View Full Version : Rooting for Failure
http://www.nytimes.com/2013/11/29/opinion/egan-rooting-for-failure.html?_r=1
Affordable Care Act and the Failpublicans
The ACA is a bad law, something like 60+ percent of Americans hope to see it replaced or repealed. It's got nothing to do with not wanting people to have health care. The premise is of the opinion piece is all wrong.
Also, the numbers in the piece are presented in a positive light:
California is just as good. It’s enrolling more than 2,000 people a day.
I remain unconvinced. California has a population of 38 million people. So that'd take 19,000 days to sign them all up, at that rate. 52 years. And that assumes the population remains constant.
At 2000 people a day, assuming people sign up 365 days/year, you sign up 730,000 people per year. 1.9% per year. California is experiencing a fairly low population growth rate at the moment, at just a hair over 1%.... So you're not *quite* falling behind the growth rate.
Seems like Something Needs Done.
iris lilies
11-30-13, 10:25pm
Also, the numbers in the piece are presented in a positive light:
I remain unconvinced. California has a population of 38 million people. So that'd take 19,000 days to sign them all up, at that rate. 52 years. And that assumes the population remains constant.
At 2000 people a day, assuming people sign up 365 days/year, you sign up 730,000 people per year. 1.9% per year. California is experiencing a fairly low population growth rate at the moment, at just a hair over 1%.... So you're not *quite* falling behind the growth rate.
Seems like Something Needs Done.
Are Obamabots unable to do mathematics? Seems so.
I continue to be frustrated. I'm still unable to complete the online procedure myself, the phone "helper" was unable to complete my application because the system went down, and the insurance commission in my state (Pennsylvania) has still not made the decision to allow my present carrier to extend my policy. I am very disappointed in this process. If I had done the registration for my school in such an incompetent way, I assure you that I would have been fired. I totally understand that this is an overwhelming program to operate fully...but, I also understand that it shouldn't have gone public before it was ready. The percent of us who lost our insurance may be small, but we still matter as individual citizens. Let me keep my "lousy"policy...is has served me well for the last 6 years!
gimmethesimplelife
11-30-13, 10:32pm
There was a recent article in the New York Times entitled - For Migrants The New Land Of Opportunity is Mexico. The article went on to explain that as wages in China are rising, more manufacturing jobs are moving back to Mexico and that the middle class in Mexico is actually GROWING while in the US it is SHRINKING. Now as to the tie in to OP's post - if you google this article and read the comments below it, many of the comments are from Americans living in Mexico that rave about it's health care and how accessible it is to all and how they would never want to return to the US now. Scattered among the comments are those from Mexicans who have lived in the US and returned due to having more opportunity in Mexico now and a few of these folks also commented on how much saner and compassionate health care is in Mexico.
Point being - a country that some Americans look down on as a third world cesspool - and parts of it are that, I'm not in denial about this at all, much as parts of the US are third world cesspools - is doing some things RIGHT to the point of becoming an immigration magnet to some in the first world. Included in what it is doing right for some is health care - and yet WE IN AMERICA CAN'T COVER ALL OUR PEOPLE. Couple this with the fact that as corrupt as Mexico is - they ACTUALLY REGULATE WHAT PHARMACEUTICALS CAN COST! (I didn't mean to scream with these all caps here - all caps due to the fact that once you think outside the box and realize facts such as above - it can really alter your perspective on so many issues.
I am no health expert. I am not the one to go to for in depth analysis of ObamaCare. I am from the lower income trenches with first hand knowledge of how this country doesn't work in many ways....but I'm keeping this condensed down to health care. Perhaps ObamaCare isn't all that great a law, OK? Perhaps those who are so against it here have some valid points. If this is indeed so how do you explain that a country such as Mexico handles health care for the masses better then we do? I'd love to hear anyone who actually believes in the United States rationalize that one away to someone who has lived the nightmare of what America is to some of it's citizenry.
Now, would I go to Mexico and live? It's looking better and better as the healthcare rollout does seem to be fraught with issues (and I do blame Obama for not keeping better tabs on whether or not the website was fully functional before it's rollout, this is really really really lame!) - if Mexico can handle healthcare better than we can in some ways, is it no surprise that even with it's corruption and cartel issues, some still find it a land of opportunity?
I gotta say the first class I signed up for at community college this upcoming semester, before I even signed up for classes pertaining to the certificate I'm interested in? Spanish 101. All I can say is it's about time on that one! And then some. As the government seems to be bungling something so elemental to human rights and human dignity as health care, learning Spanish seems to be a wise investment - something akin to potential insurance against US health care. I'm glad after reading this article I mention in the NY Times, it would seem that I'm not the only out there drawing such conclusions. Rob
Blackdog Lin
11-30-13, 11:06pm
[QUOTE][/The ACA is a bad law, something like 60+ percent of Americans hope to see it replaced or repealed.QUOTE]
Count me in here. I would love to see universal health care.....but this.....I can't call it a law (wasn't this the one Pelosi said we can't see/know what's in it till it's passed? I can't believe more people didn't find this statement so.....stupid, as to be ridiculous), but huge set of guidelines that panders to the insurance companies and does nothing to address the real reasons sickcare is so ridiculously unaffordable. (google "the Market Ticker" for thought-provoking commentary.)
And I am among the lucky ones. Retiree w/a big company and my premiums only went up $11/mo. for next year. But I realize I am in one of the lucky minorities in the sickcare healthgame.....
gimmethesimplelife
11-30-13, 11:29pm
Something that really bothers me about US health care? Just one thing? Last September I was quoted $900 for a series of ultrasounds I needed to see what was going on with my gallbladder - this was in Phoenix. So, me being me, I hopped on a Greyhound and went down to Mexicali, five hours away by bus, where I paid $58.50 for the same series of ultrasounds. Granted, I had to pay bus fare, motel room, and cheap meals but I still came out over $700 ahead. There is no excuse for this - this is the stuff my lack of loyalty to this system is made of. Can anyone give a sane answer as to why there is this price differential and why it should be tolerated?
I'm all ears. Rob
Also, the numbers in the piece are presented in a positive light:
I remain unconvinced. California has a population of 38 million people. So that'd take 19,000 days to sign them all up, at that rate. 52 years. And that assumes the population remains constant.
At 2000 people a day, assuming people sign up 365 days/year, you sign up 730,000 people per year. 1.9% per year. California is experiencing a fairly low population growth rate at the moment, at just a hair over 1%.... So you're not *quite* falling behind the growth rate.
Seems like Something Needs Done.
I'm just thinking that only the uninsured under 65 have to sign up? So maybe we're talking 7 or 8 million? And no doubt the system will improve, but we're probably haggling over details.
It's law for the time being. I say give it a chance to prove itself. If it fails, I doubt that people with pre-existing conditions and no employer covered insurance will ever see affordable health care in this generation.
At first I hoped ACA might get me access to health care. As it unfolded I began to see that the real beneficiaries of it are the insurance companies. If it is repealed I hope they don't give up, I hope they enact something that benefits us the citizens instead of insurance companies.
... Last September I was quoted $900 for a series of ultrasounds I needed to see what was going on with my gallbladder - this was in Phoenix. So, me being me, I hopped on a Greyhound and went down to Mexicali, five hours away by bus, where I paid $58.50 for the same series of ultrasounds. Granted, I had to pay bus fare, motel room, and cheap meals but I still came out over $700 ahead. There is no excuse for this - this is the stuff my lack of loyalty to this system is made of. Can anyone give a sane answer as to why there is this price differential and why it should be tolerated? . .. Rob
Have heard lots of similar stories, Rob, on border state citizens going to Mexico for treatment. Just yesterday met a guy whose friend had to have his appendix removed. The friend was uninsured and was quoted $16,000 here in AZ. Instead he went to Mexico where the operation cost him $1,600. Same "band-aid" type incision, wonderful care, but 10% of the cost.
The ACA is a bad law, something like 60+ percent of Americans hope to see it replaced or repealed. It's got nothing to do with not wanting people to have health care. The premise is of the opinion piece is all wrong.
Are you sure about that percentage?
http://www.addictinginfo.org/2013/10/22/repealing-the-aca/
catherine
12-1-13, 11:15am
Something that really bothers me about US health care? Just one thing? Last September I was quoted $900 for a series of ultrasounds I needed to see what was going on with my gallbladder - this was in Phoenix. So, me being me, I hopped on a Greyhound and went down to Mexicali, five hours away by bus, where I paid $58.50 for the same series of ultrasounds. Granted, I had to pay bus fare, motel room, and cheap meals but I still came out over $700 ahead. There is no excuse for this - this is the stuff my lack of loyalty to this system is made of. Can anyone give a sane answer as to why there is this price differential and why it should be tolerated?
I'm all ears. Rob
Read
Steven Brill, Time Magazine, Bitter Pill: Why Medical Bills are Killing Us.
http://content.time.com/time/magazine/article/0,9171,2136864,00.html
Seems you can't view this whole article without paying/getting a pass of some kind, but it's worth it if you want solid and robust investigative reporting on exactly what you're asking.
According to the Washington Post, this article can be summed up in one sentence:
His article is essentially a 26,000-word answer, the longest story that the magazine has ever run by a single author. It's worth reading in full, but if you're looking for a quick summary, the article seemed to me to boil down to one sentence: The American health-care system does not use rate-setting.
Are you sure about that percentage?
http://www.addictinginfo.org/2013/10/22/repealing-the-aca/
No, I'm not. My experience with polling shows that opinions vary greatly over time and that many polls on this subject concentrate on single points rather than multiple. The story you reference is guilty of the same. It focuses on the 33% who favor repeal and then jumps to the conclusion that 66% don't favor changing the law, leaving out the 'replace' factor I used in my estimation.
I'll stand by my contention that a majority of people would prefer the ACA be replaced or repealed.
catherine
12-1-13, 11:37am
As much as I supported Obamacare I'm really, really not happy with not being able to get a catastrophic policy anymore. At the risk of backpedaling on other posts about Obamacare perhaps being a way to cut the employer/employee bondage, this plan doesn't seem to do much for the self-employed. I really have two choices: No insurance (and pay a penalty), or pay $20k a year.
iris lilies
12-1-13, 1:23pm
As much as I supported Obamacare I'm really, really not happy with not being able to get a catastrophic policy anymore. At the risk of backpedaling on other posts about Obamacare perhaps being a way to cut the employer/employee bondage, this plan doesn't seem to do much for the self-employed. I really have two choices: No insurance (and pay a penalty), or pay $20k a year.
The President said in his 52 minute talk to the nation about the ACA that you all out there on the free market were only 5% of the population. That market has been fraught with problems such as high and ever changing costs, and changeability in coverage. You are supposed to be grateful to him for removing you from that market. He knows better than you about you.
If you were the right age you could get catastrophic coverage. Too bad you (and I) are not. It is, of course, the most sensible way to go about health care.
Ironically, VERY ironically, I am now considering trying to get back into regular full-time employment so I can get more affordable coverage. With my debt situation, I question if I can afford to be self-employed. And I really hate being quite a healthy person who has not made any demands on the healthcare system (so far) and having such a huge chunk of my income go for health insurance.
iris lilies
12-1-13, 2:20pm
Ironically, VERY ironically, I am now considering trying to get back into regular full-time employment so I can get more affordable coverage. With my debt situation, I question if I can afford to be self-employed. And I really hate being quite a healthy person who has not made any demands on the healthcare system (so far) and having such a huge chunk of my income go for health insurance.
The exchanges are that high for you? Without delving into personal detail I would imagine it's because you make a lot of money and you've said that your DH smokes; smoking adds, what, $5000 to coverage? something like that.
The exchanges are that high for you? Without delving into personal detail I would imagine it's because you make a lot of money and you've said that your DH smokes; smoking adds, what, $5000 to coverage? something like that.
Yes, you're right. I do make a good income, and DH does smoke. I've done cost comparisons on low premium/high deductible v. high premium/low deductible, and honestly it's six of one, half a dozen of another. We do use up our deductible because DH has Barrett's esophagus and gets regular endoscopies. So the premium is $1400/mo + $5k deductible + 20% coinsurance, so it tops out at 20k+ overall. Can't figure out a way to get it lower, unless I can time travel to my 65th birthday and qualify for Medicare. And I admit, if I didn't have such a huge debt burden I wouldn't be complaining as much...
No, I'm not. My experience with polling shows that opinions vary greatly over time and that many polls on this subject concentrate on single points rather than multiple. The story you reference is guilty of the same. It focuses on the 33% who favor repeal and then jumps to the conclusion that 66% don't favor changing the law, leaving out the 'replace' factor I used in my estimation.
I'll stand by my contention that a majority of people would prefer the ACA be replaced or repealed.
And in this case, as in all cases, it depends on how the question is asked. I've read in more than one place that people are more favorably inclined towards the affordable care act than they are to obamacare.
And in this case, as in all cases, it depends on how the question is asked. I've read in more than one place that people are more favorably inclined towards the affordable care act than they are to obamacare.
I agree. Some polls seem to be worded to achieve a desired result which can then be passed along as consensus. It pays to look at many different sources before reaching a conclusion.
ApatheticNoMore
12-1-13, 4:35pm
It focuses on the 33% who favor repeal and then jumps to the conclusion that 66% don't favor changing the law, leaving out the 'replace' factor I used in my estimation.
at this point 33% probably favor replace with single payer. Even single payer probably wouldn't be effective unless you broke the current medical cartel (ie held down pharma costs like they do in other countries, tightly controlled for-profit insurance etc.), but probably no form of healthcare reform would be unless you do that anyway.
As much as I supported Obamacare I'm really, really not happy with not being able to get a catastrophic policy anymore. At the risk of backpedaling on other posts about Obamacare perhaps being a way to cut the employer/employee bondage, this plan doesn't seem to do much for the self-employed. I really have two choices: No insurance (and pay a penalty), or pay $20k a year.
Ironically, VERY ironically, I am now considering trying to get back into regular full-time employment so I can get more affordable coverage. With my debt situation, I question if I can afford to be self-employed. And I really hate being quite a healthy person who has not made any demands on the healthcare system (so far) and having such a huge chunk of my income go for health insurance.
I'm annoyed I pay so much for health insurance and that it will likely only go up and up, and it's only a bit over $300 a month plus the occasional copay (but I have not seen the next years plans and I haven't needed serious care) and that's with the employer paying some. Is anyone getting raises keeping up with even the employee part of the increase in premiums? Can't say I am. If not we're ALL at this point getting poorer just to keep up with medical inflation, some of us have a long long way in the "getting poorer" to go before we hit poverty, but nontheless our standard of living seems to continue to decline each year just to keep up with the medical inflation beast.
But younger, healthier people like me have to pay more so older less healthy people can have coverage? You know if everyone really was protected (including *me* if I fell through the cracks and needed it!) that particular bitter pill would still be no party but just a little bit easier to swallow - but no we still have a healthcare system where the cracks are big enough for 50 story buildings to fall through, even people with insurance especially those on the lower end of the *wealth* scale (ie don't have say 6k just sitting around for a deductible should they get a serious illness) but not qualifying for medicaid are going to have deductibles too high for them to use their plans, plus hospitals that don't take their plans. Well in their case walking away from medical debt is still an option (it's not yet student loans).
But anyway employer coverage looks more attractive NOW, a few years down the line I think it WON'T. Because I think it's very much part of the plan for Obamacare for employer coverage to get junkier and junkier. For one thing they have a penalty on Cadillac plans only the definition of Cadillac is based purely on what it costs, not on what it covers (what if an employer has a lot of sick employees - then basic plans become Cadillac). Plus the amount to qualify as Cadillac increases every year by inflation (some form of the CPI), but as we all know medical inflation is running multiples of this with no break. So the result of graphing such a thing if current trends continue is eventually all PPOs are Cadillac. I would not be happy about this, I've tried hard to keep my PPOs and not have to go with HMOs (when HR tells you that yes the HMO is a much better deal cost wise as long as your willing to fight with the HMO to get care, it's not a good sign). Now maybe insurance companies deliberately try not to go over the Cadillac limit so that bulk buyers (corporations) will continue to use them, but though they're easy to hate they aren't the only cost driver of medical inflation!
So it's possible self-employment might start to look attractive in a few years just due to the sheer junkiness of *everyone*'s policies! If you have @#$# coverage if you work for others, might as well have @#$# coverage working for yourself! Really. If it gets to the point both options have 20k out of pocket, what can you do? And this is self-employment not as good choice among good choices, but as nothing left to lose (I do happen to know entrepreneurs who started that way because they simply could not find work. It contradicts so with the narrative of winners and losers I know ...). But anyway if @#$# sandwiches are the only thing on the menu in terms of healthcare, you stop waiting for filet minon to show up. Better a @#$# sandwich on my terms! (self-employment) Never mind that I hear the menu in Canada actually consists of real food and not just @#$# sandwiches all the time ..... oh those lucky people.
My previous sandwich was taken away from me, I'm not allowed to keep it. Nor have I readily been able to procure a new sandwich.
Our insurance is now through DW's job. As far as we can tell that won't be cancelled in the near future. She really only works for that insurance. The rate through the exchange she checked would have amounted to 64% of her income. Weeeee. I'm ok with one of the three R's. Repeal, replace or reform. There are worthwhile elements in the bill, but it appears impossible to separate the wheat from the chaff at this point.
This law does nothing to reduce the cost of health care. It may reduce some individuals cost due to subsides, but the money still has to come from somewhere.
I wondering how many are going to find out its still not affordable for them when they find out what a deductable is. I see many quote lower rates, but what is there total out of pocket cost?
Its not a big deal to me, I'm paying $1340 a month now, but have a total out of pocket of $1500. And since I don't have earned income I can shift it around some and get a subsidy without much problem.
iris lilies
12-2-13, 11:31am
And in this case, as in all cases, it depends on how the question is asked. I've read in more than one place that people are more favorably inclined towards the affordable care act than they are to obamacare.
I get your point! People (well, those opposed to Obamacare regardless of their thoughts about the ACA) are just stupid. It really IS best that the Prez is taking their health care in hand since they can't figure it out for themselves. bae, catherine--really needed help and boy they got it! Another poster here, reader99, got no help, but I suppose that can be blamed on those wascally Republicans in each state who didn't expand Medicaid because hey--the Prez cannot be expected to do EVERYTHING, can He?
I agree. Some polls seem to be worded to achieve a desired result which can then be passed along as consensus. It pays to look at many different sources before reaching a conclusion.
And yet here you have come to a conclusion and presented it as fact!:laff:
The higher prices, for a very small portion of the population I might add, isn't all the fault of the ACA. The greedy insurance companies are playing their customers for fools, and unfortunately there are plenty who ARE rooting for Obamacare to fail and are perfectly willing to do the dirty work (misinformation) for the insurance companies.
Insurance goes up. Period. It happened before the ACA and it will happen here on out, which is why we need single payer. But even that isn't free, and any one who thinks all these 'hand-wringing' republicans really really just want the people to have good affordable health care haven't been paying attention. If Obamacare is replaced, as I believe it will be in the future by single payer, it sure won't be the republicans doing it. Because you know what? They don't care. They really don't. Period.
Some of the higher costs have been due to the fact that insurance companies can no longer sell junk policies that lead people on until they actually need it, then cancel them. Remember, that was perfectly legal, and common, before the ACA put a stop to it. "What? You mean we have to HONOR our insurance policies? Well hells bells, we want more money for that!"
As more people sign on (and no, they don't need to sign up EVERYONE in California in the exchange. Sorry IL, liberals can count AND think critically) the premiums will come down in the EXACT SAME WAY that the more that belong to a food co-op, the better purchasing power the co-op has. And that, in a nutshell is what the ACA is. It's a co-op. A health co-op. But, again, there are those who root for it to fail, as the OP article link states, and those are doing everything in their power to MAKE it fail, like refusing to set up exchanges or expand Medicaid. And their minions go on forums and trash it, tossing out phony numbers and scare tactics. People who can well afford a little higher premium apparently who are OUTRAGED that they might have to actually buy insurance to cover them and their families, even if it isn't 'catastrophic' (which of course begs the question who exactly did they expect to pick up the tab up to 100,000 or whatever the definition of catastrophic is?)
Remember, in the exchange, the insurance companies must spend 80% on actual health care, so the bigger the pool, the harder it will be for these companies to justify ridiculous premiums.
Republicans are pretty transparent, and shallow. (besides, they make no bones about what they are up to and will gladly tell you...i.e. job #1) If they really really thought Obamacare would fail the citizens, they would play it for what it's worth and make attempts at appearing to want it to succeed, 'trying' to make it work so they can come back later and point to their good attempts. Thing is, they know it will succeed, even with their sabotage. It will just take a little longer. I know they are counting on young people becoming frustrated and quitting....but as in everything else, here they are completely clueless!
http://www.cnn.com/2013/11/25/politics/obamacare-boehner-costs/
He tried really really hard to make this not work, but unfortunately it did. And considering his age and that he smokes, I think he did pretty good. Certainly when you consider his employer will pick up a huge part of the tab. :~)
ApatheticNoMore
12-2-13, 1:28pm
The greedy insurance companies are playing their customers for fools, and unfortunately there are plenty who ARE rooting for Obamacare to fail and are perfectly willing to do the dirty work (misinformation) for the insurance companies.
too bad we have a health insurance plan written by insurance companies, when no other country allows the kind of for-profit insurance we do. They aren't all the UK (although that model still seems to work better than ours), a few do have insurance companies! gasp. But they are regulated to death, they are not the type of for profit insurance companies we have. Many of the places where the insurance model seems to kind of work, yes of course have single payer, but also pretty much have non-profit insurance companies.
If Obamacare is replaced, as I believe it will be in the future by single payer, it sure won't be the republicans doing it. Because you know what? They don't care. They really don't. Period.
I'm not sure the path to that. I think possibly the only one is the parts of the ACA that allow states to go single payer but even that doesn't take effect until several years (states AREN'T allowed to go single payer now). If the point is Dems in D.C. will go single payer, watch the campaign contributions, only if they cease receiving much money from healthcare inc will that ever happen. Watch that, and mute their mouths because money talks, something walks.
Some of the higher costs have been due to the fact that insurance companies can no longer sell junk policies that lead people on until they actually need it, then cancel them. Remember, that was perfectly legal, and common, before the ACA put a stop to it. "What? You mean we have to HONOR our insurance policies? Well hells bells, we want more money for that!"
I think they are selling different types of junk policies, ie those with narrow networks, excluding major hospitals in some cases. It's like a poor quality car, the engine no longer has a tendency to fail after a year, now the transmission does so.
As more people sign on (and no, they don't need to sign up EVERYONE in California in the exchange. Sorry IL, liberals can count AND think critically) the premiums will come down in the EXACT SAME WAY that the more that belong to a food co-op
through the magic of the marketplace, so we are told
the better purchasing power the co-op has. And that, in a nutshell is what the ACA is. It's a co-op. A health co-op.
Actually IF health insurance was run by co-ops I think we'd have a better shot. Waiting for libertarian socialism. Well what the heck else can you do with deeply ingrained bad systems but try to exploit their cracks fwiw (for state single payer or co-ops etc.) It is true real health co-ops CAN offer policies via the ACA, unfortunately they seem to have had some difficulty getting on the state exchanges and the playing field seems unsurprisingly overwhelmingly tilted to the same for-profit insurance companies that have been running everything in the past (I'm shocked - not).
http://www.cnn.com/2013/11/25/politi...boehner-costs/
He tried really really hard to make this not work, but unfortunately it did. And considering his age and that he smokes, I think he did pretty good. Certainly when you consider his employer will pick up a huge part of the tab.
those are much better plans than the masses get of course. The plans they get subsidized are gold level. The masses are expected to get silver plans.
And yet here you have come to a conclusion and presented it as fact!:laff:
No, actually I came to a conclusion and presented it as opinion. The tell-tale markers such as "I believe something like" and "No, I'm not sure" are normally a tip-off. ;)
flowerseverywhere
12-2-13, 5:26pm
Peggy, I don't agree that republicans don't care. I think they care about different things than you do. I think many are very concerned about the debt we are piling up, and about the increasing numbers of people getting assistance. Asking the wealthy to subsidize the poor doesn't seem to me to do much to reverse their plight and provide opportunity to them. Kind of like putting a bandaid on a gaping wound. The problem is larger than that. I'm very disappointed that they have not comeup with an alternate plan to the ACA as it stands instead of just criticizing it, though.
Read
Steven Brill, Time Magazine, Bitter Pill: Why Medical Bills are Killing Us.
http://content.time.com/time/magazine/article/0,9171,2136864,00.html
Seems you can't view this whole article without paying/getting a pass of some kind, but it's worth it if you want solid and robust investigative reporting on exactly what you're asking.
According to the Washington Post, this article can be summed up in one sentence:
You know, I've been pondering this article since it came out. The overall impression I got is that the medical industry is soaking us with high charges and thereby making a hefty profit. As I understand basic accounting and economics, profit comes down to the bottom line on the income statement where it can then be reinvested in the company or paid to the stockholders as dividends. In either case, a growing company or a company paying good dividends would be considered a good investment for a stockholder. I am not seeing that in the stock prices of the health insurance or other medical industries, like hospitals. While big pharma might charge a large amount for drugs, they have to meet rigorous FDA guidelines and have high R+D expenses.
So, if these guys were making big profits, one could become wealthy by investing in their stocks. At least on a relative scale to other industries, that just isn't happening. Back in the day when I invested in individual stocks, I owned one of the big pharma stocks and one of a large hospital corporation. They were both pretty much dogs and I sold them. Insurance companies are basically considered conservative investments and typically known for slow but steady growth.
No doubt there are CEOs with huge salaries, but that is typical for private sector companies. I am still digesting some of this, but I think the article, as well as some general public perceptions, are mislaid and that they are not making undue income. Off course there are other valid reasons for high medical expenses, but I think they are more in the realm of bureaucratic inefficiencies. Least that's where I'm at now.
Rogar, it's been a while since I read that article, but to me the take-away was not all the profit they were or were not racking up, but the lack of transparency with regard to completely capricious pricing. We can go on the internet and enter "KitchenAid mixer" and immediately get tons of competitive prices at our fingertips. And if a vendor sees he is being outsold because his prices are higher, he can do a better job at meeting the market demand.
That's not possible in healthcare. Because there are so many hands in the soup--doctor, payer, purchasing group, hospital administration, insurance company, etc. etc., the vested interest in competitive pricing is diluted. You'll notice I didn't even put patient in the mix--because we just assume it's going to be one colossal PIA to track down every charge, so we give up and let it filter through all the channels and then our copayment isn't that bad so we live with it and don't challenge.
Now, if we go to the supermarket and the cashier rings up $25 for an apple, you can be sure we'll raise holy hell, but we swallow that $25 aspirin without thinking about it.
And, to your point, because of the complexities of this crazy, messed up system, inefficiencies abound. How can it be efficient? By design it's inefficient.
The fact that every cost is almost completely random and no one bothers to care just defies any rule of free enterprise and market economics--so there's where your profitability measure falls down.
I personally don't want to see the law repealed or killed off. I'd like to see it fixed. Lots of things I dislike about it that can be changed for the better (and easily repaired imho). But first the administration has to acknowledge that things aren't working as planned - i.e. leaving the millions of working poor in non-Medicaid expanded states without affordable health insurance while those with much higher incomes can get almost full subsidies just by putting some of their earnings into tax-deferred investments to name just one of many problems with the ACA. The administration seems to be more focused on fixing the problems with the website than fixing the problems with the ACA. Fix and change don't repeal.
ETA: as one of those people who doesn't qualify for subsidies (only Medicaid) and who had their private insurance policy cancelled, and who is a state (Calif) that will not allow an extention even if the feds allow for one, I am having a difficult time finding affordable insurance myself. I do have a low cost alternative (the VA) though so am luckier than most.
gimmethesimplelife
12-4-13, 5:50pm
at this point 33% probably favor replace with single payer. Even single payer probably wouldn't be effective unless you broke the current medical cartel (ie held down pharma costs like they do in other countries, tightly controlled for-profit insurance etc.), but probably no form of healthcare reform would be unless you do that anyway.
I'm annoyed I pay so much for health insurance and that it will likely only go up and up, and it's only a bit over $300 a month plus the occasional copay (but I have not seen the next years plans and I haven't needed serious care) and that's with the employer paying some. Is anyone getting raises keeping up with even the employee part of the increase in premiums? Can't say I am. If not we're ALL at this point getting poorer just to keep up with medical inflation, some of us have a long long way in the "getting poorer" to go before we hit poverty, but nontheless our standard of living seems to continue to decline each year just to keep up with the medical inflation beast.
But younger, healthier people like me have to pay more so older less healthy people can have coverage? You know if everyone really was protected (including *me* if I fell through the cracks and needed it!) that particular bitter pill would still be no party but just a little bit easier to swallow - but no we still have a healthcare system where the cracks are big enough for 50 story buildings to fall through, even people with insurance especially those on the lower end of the *wealth* scale (ie don't have say 6k just sitting around for a deductible should they get a serious illness) but not qualifying for medicaid are going to have deductibles too high for them to use their plans, plus hospitals that don't take their plans. Well in their case walking away from medical debt is still an option (it's not yet student loans).
But anyway employer coverage looks more attractive NOW, a few years down the line I think it WON'T. Because I think it's very much part of the plan for Obamacare for employer coverage to get junkier and junkier. For one thing they have a penalty on Cadillac plans only the definition of Cadillac is based purely on what it costs, not on what it covers (what if an employer has a lot of sick employees - then basic plans become Cadillac). Plus the amount to qualify as Cadillac increases every year by inflation (some form of the CPI), but as we all know medical inflation is running multiples of this with no break. So the result of graphing such a thing if current trends continue is eventually all PPOs are Cadillac. I would not be happy about this, I've tried hard to keep my PPOs and not have to go with HMOs (when HR tells you that yes the HMO is a much better deal cost wise as long as your willing to fight with the HMO to get care, it's not a good sign). Now maybe insurance companies deliberately try not to go over the Cadillac limit so that bulk buyers (corporations) will continue to use them, but though they're easy to hate they aren't the only cost driver of medical inflation!
So it's possible self-employment might start to look attractive in a few years just due to the sheer junkiness of *everyone*'s policies! If you have @#$# coverage if you work for others, might as well have @#$# coverage working for yourself! Really. If it gets to the point both options have 20k out of pocket, what can you do? And this is self-employment not as good choice among good choices, but as nothing left to lose (I do happen to know entrepreneurs who started that way because they simply could not find work. It contradicts so with the narrative of winners and losers I know ...). But anyway if @#$# sandwiches are the only thing on the menu in terms of healthcare, you stop waiting for filet minon to show up. Better a @#$# sandwich on my terms! (self-employment) Never mind that I hear the menu in Canada actually consists of real food and not just @#$# sandwiches all the time ..... oh those lucky people.APN, I love your last paragraph. And I can see your point that self employment is going to look more and more attractive if employer based health plans cover less and less and less. If you have a skill to peddle, WHY NOT go out on your own if one of the big perks of working for someone else becomes less and less of a perk? I think you are dead on in this assessment. Rob
rodeosweetheart
12-4-13, 6:25pm
I personally don't want to see the law repealed or killed off. I'd like to see it fixed. Lots of things I dislike about it that can be changed for the better (and easily repaired imho). But first the administration has to acknowledge that things aren't working as planned - i.e. leaving the millions of working poor in non-Medicaid expanded states without affordable health insurance while those with much higher incomes can get almost full subsidies just by putting some of their earnings into tax-deferred investments to name just one of many problems with the ACA. The administration seems to be more focused on fixing the problems with the website than fixing the problems with the ACA. Fix and change don't repeal.
ETA: as one of those people who doesn't qualify for subsidies (only Medicaid) and who had their private insurance policy cancelled, and who is a state (Calif) that will not allow an extention even if the feds allow for one, I am having a difficult time finding affordable insurance myself. I do have a low cost alternative (the VA) though so am luckier than most.
Hang in there, Spartana, and i always get a lot of good info from your posts, lots of good critical thinking and you always teach me something.
Frankly, it really makes me angry that you, a vet, are getting jacked around with respect to health insurance. I am glad there is the VA but I hope another plan comes along for you, and soon.
You are an optimistic inspiration to me--you are always a positive spirit, and you think things through and you figure things out for yourself.
Hang in there, Spartana, and i always get a lot of good info from your posts, lots of good critical thinking and you always teach me something.
Frankly, it really makes me angry that you, a vet, are getting jacked around with respect to health insurance. I am glad there is the VA but I hope another plan comes along for you, and soon.
You are an optimistic inspiration to me--you are always a positive spirit, and you think things through and you figure things out for yourself.Thanks!! That is very nice of you to say. Well there are health insurance plans out there that I can buy that are not on the state exchange (can get them straight from the insurance agencies) and they really aren't that expensive overall - but they are still 3 times higher than what I was paying for before for my Blue Cross catastrophic plan and have much higher out-of-pocket so it's kind of a sticker shock thing for me. But I am one of the fortunate ones in that I can afford to pay the price increase by tapping into some of my retirement savings (and will probably do that), or just use the VA for very low cost, or even apply for the states Medicaid program if I want (I don't and won't). But I feel for those people who don't have those other options like I do. Those were the people I had really hoped the ACA would help and it seems that they are the ones that are falling between the cracks.
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