Skip to main content

Thanks Republicans, always know you are looking out for us!

-----------------------------------

 

Aside from cutting taxes on the wealthy and choking off Medicaid, House Speaker Paul Ryan's health care plan pretty much had one job: make insurance cheaper. It wasn't supposed to expand coverage. It wasn't really supposed to add any new protections for consumers. It was just supposed to make it possible for insurers to sell bare-bones plans with lower premiums, which in turn might let Washington spend less money subsidizing coverage.

 

According to at least one important insurer, Ryancare, which is currently struggling to get traction in Congress, would fail miserably at that task. J. Mario Molina, CEO of Molina Healthcare Inc., told the Wall Street Journal that he believed the American Health Care Act “could help push individual-plan premiums up by 30% or more next year.”

How come? Because, as I wrote at length Tuesday, the legislation would almost certainly make it even easier for people to wait until they were sick to buy health insurance, which would be a disaster for insurers and the market. Ryancare would keep rules in place that force carriers to enroll people with pre-existing conditions. But it would junk the individual mandate that requires Americans to buy insurance, replacing it with a weak rule that says insurers can charge new customers 30 percent extra for a year if they have a gap in their coverage history. It's a fairly toothless rule that, if anything, may turn out to be counterproductive, since the surcharge could convince some young people to stay uninsured until they absolutely needed care. It almost certainly won't encourage enough healthy Americans to buy coverage to create a healthy insurance market.

Instead, the Republicans are proposing a recipe for chaos. Here's How Molina described things to the WSJ:

[He] believes that defanging the coverage mandate could help push individual-plan premiums up by 30% or more next year—and they could rise considerably more in the future, when the reduced federal assistance for low-income enrollees kicks in. That shift, he estimated, could shrink enrollment in ACA plans by three-quarters or more, leaving a smaller, less-healthy group of consumers.
“You’re going to see big rate increases, and you’re going to see insurers exit markets…this is going to destabilize the marketplace,” he said. Dr. Molina added that the proposal’s help for insurers, including the penalty for consumers who have gaps in their coverage, wasn’t enough to offset the negatives. Molina has said it is reconsidering its ACA marketplace offerings.

Molina isn't the only insurance executive sending warning signals in the WSJ'spiece, but he's an interesting source. His company was one of the few carriers to make a profit on Obamacare's exchanges during their early rollout. However, it lost money on them in 2016 thanks to the health law's “risk adjustment” scheme—which forces companies that sign up a lot of healthy, profitable customers to pay into a fund that helps cover the costs of insurers that enroll too many sick individuals. He would like to see the ACA tweaked (preferrably in a way that would benefit his company) but thinks it's fundamentally sound.

So you could argue that Molina's warnings are just hyperbole from a CEO that's worried about losing his meal ticket. Or you could say they're the insights of a guy who has a pretty keen sense of how these markets actually work. I tend to think it's the latter, which suggests Republicans have produced legislation that would fail in its only ostensible policy goal.

You had one job, Paul. One job.

http://www.slate.com/blogs/mon...iums_30_percent.html

Original Post

Replies sorted oldest to newest

Obamadidn'tcare is getting ready to repeal itself as insurers flee the exchanges and that might be the only way both sides will ever bargain with each other. As it stands now, unless the goobermint will throw more borrowed money to the insurers because many normally healthy people stay in the plans long  enough to pay for procedures and then pay the cheaper fine while the unhealthy folks remain.

Health insurance works by having a large pool of customers paying in. So when a fraction of that pool drops out, it’s no big deal since there are a lot of people left, correct?

It turns out that it actually is a pretty big deal. In the first six months of this year, BCBSNC paid roughly $34 million in claims to customers enrolled in an Affordable Care Act plan who used their health benefits and then dropped coverage. They were among the almost 60,000 customers who quit making payments, cancelled their coverage or had their plans terminated because of data-matching issues related to their citizenship or immigration status.

Statewide, total enrollment stood at 459,714 ACA customers as of June 30, the federal government reported this week. During the April-June quarter alone, 32,300 North Carolinians dropped their ACA health insurance coverage. That’s 6.6% of total enrollment statewide.

http://blog.bcbsnc.com/2015/09...-insurance-coverage/

 

There was always a good reason the government  never took
over the insurance industries, common sense, they knew it's
too large and complicated. The primary reason for their so
called healthcare was for redistribution which the crybabies
have been whining about for years. Only a dictator would
want it and only very stupid and gullible people would vote
for it.
Kraven posted:
There was always a good reason the government  never took
over the insurance industries, common sense, they knew it's
too large and complicated. The primary reason for their so
called healthcare was for redistribution which the crybabies
have been whining about for years. Only a dictator would
want it and only very stupid and gullible people would vote
for it.

People seem to believe that they can vote politicians into office who will create new "rights" that involve robbing other people or borrowing from other countries for their free stuff. I hate to burst their bubbles, but any "right" that was created by the political class can be abrogated by another group of politicians when the real world returns and reminds us that you don't get something for nothing. The longer the wait for a better replacement of the newest entitlement the more draconian to free riders the changes will be.

Naio posted:

Too large and complicated? I've always heard this is the greatest country in the world.  Why can't our politicians figure out a way to make universal health care work?

Government is a collection of politicians, who keep in power by ensuring their supporters and cronies are satisfied, and bureaucrats, who increase their  numbers and power by empire building.  Its the opposite of private enterprise.  While necessary, their numbers should be kept small and their powers scattered -- the closer to the locals, the better. Collective farms and central planning of industries don't work. As to VA hospital care...!

My belief, and opinion, is that Government has no place in the Insurance business nor the Healthcare business other than to prevent a monopoly or gross abuse.  Obamacare/Democratic Healthcare should have been declared, by Chief Justice Roberts, as unconstitutional, which it is and was, but he claimed it was constitutional calling it a tax.  The Democrats got us in this mess when they force fed Healthcare, insurance mandate, upon all Americans (except themselves whom they exempted).  No Republicans voted for it then and now they should not only get rid of it but return the system back to a market based business.

Insurance rates, AND DEDUCTIBLES, are out of control now, unleashed because of Democratic Healthcare/Obamacare, and now the market has to help reduce them.  The Government has no place in the insurance business or the healthcare business.  Where the Government can have an effect and where they should focus their attention is on a healthcare system where you have three people and each pay a different cost.  Healthcare providers should be obligated to publish their cost for procedures and services so people can make informed decisions about who to go to.  A procedure shouldn't cost one person one amount the next person ten times that amount and a third maybe 1/2 the amount.  

Insurance companies have their own problems and contributors to abuses when they collude together to raise prices and essentially form a monopoly that secures their profitability.  Government can serve as a protector of the public but now, because of the Democrats, they are having to figure out how to get out of what they never should have been in  without harming people. 

The Republicans aren't going to correct an evil by doing something that is also unconstitutional and government is not supposed to be in the healthcare or insurance business.  How this ends, anyone knows, but the reason we are here in the first place is the Democrats own irresponsibility and attempt to create a new entitlement.   Government never does anything more efficient and before Democratic healthcare/Obamacare there was ample evidence that Government can't do healthcare and that in the VA.  It's not that the VA is a total failure but just proof that Government doesn't do anything efficiently or effectively.   It's my hope that Trump might just put some people in positions that they can improve how Government works.  As for healthcare and insurance I just hope they can get it right.  

All this "for the rich" talk is crazy when you consider that the Democrats have done more to create a class war type system making a great number, of their own supporters, rich beyond imagination.  Imagine throwing away tons of money into solar companies that did nothing but contribute well to the Democrats otherwise a deep dark hole for money to fall though.   How about taking fines from companies and groups that are fined by the Government and giving money to liberal and democratic groups instead of fines going to the Government and against the debt.  The Obama administration took care of their own and the poor stayed poor.  Both the Republicans and Democrats take care of their own, always have and always will it's just different groups that get the funds.   Hillary, herself, was in cahoots with Wall Street keeping secret all her promises to them while turning around and condemning them in the public while making promises in secret to benefit them.  

Only Donald Trump was one who publically and  actually turned down donor money so it's possible that he, alone, can actually govern without being obligated to special interest.  At least that's my own opinion. 

I would like to hear your take JT on how the "entire medical industry" is out of control? When you label the "entire medical industry" you include people in that index who have nothing to do with insurance rates nor how those plans are implemented.  most of them are working 50 -60 hours a week to provide health services and then are held ransom by the insurance companies before they can even get reimbursed for the supplies and time they took to provide that service.

jtdavis posted:

The health insurance industry has been out of  control for years,  Much longer than Obama Care has been around.  The entire medical industry is out of control




 


 

It might just be a coincidence, but goobermint commissars and lawyers have been out of control for the same period of time as the entire medical industry and Obamadidn'tcare has accelerated the problem. We could just throw more money at the problem by looting the defense budget even more and let the next-gen Visigoths sort out our entitlement system later. I guess they'll also sort out who serfs their rice paddies or fertilizes the rice plantation later as well.

JT,

Let's look at one of the issues you just raised.

The $10 for the 10 cent pill.  That 10 cent pill was probably bought in bulk and came in a package of 100.  Because of the government regulations it was sent directly to a pharmacist where it was secured, labeled and stored. This likely required oversight by a pharmacist, supervising a tech or an aide who performed this job. The doctor orders the pill to be given, where it is put into the computer, registered (again due to regulations) and sent to the floor in a locked case for dispensation. The nurse (registered with a four year degree) checks the order, verifies the medicine and then takes it to the patient to be taken. Then he or she must document that patient took the medication and the time is was given.  That 10 cent pill you needed was handled by no less than three people, required multiple safety checks, and documentations BEFORE you ever got it. Now, I am not sure what the statute of limitations is, BUT let us say you had some reaction to the medication, which is not infrequent and a couple of years down the road you decide that you were harmed by this medicine.  Actually most hospitals have a couple of hundred documented reaction per year. You decide that you merit monetary compensation because Alexandra Shunarahaha told you in his or her commercial that you should be eligible for it. You file a case. The hospital has to provide the records where you took it, and documentation of the effects of said medication. This may require the handling of your records by several clerks and aides who have to retrieve said records and copy them for the lawyer.

Again, all of this for a 10 cent pill. Most people have no concept that the fees paid for medical care support a plethora of employees from the groundskeeper to the registered nurse.  Most of these people have good secure and well paying jobs, which is why they are willing to work long hours, weekends, and holidays when government employees and people who are allowed to unionize typically do not.  Most medical jobs, including doctors, do not come with a very good retirement plan, certainly nothing that even resembles a government sector job. Yet the first to complain about the time they have to wait, or the copay, or the slow service typically are folks that never have, nor never will work in that type of environment.

I personally think that medical care in this country is good, but thanks to the government intervention over the past 20 years it is likely we will all be in a single payor system similar to Medicaid before too much longer.

 Most of these people have good and well paying jobs, which is why they are willing to work long hours, weekends, and holidays when government employees and people who are allowed to unionize typically do not

Your post was sounding good until you posted that sentence. I had a unionized job, I was sort of a federal employee, I worked 10 and 12 hour days, 6 and 7 days a week and usually doubled my yearly salary. I had a stay at home wife and 3 kids and I needed the money. Most others like me also worked all the long hours they could because they needed the money. I got a pretty good retirement because my union forced me to pay into a retirement fund, I had good insurance because my union forced me to pay for it. Before you post negative things about union people, you need to check your facts.

I am not posting negative things about union employees. I am saying that healthcare workers and doctors do not typically have a union in this country.  Most work weekends, holidays, and night shifts. Most hospitals are understaffed because the margins are so thin. Yet, here you are laying the fault of the healthcare failure on the "entire medical industry". You, a union employee, who got a great retirement, and probably worked great shifts and hours and had plenty of holidays, think that it is the fault of the people who are out there working in the trenches. I am simply pointing out to you the hypocrisy of your comment.  The caregivers are not to blame here.  They are doing their job, and doing a fine job of it. They have to put food on the table and pay their bills just like you.  That does not come freely.

I had a doctor office visit yesterday.  The lady in front of me presented her insurance cards.  The first card, Obama Care, was rejected due to them not accepting that insurance.  The second card was supplementary insurance that had an office co-pay of $75 per visit.  She was told due to what she will be charged using the co-pay card, it will be cheaper to just pay the office visit out of pocket and not even use that insurance.

Thanks to BOcare your insurance is about as worthless as the plastic card they give you.

 The caregivers are not to blame here.  They are doing their job, and doing a fine job of it. They have to put food on the table and pay their bills just like you.  That does not come freely.

I agree with that, I've been in the hospital 3 times since the last of October with pneumonia. The nurses do the best they can with what they have to work with and the load they have to carry. I have nothing but admiration for them.

Add Reply

Post

Untitled Document
×
×
×
×
Link copied to your clipboard.
×