michael Lawson, an independent consultant for local governments in Washington, D.C., said the monthly premiums for his basic plan from CareFirst jumped to $527 this year from $290 last year."-NYT
These people need the individual mandate the most to get more people enrolled and lower their premium. Instead, some of these people voted for Trump, who wants to use "Skinny Appeal" that is removing individual mandate like a dagger to the heart of Obamacare. These people do not understand free market nor the statistics behind insurance so they voted against their own interest due to ignorance.
These people need the individual mandate the most to get more people enrolled and lower their premium. Instead, some of these people voted for Trump, who wants to use "Skinny Appeal" that is removing individual mandate like a dagger to the heart of Obamacare. These people do not understand free market nor the statistics behind insurance so they voted against their own interest due to ignorance.
12
Really, the mandate doesn't work any more. First, the amount is minuscule versus the alternative of paying the insurance premium. Second, the IRS can only collect it out of any tax refund due. Date shows that the large majority of people "paying" the mandate had refunds due. People who earn enough to be taxpayers are smart enough to dodge the mandate.
The max penalty of around $2900 may have looked sufficient back in 2010 when the average family premium was $5,000 with a modest deductible, expectations were that premiums would drop by $2,500 for that average family, and we could all keep our plans/doctors if we wanted. Fast forward to today: premiums of $15,000, deductibles of $10,000, both going up rapidly, and networks with doctors we never heard or and no access to first-rate facilities. Any surprise that the mandate penalty is a minor irritant that most people choose to ignore?
The max penalty of around $2900 may have looked sufficient back in 2010 when the average family premium was $5,000 with a modest deductible, expectations were that premiums would drop by $2,500 for that average family, and we could all keep our plans/doctors if we wanted. Fast forward to today: premiums of $15,000, deductibles of $10,000, both going up rapidly, and networks with doctors we never heard or and no access to first-rate facilities. Any surprise that the mandate penalty is a minor irritant that most people choose to ignore?
1
Nonetheless the individual mandate is needed to secure enough people in the system so that older, not as healthy patients are NOT assigned to the very expensive high-risk pool insurance.
instead of trying to destroy ACA, congress and the President should be working to fix ACA as a living breathing healthcare system.
In early as 2014, Republicans inserted a provision in budget omnibus legislation that ripped apart the risk corridors program, panicking insurance companies, many of which dropped out causing the remaining ones to raise premiums.
Now it's time to increase the mandate penalty yearly, stop blocking recruitment, stop threatening to pull government subsidies, ask the 17 red states that didn't accept Expanded Medicaid to wake up, and FIX IT.
instead of trying to destroy ACA, congress and the President should be working to fix ACA as a living breathing healthcare system.
In early as 2014, Republicans inserted a provision in budget omnibus legislation that ripped apart the risk corridors program, panicking insurance companies, many of which dropped out causing the remaining ones to raise premiums.
Now it's time to increase the mandate penalty yearly, stop blocking recruitment, stop threatening to pull government subsidies, ask the 17 red states that didn't accept Expanded Medicaid to wake up, and FIX IT.
5
imagine how super successful ACA would have been if not sabotaged.
97
I'm very happy to read that some big health insurance providers are healthy. Regardless of at whose expense, I'm just so glad to read they're recovering. My thoughts and prayers are with them every day, even now as I conclude.
8
Your worries are not worth losing sleep over. There is not an insurance company in the US that is not making HUGE profits. I am not glad they expanded their service area as a crisis would force us to look at Medicare for all.
3
Iver, you sound like my kind of guy! :-)
It is very clear the uncertainty the Trump administration and most of the Republicans continue to create is the only reason the ACA has been threatened.
What this article shows is just how resilient the ACA is and how just some tweaking would have given us a consistent path towards possibly single payer plan as in Canada, that includes private insurers.
The Demarcates worked with President G. Bush for part D for medicare to help pay for seniors spiraling drug costs, to these Republicans now who back undermining the ACA with Trump, to you I say petty, shameful and repugnant.
What this article shows is just how resilient the ACA is and how just some tweaking would have given us a consistent path towards possibly single payer plan as in Canada, that includes private insurers.
The Demarcates worked with President G. Bush for part D for medicare to help pay for seniors spiraling drug costs, to these Republicans now who back undermining the ACA with Trump, to you I say petty, shameful and repugnant.
9
The share values of the top 5 publicly traded insurance companies, Humana, Aetna, Cigna, United Healthcare, and Anthem, are up between 200% and 465% since the ACA went into effect in March, 2010. For reference, the S&P500 is up 110% in that same time frame.
I know that share values are not the only measure of a company's health. But the growth in the health insurance shares is truly astounding, especially considering the sob stories we keep hearing from them about their struggles to provide coverage to the poor and the weak.
It seems they have no problem providing extraordinary returns to their shareholders.
I've had occasion to mention it a few times, on other articles about the health insurance industry. But Times journalists seem disinclined to take it up.
I know that share values are not the only measure of a company's health. But the growth in the health insurance shares is truly astounding, especially considering the sob stories we keep hearing from them about their struggles to provide coverage to the poor and the weak.
It seems they have no problem providing extraordinary returns to their shareholders.
I've had occasion to mention it a few times, on other articles about the health insurance industry. But Times journalists seem disinclined to take it up.
83
Trump don't care.
31
Nail on head.
9
The ACA needs to fixed or we will wind up returning to the days when too many Americans are underinsured or uninsured. Other countries manage to provide medical and dental care for all their citizens. American politicians claim that our health care is the best in the world. They also tell us that Americans are ingenious. The only ingenuity being displayed is in depriving Americans of access to decent health care when and where they need it regardless of their income or employment status. Living in a country with the best health care in the world is useless if we can't afford it.
Therefore our politicians assignment is twofold: make healthcare affordable for all of us without the red tape and narrow networks and make it so that it's a system that works for all of us rather than just some of us. There is no reason that our health and well being should be subject to the one size fits all attitude of health insurance companies or that we should have to buy a plan, pay a premium and be subjected to deductibles, copays, and other obstructions. If our politicians had the courage to look outside their own narrow interests they could learn from other countries that have universal health care. Unfortunately that sort of courage is in short supply in DC.
Therefore our politicians assignment is twofold: make healthcare affordable for all of us without the red tape and narrow networks and make it so that it's a system that works for all of us rather than just some of us. There is no reason that our health and well being should be subject to the one size fits all attitude of health insurance companies or that we should have to buy a plan, pay a premium and be subjected to deductibles, copays, and other obstructions. If our politicians had the courage to look outside their own narrow interests they could learn from other countries that have universal health care. Unfortunately that sort of courage is in short supply in DC.
21
No one, absolutely no one should be surprised that the insurance companies continue to prosper. I want them to, so they can continue to pay claims DUE!!!!
2
Needed most for all citizens of this country is approval of Congressman John Conyers’s bill H.R. 676, the Expanded & Improved Medicare for All Act. This legislation would upgrade Medicare coverage, eliminating copayments and deductibles, and fix its other flaws. Almost no one would face increased copayments or deductibles under H.R. 676 (or Bernie Sanders’s forthcoming legislation, or the many state bills), although wealthy Americans’ taxes would rise. And few people would complain about being freed from insurers’ narrow provider networks , and under single payer insurance patients could, as in Canada, choose any hospital or physician.
The real enemies of single payer health insurance, Medicare for All, are the very profiteering insurance and pharmaceutical firms described in this article. That powerful opposition is the real problem all citizens of the U.S.A. have to overcome if they are to ever have quality, affordable health insurance.
The real enemies of single payer health insurance, Medicare for All, are the very profiteering insurance and pharmaceutical firms described in this article. That powerful opposition is the real problem all citizens of the U.S.A. have to overcome if they are to ever have quality, affordable health insurance.
128
They say that they are losing money or are they just losing mega bucks in profit?
https://www.consumeraffairs.com/news/health-insurance-industry-rakes-in-...
https://www.consumeraffairs.com/news/health-insurance-industry-rakes-in-...
Without sabotage from Trump, this sounds promising. It is not surprising that the insurance market needed adjustment time and data on those who have signed up for the ACA.
As for some of the large insurance companies that have left, there are political dynamics beyond market ones: the Mercer family (among Trump's and Breitbart's main donors) have large holdings of Humana and Aetna in their portfolio for Renaissance Technologies., including 2.7 million shares of Humana and 3.1 million shares of Aetna. As with the Kochs and their pollution interests, the Mercers are happy to try to destroy the ACA.
By the last quarter of 2016, there was the lowest number of uninsured Americans in history, one major measure of success. 20 million more Americans have health care now, while before the ACA, 49 million Americans did not. The federal deficit was lowered. Insurance was higher quality, covering a better mix of medical needs. Those with preexisting conditions are covered, and lifetime caps that were devastating for those with longterm illnesses such as children with cancer or other diseases. Premiums were increasing before the ACA, an inconvenient fact that many right wing people want to ignore.
Senator McCain once again was an American hero to save the ACA and healthcare for Americans. It should never be forgotten that Republicans and Trump tried to completely destroy it, ripping away coverage for every single American of the tens of millions who have the ACA or Medicaid.
As for some of the large insurance companies that have left, there are political dynamics beyond market ones: the Mercer family (among Trump's and Breitbart's main donors) have large holdings of Humana and Aetna in their portfolio for Renaissance Technologies., including 2.7 million shares of Humana and 3.1 million shares of Aetna. As with the Kochs and their pollution interests, the Mercers are happy to try to destroy the ACA.
By the last quarter of 2016, there was the lowest number of uninsured Americans in history, one major measure of success. 20 million more Americans have health care now, while before the ACA, 49 million Americans did not. The federal deficit was lowered. Insurance was higher quality, covering a better mix of medical needs. Those with preexisting conditions are covered, and lifetime caps that were devastating for those with longterm illnesses such as children with cancer or other diseases. Premiums were increasing before the ACA, an inconvenient fact that many right wing people want to ignore.
Senator McCain once again was an American hero to save the ACA and healthcare for Americans. It should never be forgotten that Republicans and Trump tried to completely destroy it, ripping away coverage for every single American of the tens of millions who have the ACA or Medicaid.
115
How do those with greedy shareholders be punished, seems they prefer the short term rather longterm?
The only verifiable fact seems to be is that Affordable Care Act is costing hundreds of billions of dollars more than what Obama said it would cost. Insurers are either dropping out or demanding huge premium increases.
Trump is simply looking at the actual costs and ways to reduce them. Trump should publish the amount of taxes each person would be required to pay in order to fully fund Obamacare.
Perhaps those numbers will inspire politicians and individuals from all political parties to come up with a truly realistic affordable healthcare policy.
Trump is simply looking at the actual costs and ways to reduce them. Trump should publish the amount of taxes each person would be required to pay in order to fully fund Obamacare.
Perhaps those numbers will inspire politicians and individuals from all political parties to come up with a truly realistic affordable healthcare policy.
7
Maybe those numbers will "inspire politicians and individuals from all political parties" to cut out insurance companies and go for single payer!
42
Medicare is the most efficiently run health care program. Medicare for all would save billions. Republicans hate medicare because it shows that government solutions are possible.
231
The only cost Trump is interested in reducing is the cost of his own tax burden.
Look, there's no doubt that healthcare is very expensive. But here are the options: we can either (a) accept the expense of insuring everyone up front, or (b) save money up front by forcing more people to go without health insurance, which will ultimately result in many of those folks delaying seeking medical care until their illnesses and ailments are much more serious and much more expensive to treat, and the costs of any medical care they cannot afford to pay for being passed on to the rest of us in the form of still higher healthcare costs.
Look, there's no doubt that healthcare is very expensive. But here are the options: we can either (a) accept the expense of insuring everyone up front, or (b) save money up front by forcing more people to go without health insurance, which will ultimately result in many of those folks delaying seeking medical care until their illnesses and ailments are much more serious and much more expensive to treat, and the costs of any medical care they cannot afford to pay for being passed on to the rest of us in the form of still higher healthcare costs.
16
There has to be a weaning process as was set up with ACA with re-insurance and slowly backing off the government reimbursements to smaller levels and not to do big drastic stop at one time.
Most folks don't understand the big insurance Cartel, United Healthcare, aka Optum as that division is not insurance, it's algorithms, management, billing, etc. and it helps United make money, as Aetna, Humana, Health-Net, etc. are all clients of Optum, learn that if nothing else folks.