# Oops. Looks like we were lied to about Obamacare after all. **URL:** \ **Category:** Great Debates\ **Created:** [October 29, 2013, 7:22am UTC](https://boards.straightdope.com/t/oops-looks-like-we-were-lied-to-about-obamacare-after-all/672534 "2013-10-29T07:22:23Z")\ **Posts on this page:** 20\ **Page:** 26
**Author:** ![Stratocaster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/stratocaster/32/16393_2.png) [@Stratocaster](https://boards.straightdope.com/u/Stratocaster)\ **Post date:** [November 2, 2013, 9:01pm UTC](https://boards.straightdope.com/t/oops-looks-like-we-were-lied-to-about-obamacare-after-all/672534/501 "2013-11-02T21:01:00Z")
> [@elucidator](#): > > Seriously? You don’t know about any of this, you come to argue about something which you have no information regarding? To oversimplify for the sake of brevity, hospital musts provide emergency care whether the patient can pay for it or not. They cover their losses by jacking up prices for people who _can_ pay. But you hadn’t heard about any of this? Huh? Of course I’ve heard of such excesses. That wasn’t the question. So, then you have some sort of cite that demonstrates that ACA will make the $27 Tylenol pill go the way of the dodo then? Please share. > [@](#): > > **Hentor** ’s site offers a good starting point. The thing about terrible coverage is you don’t know its terrible until you need it. Your cite offered the startling revelation that ACA will force people into policies that meet ACA requirements. Where did it indicate the horrors with their current coverage you were scaring me so with? Funny, you seem to know it’s all largely terrible somehow, even though these people don’t. Hmm. ---
**Author:** ![Terr](https://avatars.discourse-cdn.com/v4/letter/t/839c29/32.png) [@Terr](https://boards.straightdope.com/u/Terr)\ **Post date:** [November 2, 2013, 9:03pm UTC](https://boards.straightdope.com/t/oops-looks-like-we-were-lied-to-about-obamacare-after-all/672534/502 "2013-11-02T21:03:32Z")
> [@Really\_Not\_All\_That\_Bright](#): > > Prestige? Pull the other one. If they were making a loss on Medicare patients, they’d stop taking them and the savings would allow them to cut private rates. And they would have to downsize. And when I go to the hospital, I prefer going to a big one. So do a lot of other people. > [@](#): > > So, either: (1) hospital administrators don’t understand business; (2) insurers don’t care what they are being charged; or, (3) they aren’t actually taking a loss. or (4) You don’t know what you’re talking about and MedPAC does? ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [November 2, 2013, 9:11pm UTC](https://boards.straightdope.com/t/oops-looks-like-we-were-lied-to-about-obamacare-after-all/672534/503 "2013-11-02T21:11:14Z")
The phrase you were looking for is “I suppose you’re right.” ---
**Author:** ![John\_Mace](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/john_mace/32/185_2.png) [@John\_Mace](https://boards.straightdope.com/u/John_Mace)\ **Post date:** [November 2, 2013, 9:12pm UTC](https://boards.straightdope.com/t/oops-looks-like-we-were-lied-to-about-obamacare-after-all/672534/504 "2013-11-02T21:12:28Z")
Can we stop that hijack and concentrate on the other hijack? 🙂 What does Obamacare do to the infamous $25 aspirin charge at the hospital? ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [November 2, 2013, 9:15pm UTC](https://boards.straightdope.com/t/oops-looks-like-we-were-lied-to-about-obamacare-after-all/672534/505 "2013-11-02T21:15:48Z")
> [@Really\_Not\_All\_That\_Bright](#): > > John: it makes it better and worse. There will be far fewer write-offs for ER visits by the uninsured, but there will also be some reimbursement rate cuts for CMS patients. It’s not yet clear which numbers will be bigger. It’s also important to note that the $25 aspirin doesn’t just stem from offsets to lower reimbursement rates; they’re also a bargaining chip. Private insurers reimburse according to fee schedules, which are sometimes “take it or leave it” arrangements for providers, but are more frequently negotiated between insurers and individual providers. If the hospital’s base charge for aspirin is $25 then it’s a lot easier to justify charging the insurer $3 under the fee schedule. ---
**Author:** ![elucidator](https://avatars.discourse-cdn.com/v4/letter/e/8edcca/32.png) [@elucidator](https://boards.straightdope.com/u/elucidator)\ **Post date:** [November 2, 2013, 9:18pm UTC](https://boards.straightdope.com/t/oops-looks-like-we-were-lied-to-about-obamacare-after-all/672534/506 "2013-11-02T21:18:26Z")
> [@](#): > > …What does Obamacare do to the infamous $25 aspirin charge at the hospital? Well, he’s lying, its really only $24.95, but his perfidy knows no bounds. Plus, its _Tylenol_, the unspeakable swine! ---
**Author:** ![John\_Mace](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/john_mace/32/185_2.png) [@John\_Mace](https://boards.straightdope.com/u/John_Mace)\ **Post date:** [November 2, 2013, 9:24pm UTC](https://boards.straightdope.com/t/oops-looks-like-we-were-lied-to-about-obamacare-after-all/672534/507 "2013-11-02T21:24:17Z")
> [@Really\_Not\_All\_That\_Bright](#): > > It’s not yet clear which numbers will be bigger. It’s also important to note that the $25 aspirin doesn’t just stem from offsets to lower reimbursement rates; they’re also a bargaining chip. Private insurers reimburse according to fee schedules, which are sometimes “take it or leave it” arrangements for providers, but are more frequently negotiated between insurers and individual providers. If the hospital’s base charge for aspirin is $25 then it’s a lot easier to justify charging the insurer $3 under the fee schedule. Thank-you. Sounds like the real answer is: we don’t know, but there isn’t any compelling reason to think it’s going to decrease significantly. More importantly, though… Hospitals aren’t going to suddenly decide that it’s fine and dandy to be less profitable. If they get squeezed in one area, I have no doubt they will figure out how they can make up the difference in another area. ---
**Author:** ![elucidator](https://avatars.discourse-cdn.com/v4/letter/e/8edcca/32.png) [@elucidator](https://boards.straightdope.com/u/elucidator)\ **Post date:** [November 2, 2013, 9:27pm UTC](https://boards.straightdope.com/t/oops-looks-like-we-were-lied-to-about-obamacare-after-all/672534/508 "2013-11-02T21:27:41Z")
> [@Stratocaster](#): > > Huh? Of course I’ve heard of such excesses. That wasn’t the question. So, then you have some sort of cite that demonstrates that ACA will make the $27 Tylenol pill go the way of the dodo then? Please share.Your cite offered the startling revelation that ACA will force people into policies that meet ACA requirements. Where did it indicate the horrors with their current coverage you were scaring me so with? Funny, you seem to know it’s all largely terrible somehow, even though these people don’t. Hmm. “Good starting point” does not mean that all your questions are answered. Hence, the word “starting”. I’ve read a lot about this, you can too. Fighting ignorance does not require that I type my fingers off. However, if your whole point is pissing me off, insinuating dishonesty without proving squat is a good way to start. You got, you bring, otherwise, here’s your cuppa. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [November 2, 2013, 9:28pm UTC](https://boards.straightdope.com/t/oops-looks-like-we-were-lied-to-about-obamacare-after-all/672534/509 "2013-11-02T21:28:44Z")
> [@John\_Mace](#): > > Sounds like the real answer is: we don’t know, but there isn’t any compelling reason to think it’s going to decrease significantly. What this will basically depend on is how many previously uninsured people actually sign up for coverage. The amount hospitals eat on write-offs ($34 billion) is vastly bigger than the amount they claim to be eating on below-cost federal reimbursement, and adds about $900 to the cost of a policy for a family of four. ---
**Author:** ![Bone](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bone/32/407_2.png) [@Bone](https://boards.straightdope.com/u/Bone)\ **Post date:** [November 2, 2013, 9:31pm UTC](https://boards.straightdope.com/t/oops-looks-like-we-were-lied-to-about-obamacare-after-all/672534/510 "2013-11-02T21:31:37Z")
> [@elucidator](#): > > And so we are compelled to permit someone to offer bad coverage because Freedumb? Are you trying to make the word ‘freedom’ into a pejorative? ---
**Author:** ![John\_Mace](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/john_mace/32/185_2.png) [@John\_Mace](https://boards.straightdope.com/u/John_Mace)\ **Post date:** [November 2, 2013, 9:31pm UTC](https://boards.straightdope.com/t/oops-looks-like-we-were-lied-to-about-obamacare-after-all/672534/511 "2013-11-02T21:31:54Z")
> [@Really\_Not\_All\_That\_Bright](#): > > What this will basically depend on is how many previously uninsured people actually sign up for coverage. The amount hospitals eat on write-offs ($34 billion) is vastly bigger than the amount they claim to be eating on below-cost federal reimbursement, and adds about $900 to the cost of a policy for a family of four. It also depends on whether hospitals can keep up with the demand. If we suddenly have a whole slew of newly insured people who start using the hospitals more, then demand goes up. I’m trying to remember what happens when supply lags demand, but for some reason I just can’t put my finger on it. And I presume there are quite a few other imponderables out there, making it very hard to predict exactly what will happen. Else, we’d all know whether or not to short Bayer stock! ---
**Author:** ![Stratocaster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/stratocaster/32/16393_2.png) [@Stratocaster](https://boards.straightdope.com/u/Stratocaster)\ **Post date:** [November 2, 2013, 9:31pm UTC](https://boards.straightdope.com/t/oops-looks-like-we-were-lied-to-about-obamacare-after-all/672534/512 "2013-11-02T21:31:58Z")
> [@elucidator](#): > > “Good starting point” does not mean that all your questions are answered. Hence, the word “starting”. I’ve read a lot about this, you can too. Fighting ignorance does not require that I type my fingers off. > > However, if your whole point is pissing me off, insinuating dishonesty without proving squat is a good way to start. You got, you bring, otherwise, here’s your cuppa. Does this stuff actually make sense as you’re typing it? Or is it conscious misdirection? ---
**Author:** ![elucidator](https://avatars.discourse-cdn.com/v4/letter/e/8edcca/32.png) [@elucidator](https://boards.straightdope.com/u/elucidator)\ **Post date:** [November 2, 2013, 9:32pm UTC](https://boards.straightdope.com/t/oops-looks-like-we-were-lied-to-about-obamacare-after-all/672534/513 "2013-11-02T21:32:43Z")
You and me, we’re done. ---
**Author:** ![Stratocaster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/stratocaster/32/16393_2.png) [@Stratocaster](https://boards.straightdope.com/u/Stratocaster)\ **Post date:** [November 2, 2013, 9:33pm UTC](https://boards.straightdope.com/t/oops-looks-like-we-were-lied-to-about-obamacare-after-all/672534/514 "2013-11-02T21:33:39Z")
Sorry, you’re not fooling anyone who’s actually reading this. ---
**Author:** ![John\_Mace](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/john_mace/32/185_2.png) [@John\_Mace](https://boards.straightdope.com/u/John_Mace)\ **Post date:** [November 2, 2013, 9:37pm UTC](https://boards.straightdope.com/t/oops-looks-like-we-were-lied-to-about-obamacare-after-all/672534/515 "2013-11-02T21:37:12Z")
Both of you go take an aspirin and call it day. That’ll be $50, please. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [November 2, 2013, 9:39pm UTC](https://boards.straightdope.com/t/oops-looks-like-we-were-lied-to-about-obamacare-after-all/672534/516 "2013-11-02T21:39:24Z")
> [@John\_Mace](#): > > It also depends on whether hospitals can keep up with the demand. If we suddenly have a whole slew of newly insured people who start using the hospitals more, then demand goes up. I’m trying to remember what happens when supply lags demand, but for some reason I just can’t put my finger on it. And I presume there are quite a few other imponderables out there, making it very hard to predict exactly what will happen. Else, we’d all know whether or not to short Bayer stock! It’s unlikely that the newly insured will result in increased demand for _hospital_ services, except for outpatient services which cannot be provided in a clinic setting (certain types of diagnostic procedure, for example). Insured patients will treat in a clinical setting rather than a hospital setting, where billed rates are much closer to actual cost (because non-hospital providers don’t have to provide care to uninsured patients regardless of ability to pay, jacking up prices for everyone else). Think about your own health insurance: look at the copay or coinsurance for doctor visits versus hospital visits. You (presumably) don’t go to the hospital unless you really have to, because your copay is probably ten times higher than the copay for a visit to your PCP (assuming you’re lucky enough to not have coinsurance for hospital care instead.) So the likely spike in demand won’t affect hospitals much at all in terms of patient volume. ---
**Author:** ![Stratocaster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/stratocaster/32/16393_2.png) [@Stratocaster](https://boards.straightdope.com/u/Stratocaster)\ **Post date:** [November 2, 2013, 9:39pm UTC](https://boards.straightdope.com/t/oops-looks-like-we-were-lied-to-about-obamacare-after-all/672534/517 "2013-11-02T21:39:11Z")
It’s $27, John, not a penny more… ---
**Author:** ![elucidator](https://avatars.discourse-cdn.com/v4/letter/e/8edcca/32.png) [@elucidator](https://boards.straightdope.com/u/elucidator)\ **Post date:** [November 2, 2013, 9:41pm UTC](https://boards.straightdope.com/t/oops-looks-like-we-were-lied-to-about-obamacare-after-all/672534/518 "2013-11-02T21:41:22Z")
> [@Bone](#): > > Are you trying to make the word ‘freedom’ into a pejorative? No, its a sarcastic reference to bland and empty political philosophical abstractions to justify allowing people to suffer in service to an empty concept. Someone who is sick and in pain has no use for freedom, unless that means freedom from sickness. For the hungry, it means freedom from want. Right at the moment, for me, it means freedom from having to explain the bleeding obvious. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [November 2, 2013, 9:45pm UTC](https://boards.straightdope.com/t/oops-looks-like-we-were-lied-to-about-obamacare-after-all/672534/519 "2013-11-02T21:45:22Z")
> [@Bone](#): > > Are you trying to make the word ‘freedom’ into a pejorative? I would say certain brands of conservative have already made it a pejorative, since to them it really means “absence of government intrusion I don’t like.” ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [November 2, 2013, 10:30pm UTC](https://boards.straightdope.com/t/oops-looks-like-we-were-lied-to-about-obamacare-after-all/672534/520 "2013-11-02T22:30:48Z")
[A fairly comprehensive summary](http://dyn.politico.com/printstory.cfm?uuid=A347ACA5-D34B-449E-B7FD-511D21BF723C) of the Republican campaign to sabotage ACA at every step. > [@](#): > > n fact, putting an excessive burden on the federal government was the explicit aim of the law’s opponents. “Congress authorized no funds for federal ‘fallback’ exchanges,” the Tea Party Patriots website noted as long ago as last December. “So Washington may not be able to impose exchanges on states at all.” The group went on to suggest that since Washington was not equipped to handle so many state exchanges, “both financially and otherwise — this means the entire law could implode on itself.” > [@](#): > > For months, the White House has hoped that every politician’s instinct to render effective constituent service would trump political resistance to the law among Republicans. Even that has proved doubtful. Rep. Tim Huelskamp (R-Kan.) said last summer that his office would not provide assistance in signing up for the law. “Given that we come from Kansas,” he said, “it’s much easier to say, ‘Call your former governor,” meaning Sebelius. “You say, ‘She’s the one. She’s responsible.’’’ Aren’t you people proud of yourselves now? [Previous page](https://boards.straightdope.com/t/oops-looks-like-we-were-lied-to-about-obamacare-after-all/672534.md?page=25) [Next page](https://boards.straightdope.com/t/oops-looks-like-we-were-lied-to-about-obamacare-after-all/672534.md?page=27)