LOL. A cite from 14 years ago! Excellent 
What about those European Death Panels!!!
Yup. Part of the problem is that the medical industry is so powerful that the ACA had to cut out all the programs that could cut costs because a law that angered these groups wouldn’t pass.
Remember when ‘Harry and Louise’ sank Clinton’s health reform in 1993? Harry and Louise (aka the Pharma industry) were on board with Obamacare because Obamacare meant more customers and a variety of giveaways.
The public option, which would’ve reduced costs, was gotten rid of to get support from the health insurance industry.
True health reform that this country truly needs is going to require taking on the medical industry. The true reform we need will enrage the pharma industry, medical device industry, hospitals, AMA and insurance industry. Until politicians are willing to do that (or by some miracle, something arises on the private market to force them to improve quality while lowering costs) health care costs will spiral out of control.
Do you want to reduce medical costs? Do some or all of the following:
[ul]
[li]Let the public sector at the federal level negotiate all medical prices for everything. Drugs, procedures, surgeries, hospital stays, etc. [/li][li]Allow the importation of medical devices and pharmaceuticals from overseas[/li][li]Promote medical tourism for surgery and long term care[/li][li]Create a single payer system, or failing that create a medicare buy in or strong public option tied to medicare. [/li][li]Incentivize hospitals and outpatient facilities to provide quality of care, not quantity of care.[/li][li]Create a system similar to the UK"s NICEsystem to determine what care is covered or not based on the impact in QALY vs $$ spent. [/li][li]Create an all payer system where all providers have to negotiate with all health insurance companies, rather than let them negotiate one by one[/li][li]Streamline care (Atul Gawande had a piece about knee replacement surgeries, how doctors had too much leeway and when you took that away and treated it more like an assembly line, prices were cut in half). [/li][/ul]
Doing things like that will actually reduce medical care costs. They also are things that the medical industry hates and doesn’t like.
Merck is trading at $62 a share today … it was $30 a share in 2010 … what’s not to like about the ACA?
I would think double the money in six years is affordable … maybe that’s just me …
I get my insurance through ACA. I don’t get a subsidy. And my premium for next year, while going up if i stay at the Gold level, is not going up by 25%.
I am fortunate to live in California, where we have lots of choices in our state-run marketplace, and I’m also fortunate to be in a financial position to afford my ACA premiums.
However, if we didn’t have ACA, I would have had to take COBRA when I left my job last January, the premium for which was nearly double what I’m paying for my comparable ACA plan, and which would have only lasted 18 months. There’s no telling if I would have been able to get insurance after that 18 month period. I’m a middle aged woman, too young for Medicare, healthy for now but who knows what the future brings.
The ACA is far from perfect, but it’s working a lot better in states where the governors and legislatures weren’t hell-bent on destroying it. n
According to Healthcare.gov
The Affordable Care Act put in place comprehensive health insurance reforms that have improved access, affordability, and quality in health care for Americans. Learn about the law, how to get coverage, and how it has helped people across the country."
bolding is mine
Right from the start affordability was a part of the issue, referenced on par with increasing access.
As to the risk corridor issues…
The PPACA provided a means of reinsurance to help stabilize the markets for a limited period of time. The law contained provisions whereby insurers who ended up with a higher share of riskier patients would have a portion of their losses paid from what is effectively a reinsurance fund that all insurers were to pay into. The idea being that some of the “excess” profits of those insurers which had a healthier than average risk pool would help cover the losses of insurers with higher risk pools.
Part of the rationale in setting up these premium stabilization programs was that insurers did not have experience underwriting the risk pools that the law was demanding. And after a few years the presumption was that the insurers would have enough experience with these risk pools that the risk corridors would no longer be needed.
But there was a problem. Not enough insurers had better than expected returns and the reinsurance pool was not large enough to pay the losses of those insurers making claims under the program. And in any event the PPACA did not authorize the spending of such collected funds for disbursement to insurers. So the Obama administration attempted to fund payments using general revenue funds appropriated to HHS. U.S. District Court Judge Rosemary Collyer ruled such funding was not authorized. She stayed her ruling, pending appeal.
So the issue is not Republicans blocking already appropriated funding. The issue is a lack of Congressional appropriation of the funding in the PPACA to begin with for these programs. That leaves any funding up to annual allocations from Congress. But when HHS wants to spend monies that have not been appropriated they have to go back and ask Congress for more money like any other agency.
What Congress did do in 2015 and 2016 funding bills was explicitly make the risk corridor program budget neutral. This limited HHS from disbursing more funds that are collected. Yet HHS attempted an end around.
Except it’s really not. My car gets wrecked and I pay my $250 deductable and everything is takent care of. I get sick I still have co-pays for visits and medicine, an annual deductable to meet, hospital percentages, etc. Are you telling me that if someone with health insurance came down with serious but treatable cancer that it would cost them less than $30K?
It sounds like you’re arguing that health insurance isn’t really insurance because it has extra ancillary costs. That makes no sense. Let’s say your responsible portion of a treatable cancer is $30K. That’s still a fraction of the cost you’d pay out of pocket if it wasn’t insured. I’m not sure what point you think you’re making here, but it’s not coming across very well.
The first sentence here - the one that “no one can argue” against - is a bit misleading in the context of the rest of the OP.
There is no doubt that the number of uninsured people has decreased since ACA was passed. However the biggest factors in that decrease are the expansion of Medicaid and the decrease in unemployment (and increase in employer coverage) during that time.
http://www.rand.org/news/press/2015/05/06.html
The exchanges are a small part of the reduction in uninsured. But the exchange are the focus of this OP.
Yup. Obamacare was really just a small band-aid covering up a gaping infected wound. Cut the direct costs on things that are out of control liked pharmaceuticals and the price of insurance goes down.
It is insurance but it is crappy insurance. And as to the point of this thread it is a poor insulator against medical costs. For example, a doctor wanted to test Mrs Cad for sleep apnea which involved a guy watching her sleep for 6 hours in a hospital room. Total cost was $3000 of which we were on the hook for 40%. What about that test cost $1200 (let alone $3000)? And how has the ACA made that scenario affordable? Does here insurance cover more of the bill? spoiler alert - no. Did ACA drive down health care costs to something reasonable? No. So ACA has left us with higher health care costs, more expensive insurance that covers less than it should.
We are. Obamacare is a lifesaver — literally.
Mrs. Devil and I are self-employed.
In our last year buying insurance before the ACA launched we were paying ~$1,200 per month for something that approximated the silver plans. This was after shopping the hell out of insurance every year.
Taking a quick look at our upcoming year’s premiums, it looks like the lowest silver plan will start around $1,400. Already we’re saving over a non-ACA world because not only had the price of insurance been going up every year, but benefits were being slightly curtailed. Even if you compare the mid-range silver plans at $1700 per month, we’re still in an expected or slightly higher range than we would have been under the status quo.
It gets better (or worse, depending on perspective).
In March, Mrs. Devil was diagnosed with pancreatic cancer. A full year of chemotherapy and some major surgery.
Pre-Obamacare, we had several different insurers over the years due to premium hikes and some insurers stopping to offer their plans (yes, insurers went out of the business before the ACA).
Our expenses without Obamacare’s maximum benefit clause would be astronomical.
Looking at 2017, our premiums without Obamacare’s pre-existing condition clause would be catastrophically high — if we could even find coverage.
Yes, this is anecdotal, but the actual numbers are out there (all I can find at the moment are receipts for what we paid and non-trustworthy/biased websites). If anyone can find and compare 2009 averages to publicly available amounts on the New York State of Health marketplace, then it’ll shift from anecdote to data.
(And not averages for shitty catastrophic insurance. We skated by on that for a few years and were lucky enough to have purchased ‘real’ insurance the year before the Devilling was born.)
We’d be fucked without Obamacare. We happily shell out the 20 grand for the level of coverage it gets us, which gets us more than we would have had before. And even if there is a way to find a price increase in there, we’d gladly consider it a tax to help my neighbour get coverage.
The shits who put partisanship over party to work against implementing decent reform deserve to be pitted.
Depends on whether the person had anyone else to watch and how much their income is. If they were a highly trained tech who had to closely watch one person, then $1200 is eminently reasonable. That would be their entire shift, and assuming, including support personnel, that they get paid $100K a year, personnel expense alone is $500. In IT, it’s standard to double this cost for stuff like licensing etc, so assume the burdened cost is $1000. Someone has to pay for the equipment and space.
On the other hand, if the tech could watch over 4 people, then $3000 does seem high.
The problem with adding tens of millions of people to insurance to reduce cost is not enough younger and healthier people signed up, because if you have middling income do you really want to toss out another 100-200 dollars a month? Specifically, people who make too much for subsidies but not enough for a real cushion for other life expenses and are healthy have much less incentive. Thinking of people in the 30k range of income per year.
The people that were more inclined tended to be less healthy. Again, if we took all the people that needed care and did not have it vs the ones that needed it and had it through gainful employment, I suspect the former group would be less healthy. Wealthier people that already had health insurance, often through employment tend to be healthier in general.
Not the same populations. For this to work well, everyone has to be in the system. No voluntary enrollment.
Easiest route? A tax to cover the cost of enrolling everyone in healthcare. EVERYONE. The private insurance costs need to be phased out to nothing over time, completely decouple healthcare from employment. If some companies still want to provide additional benefits like the German model with solid care for all but gold plated care for the well to do, because such people are special and their lives and health are more valuable to this proud christian nation, then so be it.
I want the largest biller of healthcare to be the government, to gain more leverage in lowering prices from hospitals and drug companies. Take a fraction of the money we save and COMPLETELY shore up the research and development budgets of the scientists working on new drugs and treatments with PLENTY of cash to spare.
Yes, but $30,000 is still enormous. Doesn’t matter if the non-insured tab would have been $1 million; a $30k bill is backbreaking for many Americans.
It will only be a matter of time until hospitals turn into HMOs like Kaiser and Mayo. In major cities, all the hospitals could pool together and sell insurance. No paperwork to file for external offices. Sign up patients on yearly basis Jan 1. I would pay up to 800 a month for two of us, -ages 60 and 62.
Set up death panels to bring my costs down. 
Article in the New Yorker providers a quick summary of ways to modify Obamacare’s current implementation to make it better: http://www.newyorker.com/news/john-cassidy/three-ways-to-fix-obamacare
You missed my numbers. You came up with at best $1000. Where’d the other $2000 go to? And if the true cost is $1000 and with insurance we paid $1200 then I think my point is proven and I’ll drop the mike now.
All of the Silver plans in New York have max out-of-pocket expenses under ten grand and many have hospitalization co-pays under two grand.
Obamacare removed benefit caps. This is how a year of chemotherapy plus major surgery can run under $30K insurance-wise. Even if you pretend every increase in rates/decrease in benefits are attributable to Obamacare (completely forgetting that that exact issue was a major focus of the 2008 election), it’s still far better now than it would have been a few years ago. Factor in the ban on pre-existing condition exclusions, and Obamacare comes out even further ahead.
There are many ways to criticize Obamacare, but this direction is flat out wrong. (YMMV in red states that resisted implementation or some outlying states. Our only experience is buying independently in NY.)
Yes, but as backbreaking as $30,000 can be, it’s achievable for many — particularly over time. Facing $1 million in costs means treatment foregone. They are two fantastically different numbers.