People who couldn’t get or couldn’t afford healthcare before now can, and that makes you furious. Thank you for summing up the Republican position so succinctly.
Additionally, Terr posted that article to show lecture us on narrowing network. Except the example in the article is someone who didn’t have any kind of network before. So, how about you recant that article, Terr.
Now, that would be a cite for sore eyes…
The point of the ACA is to increase the number of people who can have insurance, and improve the quality of that insurance.
Recant what, exactly? The fact that the networks that ACA policies provide are so narrow that the subscribers are, in WaPo’s words, “furious”? No, don’t think so. Just think how wonderful it is for the Democrats to have all those “furious” voters.
At least it’s WaPo so the lefties cannot just handwave it as they would if it was Fox. Oh, wait… Sure they can. Blinders are fairly indiscriminate.
Again, she didn’t have a network before at all. Period. So this network is much bigger than the one she had before.
High costs are the major problem in U.S. health care. Contrary to popular opinions, higher costs are not primarily due to malpractice lawsuits nor due to higher U.S. salaries. Experts in health-care costs played a major role in the design of ACA.
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Correction: An earlier version of this story misstated the reason why Concord Hospital is not a member of Anthem’s network. The hospital declined to join the network.
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Is your point just that voter ignorance may help the GOP? If not, you seem to have missed the nuances in that article:
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Just the name itself, a narrow network, sounds like a miserable, restrictive health plan that you would just as well avoid. But health-care experts love narrow networks, pointing out that they underpin some of the country’s most successful health plans.
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If you’re an expert on health-care costs, Terr, perhaps you should comment on the substance of the article, and the alleged benefits of “narrow networks,” rather than just its title.
Because sticking your fingers in your ears and going “na na na na na” is as effective now as it was in primary school?
The problem is that those experts were industry affiliated and wrote in ways the insurance and hospital industries could continue to reap profits, which is the driving factor in high costs.
Those costs do have some to do with malpractice insurance (but mainly for independent primary care doctors that don’t get a reduce rate through a hospital blanket program), but a very little to do with higher salaries. But both of these are fairly well mitigated through the number of patients most doctors see. Even at the low end: six patients a day, five days a week, 48 weeks a year can net you $14,400 at +$10 per visit. That should cover malpractice insurance AND a small raise.
The health care experts that love them are the ones that want to make their industry profits. If you create a narrow network, you can squish your costs to a very predictable level and use that as a platform for profit.
If you wanted to save money, you could have written the law any number of ways. For instance, instead of paying monthly to an insurance company, pay monthly to an HSA. You pay for medical bills as you go. When tax time rolls around, you get paid for everything over $8,000 - even if you haven’t paid it out, so you can pay back the medical providers on tax day. The less you make, the more you get back. I just saved you from a guaranteed 20% profit going to the insurance companies.
Want to save more money? Require all medical providers to be privately owned and non-profit. When they only covering their costs and enough to sock away for 1 year of operations, prices will drop.
Better yet, do that second bit and go to a single payer to private player system where every visit, lab, and treatment has a fixed payout cost (and they can’t charge more to make up the difference to a patient, ever.) Any visit or treatment (think: cosmetic surgery) that’s not on the schedule is paid by the patient, but still restricted by the mandate that they can’t be for-profit and can’t be publicly owned.
I think your HSA idea is a fantastic one. I’ll just float that million-dollar operation until tax time, no problem! Plus, once I get past the $8,000 deductible, it’s daily MRIs for me! I mean, why not?
Terr, the problem with your anecdote-by-anecdote method is that it is pretty fairly crushed by the millions of people who now have insurance and never did before. The Republicans trot out one (dubious) story after another, adding up to 10s, maybe even scores of scare stories. Meanwhile, 100,000 times that amount of people are now covered.
Well, first, that’s already what happens. If you have a high deductible health plan, you are paying $X a month and you self-pay your medical care until you hit your deductible in addition to that $X a month. In this off-the-top-of-my-head idea, you simply pay that $X a month directly towards your health care provider, which means you pay out less overall to hit that threshold.
Part two, for care: that’s what already happens with HDHPs. Ask doctors about their busiest months. It’s the last three months of the year when healthcare is “free” because people hit their deductibles. I don’t understand the disconnect that people have about this (If you spend your deductible in January, it’s “Free” health care for 11 months instead of three!), but there you go.
If your point was for fraud, there’s as much potential for fraud under this system as there is under the insurance system. You can doctor shop until you find a doctor willing to write you up for an MRI every single day. But most patients would doctor shop for pills and most doctors wouldn’t bother with the trends that are easy as heck to see (“all of Doctor Bill’s patients get 356 MRIs a year”). They’d simply bill each patient for an extra $50 lab charge and only take it back if the patient complained. It’s a “mistake” if you are caught and free money if you aren’t.
For the point about floating the million-dollar operation…this is also already done under the HDHP plans, because people only put a little bit away to pay for medical expenses and spread it over the entire year, note that this is ON TOP of the money paid for insurance in the first place. So people either pay out of liquid funds or out of an HSA, both of which are drained fairly quickly once anything of a medical nature hits, so they are on payment plans to split a couple hundred a month between several medical providers.
I’m not saying it’s perfect, but it’s cheaper to pay your provider than continue paying a middle-man markup.
Ah well, then you have nothing to worry about for 2014 elections. Nothing at all. All those satisfied voters will help you crush the opposition and win House and Senate.
Well, that and massive voter fraud. But I’m not supposed to mention that. 
I have to get off the boards for a bit, but I finally have my own Obamacare horror-story to share!
I signed up with my insurer on the Covered California exchange. I got my January bill on time and paid it. But I didn’t get my February bill. Stupid Obamacare! I never had billing screw-ups from any private corporate ever before Obamacare!
So, I tried calling my insurer. I had to punch a bunch of menu buttons on my phone! Which I never had to do with any company ever before Obamacare!
Then I had to wait on hold for an hour. Whoever heard of waiting on hold with an insurance company before Obamacare!
Then I finally got an agent on the line. She said that they had a problem with their third-party biller, and that’s why invoices didn’t go out. She said that I should receive my bill in the next few days! Stupid Obamacare! Nobody ever had a third-party provider screw up before.
Then she told me my account wasn’t linked properly because I had previously been with them several years ago, and so the link didn’t happen the way it should have. She said she would fix it and then call me back when it was fixed so I didn’t have to wait on hold. Stupid Obamacare! What if I wanted to wait on hold?
Then she called me back and said it was fixed, but it would take a few weeks to process. In the meantime, they had instituted some program called “Belive Me” or something with an equally cloying name. Apparently, I could go in, and see a doctor, and they would cover it all – NO COPAYS – until the issue was fixed on their end. Can you believe the nerve of this? Trying to give me a free copay?
Fuck Obamacare!
I weep for what you went through.
Refuse that help! Insist on paying your own way! Ask yourself, what would John Galt do?
If you take that liberal money, its all over, its straight down from there to atheism, homosexuality, drug addiction and autoerotic asphyxiation. Though not necessarily in that order.
Come to think on it, silly question, John Galt just wouldn’t get sick. Still, wouldn’t get old.
That seems like a bit of a misconception. The important distinction is not the mechanisms of single-payer vs. multi-payer, but the degree of regulation and whether actuarially-based private insurance for medically necessary procedures exists. Proponents of private insurance sometimes like to single out Canada by comparing it with those countries in respect of being pure single-payer, but the prohibition against private insurance (actually, just a statement that any province that doesn’t conform to provisions of the Canada Health Act won’t receive federal health care transfers) exists because of concern that the proximity and influence of US private health insurers – who once dominated the health insurance market until they were duly kicked out by force of law – would flood the marketplace and undermine the public system.
It’s a mistake to regard Germany as having a system that is in any way like the US with many “competing” private insurers. The system in Germany evolved from a philosophy of social solidarity and belief in universal health care coverage that dates back to the time of Bismarck. It is entrenched social policy. The distinction that exists there is primarily one between the statutory public system and the private one. The statutory public system, despite being comprised of a myriad of “sickness funds”, is tightly regulated and provides uniform costs and benefits as well as an effective system of cost control; in that respect, it’s a de facto single-payer system because it functions like one. The private system is actuarial and superficially resembles the US insurance system except for these key differences: only suitably qualified high-income earners are eligible to participate, they receive only nominally improved amenities over the public system, and the participation rate is low (I believe it’s around 10%).
I agree with some of the others who believe the US is inevitably headed for what will effectively be a single-payer system, or more precisely a mix of single-payer and an optional private tier like in Germany, due if nothing else to simple economics. The extraordinary costs of a private insurance system, incurred by a combination of administrative waste and inability to control provider costs, makes it not a question of “if” but of “when”. Insurance companies try to save money in the only way they can – by wasting huge resources adjudicating individual claims, trying to deny them or hammer down their payouts, while drowning in paperwork and being largely unable to address the real elephant in the room – the provider costs. The major obstacle to real reform is rampant ideology fueled by the usual FUD about “creeping socialism”.