The Goat Pen

On my way home from work I always listen to npr. Last night they attempted to run a puff piece in support of Obamacare about how it will save money for these unhealthy middle aged people. The argument is that now this "struggling" unhealthy middle aged couple can retire early because their premiums were lowered with Obamacare. I am sure the young and healthy are excited that they will be paying more so that Mr. and Mrs. Petersen can enjoy the good life...

http://www.npr.org/blogs/health/2013/11 ... -obamacare

I still don't understand how the subsidies are going to be paid for while still delivering quality health care. Are the insurance companies giving a huge kickback to the government for all the revenue coming from mandatory sign ups and increased cost of premiums?

As always, subsidies, tax breaks, and "discounts" for one consumer will be paid by another consumer.

I do expect them to adopt the Medicaid model, though: painfully low reimbursements and something they like to call "value-based purchasing" which is a relatively new program where they withhold a portion of the reimbursements you earned and only give you your money if you meet certain quality initiatives.

It would be like me buying a $500 TV at BestBuy and only paying them $400 up front, holding the rest of the money for a few months and only giving them the balance if I thought the TV was a quality purchase.

It's one of the reasons certain health care professionals are refusing MedicAid.

yea thats why I put in the caveat "while still delivering quality healthcare" -but the reality is we can't pay for the obligations we have now - and especially not in the future. We have 86 trillion with a "t" in obligations coming at us in the next 30 years to the tune of 1.1 million per taxpayer in deficit.

"It's one of the reasons certain health care professionals are refusing MedicAid."

that option is going to go away when obamacare becomes the only game in town in about 10-15 years

I keep hearing single payer is the ultimate goal--I just wonder what the big insurance companies seem to be sitting on the sideline with this okaying it. single payer puts them out of buisiness doesnt it?

you know I'd do the same thing this dude did but sonuvaabitch life is a cruel mf sometimes

http://news.yahoo.com/injured-indiana-h ... 36165.html

Single payer will not put the insurance companies outta business - it will just change their business. The government does not have the infrastructure or personnel to run Obamacare. They will do what they do with medicare and medicaid: have private insurance companies (like bcbs) administer their plans for them.

" painfully low reimbursements"

I guess this means BOJ's hourly wage is going to go back into the single digits. Poor doctors, they just can't get a break...

AlabamAlum wrote:Single payer will not put the insurance companies outta business - it will just change their business. The government does not have the infrastructure or personnel to run Obamacare. They will do what they do with medicare and medicaid: have private insurance companies (like bcbs) administer their plans for them.

I don't know about now but in the 90's they would have put it up for a government contract to someone like an EDS or Accenture. They would have run oversight on it to process claims and payouts. I worked for EDS processing the medicaid accounts in Kentucky back in the late 80's. Once I learned the system, I started asking questions like "what prevents a pharmacy from just filling out a claim request on an existing patient to get paid?". Their response was to move me to another group. It was no different when I worked on the Tennessee account working for TVCC.

When you subcontract this out with the government paying the bills, the desire to actually verify (which insurance companies have in spades right now) is replaced with the desire to smoothly and quickly process claims, which what you get paid for. We see this now in Medicare and Medicaid with the billions in fraud and the P.O. Box service providers who bounce around from location to location.

You'll see this happen in the VA (not that it hasn't happened in the past) now that they are under great scrutiny to speed up processing of VA claims.

One of the fundamental flaws of the Affordable Care Act is that, despite its name, it makes health insurance more expensive. Today, the Manhattan Institute released the most comprehensive analysis yet conducted of premiums under Obamacare for people who shop for coverage on their own. Here’s what we learned. In the average state, Obamacare will increase underlying premiums by 41 percent. As we have long expected, the steepest hikes will be imposed on the healthy, the young, and the male. And Obamacare’s taxpayer-funded subsidies will primarily benefit those nearing retirement—people who, unlike the young, have had their whole lives to save for their health-care needs.



41 states, plus D.C., will experience premium hikes

If you’ve been following this space, you know that I and two of my Manhattan Institute colleagues—Yevgeniy Feyman and Paul Howard—have developed an interactive map where you can see how Obamacare affects premiums in your state. (If you ever need to find it, simply Google “Obamacare cost map.”)

In September, we released the first iteration of the map, which included data from 13 states and the District of Columbia. We only had data from a few mostly-blue states because the remainder were mostly participating in the federal exchange, and the federal exchange—for reasons we now understand more fully—hadn’t released any premium information at that time. That analysis found that underlying premiums would increase by 24 percent in those 13 states plus D.C.

Obamacare’s supporters argue that these rate increases aren’t important, because many people will be protected from them by federal subsidies. Those subsidies aren’t free—they’re paid for by taxpayers–and so it is irresponsible for people to argue that subsidies somehow make irrelevant the underlying cost of health insurance. Nonetheless, it’s important to understand the impact of subsidies on Obamacare’s exchanges; later in September, we released a second iteration of the map to do just that.

Today’s release, with the third iteration of the map, contains both premium and subsidy data for every state except Hawaii. (Believe it or not, we’ve had success mining data from every exchange website but Hawaii’s.) This nearly-complete analysis finds that the average state will face underlying premium increases of 41 percent. Men will face the steepest increases: 77, 37, and 47 percent for 27-year-olds, 40-year-olds, and 64-year-olds, respectively. Women will also face increases, but to a lesser degree: 18%, 28%, and 37% for 27-, 40-, and 64-year-olds.

Biggest winners: NY, CO, OH, MA; Biggest losers: NV, NM, AR, NC

Eight states will enjoy average premium reductions under Obamacare: New York (-40%), Colorado (-22%), Ohio (-21%), Massachusetts (-20%), New Jersey (-19%), New Hampshire (-18%), Rhode Island (-10%), and Indiana (-3%). Most, but not all, of these states had heavily-regulated individual insurance markets prior to Obamacare, and will therefore benefit from Obamacare’s subsidies, and especially its requirement that everyone purchase health insurance or pay a fine.

The eight states that will face the biggest increases in underlying premiums are largely southern and western states: Nevada (+179%), New Mexico (+142%), Arkansas (+138%), North Carolina (+136%), Vermont (+117%), Georgia (+92%), South Dakota (+77%), and Nebraska (+74%).

http://www.forbes.com/sites/theapotheca ... o-elderly/

At first blush, it appears that map is almost exactly correct in my case, i.e., my premium will jump 136% (slightly more, actually)...

Obamacare is an abortion. the old system was worse. I think single payer could work but I urge all of you to consider my plan which I know will work:

single no payer.

Ok, we need to start impeachment proceedings...

http://healthland.time.com/2013/11/07/7 ... -banned/#!

Horseshit on impeachment proceedings!! More like drag out in the streets and stone some motherfuckers!!

Saint wrote:Obamacare is an abortion. the old system was worse. I think single payer could work but I urge all of you to consider my plan which I know will work:

single no payer.

I agree the old system was broken, and left untouched it was going to get alot worse

but this plan is just representative of government. Take something that is bad but working and make it expensive while creating dependency on the government for the impoverished.

That is a form of slavery and I'm completely lost as to how people tolerate , much less stand up and demand it.

probably because despite all the gloom and doom, the vast majority have seen no change in their premiums.

Owlman wrote:probably because despite all the gloom and doom, the vast majority have seen no change in their premiums.

its still early in the process. The president apologized for misleading the public on national news tonight - he said only 5% - that is premature

The vast majority get part or all of their premium paid by their employer, but I guess it's "OK" for people who pay for their own to get a huge increase, since they're not part of the "vast majority". Who care what they (we, I) think, right?

Hey, let's re-institute slavery. After all, the vast majority of the population (i.e., white folks) didn't have to worry about being slaves, who cares about that 5% (or whatever) that we can get to do all the work for free? It's all about what "the vast majority" wants, right?

Actually hedge, you're getting a big increase because of the amount of coverage you had, which wasn't much. Those with low coverage and those with no coverage will pay more. The rest, less. The majority of people who are in small businesses and owners (such as my brother and my roommate from college) will be paying less with the subsidies.