(UPDATED) Trying to stay out of the Obamacare debate...

Shawshank

jeffbr said:

I know the ACA apologists don't or won't look at the real world effects of this policy, but while it is great that ACA created coverage for the poor who couldn't previously afford insurance, it is now about to tank the middle class' ability to receive healthcare. The policy choices are disappearing, rates are skyrocketing, coverage is diminished, insurers are either getting double digit rate requests approved, or leaving exchanges, etc... This has been going on for awhile. I know this past year in this thread there have been people who buried their heads in the sand and said all is well, ACA is a success. But the consequences of ACA are getting harder and harder to obfuscate no matter how much hand waving and misdirection they use. All across the country exchanges are getting decimated and choice is disappearing. That blog post link a couple of posts above basically acknowledges all of the failures, but decides that the ACA isn't a failure because 20 million more people have insurance. Well, many of them were forced to get it, and most who have it can't use it because of high deductibles. So while "failure" may be too harsh a word for the blog post author, it is an accurate word for those of us struggling with the effects of premium hikes and high deductibles.

Obamacare Is Stuck in a Feedback Loop of Bad Policy and Bad Politics

^^^^^^^
[/endthread] That pretty much says all that needs to be said, and unless you're just obtuse, there is literally no argument against it

Go Beavers

Would it be obtuse to say that in the 20 years before ACA people's premiums were skyrocketing, coverage was getting more and more limited, and they were being dropped by insurance companies?

Shawshank

Go Beavers said:

Would it be obtuse to say that in the 20 years before ACA people's premiums were skyrocketing, coverage was getting more and more limited, and they were being dropped by insurance companies?

Aside from the first year of the ACA...I actually had better coverage, with a lower premium, with my old plans. My max out of pockets are the same as they were with my old plans, and I actually have a higher copay now...and I pay a higher premium for that privilege.

And when you lose the ability to find coverage because your carrier is dropping out of the exchange...you are essentially being dropped by your provider. So you not only have people being dropped, but you have limited availability and skyrocketing premiums (I've paid at least 15-20% more each year since year one of this bullshit). So not much has changed.

Gern Blansten

Go Beavers said:

Would it be obtuse to say that in the 20 years before ACA people's premiums were skyrocketing, coverage was getting more and more limited, and they were being dropped by insurance companies?

nope...

I became self employed in 1998. Every year my premiums would go up 20-25%. This was a high deductible policy to begin with.

About 7 years ago, when talk of health reform was beginning, my premiums would only go up like 10-15%/year. I always assumed that it was because the insurance companies were trying to say "see we can control costs and keep the annual increase down" but that's just a guess.

At least with the ACA you are guaranteed coverage. The days of being denied and lifetime caps are gone. Thanks Obama.

Shawshank

Gern Blansten said:

At least with the ACA you are guaranteed coverage. The days of being denied and lifetime caps are gone. Thanks Obama.

Missing the point. IF you can find an insurance provider in your region. As I said before, what difference does it make that you are guaranteed coverage, if you can't find a company that offers insurance in your area? What kind of "savings" do you think you will get when their is only one provider in the exchange for your area?

jeffbr

Go Beavers said:

Would it be obtuse to say that in the 20 years before ACA people's premiums were skyrocketing, coverage was getting more and more limited, and they were being dropped by insurance companies?

Yup. While you could say that it is only a distraction because those things are nothing compared to what we're seeing today. I had insurance during that entire period. Reasonable deductibles, reasonable premiums that I look back on longingly. Lots of choices of plans from PPOs to HMOs. Since ACA I have no choices of plans, my premiums are outrageous, my deductible makes it so any expenses I incur are out of pocket. So I don't use my insurance, but I am forced by the feds to have it. And the promise with ACA was that it would cut skyrocketing healthcare costs. Mylan must be a great recent example of how costs are now under control.

And "dropped by insurance companies" really took off after ACA. Remember that canard from BHO "If you like the plan you have, you can keep it. If you like the doctor you have, you can keep your doctor, too. The only change you’ll see are falling costs as our reforms take hold." I guess he got the last laugh.

I'll grant you that the ACA was enacted with the best of intentions. Unfortunately, the best of intentions aren't paying my premiums or controlling my healthcare costs.

Gern Blansten

Shawshank said:

Gern Blansten said:

At least with the ACA you are guaranteed coverage. The days of being denied and lifetime caps are gone. Thanks Obama.

Missing the point. IF you can find an insurance provider in your region. As I said before, what difference does it make that you are guaranteed coverage, if you can't find a company that offers insurance in your area? What kind of "savings" do you think you will get when their is only one provider in the exchange for your area?

That depends on your ailment doesn't it? If your premium is $1,000/month and you get cancer then you saved a million bucks by having insurance.

The ACA requires insurers to only allow 20% of premiums to go toward admin costs. 80% must be toward providing medical care to those insured.

mace1229

Early in the thread cash visits were mentioned. With the exception of life-threatening illnesses that require months of treatment, it seems like that could easily be the best.
In so many ways insurance is such a scam. We had a baby just a couple months ago and the headache of all the insurance was worse than the labor my wife went through (she'll probably disagree with that).
Every visit we get a bill that states what the hospital wanted, then the "negotiated" fee which is a fraction of the original bill, then the portion my insurance covered.
On more than one occasion we got a bill for over $2,000 because it was for lab work our insurance did not cover, and when we called the lab company they said they just send out a bill for $2,000 and see if insurance will pay it, and since it was out of network they didn't cover it so the lab reduced the fee to a mere $50. How can you go from $2000 to $50?
Even with having a baby, and both mom and baby stayed in the hospital for 3 days, we barely saved any money using insurance for that month if you compare it to the "negotiated" fee when you consider between myself and employer we pay $1500/ month. Or "negotiated' fees only totaled about $2500 for that month, and we paid $1500 of that in premiums, and another $700 in copays. Our insurance was only out about $300 for that month, and we had a freaking baby! The other 11 months of this year there was almost no expense to our insurance.
Cut out the middleman (insurance) and have reasonable fees that people can afford (the "negotiated" rate).
On top of that, most doctor offices have to have at least 1 full time person to just deal with insurance, which raise costs too.

Shawshank

Gern Blansten said:

That depends on your ailment doesn't it? If your premium is $1,000/month and you get cancer then you saved a million bucks by having insurance.

The ACA requires insurers to only allow 20% of premiums to go toward admin costs. 80% must be toward providing medical care to those insured.

I really don't know why this is so hard for some of you to understand. You do realize that insurance providers are dropping out of the exchange like crazy right? That there are fewer and fewer plans being offered. That there are fewer doctors incorporated into those plans. You do realize that don't you?? That is the whole point behind the resurrection of this thread. If you can't find an insurance provider that will allow you see a doctor within an hour of where you live, because that is pretty much where we will be next year, then what difference does it make if you have insurance?? So now you either have the added expense of seeing someone out of network...which may not even be permitted in some plans...or you have to drive 50 or 60 miles to see a doctor that is in their network, which may be impossible for some that don't have adequate transportation.

mace1229

Shawshank said:

Gern Blansten said:

That depends on your ailment doesn't it? If your premium is $1,000/month and you get cancer then you saved a million bucks by having insurance.

The ACA requires insurers to only allow 20% of premiums to go toward admin costs. 80% must be toward providing medical care to those insured.

I really don't know why this is so hard for some of you to understand. You do realize that insurance providers are dropping out of the exchange like crazy right? That there are fewer and fewer plans being offered. That there are fewer doctors incorporated into those plans. You do realize that don't you?? That is the whole point behind the resurrection of this thread. If you can't find an insurance provider that will allow you see a doctor within an hour of where you live, because that is pretty much where we will be next year, then what difference does it make if you have insurance?? So now you either have the added expense of seeing someone out of network...which may not even be permitted in some plans...or you have to drive 50 or 60 miles to see a doctor that is in their network, which may be impossible for some that don't have adequate transportation.

The only time myself or anyone else with my same health plan would actually benefit from health insurance would be something catastrophic like cancer that requires hundreds of thousands of dollars of treatment.
It's ridiculous that we contribute over $1500/month for insurance and still have copays and deductibles as high as they are.
Think of car insurance, if you get into an accident or your car gets stolen you think "I'm glad I have this insurance, it saved me thousands this month."
But even after having a baby, after the copays and premiums I essentially broke even last month (meaning my out of pocket expenses would have been the same with or without insurance for last month), and that's just for the month. You would think maybe some years I don't get much of a return on it, but when I have a baby you'd think to yourself "I'm glad we had insurance or we couldn't afford these bills." But nope, between my premiums and copays I would have paid about thee same amount last month, and saved most of the $1500 a month prior to that (with some dr visits totally a couple hundred bucks). All the other months I spend $1500 and get virtually nothing back. I've been forced to pay $1500 a month for insurance and don't even have a choice in the plan because since it is through my employer. I don't have the option to search for other health plans and don't qualify for state or government sponsored plans, or anything else offered through ACA.

I've even learned to ask for the cash price when filling a prescription because I've found that my plan, that I have no choice in, often has a higher co-pay for prescription than the cash out-of-pocket price. A copay might be $30 to fill a prescription, but the cash price is only $12, how does that make any sense?

jeffbr

mace1229 said:

I've even learned to ask for the cash price when filling a prescription because I've found that my plan, that I have no choice in, often has a higher co-pay for prescription than the cash out-of-pocket price. A copay might be $30 to fill a prescription, but the cash price is only $12, how does that make any sense?

Me, too. It makes no sense at all. I tell the pharmacist at the grocery store that I don't have insurance, and they give me the cash price. For a while it was $4 for generics, so it was way cheaper than my prescription co-pay.

Between our unwieldy regulatory environment, greedy big pharma, and asshole insurance companies, our healthcare system is a mess.

PJ_Soul

Reading this thread... oh man.

gimmesometruth27

here is a solution.

everyone pays cash. full cost of everything billed is your out of pocket responsibility.

i'll bet that terrible obamacare looks pretty good in that situation.

jeffbr

gimmesometruth27 said:

here is a solution.

everyone pays cash. full cost of everything billed is your out of pocket responsibility.

i'll bet that terrible obamacare looks pretty good in that situation.

If it went that direction patients would become consumers and would price shop. $1,500 bills would suddenly become $100 bills. I'm not advocating for that but most of the bloat is due to regulation and insurance companies. All current pricing is completely detached from any market forces. Totally artificial. Something has to change and the ACA is a misnomer. "Affordable" is some sort of Orwellian newspeak.

Shawshank

And just to be clear, I'm not bitching about Obamacare in general, or even the exchange. When I first created this thread, like 3 years ago, I was pissed because the insurance I was told I could keep, I couldn't. And the policy was cancelled because it didn't comply. However, at the time, the insurance I got through the exchange in many ways was actually better than I had before...at least that first year.

The problem now has become that I am extremely restricted on choices for health coverage through the exchange. My current insurance plan/company is exiting the marketplace. It allowed me to see local doctors, and while comparable to what I had before Obamacare in both coverage and costs, it was still considerably more expensive than the previous two years. The one I the year before that was the shittiest insurance I've ever had, and none of my doctors were in their network, which sucked because we had to drive 45 miles to see a doctor. They too exited the market place. The one I had the year before that...the first year of Obamacare...was the best coverage I've had...and it also exited the marketplace.

The first year we signed up I think we had probably 12 to 16 companies to choose from. The following year it was barely half that. When I signed up last year I had 4 choices for insurance providers. Only one of them had our doctors in their network. So obviously we took that one. Now that insurance company is exiting the marketplace.

Are there seriously only a couple of people on these boards that realize what a fucking disaster that is? I'm wondering what could possibly be blinding some of you to the reality that many people are experiencing. Granted what I've described is just my experience, but it is far from an isolated case. Even the post that was linked to earlier today, lauding that Obamacare isn't in as bad of shape as people say it is, shows that many markets only have one or two choices for insurance. In what universe is that considered a success??

What does that do to the people who do have cancer and other serious ailments, who do want to continue seeing their current specialists, who don't want to change doctors, who don't have the means to drive 30, 40 or 60+ miles to stay within the network of some shitty insurance plan???

mace1229

gimmesometruth27 said:

here is a solution.

everyone pays cash. full cost of everything billed is your out of pocket responsibility.

i'll bet that terrible obamacare looks pretty good in that situation.

not really.
If I get to keep an extra $1500 a month, and if the hospital would only bill me $2500 like they billed my insurance for having a kid instead of the ridiculous fees they charge the uninsured, then we'd all be better off.

Instead, if you dont have insurance they bill you 10 times what they bill insurance. Knowing people who didnt have insurance, and looking at our original bills, they charge more than 20K for a baby, but the "negotiated" fees were reduced to $2500 through insurance.

If they charged those reasonable rates to begin with, we wouldnt need insurance and I'd keep an extra $1500 a month that would easily cover any of my medical expenses.
And the premiums are so ridiculously high that the insurance makes money even during the months of when I have expensive healthcare issues, because my premium more than covers the expenses in every month I've ever hard it except when I had a baby, and it only saved me about $200-$300 by using it for that month. The rest of the time I'm being forced to pay $1500 a month for nearly nothing.

gimmesometruth27

health care providers and hospitals need to charge 3 times the rate because insurance negotiates them down from that billed price. i work with a surgeon. we gets thousands less than what is billed because of buerocracy and red tape and resistance from insurance companies.

united health care takes everyone's premiums, denies payment to doctors, sticks their customers with high out of pocket costs, and their executives get billion dollar bonuses each year. that to me is the definition of criminal.

Shawshank

gimmesometruth27 said:

united health care takes everyone's premiums, denies payment to doctors, sticks their customers with high out of pocket costs, and their executives get billion dollar bonuses each year. that to me is the definition of criminal.

I thought those typed of plans were prohibited since Obamacare was enacted?

gimmesometruth27

Shawshank said:

gimmesometruth27 said:

united health care takes everyone's premiums, denies payment to doctors, sticks their customers with high out of pocket costs, and their executives get billion dollar bonuses each year. that to me is the definition of criminal.

I thought those typed of plans were prohibited since Obamacare was enacted?

i work with a specialist. maybe they could not deny services for primary care/preventive stuff. god knows united denies our hip arthroscopies 90% of the time and we have to appeal only to get denied again. then we try to set up a peer to peer with my doctor and an insurance company doctor. they ask us for 3 different dates/times that my doctor is available to review case with their doctor. they don't call during those times, instead they call after hours. we appeal, they said they called, which they were obligated to do. they win by technicality. fuck united health care with a big metal dildo.

i was taught that high deductible plans were illegal under obamacare. i have found out that we were misinformed.

Shawshank

gimmesometruth27 said:

fuck united health care with a big metal dildo.

Bahahahaha!!! Perfect!!

Yeah I was told my pre-obamacare plan was illegal and had to be terminated, even though it was perfect for us. Now my deductible and max out of pocket is actually higher than that one was.

mace1229

gimmesometruth27 said:

health care providers and hospitals need to charge 3 times the rate because insurance negotiates them down from that billed price. i work with a surgeon. we gets thousands less than what is billed because of buerocracy and red tape and resistance from insurance companies.

united health care takes everyone's premiums, denies payment to doctors, sticks their customers with high out of pocket costs, and their executives get billion dollar bonuses each year. that to me is the definition of criminal.

I understand they present a high bill because it's negotiated down. But if they would just present a $200 bill to begin with, instead of $2,000 that's negotiated down to $200, I could actually afford that and wouldn't need insurance, and would be saving $1500 a month

jeffbr

Looks like Bill Clinton is now speaking the truth about the ACA. Hopefully he's had a little Obamacare pillow talk with the presidential front runner.

Even Bill Clinton Thinks Obamacare Is a “Crazy System” That “Doesn’t Make Sense”

"So you've got this crazy system where all of a sudden 25 million more people have health care and then the people who are out there busting it, sometimes 60 hours a week, wind up with their premiums doubled and their coverage cut in half. It's the craziest thing in the world," the former president said, according to CNN.

"The current system works fine if you're eligible for Medicaid, if you're a lower-income working person, if you're already on Medicare, or if you get enough subsidies on a modest income that you can afford your health care," he said. "But the people that are getting killed in this deal are small business people and individuals who make just a little too much to get any of these subsidies."

Go Beavers

A subtle nod to a single payer system.

jeffbr

Go Beavers said:

A subtle nod to a single payer system.

Probably, and that's ok with me. I'm just glad that we finally have a respected Dem admitting the failings of the ACA, instead of the obfuscation and hand waving we usually get, where Obama disciples attempt to downplay the negative effects that we are actually experiencing. The good news is that it seems certain that no matter who wins next month, the ACA will be a target for some major reform. Obama couldn't touch it, since he hangs his hat on this "accomplishment." I applaud his efforts to try to do something, but have been disappointed by his unwillingness to admit that it didn't work. So now let's try something different.

Go Beavers

I've never really seen anyone who declares that ACA didn't objectively define how it didn't work. They usually reference anecdotal stories, or their own insurance story, which isn't a broad enough sample size. I would say it hasn't really kept costs down, which I didn't think it would do in the first place. I like that it's a step toward a single-payer system. Some day we'll get there.

pjalive21

Dr. Ezekial Emmanuel is an idiot and lied deceiving thousands of people...this guy had no clue what was going to happen...Megyn Kelly thrashes this tool

http://nation.foxnews.com/2016/10/05/megyn-kelly-confronts-obamacare-architect-about-rising-premiums-fiery-exchange

lukin2006

It's outrageous that the world’s richest country doesn't provide healthcare as a right, like virtually all other developed nations.-Jill Stein

lukin2006

Since obamacare was passed around eight years ago...

Has the law been adjusted, reviewed for any short coming, are they fixed? Are their annual reviews?

jeffbr

It's been tweaked but mostly we're just sitting back and watching it go into a death spiral .

lukin2006

Like Romneycare that preceded it in Massachusetts, Obamacare was designed to enrich the health insurance and pharmaceutical industries. - Jill Stein