90% of Americans have health insurance....

what dreams · May 2016

Good morning. I'm backing out of the discussion. We've all got our heels dug in, and I can pretty much predict everyone's responses by now (my own included).

I'll just remain thankful that we will not see single payer in my lifetime in this country and thankful for the few provisions in ACA that curb insurance company abuse. I can't be upset with reality on this one. It's on my side.

mace1229 · May 2016

what dreams said:
The discussion topic, actually, started with the statement that 90% of Americans are now insured. In my world, 90% is an A. Excellent, or at least very good. In whose world is 90% a failed system?

The discussion turned to universal health care and single payer, and my personal experience does tell me that in no way am I interested as a taxpayer in supporting any more deadbeats. We already support enough deadbeats in the variety of ways I illustrated, and no, nothing about that makes us better as a society.

And trust me, if any of my aforementioned family were pulled off public health care, there would be no change in their actual health. They would still smoke and drink excessively, eat crap, not exercise, and otherwise poison their bodies. Being on public health care does not guarantee health.

I agree. I was reluctant to say anything due to the fact it comes across as insensitive, but its true. While there are of course many who need assistance for various reasons who deserve it and don't abuse it, I can't help but feel I witness more people abusing it than not. I fortunately don't have any immediate family members in that situation, but know lots of people from other areas of my life.

I've known people turn down jobs because they'd rather collect financial assistance than earn it. I've known people who had no intentions to finish school because they came from a family that knew how to take handouts and that was what was taught them. I was also in education, in South Central Los Angeles, one of the poorest areas that I have seen with 98% of our students on free lunch. This was an area where drug raids across the street were common, shootings and bomb threats were a regular occurrence in the neighborhood. Students were not allowed to wear jewelry to school because they would get beat up and robbed on the public bus on their way home if they wore any. I even got stopped at a DUI check point on my way to work one day...only to find it wasn't a DUI check , they were searching every car for a missing body. But who had the worse cell phone in the class? I did. I only updated from a flip phone 2 years ago, while my students (on free lunch) were coming in with the newest iphone all the time. I've had parents flat out tell me they don't need their son/daughter to finish school because they can just collect assistance.

ACA seems like an extension of that to me. One more reason to not work and you get free healthcare. But if you do work and can afford it, we'll raise the cost and make you pay for things you don't need to cover everyone else.

Gern Blansten · May 2016

what dreams said:
The discussion topic, actually, started with the statement that 90% of Americans are now insured. In my world, 90% is an A. Excellent, or at least very good. In whose world is 90% a failed system?

The discussion turned to universal health care and single payer, and my personal experience does tell me that in no way am I interested as a taxpayer in supporting any more deadbeats. We already support enough deadbeats in the variety of ways I illustrated, and no, nothing about that makes us better as a society.

And trust me, if any of my aforementioned family were pulled off public health care, there would be no change in their actual health. They would still smoke and drink excessively, eat crap, not exercise, and otherwise poison their bodies. Being on public health care does not guarantee health.

guess what....you already support the deadbeats. Their cost is built in to what you already pay for health services

Single payer or universal cuts out the millions paid to insurance companies.

I'm always amazed at how conservatives are ok with letting an insurance company dictate their health needs but freak out at the suggestion that the government might get involved. I'll trust a nonprofit over a for profit any day.

mace1229 · May 2016

Gern Blansten said:

what dreams said:
The discussion topic, actually, started with the statement that 90% of Americans are now insured. In my world, 90% is an A. Excellent, or at least very good. In whose world is 90% a failed system?

The discussion turned to universal health care and single payer, and my personal experience does tell me that in no way am I interested as a taxpayer in supporting any more deadbeats. We already support enough deadbeats in the variety of ways I illustrated, and no, nothing about that makes us better as a society.

And trust me, if any of my aforementioned family were pulled off public health care, there would be no change in their actual health. They would still smoke and drink excessively, eat crap, not exercise, and otherwise poison their bodies. Being on public health care does not guarantee health.
guess what....you already support the deadbeats. Their cost is built in to what you already pay for health services

Single payer or universal cuts out the millions paid to insurance companies.

I'm always amazed at how conservatives are ok with letting an insurance company dictate their health needs but freak out at the suggestion that the government might get involved. I'll trust a nonprofit over a for profit any day.

That's true, but it seems like that cost is even higher now. My rates have certainly risen. And one example as to maybe why is from a friend who works in the ER. He has told me the majority patients who come to his ER don't need emergency treatment. But openly admit since they are on a government paid plan they'd rather go to the ER at some weird hour than make an appointment during the day. And not only is it costing everyone more for these ridiculous ER visits, but the wait at his ER has also significantly increased to several hours due the increase in patients.

And aren't all insurance companies still for profit? That hasn't changed, the only change is the government tells you what you must be covered for even if you don't want it and forks some of the bill now for those "deadbeats". Sign me up for any auto, house, life or health insurance that is run by a nonprofit. I'll even start taking the insurance when the dealer is showing an Ace if its run by a nonprofit.

rgambs · May 2016

mace1229 said:

Gern Blansten said:

what dreams said:
The discussion topic, actually, started with the statement that 90% of Americans are now insured. In my world, 90% is an A. Excellent, or at least very good. In whose world is 90% a failed system?

The discussion turned to universal health care and single payer, and my personal experience does tell me that in no way am I interested as a taxpayer in supporting any more deadbeats. We already support enough deadbeats in the variety of ways I illustrated, and no, nothing about that makes us better as a society.

And trust me, if any of my aforementioned family were pulled off public health care, there would be no change in their actual health. They would still smoke and drink excessively, eat crap, not exercise, and otherwise poison their bodies. Being on public health care does not guarantee health.
guess what....you already support the deadbeats. Their cost is built in to what you already pay for health services

Single payer or universal cuts out the millions paid to insurance companies.

I'm always amazed at how conservatives are ok with letting an insurance company dictate their health needs but freak out at the suggestion that the government might get involved. I'll trust a nonprofit over a for profit any day.
That's true, but it seems like that cost is even higher now. My rates have certainly risen. And one example as to maybe why is from a friend who works in the ER. He has told me the majority patients who come to his ER don't need emergency treatment. But openly admit since they are on a government paid plan they'd rather go to the ER at some weird hour than make an appointment during the day. And not only is it costing everyone more for these ridiculous ER visits, but the wait at his ER has also significantly increased to several hours due the increase in patients.

And aren't all insurance companies still for profit? That hasn't changed, the only change is the government tells you what you must be covered for even if you don't want it and forks some of the bill now for those "deadbeats". Sign me up for any auto, house, life or health insurance that is run by a nonprofit. I'll even start taking the insurance when the dealer is showing an Ace if its run by a nonprofit.

The stuff about the ER is just confirmation bias. ER visits have always been overused, and always for the same two reasons.
1. It is easier than scheduling an appointment weeks out during working hours
2. Many/most insurance plans cover ER visits more fully than office visits.

The ACA hasn't changed anything in regards to this issue, so it is a clear case of confirmation bias.
I saw it a ton when I was working in the surgical department of a very large hospital, it was during the earliest debate about Obamacare, before and during its passing. Surgeons were shouting doom and gloom down the halls and claiming that they were going to drop all Medicaid and Medicare patients immediately and other outlandish claims. Years later and it's still business as usual, not much has changed.

mace1229 · May 2016

I've always avoided the ER because in every plan I've ever been on its been outrageously expensive, where a Dr visit was affordable. I'll pay $20 to see a Dr, or several hundred (at best) to use the ER.
We change health coverage about every other year at my employment, but that is one thing every plan has had in common. I don't remember ever seeing cheaper ER visits than Dr appointment visits, even when researching to do out-of-pocket insurance. ERs get overused when someone else is paying for it.

What I will agree on is it has always been an issue. Even without insurance. In low-income areas many were using the ER with no intention of paying the bill knowing they couldn't be turned down. Several local hospitals in my area were shut down, reporting this as the cause. This was several years before ACA, so obviously was not connected. It seems logical this problem would only increase if more people don't have to pay their own bills though.

RoleModelsinBlood31 · May 2016

I haven't had insurance for the last four years, since I left a company that had a good package. I haven't paid a fine yet. I make good money so can't get subsidized rates so I just said fuck em. When I do my taxes it asks why you didn't have insurance and I just check the box that says "couldn't afford it," and all is good!

Of course as I get older I don't have that peace of mind without it, but paying $300 this past year for two visits to the clinic sure beat the shit outta $400+ a month!

Gern Blansten · May 2016

RoleModelsinBlood31 said:
I haven't had insurance for the last four years, since I left a company that had a good package. I haven't paid a fine yet. I make good money so can't get subsidized rates so I just said fuck em. When I do my taxes it asks why you didn't have insurance and I just check the box that says "couldn't afford it," and all is good!

Of course as I get older I don't have that peace of mind without it, but paying $300 this past year for two visits to the clinic sure beat the shit outta $400+ a month!

I'll be interested to see if you get challenged on that. The rates are published so if the published rates are less than 8% of your income you are technically considered to be able to afford it.

That being said....I haven't seen a case yet (I'm a CPA/tax guy) where the IRS has levied the penalty on anyone. I have seen a few cases where they sent out a letter saying "you paid a penalty but it looks like your income was too low" which I thought was interesting.

EdsonNascimento · June 2016

http://www.msn.com/en-us/money/healthcare/obamacare-worries-largest-texas-insurer-asks-for-60-percent-price-hike/ar-BBtKIHr?li=BBnbfcN

Who is paying for 70% of those rate increases? The small % of people that actually pay Federal Income Taxes.

All he did was a massive expansion of Medicaid. Everyone laughed at the Republicans who said - hidden tax. Well, they were clearly correct.

Expect roll backs in required benefits. We are already in a massive deficit. Where is this money coming from?

inmyNC · June 2016

EdsonNascimento said:
http://www.msn.com/en-us/money/healthcare/obamacare-worries-largest-texas-insurer-asks-for-60-percent-price-hike/ar-BBtKIHr?li=BBnbfcN

Who is paying for 70% of those rate increases? The small % of people that actually pay Federal Income Taxes.

All he did was a massive expansion of Medicaid. Everyone laughed at the Republicans who said - hidden tax. Well, they were clearly correct.

Expect roll backs in required benefits. We are already in a massive deficit. Where is this money coming from?

I paid $450per mo for my son and i back in 2009. Then my residential construction business went south as if a light switch had been turned off. I went 3 years with no coverage and paid all health care out of pocket. In 2013 I once again got coverage with at $500per mo. Then the Affordable Care Act came into affect. I was excited to maybe save money on health insurance. I went to healthcare.gov. put in my info and was quoted $500per mo. I was surprised and confused. Not "affordable ", not "caring" and not an. "act" of helping me with the cost of health care insurance. I saw no difference but a slight increase. But I suppose its cause I pay taxes?

Gern Blansten · June 2016

inmyNC said:

EdsonNascimento said:
http://www.msn.com/en-us/money/healthcare/obamacare-worries-largest-texas-insurer-asks-for-60-percent-price-hike/ar-BBtKIHr?li=BBnbfcN

Who is paying for 70% of those rate increases? The small % of people that actually pay Federal Income Taxes.

All he did was a massive expansion of Medicaid. Everyone laughed at the Republicans who said - hidden tax. Well, they were clearly correct.

Expect roll backs in required benefits. We are already in a massive deficit. Where is this money coming from?
I paid $450per mo for my son and i back in 2009. Then my residential construction business went south as if a light switch had been turned off. I went 3 years with no coverage and paid all health care out of pocket. In 2013 I once again got coverage with at $500per mo. Then the Affordable Care Act came into affect. I was excited to maybe save money on health insurance. I went to healthcare.gov. put in my info and was quoted $500per mo. I was surprised and confused. Not "affordable ", not "caring" and not an. "act" of helping me with the cost of health care insurance. I saw no difference but a slight increase. But I suppose its cause I pay taxes?

No it's because of our for profit healthcare system.

If your premium stayed the same that's the benefit. Mine has consistently gone up 15-25%/year since 1998

gimmesometruth27 · June 2016

medicare for all.

inmyNC · June 2016

Gern Blansten said:

inmyNC said:

EdsonNascimento said:
http://www.msn.com/en-us/money/healthcare/obamacare-worries-largest-texas-insurer-asks-for-60-percent-price-hike/ar-BBtKIHr?li=BBnbfcN

Who is paying for 70% of those rate increases? The small % of people that actually pay Federal Income Taxes.

All he did was a massive expansion of Medicaid. Everyone laughed at the Republicans who said - hidden tax. Well, they were clearly correct.

Expect roll backs in required benefits. We are already in a massive deficit. Where is this money coming from?
I paid $450per mo for my son and i back in 2009. Then my residential construction business went south as if a light switch had been turned off. I went 3 years with no coverage and paid all health care out of pocket. In 2013 I once again got coverage with at $500per mo. Then the Affordable Care Act came into affect. I was excited to maybe save money on health insurance. I went to healthcare.gov. put in my info and was quoted $500per mo. I was surprised and confused. Not "affordable ", not "caring" and not an. "act" of helping me with the cost of health care insurance. I saw no difference but a slight increase. But I suppose its cause I pay taxes?
No it's because of our for profit healthcare system.

If your premium stayed the same that's the benefit. Mine has consistently gone up 15-25%/year since 1998

My point is that is wasn't affordable then or now.. The ACA in my my case did nothing except force me to have health insurance.yes it has given affordability to the less financially stable but once again who pays for it? The taxpayers who are burden with higher premiums.

mickeyrat · June 2016

I wonder how much of this rate increase is due to short term increases in payouts as those who can now have things seen toin order to get to better overall health? That it is really just short term on the whole? I do understand some previously uninsurable conditions would be a continuing payout for service.

I am under NO illusion that if Ins companies saw a decrease in payouts , they would lower rates. Afterall , shareholder is king.

EdsonNascimento · June 2016

mickeyrat said:
I wonder how much of this rate increase is due to short term increases in payouts as those who can now have things seen toin order to get to better overall health? That it is really just short term on the whole? I do understand some previously uninsurable conditions would be a continuing payout for service.

I am under NO illusion that if Ins companies saw a decrease in payouts , they would lower rates. Afterall , shareholder is king.

It's actually simpler than that. As expected, healthier people are paying the penalty and a sicker than priced population chose to pay for benefits. It's actually very simple to understand and it baffles me that people don't get it. It's a simple economic decision - does the price I pay get me my perceived value? Those that do, buy off the exchange/get expanded Medicaid. Those that don't pay their extra taxes.

And, they would have to lower rates as all rates are regulated including Minimum Medical Loss Ratios and such. So, you can bust your illusion.

You understand that large carriers are reporting 100's of millions of dollars in losses, right? that's not profit that went away. That's claims that got paid that the Gov't would have had to pay if it was a direct FFS Federal plan that health carriers have paid and lost. I guess the Gov't has a better way of funding that - by not funding it. One of the biggest failures was the "stop loss" the Feds promised and couldn't fund appropriately. And Federal Co-ops opened (on your tax dollar) betting that worst case someone else (the stop loss pool) would pay for it. Then, the Feds who backed those companies didn't fund the pool. Do you not see that the Gov't is the least able and least efficient at running anything? They didn't even have a means to fund the pool to support the companies they opened!

Gern Blansten · June 2016

EdsonNascimento said:

mickeyrat said:
I wonder how much of this rate increase is due to short term increases in payouts as those who can now have things seen toin order to get to better overall health? That it is really just short term on the whole? I do understand some previously uninsurable conditions would be a continuing payout for service.

I am under NO illusion that if Ins companies saw a decrease in payouts , they would lower rates. Afterall , shareholder is king.
It's actually simpler than that. As expected, healthier people are paying the penalty and a sicker than priced population chose to pay for benefits. It's actually very simple to understand and it baffles me that people don't get it. It's a simple economic decision - does the price I pay get me my perceived value? Those that do, buy off the exchange/get expanded Medicaid. Those that don't pay their extra taxes.

And, they would have to lower rates as all rates are regulated including Minimum Medical Loss Ratios and such. So, you can bust your illusion.

You understand that large carriers are reporting 100's of millions of dollars in losses, right? that's not profit that went away. That's claims that got paid that the Gov't would have had to pay if it was a direct FFS Federal plan that health carriers have paid and lost. I guess the Gov't has a better way of funding that - by not funding it. One of the biggest failures was the "stop loss" the Feds promised and couldn't fund appropriately. And Federal Co-ops opened (on your tax dollar) betting that worst case someone else (the stop loss pool) would pay for it. Then, the Feds who backed those companies didn't fund the pool. Do you not see that the Gov't is the least able and least efficient at running anything? They didn't even have a means to fund the pool to support the companies they opened!

source?

EdsonNascimento · June 2016

http://www.modernhealthcare.com/article/20151119/NEWS/151119858

The loss numbers are actually higher since this was posted, but the one I found was on Fox News, so didn't want to get into that argument. Please let me know if there was something else you wanted me to source.

Edit: Bonus - it also mentions the half of coops that have failed (and growing!)

Edit2 - an update on UHC - http://www.modernhealthcare.com/article/20160119/NEWS/301199998

EdsonNascimento · June 2016

Just for fun- the direct link to the coops failing:

http://www.modernhealthcare.com/article/20151105/NEWS/151109937

I wonder who funded those unpaid loans. Hmmmmmm.....

Gern Blansten · June 2016

I guess I was referring to the "large carriers reporting 100s of millions in losses"

90% of Americans have health insurance....

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