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Obama care will be good for the economy

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  • by rickyp
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Ray Jay
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Post 10 Jun 2013, 12:00 pm

geojanes wrote:
Ray Jay wrote:Does everyone agree with the premise that the ACA exacerbates the high expense of our existing health care system by strengthening the main economic forces that result in those high costs, namely that insurance is tax free and through one's employer.


Tax free health insurance is the main cause of high health care costs in America? I had no idea.


"and through one's employer".

What do you think in the primary reason why our health care costs are so expensive?
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Ray Jay
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Post 10 Jun 2013, 12:05 pm

Ricky:
There are far more important factors, primarily things like fee for service, and the direct involvement in doctors in profit/loss and revenue generation.


We have fee for service and direct involvement of doctors in profits for elective eye surgery (e.g. lasik) but those costs have not increased as you have said numerous times.

Ricky:
The problem with the US insurance industry is that it isn't structured to care about health care costs, whether its premiums are paid by employers or individuals...


How so? Insurance companies routinely deny or reduce claims and protect their costs.
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rickyp
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Post 10 Jun 2013, 12:24 pm

tom
If people in Massachusetts like this plan, why does that mean people in Montana will like the plan as well?


People in Montana who have Medicare like Medicare just as much as people in New York or California.
I think it was in North Carolina we first heard "Keep your government hands off my Medicare".
If something works to provide value, security, and relative convenience ... people like it. Medicare is a great example of a popular government program with conservatives and liberals...

tom
Yes, this is what Obama had "promised" yet we should not let facts get in the way should we?


What facts are those? The estimates and forecasts you and Fate have paraded?
There's not much in the way of facts yet...Only similar experiences in Mass, and under Medicare and now the first rates from the California and Vermont exchanges...
Opponents to change always tend to exaggerate or even fabricate the negatives in their prognostications when faced when change. I remember restaurateurs claiming that bringing in nonsmoking laws would ruin their business. didn't.

tom
We already spoke of how employers will cut hours and how some already fully plan on t...


Sure. Like Wal Mart and the fast food industry haven't been pursuing this strategy for 20 years in order to avoid paying benefits...
At least the poor saps who have to piece together part time jobs to make a real living will have an option of going to the insurance exchange to get affordable coverage now...
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rickyp
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Post 10 Jun 2013, 12:30 pm

ray
We have fee for service and direct involvement of doctors in profits for elective eye surgery (e.g. lasik) but those costs have not increased as you have said numerous times.

Lasik is an almost entirely elective surgery. As such the market demand is elastic.And the majority of Lasik surgeries are paid for privately. Not through insurance.
Heart surgery not so much...



Ricky:

The problem with the US insurance industry is that it isn't structured to care about health care costs, whether its premiums are paid by employers or individuals...


ray
How so? Insurance companies routinely deny or reduce claims and protect their costs.

Denying claims from the insured person doesn't attack the cost of the service. The claimant who has been denied is still on the hook for the medical debt.
All that the insurance company is attempting to do in denying a claim is make a larger profit by passing the cost along to the end user.
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GMTom
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Post 10 Jun 2013, 12:33 pm

all the FACTS have been against Obamcare so far, yours so far have been opinions and all shot down. The FACTS are not on your side, please provide some new ones and not opinion pieces as you have done so far. The cost is going up for the majority, the plan is complicated and unruly, even those who designed it are jumping ship, those are the facts. Those are what you need to explain away as how it will be "good for the economy"
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Post 10 Jun 2013, 1:11 pm

It appears that the health care reform in Mass has done a good job of lowering health care cost increases and premiums up to now, but there is concern about future increases. http://www.bostonglobe.com/business/201 ... story.html

btw Brad I would favor states being able to choose different methods of delivering healthcare as long as they met minimum levels of universal coverage. This would give us a real-world laboratory of what works and presumably states would copy those states who did better. I think that would be better than a one size fits all reform, but since that is not an option I'll go with the ACA.
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Post 10 Jun 2013, 1:49 pm

freeman3 wrote:It appears that the health care reform in Mass has done a good job of lowering health care cost increases and premiums up to now, but there is concern about future increases. http://www.bostonglobe.com/business/201 ... story.html


I cited a survey that said MA was last of all the States in terms of medical cost per capita.

So, how has MassHealth "lowering" increases?

In fact, your article cites no numbers to prove your summary of it. Here's an excerpt that seems to contradict your premise:

Reining in health expenses has been a top priority for Massachusetts officials, who view it as a pressing follow-up to the 2006 state law that created near-universal access to health insurance. Governor Deval Patrick last year signed legislation limiting the annual per-capita increase in health care costs to the state’s economic growth, projected to be 3.6 percent in 2013. The measure was applauded by business and consumer groups. Now, there is mounting skepticism about the chances of avoiding a higher increase.

“This goal is completely untested,” said Lynn Nicholas, president of the Massachusetts Hospital Association. “It’s being used for the first time anywhere. This is like turning around a giant tanker in a short amount of time. People totally underestimate how difficult that is.”


Why would "reining in health expenses has been a top priority for Massachusetts officials . . . " if what you said is correct?

And, notice the Democratic approach: not sure how to control costs? Pass a law tying it to projected growth. Sure, just pick out a number and then try to figure out how to force the market to adapt. Piece of cake.

:no:

btw Brad I would favor states being able to choose different methods of delivering healthcare as long as they met minimum levels of universal coverage. This would give us a real-world laboratory of what works and presumably states would copy those states who did better. I think that would be better than a one size fits all reform, but since that is not an option I'll go with the ACA.


Because healthcare is a "right?"

Every State should have the right to determine whether or not it wants to do as you demand. We are a Republic, with semi-autonomous States, which retain all responsibilities not specifically delegated to the Federal government. Find "healthcare" in that list.

I'll wait.
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geojanes
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Post 10 Jun 2013, 1:57 pm

Ray Jay wrote:
geojanes wrote:
Ray Jay wrote:Does everyone agree with the premise that the ACA exacerbates the high expense of our existing health care system by strengthening the main economic forces that result in those high costs, namely that insurance is tax free and through one's employer.


Tax free health insurance is the main cause of high health care costs in America? I had no idea.


"and through one's employer".

What do you think in the primary reason why our health care costs are so expensive?


I speculate that there are massive inefficiencies with insurance & administration, but more than that, the incentives for service are all wrong and are completely unrelated to cost. There is a huge incentive to over-test and over-treat to cover one's ass when someone ends up the system without any attention to cost. It's nearly impossible to shop medical services, so there is effectively no market and any service that does not have a market will be hugely expensive.

Also, many people who work in the medical industry, especially pharma, earn unbelievable amounts of money off the system: sucking on the teat, and fighting any effort to wring those inefficiencies out. As I've said before, one man's inefficiency is another man's payday.

Tax free health insurance through one's employer is, I speculate, at best cost neutral to the system, or at least I don't understand how it can compare to other, more obvious culprits. Taxing the benefit would certainly bring more revenue to the gov't but I expect would likely cause an overall increase in the cost of health care due to taxing the benefit.

How's that? I don't know anything about this topic beyond my personal experience so be kind.
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Post 10 Jun 2013, 1:58 pm

fate
Because healthcare is a "right?"


The Emergency Medical Treatment and Active Labor Act (EMTALA)[1] is a U.S. Act of Congress passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA). It requires hospitals to provide care to anyone needing emergency healthcare treatment regardless of citizenship, legal status or ability to pay. There are no reimbursement provisions. Participating hospitals may only transfer or discharge patients needing emergency treatment under their own informed consent, after stabilization, or when their condition requires transfer to a hospital better equipped to administer the treatment.[1]


http://en.wikipedia.org/wiki/Emergency_ ... _Labor_Act
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Post 10 Jun 2013, 2:04 pm

rickyp wrote:What facts are those? The estimates and forecasts you and Fate have paraded?


You're being moronic again. You posted a site. You said it proved CA would experience lower rates under the ACA. Tom went to the site, plugged in some examples and said the results showed big increases.

So, YOU provide the site. YOU do nothing but boast about ACA working.

Tom goes to the site, does some work, posts the results . . . and you doubt his integrity, but won't go back and double-check his work?

NOW, you call his work "an estimate?" That's funny since he used YOUR site!

There's not much in the way of facts yet...Only similar experiences in Mass, and under Medicare and now the first rates from the California and Vermont exchanges...


So, again more of your foolishness.

I post a study showing that MA has THE HIGHEST per capita health costs of any of the 50 States, yet you keep saying the ACA is "similar" and will have (presumably) "similar" effects.

That's a GOOD thing????

You've demonstrated NOTHING concerning CA and VT. You SAID that they were cheaper, but Tom showed that CA wasn't.

So, if you want to make a case, MAKE YOUR BLEEPING CASE!

Opponents to change always tend to exaggerate or even fabricate the negatives in their prognostications when faced when change. I remember restaurateurs claiming that bringing in nonsmoking laws would ruin their business. didn't.


So far all you've done is exaggerate and fabricate.

You've not proven Obamacare will be good for the economy.

You've not proven it will lower rates anywhere. When I pointed out you were wrong in MA--that costs for employees had gone up, you didn't even respond.

Again, if, as Freeman's article said (caps in original, on p. 19 as you referenced), "AS PREMIUMS HAVE INCREASED, EMPLOYERS’ SHARE OF PREMIUMS HAS FALLEN OVERALL," there's only one party left to pay for the increase in premiums--the consumer (aka the "employee," or the "chump").

tom
We already spoke of how employers will cut hours and how some already fully plan on t...


Sure. Like Wal Mart and the fast food industry haven't been pursuing this strategy for 20 years in order to avoid paying benefits...


Completely irrelevant and more stupidity.

If companies are NOW doing this (like the Darden restaurants) because of the ACA, how can that be "good?" We're talking about companies that previously had not done this, but now will and are.

At least the poor saps who have to piece together part time jobs to make a real living will have an option of going to the insurance exchange to get affordable coverage now...


No, it's not an option. If they fail to do so, the IRS will come calling.

It's glorious, comrade!
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Post 10 Jun 2013, 2:21 pm

rickyp wrote:fate
Because healthcare is a "right?"


The Emergency Medical Treatment and Active Labor Act (EMTALA)[1] is a U.S. Act of Congress passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA). It requires hospitals to provide care to anyone needing emergency healthcare treatment regardless of citizenship, legal status or ability to pay. There are no reimbursement provisions. Participating hospitals may only transfer or discharge patients needing emergency treatment under their own informed consent, after stabilization, or when their condition requires transfer to a hospital better equipped to administer the treatment.[1]


http://en.wikipedia.org/wiki/Emergency_ ... _Labor_Act


That still doesn't make it a right.

Think about it: if that were true, then your other major complaint, the bankruptcies caused by medical bills, could not happen.

We don't pay for "rights," other than the taxes to keep the government going so they can try to restrict/remove rights.
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rickyp
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Post 10 Jun 2013, 5:06 pm

fate
Think about it: if that were true, then your other major complaint, the bankruptcies caused by medical bills, could not happen.

Nonsense.
A hospital can't legally turn someone away, but they can still present them with a bill.
Whether that persn can ever pay doesn't matter.
And they do need to be billed so that hospitals can seek compensation from the state, where possible, for unpaid bills by indigents.
The fact is that both the law exists, even if you don't beleive it, and its implications are that the US has had socialized medicine. Only a really lousy version of iit...
This is a rather dated analysis of the costs of the EMTALA back before the turn of the century. 16 years later the costs have probably trebled.

One important consequence is monetary. According to the American Hospital Association (AHA), in 1996 about 16% of ED patients were uninsured
The ED is the portal of entry for as many as 3 of every 4 uninsured patients admitted to the nation's hospitals Traditionally, uncompensated care was recouped by charging more for services for the insured. Through such cost-shifting, hospitals were able to provide care for the indigent and stay financially solvent. However, prospective payment systems, diagnosis-related groups, and health maintenance organizations have hindered hospitals' abilities to continue this practice. The uncompensated costs to emergency physicians for services provided under EMTALA were estimated to be $426 million in 1996, and the costs to hospitals for uncompensated inpatient care is a staggering $10 billion
In addition, the number of uninsured in the country continues to rise, with many more being the “working poor.” From 1988 to 1996, the number of working people with employer-sponsored health care coverage dropped from 72% to 58%
These people go to the ED for much of their acute care. This helps to explain the 25% increase in ED visits during the same period. In 1998, 3.4% of children under the age of 18 were reported to use the ED as their usual source of health care Add to this the fact that the number of EDs in this country has decreased over the same period, and financial strains on the remaining departments and hospitals to provide indigent care and stay financially afloat become critical. Studies have shown that the bulk of this financial strain falls on urban and rural hospitals, the former becoming overcrowded and the latter unable to financially compete and thus threatened with closure
Recently, HCFA has begun to consider such uncompensated care in its reimbursement formulas for emergency physicians. However, until there is some guarantee of insurance coverage for all Americans, our system of EDs will continue to be the “safety net” that protects people from catastrophic medical problems, and EMTALA will continue to be the government's guarantee that the system will work in the best interest of those people.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1305897/
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Post 10 Jun 2013, 5:23 pm

I accessed another Blue Cross PDF file that says growth in family premiums rose 9.0 percent in Mass from 2000-2006 and 6.8% from 2007-2011. That is what the Boston Globe meant by moderating costs.
I never said that health care was a constitutional right (thought as Ricky says the law requires hospital to provide emergency treatment), but alleged simply that rights evolve in the process of development. Do you believe that people can be left to die if they don't have money to pay for treatment? If you don't believe that then aren't you agreeing that health care is a human right (in an advanced western economy)?
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Post 10 Jun 2013, 7:47 pm

If you can be forced into bankruptcy, it simply is not a right. Fundamental rights don't force you to go broke now do they?
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rickyp
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Post 11 Jun 2013, 6:19 am

tom
If you can be forced into bankruptcy, it simply is not a right. Fundamental rights don't force you to go broke now do they?


You aren't forced to go to the emergency ward or to doctor. You have the option of laying down and dieing.
But, the doctors at the EM can't turn you away. By law.
Now, thats not a constitutional right, but it is a legal right. (The difference being that fundamental rights cannot have laws written that infringe on the right. And that rights created by laws, are easier to alter. )
So you aren't being forced into bankruptcy. Unless you want to live.


Fate
Tom goes to the site, does some work, posts the results . . . and you doubt his integrity, but won't go back and double-check his work?


I pointed out that in every comparison produced in the press that a bait and switch was being used. And pointed out that all Tom did was say he had results, without posting a way for us to check them.
He doesn't state what benefits, what deductibles, what exclusions etc. are in the packages he compared. And as the examples i posted from the press illustrate these kinds of things generate enormously different results.
I can't replicate Toms results without knowing what these variables were. and apparently Tom is now unable to replicate his results...
Could be that he made a mistake.

Fate
I post a study showing that MA has THE HIGHEST per capita health costs of any of the 50 States,


Yes. But MA had the highest per capita costs before their version of the ACA as well.
The question is what happened to medical inflation after Romney care was instituted. Oh wait, here's the answer:
Freeman3

I accessed another Blue Cross PDF file that says growth in family premiums rose 9.0 percent in Mass from 2000-2006 and 6.8% from 2007-2011. That is what the Boston Globe meant by moderating costs

If the ACA has the same moderating affect on health care inflation, and the early indications are that it has, then thats generally considered a boon to the economy. Health care costs are generally considered to be too high aren';t they fate?