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Politics Obamacare

Discussion in 'Tilted Philosophy, Politics, and Economics' started by pan6467, Mar 28, 2012.

  1. Aceventura

    Aceventura Slightly Tilted

    Location:
    North Carolina
    The A in ACA stands for "affordable"? People who have signed up and may not have had insurance before and who are poor are starting to find out that something like a $6,500 deductible still forces them in some cases to go without healthcare or get healthcare given a potential debt they cannot afford - along with the premium. Are they better off? Each person has to do their own math. Republicans have had a focus on actually reducing healthcare costs - making actual healthcare affordable. Low subsidized health insurance premiums is not the end goal - unless you own an insurance company.

    In-spite of what many think, I am more pragmatic than an ideolog. If you can't beat'm profit from them.

    Connecting the dots if the points are missed - people sign up for coverage, premiums are paid (some subsidized by government) perhaps some high deductible plans don't get used, profit margins on a larger premium base, if the system fails - government bailout, guaranteed profits, less risk, etc.....​
     
    Last edited: Apr 21, 2014
  2. fflowley

    fflowley Don't just do something, stand there!


    Are you actually serious, or is this just a joke?
    Republicans recently had the chance to slash payments to Medicare Advantage plans. What do you think they decided to do?
    While you are at it do some reading on how the government found a way to pay MORE for Medicare than they needed to by throwing money at insurance companies in Medicare Advantage plans.

    You may not like the Democrats and that's fine. But stop pretending that the Republicans are the party of your dreams.
     
  3. ralphie250

    ralphie250 Fully Erect Donor

    Location:
    At work..
    ok, so how do we put the a back in aca?
     
  4. redravin

    redravin Cynical Optimist Donor

    Location:
    North

    The more people who sign up (healthy people sadly) the cheaper it's going to be.
    The more Republican governors who pull their head out of their asses and sign up for the Medicaid will help.
    They have also done their best to fight helping people sign up including making it illegal for the local guides to help people sign up.
    The insurance companies haven't been helping by trying to lock people into more expensive plans before the ACA went into effect.
    That was a lot of the "my plan went up 200%" stuff,
    The insurance company had them on crap plans so just before they had to get rid of the plan they sent out notices that the plan was going away and the new plan was going to be this much more.
    If the people had gone on the website instead of taking the companies word for it they would have found much cheaper plans.
     
    • Like Like x 1
  5. ralphie250

    ralphie250 Fully Erect Donor

    Location:
    At work..
    ok, so
    1, is it safe to blame some of it on the insurance companies?
    2, people are ignorant??

    how will the medicaid part help??
    remember im ignorant with this
     
  6. redravin

    redravin Cynical Optimist Donor

    Location:
    North
    People in general aren't ignorant.
    Some choose to be, some have been misled, some are just frustrated, and in general there are a lot of people who want to make this more complicated than it needs to be.
    The Medicaid piece would cover so many people who are low income and are currently using emergency care when they get too sick.
    That drives up the cost of care, this the cost of insurance.

    Yes, it is very safe to blame some of this on the insurance companies.
    They wanted to lock in as many people as they could before the law took effect.
     
  7. ralphie250

    ralphie250 Fully Erect Donor

    Location:
    At work..
    ok, why dont they install the medicaid piece???
     
  8. redux

    redux Very Tilted Donor

    Location:
    Foggy Bottom
    The expanded Medicaid provisions in the ACA was the only provision struck down by the Supreme Court. Medicaid is essentially a state run program (with both federal and state funding) and the Court said the federal government could not force states into expanding, even if the feds pay the full cost.

    The expansion raised Medicaid eligibility to from 100% of poverty level to 138% of poverty level, allowing millions to become eligible and more than 6 million people across the country now have coverage.....but not in red (Republican) states, with a few exceptions.

    The federal government pays for the expansion for the first three years, then pays 90% and the state pays the rest. The irony is that you, as a Georgia taxpayer, are paying for the expansion in other states, but not in Georgia.

    New State-by-State Analysis: States Rejecting Medicaid Expansion Under the Affordable Care Act Are Costing Their Taxpayers Billions - The Commonwealth Fund

    --- merged: Apr 22, 2014 at 6:45 PM ---
    Georgia was also a state that intentionally made it harder for people to learn about the ACA and enroll by imposing regulations on the workers who were there to help residents find the right plan and enroll.....while the governor and insurance commissioner gleefully were taking contributions from insurance companies.

     
    Last edited by a moderator: Apr 29, 2014
    • Like Like x 2
  9. ralphie250

    ralphie250 Fully Erect Donor

    Location:
    At work..


    ok, i always assumed and we know what that means, that the republicans were 100% agnist it and the democrats were 100% for it, now i see that is not a fact.

    but why would you nathan deal, ralph hudgens, not allow people in ga to be part of the aca? cause they are red??
     
    Last edited by a moderator: Apr 30, 2014
  10. redravin

    redravin Cynical Optimist Donor

    Location:
    North


    Their excuse is that in the future the feds might stop paying for the medicaid and the state would have to foot the bill.
    Which is bullshit.
    The state could drop out or reduce the amount of people covered (like so many did with the kids who were covered recently).

    It's basically that they hate Obama and anything he supports.
     
  11. Aceventura

    Aceventura Slightly Tilted

    Location:
    North Carolina
    In economics there is a difference between price and cost. I tend to focus on costs. Many Republican healthcare initiatives that I support also focus on costs. Payments to Medicare Advantage has nothing to do with healthcare costs. There may be reasons to support cuts for various reasons, but those reasons are not related to actual costs. I don't want to repeat what I have shared regarding the poor outcomes for Medicaid - but putting more people into a broken system is not good.
    --- merged: Apr 23, 2014 at 1:56 PM ---
    It will be cheaper for some and more expensive for others. The net, in terms of cost, zeros out. to reduce costs we have to do something in the system that enhances efficiency, innovation, or productivity. Competition along with free choice is the best general approach in my view.

    The Federal government is doing a "loss leader" to sell Medicaid expansion. This is a deceptive practice in my opinion. Like a drug dealer giving the first high for free...get them hooked...bleed them dry.

    In every state I have lived in - a licensee and extensive education was required to sell people health insurance before the ACA - now these local guides are basically selling health insurance and most have no clue. I have personal experience. I had to work with a few of these people to get my coverage secured for 2014. This is another example of the short-sightedness of the ACA.

    No surprise here. Again, personal experience. I got a letter (after getting a letter saying my old policy would not be available) saying that I should renew my old policy and avoid the ACA. After research, doing that would have cost me about $150/month in premiums. I wonder how many people made the choice without doing their homework?

    True.

    It is a complicated process. Insurance companies have their agenda, the ACA website was a mess (hard to get real costs to compare), and the guides were not helpful and in some cases were misleading (I am not saying on purpose). And after all of it - actual out of pocket costs will depend on a number of factors - it is like a gamble regarding what the right choice should have been.

    In terms of price. Actual out of pocket costs is another matter. For example a young healthy person who had no policy and has no medical costs will pay more simply based on premiums. sure they have the benefit of insurance, but if they picked a $6,500 deductible they would have to have expenses greater than premiums and expenses before they can start to break-even.
    --- merged: Apr 23, 2014 at 2:03 PM ---
    States and the Federal government share the costs. Under the ACA in the early years the Federal government is picking up a greater share of the expansion - over time the shares will be normalized. So, if a state had no money for expansion in 2014, where is the money going to come from in 2024? What will they sacrifice? Education, roads, welfare programs, police, fire, other state government services? What? Some states are better situated than others, a one size fits all approach does not work for all. If we want consistency across all states, make it a pure Federally supported program.
     
    Last edited by a moderator: Apr 30, 2014
  12. redux

    redux Very Tilted Donor

    Location:
    Foggy Bottom
    What Republican initiatives? Those scored by the CBO put them as resulting in a greater deficit and fewer people covered. In particular, the Republican plans that I have seen for a high risk pool for those with pre-existing condition would be far more costly to the treasury than the ACA.


    Studies have shown that only about 1/5 to 1/4 of of the added reimbursement for MA plans goes to patient care; the bulk goes to insurance company profits and advertising. This is a reason to support cuts.... unless you believe taxpayers should support those can afford MA over those who cannot and must rely on Medicare alone. MA was a Bush experiment that, for the most part, failed.

    There is far more competition with the Insurance Exchanges than prior to the ACA, with dozens of plans at three different levels offered by both large and small insurance companies.If by more choice, you are suggesting selling across state lines again, we've been down that road and the result is not pretty.


    Expanding Medicaid to cover more working poor is hardly deceptive. Privatizing it would "bleed" these workers dry unless you have a magic bullet that no Republican has offered.


    Insurance agents are in the business to make money. The ACA "navigators" are in the business to educate consumers.


    The issue of cancelling existing policies was way overblown. Such policies were cancelled routinely if one exceeded the insurers' expectations of claims. One study put the number of individual plans cancelled as a result of the ACA at less that 20% ; at least half of those individuals would have income levels that would qualify them for subsidies....better coverage/equal or lower costs./


    On the one hand, it is an issue of risk v benefits. On the other hand, it is increasing the size of the pool and spreading the exposure. ...unless you think thohse with pre-existing conditions should be segregated into a separate high-risk pool (that would cost taxpayers much more). Or if you believe in age-rating, as is the case with Republican plans.


    The federal government pas 100% of in the increased cost for the first three years, then 90% in the out-years. Where is the money to come from....how about a small increase in state income tax for the top bracket to start rather than cutting education, roads, police/fire...
     
  13. Baraka_Guru

    Baraka_Guru Möderätor Staff Member

    Location:
    Toronto
    That would be a sensible thing to do, but for some reason the most controversial as well.

    An interesting point was made in this article regarding the recent discovery that middle-class Canadians are now wealthier than their American counterparts.:
    The U.S. Middle Class Cedes Gold to Canada - Businessweek

    I keep hearing that the U.S. doesn't have the political will for universal health care (single payer). Fine, but something has got to be done about keeping health care affordable. I understand the costs (or prices, whatever) are unnecessarily high in the U.S. Fix that. But the fact remains that health care needs to remain affordable to those who need it. If this means a tax increase on the "morbidly wealthy," then so be it. The idea that they should cut education and infrastructure before considering tax increases in a relatively low tax environment is ridiculous.

    I think the minimum wage issue is relevant too, by the by, as I'm assuming that despite ACA there are a lot of out-of-pocket expenses that Americans pay despite insurance coverage.

    As for consistency of health care funding, that's part of the reason why Canada's system is both provincially and federally funded. Not all provinces have the same economy to support a minimum quality of health care services.
     
    • Like Like x 1
  14. Aceventura

    Aceventura Slightly Tilted

    Location:
    North Carolina
    Most important to me would be having the ability to buy a policy across state lines. No impact on deficit.


    Something is not adding up - I would need the see the studies - we need to make sure we are discussing the same issue. I agree there are legitimate reasons to support reimbursement cuts for MA plans - my point was related to healthcare costs. If your point is that MA plan costs can be better allocated, I agree that would be an efficiency and a true cost reduction measure - I am not sure I agree with the premise that MA plan costs can be better allocated through the ACA.


    In my situation I can not say that I have more choice with the ACA. I have not measured the choice options, but it feels like my choices are fewer. However, if I could buy any plan offered in any state - that certainly would increase my options and increase competition. This could be a simple consumer freindly change to the ACA - the insurance companies would not support this kind of choice.



    I think you purposefully took my point out of context. Expanding Medicaid and the convoluted system of state v federal contribution is another matter.

    Privatizing what? Medicaid is a social welfare program, I do not understand your point. Also, I have stated many times that I could support a single payer system for healthcare for all.


    I am not going to be sarcastic, although I was tempted. ACA "navigators" as a group do the best they can - so do insurance agents. Regardless of their efforts they all should be well trained and screened.


    No dispute from me on the above. Insurance is or was a for profit business. If a risk has costs that exceed expected costs (in any form of insurance) the risk may face cancellation. There are ways to address this issue from a societal point of view but it is unreasonable to expect a company in the insurance business to act in a manner inconsistent with being in business to make a profit.



    I think higher risk people should pay higher premiums. For example, I have a 17 year old son, males pay more for auto insurance than females - 17 year old people pay more than 50 year old people, etc. I am o.k. with this. Again, as a society we can address bigger issues with pre-exsisting conditions and insurability in many ways. In many state in auto insurance, with people who are considered sub-standard risks and otherwise could not get affordable auto insurance there are assigned risk pools - in some cases these risks are apportioned to insurance companies based on market share - this system works in this auto insurance and could work in health insurance - along with many other potential ideas, better than the ACA.



    True. I do not support tax increases at this time. At least we agree that it is an increased cost to the states.
    --- merged: Apr 23, 2014 at 6:42 PM ---
    The tax code in the US is overly complex, making it simple for some to pay low tax rates regardless of the actual tax bracket consistent with their lifestyle. Raising nominal tax rates will mostly result in more tax avoidance measures. We need total tax reform and simplification. If we can achieve a real tax increase on the "morbidly wealthy" we should do it - I prefer to tax people based on their consumption and lifestyle, rather than their work and savings.
     
    Last edited by a moderator: Apr 30, 2014
  15. Baraka_Guru

    Baraka_Guru Möderätor Staff Member

    Location:
    Toronto
    A system based mostly on consumption taxes would simply increase the wealth disparity in the U.S. I don't think shifting the tax burden towards the less well off is a good plan. Maybe that's just me.

    Do you mean introducing a new federal VAT tax as a tax increase like Canada did with the GST?
     
  16. ASU2003

    ASU2003 Very Tilted

    Location:
    Where ever I roam
    Buying policies across state lines won't work, unless doctors in rich areas of New York and California are willing to accept Wyoming and Iowa prices and salaries. Why would someone living it up in a nice beach-side resort city pay the cost. Now, why the population density is driving up home prices and other costs of living is one thing, but the same reason applies to why healthcare costs more in high end suburbs than midwest cities.
    Now, I will fault Obama and the administration for not using the web and for not producing their own video explaining how the ACA was supposed to work and how it would be implemented. Yes, it had to be 3,000 pages to close a bunch of loopholes, but your supporters and the general public needed to know the facts and the vision for how this was supposed to work and all the benefits. And you can't trust the media to do this job since they want to either give equal time or to create controversy.
    To bring costs down, I think they should be promoting healthy living and preventing the spread of diseases that adds up. It wouldn't be all of the costs, but it's a good start. Then you go after the unnecessary tests, trying to cure patients instead of drug them every day, and go after the ease of getting health damaging food and substances. You throw it right back and blame the people who complain about the high cost of healthcare that their American diet and lifestyle that they choose are the causes.
     
  17. Baraka_Guru

    Baraka_Guru Möderätor Staff Member

    Location:
    Toronto
  18. ralphie250

    ralphie250 Fully Erect Donor

    Location:
    At work..
    OK, Regarding medicaid, shouldnt ole people and kids be the people deserving of it, i mean they are our past and our future
     
  19. Baraka_Guru

    Baraka_Guru Möderätor Staff Member

    Location:
    Toronto
    Well, Medicaid is for poor people who don't otherwise have much means to pay for health care. As it happens, poverty has historically affected children and the elderly disproportionately. In recent years, much fewer elderly people live in poverty, in large part due to an improvement of social security. Child poverty has fluctuated, but it hasn't fared that well since the financial crisis.

    Either way, families that are poor enough deserve something like Medicaid, despite their age.
     
  20. ralphie250

    ralphie250 Fully Erect Donor

    Location:
    At work..
    this is true, but why is it that my dad retired from a government job, carried his health insurance til he turned 65 then they stoped paying for things and said he needed to be on medicaid??