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The Great ObamaCare Debate, Part 237: Back to Court The Great ObamaCare Debate, Part 237: Back to Court

05-07-2014 , 03:00 PM
Taking a break from negs' bold stance that health insurance is bad for people and so they shouldn't want it, lol the GOP's big health care hearing today did not go well:
http://thehill.com/policy/healthcare...o-care-punches

Quote:
But Republicans were visibly exasperated as insurers failed to confirm certain assumptions about ObamaCare, such as the committee's allegation that one-third of federal exchange enrollees have not paid their first premium.

Four out of five companies represented said more than 80 percent of their new customers had paid. The fifth, Cigna, did not offer an estimate.
Step 1: Structure a survey on payment of premiums to produce misleading results
Step 2: Release that survey's results for political gain
Step 3: For some reason, forget that you did Step 1 and actually believe the survey
Step 4: Schedule a victory lap hearing about low rates of payment
Step 5: ????
05-07-2014 , 03:20 PM
There is a rather good and obvious reason why payment rates are so high:

The federal government is footing most of the bill.
05-07-2014 , 06:55 PM
Quote:
Originally Posted by grizy
There is a rather good and obvious reason why payment rates are so high:

The federal government is footing most of the bill.
Do you have data on that? I think that you're right, but I am having a hard time finding anything up to date. This article from Kaiser is interesting though. It only goes through the end of February.
Quote:
As expected, the vast majority of enrollees (83%) have qualified for premium subsidies, since people who are not eligible for premium subsidies can buy comparable coverage with similar consumer protections outside of the marketplaces. We estimate that about 21% of those eligible for premium subsidies have applied for assistance, with significant variation across states.
http://kff.org/health-reform/issue-b...able-care-act/
05-07-2014 , 06:57 PM
#GOPTEARS
05-07-2014 , 06:58 PM
You mean just payment data?

Honestly, nothing that's not already publicly published. But if a lot of people aren't paying, i am sure I would have heard about it by now.
05-07-2014 , 07:13 PM
Quote:
Originally Posted by grizy
You mean just payment data?

Honestly, nothing that's not already publicly published. But if a lot of people aren't paying, i am sure I would have heard about it by now.
I was just curious if you had seen data on how many people in the exchanges are receiving a subsidy and what % of overall premium is being subsidized by the federal government.
05-07-2014 , 08:00 PM
So I think I've mentioned that I've been volunteering at the local clinic for the working uninsured. I usually don't press signing up via exchanges, these people are there for healthcare, not to be persuaded for anything.

Today this lady who makes ~25,000 brought up how she wanted to sign up and how she qualified for subsidies, but was worried about the extremely high deductible. What would you say in that situation?
05-07-2014 , 08:04 PM
Well the thing I discovered signing up for a Kaiser high deductible plan is that office visits were $35 I think - almost the same price that I was paying in copay when I had lower deductible insurance. That might be what she's paying now but she'd be able to go to a real doctors office and not sit around waiting all day at a clinic.

Also the prices on everything else are the negotiated insurance rates, not the ridiculous sticker rates. At least with Kaiser.
05-07-2014 , 08:04 PM
Try to compare it to what, if anything, she's paying now? How much HC does she need in a year? Is she not getting care she otherwise would?
05-07-2014 , 08:05 PM
Quote:
Originally Posted by NHA
So I think I've mentioned that I've been volunteering at the local clinic for the working uninsured. I usually don't press signing up via exchanges, these people are there for healthcare, not to be persuaded for anything.

Today this lady who makes ~25,000 brought up how she wanted to sign up and how she qualified for subsidies, but was worried about the extremely high deductible. What would you say in that situation?
The high deductible is better than absolutely no coverage, and many things are covered before the deductible.
05-07-2014 , 08:10 PM
lol doctors, lol wsj for printing this fecal matter

http://online.wsj.com/news/articles/...?mg=reno64-wsj

Quote:
Bravo to Dr. Daniel F. Craviotto Jr. for "A Doctor's Declaration of Independence" (op-ed, April 29). Like him I have witnessed the gradual erosion of the practice of medicine over my last 40 years as a physician. We are the only profession where our workload consistently goes up while our incomes go down predictably every year, slashed whimsically by the government and insurers for the simple reason that they can.

We physicians have no voice and cannot unionize like others to protect our incomes, and we cannot bill by the minute like lawyers with no oversight or checks and balances. Countless hours of phone calls, chart reviews, curbside consults to help another doctor and reviewing films are not reimbursed; they are done as good will. And to add insult to injury we spend 10 to 15 years learning our trade, get held to impossible standards of perfection, are vulnerable to being sued daily by a corrupt and unregulated legal system, then forced to conform to an electronic billing system that adds hours to our day. If patients knew how we get paid, they would rally to defend their doctors and not vote for corrupt politicians who brainwash the public into thinking we are overpaid, and thus deserving of cuts.

We did surveys many years ago asking patients how much their doctor was paid for a coronary angioplasty and, no surprise to us, they had no clue and were uncomfortable even thinking about it. The average guess was $10,000 per procedure, when the real number was $900 then (now $600). Even today a heart surgeon is paid only $900 for open-heart bypass surgery no matter how many hours he spends in the operating room, how long it takes to see the patient before the procedure or the five to seven days afterward required to take care of them.

The public needs to get educated and involved in its health care, as we are all in it together. Doctors are fleeing their practices in record numbers and there will be fewer of them to take care of a growing number of patients. You can do the math and realize the quality of care and access will go down as doctors spend more time filling out forms than seeing patients.

Richard A Schatz, M.D.

San Diego
Renodoc, did you move to California?
05-07-2014 , 08:11 PM
Quote:
Originally Posted by NHA
So I think I've mentioned that I've been volunteering at the local clinic for the working uninsured. I usually don't press signing up via exchanges, these people are there for healthcare, not to be persuaded for anything.

Today this lady who makes ~25,000 brought up how she wanted to sign up and how she qualified for subsidies, but was worried about the extremely high deductible. What would you say in that situation?
I empathize with her situation and that health care costs too much. That being said, health insurance protects you from bankruptcy so it is important to have. I'm not sure what else you can say beyond that.
05-07-2014 , 08:13 PM
Quote:
Originally Posted by rawkfanseth
I empathize with her situation and that health care costs too much. That being said, health insurance protects you from bankruptcy so it is important to have. I'm not sure what else you can say beyond that.
This is a really poor way to go about things and demonstrates a fundamental misunderstanding of the woman's situation. People making 25k generally don't have some big set of savings they need to protect from bankruptcy.
05-07-2014 , 08:15 PM
If you make $25,000, avoiding bankruptcy isn't especially valuable. It is a legitimate point. Maybe sell her on the ability to reliably get in to see a doctor as opposed to having to go to the emergency room in the event something goes wrong?
05-07-2014 , 08:18 PM
Quote:
Originally Posted by ikestoys
This is a really poor way to go about things and demonstrates a fundamental misunderstanding of the woman's situation. People making 25k generally don't have some big set of savings they need to protect from bankruptcy.
True. You did a better job of explaining it than I did. I just went off the top of my head and that's what came out.
Quote:
If you make $25,000, avoiding bankruptcy isn't especially valuable. It is a legitimate point. Maybe sell her on the ability to reliably get in to see a doctor as opposed to having to go to the emergency room in the event something goes wrong?
Also true.

This is why I'm not in sales.
05-07-2014 , 08:25 PM
I mean, she still should want to avoid bankruptcy
05-07-2014 , 08:32 PM
Not for a 3k+ deductible, assuming no savings
05-07-2014 , 09:36 PM
Open enrollment ended like 5 weeks ago.
05-07-2014 , 09:40 PM
Quote:
corrupt and unregulated legal system
What.

Quote:
Doctors are fleeing their practices in record numbers and there will be fewer of them to take care of a growing number of patients.
http://theincidentaleconomist.com/wo...t-of-medicare/


Mother****ers as stupid as that guy should not be allowed to touch sharp objects.
05-07-2014 , 10:45 PM
Quote:
Originally Posted by rjoefish
Try to compare it to what, if anything, she's paying now? How much HC does she need in a year? Is she not getting care she otherwise would?
Not paying anything now except the penalty for not having insurance. She seemed pretty fine, other than some semi-serious hypertension.

Certainly better than the dude who had a 14.0 (!!!) on his A1C test.
05-07-2014 , 10:47 PM
Fly... no ****.

Ikes, forgot about the many things covered before the deductible, will def mention next time I see her.
05-08-2014 , 01:11 AM
Quote:
Originally Posted by neg3sd
That should be reason enough to reject it.

Police, fire, utilities are provided at the local level. Would you want the federal govt running those departments?
"First in war, first in peace, last in the American league." Micromanaging from the top doesn't work very well. Each community has different needs.

Medicare is expected to go broke by 2026. Seniors love medicare because seniors pay 20% and you guys pay the other 80%.

Already stated the SF plan would not be appropriate for poorer rural communities. They need a cheaper nurse practitioner model.
How well is medicaid working? Can they find doctors? Do many just go to the ER?
You mean like the FBI and secret service?

By the way stop quoting that bit about Medicare going bankrupt in 2026. It makes you seem like you literally just woke up from a thirty year nap. If you need me to explain to you, again, why parroting that particular line makes you come across exponentially worse, just let me know. That is without even getting into the ridiculousness of your 20%/80% nonsense.

Did you ever reveal where you get your information from? It seems unlikely you figure it out for yourself so you must be copying it from somewhere else. The problem is two-fold. You are copying from people who aren't that knowledgable and you also seem to be changing stuff around from how it was fed to you to make it even worse.

Do you want to take a legitimate stab as to why your allegation that Medicare will go bankrupt in 2026 is irrelevant? Just guess. It is a fairly important part of logic and debate to be able to look at the other side and at least glean something from it. This particular one is a slow pitch softball, so it should be easy for you to at least formulate an argument as to why that is not relevant.
05-08-2014 , 01:24 AM
Quote:
Originally Posted by ikestoys
grizy,

I'll put this nicely, but I'll take the word of just about every expert over you.
You don't know any other experts.

I am not sure you know any doctors either, which is crazy for someone claiming to be in med school.
05-08-2014 , 01:39 AM
Quote:
Originally Posted by ikestoys
Not doing it based on age is a massive subsidy to older people though. Unless, you're going to massively overcharge people who may more (more than cost I mean).
The perfectly healthy 50 year old who is subsidizing the 10 year old with leukemia might disagree.

Human beings, as a group, are massively predictable to a very precise level. So why would you avoid the reality of the average cost to treat older people as being more if the goal is to provide quality healthcare to everyone? Do these young people not expect to age?

If you really believe in a goal of providing a high level of healthcare to everyone while making it as affordable as possible to everyone involved than age bias is an absolute must.

You somehow think if young people were forced to deposit 15% of their gross income into a future health fund (which they could not access until they were 60 and only for healthcare) that you would some how have a better system.

Everyone knows older people are going to, on average, have higher health costs. We also know most people will one day be old. So it makes absolutely no sense in modifying pricing by age if your goal is to provide the highest possible healthcare, at the most affordable price. You are discussing this like you third grade teacher just wrote "Health care" on the board and you are hearing about it and talking about it for the first time.

Do you know how dumb a 20 something who says "Damn obamacare, I pay fifty dollars more a month now so I will pay five dollars a month less later. Screw them!"

It is a complete economic, financial and logical meltdown for someone to approach the issue that way.
05-08-2014 , 01:41 AM
Oh cute marksman, more nonsensical posts from you. See the rest of the conversation if you want to know why you're wrong

      
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