90% of Americans have health insurance....

Gern Blansten · May 2016

http://www.vox.com/2016/5/17/11690370/obamacare-uninsured-2015

9.1% still uninsured...down from 15% in 2011

jeffbr · May 2016

And because of the ACA, insurance companies are now looking for 20% - 40% increases in rates, which will pretty much fuck most of the middle class that doesn't get rate subsidies. I've praised the act for getting people insured, but railed against it for what it has done to coverage and premiums.

Health Insurance Companies Seek Big Rate Increases for 2016

Blue Cross and Blue Shield plans — market leaders in many states — are seeking rate increases that average 23 percent in Illinois, 25 percent in North Carolina, 31 percent in Oklahoma, 36 percent in Tennessee and 54 percent in Minnesota, according to documents posted online by the federal government and state insurance commissioners and interviews with insurance executives.

The Oregon insurance commissioner, Laura N. Cali, has just approved 2016 rate increases for companies that cover more than 220,000 people. Moda Health Plan, which has the largest enrollment in the state, received a 25 percent increase, and the second-largest plan, LifeWise, received a 33 percent increase.

Jesse Ellis O’Brien, a health advocate at the Oregon State Public Interest Research Group, said: “Rate increases will be bigger in 2016 than they have been for years and years and will have a profound effect on consumers here. Some may start wondering if insurance is affordable or if it’s worth the money.”

I can tell you that in my case insurance is neither affordable nor worth the money.

Gern Blansten · May 2016

That's not because of the ACA. My rates with Anthem went up 20-25%/year starting back in 1998 when I became self employed.

jeffbr · May 2016

I know we've gone back and forth on this a few times. Our insurance experiences have been vastly different, so it makes sense our opinions are as well. I had very stable rates and coverage clauses until ACA at which point my deductibles skyrocketed, my premiums did as well, and it came with more exclusions and limitations. ACA was a good attempt, but there are many consumers who will now be negatively affected. The last line of that NYT article sums up my experience.

Gern Blansten · May 2016

I know a lot of people were effected because the plans they were on were not conforming.

I would have rather had single payer....I have been tempted to ditch health insurance altogether.

But this post is about 90% of Americans being covered. That can't be argued with.

Gern Blansten · May 2016

Just an FYI....I'm a CPA and would guess that for every story like yours that I come across from my clients I have at least 2-3 clients who have seen the reverse. They have gone from paying $1,300/month to $600/month because of the pre-existing condition bullshit. They were hostages to their original health insurance provider until the ACA kicked in.

jeffbr · May 2016

Yeah, I certainly don't dispute that more Americans are covered, and that is a good thing. Perhaps the ratio of increases vs decreases in premiums is a state by state issue, but in my circle I don't know anyone who had coverage who is happy with how it has turned out. I do have a few friends who now have insurance who didn't before, and I am happy for them (no sarcasm here). So for me, ACA has been great for getting people covered, and less than great for those who were covered and make too much to qualify for subsidies.

I've also been tempted to ditch coverage. At this point it may be cheaper to pay the fucking IRS fine, and pay the medical bill myself for the rare occasion I use the healthcare system. But I don't want to risk something catastrophic occurring and not being able to get it taken care of (although with deductibles and policy limitations it would still end up being "catastrophic" on my financial situation). Unfortunately, I don't see Trump or Clinton having any sort of solution to the problem, so we've got 4 - 8 more years of the status quo as far as I can tell.

what dreams · May 2016

My employer is now instituting a $2000 deductible to include routine visits because they want people to be more selective about when they go to the doctor. If we have to pay for it, the logic goes, we will decide we really don't need care. Straight out of HR's mouth in an employee meeting. Total BS.

ACA sucks, and single payer would be worse. Look at the VA situation and Medicare. Not too many success stories coming out of those systems. I would never vote for anyone who proposes single payer. I say that as a cancer survivor who would never be okay with waiting months for appointments or with a doctor offering treatment based on a govt approved protocol. When I was going through treatment, I belonged to an online support group, and I heard sad, sad stories from Canadian and European patients who had no options because their govt sponsor health plans would not approve them. That's jacked up. My life. My body. I decide.

Gern Blansten · May 2016

jeffbr said:
Yeah, I certainly don't dispute that more Americans are covered, and that is a good thing. Perhaps the ratio of increases vs decreases in premiums is a state by state issue, but in my circle I don't know anyone who had coverage who is happy with how it has turned out. I do have a few friends who now have insurance who didn't before, and I am happy for them (no sarcasm here). So for me, ACA has been great for getting people covered, and less than great for those who were covered and make too much to qualify for subsidies.

I've also been tempted to ditch coverage. At this point it may be cheaper to pay the fucking IRS fine, and pay the medical bill myself for the rare occasion I use the healthcare system. But I don't want to risk something catastrophic occurring and not being able to get it taken care of (although with deductibles and policy limitations it would still end up being "catastrophic" on my financial situation). Unfortunately, I don't see Trump or Clinton having any sort of solution to the problem, so we've got 4 - 8 more years of the status quo as far as I can tell.

I've thought through it to some degree...

If you have no insurance and get hit by a car and your medical bills are $ 300,000 you basically work out a payment plan with the hospital....no different than insurance. If they want to force collection you just declare bankruptcy.

If you get cancer you just wait for the next enrollment period and then sign up....they can't refuse you anymore.

It's tempting as hell. We've been lucky and have only been close to maxing our deductible once or twice the past 20 years.

what dreams · May 2016

jeffbr said:
I know we've gone back and forth on this a few times. Our insurance experiences have been vastly different, so it makes sense our opinions are as well. I had very stable rates and coverage clauses until ACA at which point my deductibles skyrocketed, my premiums did as well, and it came with more exclusions and limitations. ACA was a good attempt, but there are many consumers who will now be negatively affected. The last line of that NYT article sums up my experience.

Your experience is my experience. I would venture to say it's probably true of most people in large pools. Apparently I had a "Cadillac" plan but now I'm driving a Ford Focus.

Gern Blansten · May 2016

what dreams said:
My employer is now instituting a $2000 deductible to include routine visits because they want people to be more selective about when they go to the doctor. If we have to pay for it, the logic goes, we will decide we really don't need care. Straight out of HR's mouth in an employee meeting. Total BS.

ACA sucks, and single payer would be worse. Look at the VA situation and Medicare. Not too many success stories coming out of those systems. I would never vote for anyone who proposes single payer. I say that as a cancer survivor who would never be okay with waiting months for appointments or with a doctor offering treatment based on a govt approved protocol. When I was going through treatment, I belonged to an online support group, and I heard sad, sad stories from Canadian and European patients who had no options because their govt sponsor health plans would not approve them. That's jacked up. My life. My body. I decide.

Wrong....you hear a lot of VA horror stories but the majority of people are very happy with it. Same with medicare...the approval rating is like 85%

And FYI...the US systems ranks WAY below Canada and most European countries health care systems

what dreams · May 2016

Well, please share the stories where vets and seniors praise the VA and Medicare.

I guess if you're healthy and can afford a fancy supplement, it's easy to approve. . . . Sick, poor people? Everyone I know with elderly parents, including my own, get practically nothing covered that old people actually need. Medication costs are through the roof. Doctors no longer accepting Medicare patients . . .

Statistics lie.

Gern Blansten · May 2016

Look up the approval ratings. The majority approve.

what dreams · May 2016

Gern Blansten said:
Look up the approval ratings. The majority approve.

Google search yields a 60% approval rating in the two top articles. Sure, it's a majority, but it's not knocking it out of the ball park.

I'm sure people generally approve of the idea. I'd like to see some real research on patient satisfaction.

Gern Blansten · May 2016

The ACA now ties hospital reimbursement to patient satisfaction...try arguing that doesn't improve care

lukin2006 · May 2016

Maybe health insurance should be tied to income ... Say 5%, so if you make more you pay more. Because it just seems to some Americans universal health care is just too much a social program to institute.

With exemption that the poor or working poor are covered freely.

what dreams · May 2016

Gern Blansten said:
The ACA now ties hospital reimbursement to patient satisfaction...try arguing that doesn't improve care

Actually, curiously enough, I just read two articles -- one in The Atlantic and one in Modern Healthcare -- that state the hospitals with the highest ACA mandated satisfaction rates tend to have the worst outcomes. People are more likely to get infections, be re-admitted, or even die in hospitals with the highest satisfaction ratings. Nurses are now being coached to satisfy patients instead of treat patients . . . i.e., give people what they want, not what they need. It’s not my argument. It's two 2015 reports based on research in the medical schools.

mace1229 · May 2016

My rates have only gone up slightly, but the coverage gets worse and worse. Copays and deductibles are a lot higher.
What makes me more upset is the loopholes to get medication they put us through now that we never had to do before. My wife takes a medication that must be delivered. Every time the Dr. changes the dosage they require so much more paperwork and approval process than before that by the time it all gets through she's back to the normal dosage. A tone time the completely denied her R.A. medication for 3 months requiring more Dr. approval (even though she had been on it for years). Every time we called in we were given a DIFFERENT number to pass to our doctor complete the approval. Each time we were told "I don't now why they gave you that number. That's the wrong number that's why it didn't go through, call this number."
This went on for 3 months until I said "You get this approved today or I am speaking to a lawyer." I was on hold for 30 seconds before the agent came back and said "it's been approved and you will receive it tomorrow."
Unfortunately our Dr. told us this has become more common to delay medication to save money on their end.

Go Beavers · May 2016

This is how the ACA is a step towards a single payer system. Now we're all in, and private companies aren't bringing down the costs, so people will eventually look to the government to do the leveraging, after looking at the several functioning models from other countries.

callen · May 2016

It's not perfect but step in right direction. Full stop.

my2hands · May 2016

I support the idea of Universal Health Care... But the track record of the VA and the general incompetence and red tape of the government scares the s*** out of me when it comes to my health care

Jason P · May 2016

10% of Americans can now be fined by the IRS

Godfather. · May 2016

Jason P said:
10% of Americans can now be fined by the IRS</blockquote

my friend could not afford insurance so he didn't pay it last year and got a fine of $2100.....to broke to pay but the government wants that fine money anyway..

Godfather.

Gern Blansten · May 2016

Godfather. said:

Jason P said:
10% of Americans can now be fined by the IRS

If he's broke he could get free insurance through the marketplace.

$2100 penalty means he isn't broke...just lazy

BinFrog · May 2016

Godfather. said:

my friend could not afford insurance so he didn't pay it last year and got a fine of $2100.....to broke to pay but the government wants that fine money anyway..

Godfather.

That's a complete lie and not at all how the fining system works. If your friend paid $2100, then he is not broke at all and is just stubborn. Or you are completely lying and he either paid far less or nothing at all because his income was too low to meet the threshold.

HughFreakingDillon · May 2016

I am Canadian, so all this goes over my head. I just show up and get better. No money. But admittedly, sometimes a VERY long wait.

BinFrog · May 2016

HughFreakingDillon said:
I am Canadian, so all this goes over my head. I just show up and get better. No money. But admittedly, sometimes a VERY long wait.

http://www.forbes.com/sites/theapothecary/2014/06/13/if-universal-health-care-is-the-goal-dont-copy-canada/#50a6e2c9290d

HughFreakingDillon · May 2016

BinFrog said:

HughFreakingDillon said:
I am Canadian, so all this goes over my head. I just show up and get better. No money. But admittedly, sometimes a VERY long wait.
http://www.forbes.com/sites/theapothecary/2014/06/13/if-universal-health-care-is-the-goal-dont-copy-canada/#50a6e2c9290d

of course. there are MANY issues with it. including losing doctors to the US because staying up here just makes no financial sense. it's damn difficult finding a GP if you don't get grandfathered in with your parents.

HughFreakingDillon · May 2016

there was a guy who died in the waiting room in Winnipeg years ago from complications from a bladder infection because he was overlooked for over 36 hours. the nurses are just plain too busy here.

Godfather. · May 2016

BinFrog said:

Godfather. said:

my friend could not afford insurance so he didn't pay it last year and got a fine of $2100.....to broke to pay but the government wants that fine money anyway..

Godfather.

That's a complete lie and not at all how the fining system works. If your friend paid $2100, then he is not broke at all and is just stubborn. Or you are completely lying and he either paid far less or nothing at all because his income was too low to meet the threshold.

no it's not, no he's not....we need to have beer.

Godfather.

BinFrog · May 2016

If your friend is single, and he was forced to pay $2100, then he makes six figures.

90% of Americans have health insurance....

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