Projections of ACA impact on 2014 elections

lifegoesonbrah said:

I'm just asking you to show some evidence of your claim that the costs of healthcare have not increased..... There is a difference between insuring a piece of machinery and a human being. A vehicle is valued at a set amount, the insurance costs take the value of the vehicle and the costs of repairs into consideration when determining costs to insure. If the costs of repairing vehicles increased, so would the cost of insurance. No? I am not understanding your point and am unconvinced that the rise in overall healthcare costs has not directly contributed to the rise in premiums. You have not proved this.

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Healthcare costs (not insurance premiums) have gone down
Pick one
https://www.google.com/search?q=healthcare+costs+have+decreased&rls=com.microsoft:en-us:IE-Address&ie=UTF-8&oe=UTF-8&sourceid=ie7&rlz=1I7GGHP_enUS495

see4 said:

I am saying that HAVE increased. Please read over my comments. Thanks. In fact, I think you are missing the point entirely. And to the point of UB's assertion. Regardless of rising healthcare or stagnant thereof, premiums fluctuate greatly for different demographics. ACA is only trying to level the playing field for everyone.

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So what is your point here? You seemed to be drawing the conclusion that the cause of increasing healthcare costs were "free market hospitals". lol

see4 said:

No. That is not how insurance works. There is a minor correlation between cost of vehicle and price of insurance, the rest of the premium is attributed to the number of insurance pool participants, the level of insurance coverage, and factors like environment variables, will the car more likely get stolen, will it more likely get into an accident, etc etc.

Coverage of your vehicle or boat is not unlike your coverage of yourself, in terms of actuarial data points. It does differ in coverage, for obvious reasons. One is a human body, the other a machine.

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Again, what is your point of comparing the two? It seemed you were attempting to draw a complete disconnect between costs of insurance and costs of healthcare/auto repair costs. You are an awfully deceptive debater.

ChesusRice said:

Healthcare costs (not insurance premiums) have gone down
Pick one
https://www.google.com/search?q=healthcare+costs+have+decreased&rls=com.microsoft:en-us:IE-Address&ie=UTF-8&oe=UTF-8&sourceid=ie7&rlz=1I7GGHP_enUS495

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Heres an idea, you pick one. Someone not so partisan would search "healthcare costs" not "healthcare costs have decreased". Find your own statistical evidence that healthcare costs have decreased (lol) and present it here.

lifegoesonbrah said:

I'm just asking you to show some evidence of your claim that the costs of healthcare have not increased.....

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i did in post 48. health care costs have held steady the last three years, even though premiums have still gone up (just not as fast as in the 20 years prior).

you don't have to credit this to the PPACA, but you sure as hell can't blame rising premiums on the PPACA for the same reason.

see4 said:

Yea, that's what I thought. In the face of fact you back down and/or change the subject. Pussy. I didn't scream anything, I calmly typed it out while high on some Blue Dream. You took it as me screaming. Pussy. "Pretending I put words in your mouth is just a lie." - Ok smartypants, quote me. Find where I said I now pay less for not so amazing insurance. Find it. Quote me.

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Where did I back down or change the subject? Claiming victory where none exists? You clearly stated your insurance at IBM was "amazing", while not describing your newer, BUT STILL PRE-ACA, insurance as such. Pretending I must find a quote that you get to define is typical of your merit-less arguments. Ending every line with "pussy" just proves you have no debate. Good Day.

UncleBuck said:

i did in post 48. health care costs have held steady the last three years, even though premiums have still gone up (just not as fast as in the 20 years prior).

you don't have to credit this to the PPACA, but you sure as hell can't blame rising premiums on the PPACA for the same reason.

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Oh I see, I have been looking at charts that span over a longer period seeing pretty substantial increases in healthcare costs, I did not look at the last 3 years independently. So costs have grown at 4% the past 3 years, which isn't bad. Now, have premiums increased more than this 4% per year over the past 3 years?

My knowledge of healthcare is limited, will continue tomorrow. Good night!

UncleBuck said:

since desert dipshit is off in la la land citing the goddamn heritage foundation (and most likely laughing to himself, hoping no one notices), i'll go ahead and cite something a little more credible.

http://www.dailyfinance.com/2013/01/08/health-care-costs-are-holding-relatively-steady-for-now/

Americans kept health care spending in check for three years in a row, the government reported Monday, an unusual respite that could linger if the economy stays soft or fade like a mirage if job growth comes roaring back.

so despite the right wing, heritage foundation nonsense that desert dipshit is flinging wildly, the fact is that for three years health care costs have remained steady. so everyone blaming their premium increases on 'obamacare' is only illustrating what an easily duped buffoon they truly are.

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If healthcare costs are actually increasing, as your article states, I'm puzzled about how they're holding "steady." The increases in premiums would be 2/3s explained by the increase in actual healthcare expenditures.

lifegoesonbrah said:

So what is your point here? You seemed to be drawing the conclusion that the cause of increasing healthcare costs were "free market hospitals". lol


.

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Absolutly the number one cause of healthcare cost increases is Free market hospitals. The medical industry is still building hospitals at more than capacity. This should decrease the cost of healthcare but it doesnt. There are only so many doctors and nurses and you still have to support the infrastructure. Add into the equation that no one "prices" medical care and medical practices dont advertise. It is not really a free market. If I go to a doctor here with a stubbed toe I am looking at a 400 dollar medical bill after the initial visit, lab work, xrays and referral to a stubbed toe doctor.

see4 said:

I want to focus on this for a moment. How do you know that Obamacare is an ill-fated program? It has barely been implemented in its entirety. Are you an economist? A sociologist? Both? I'm betting neither.

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Because the present system is ill-fated. Any extension of that system is likewise ill-fated, because the "solution" actually does nothing to address the problem, which is skyrocketing costs.

I have to disagree completely that insurance is part of the problem of healthcare costs, as they are two completely separate things. That is like saying your car insurance is the same as your car payment. It's not. They are part-in-parcel, but certainly not congruent.

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Now you're on to something. When you shop for a car, how do you do it? Do you go to the nearest car lot and agree to pay whatever price they demand? Are you locked into the Ford network and unable to even consider buying a Honda or Toyota? Of course not! Most people conduct extensive research and seek out the best possible price for the car so that they can pay as little as possible; and if the dealer you're talking to won't budge on his price, you leave and find another dealer.

Health insurance is problematic for several reasons:

1) It masks actual costs. If you need to have surgery and you have insurance, do you call three or four different hospitals for quotes on the procedure? No! Likewise, if you need to see a doctor, do you call around to a few different offices and ask how much the exam fee, lab fees, etc. are? No! You walk in, hand over your insurance information, use the service, and then wait for the bill to come, hoping that your insurance will pick up most of the tab.

2) It discourages provider competition. If you live in a town with two hospitals, your insurance might only have one of them in its network, cutting you off from half the hospital market; likewise, if your town has 200 doctors and you only have 50 in your insurance network, you're cut off from 3/4s of the doctor market. What happens when you don't have to compete for business? You raise prices. It's a classic antitrust problem (and I am ardently anti-monopoly).

3) It's regulated by a patchwork of state law in all 50 states. This limits competition between insurance companies for consumer business and magnifies the anti-competitive problem above. Many markets have only 2 or 3 insurers to choose from even though there are dozens of other companies.

If we treated healthcare like any other consumer good, the prices would plummet. If there are 3 hospitals charging $10,000, $15,000, and $20,000 for the same procedure and the consumer actually cares about how much the cost is going to be, because the insurance company isn't going to foot the bill, the price of the procedure is going to be driven down closer to $10,000--the hospital charging $20,000 will have no business at that price.

Which leaves us only with the beginning part of this argument; and your baseless assumption that Obamacare, though not fully enacted, is somehow already failing completely.

Ok, then let's say for arguments sake that Obamacare is a total failure and in 2014 it is completely repealed. What do you offer as suggestion to control healthcare costs and provide coverage for those with preexisting conditions and others who might not otherwise be able to afford coverage? The country is listening.

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The present system is already failing completely. You're under the impression that I was perfectly fine with the healthcare system as it was, and that's not true at all. I would rather have single payer than Obamacare/the present system, which I've often repeated here. Obamacare is corporate welfare at its worst: it is handout of vast sums of money to health insurance companies and the healthcare industry, which spent a fortune lobbying and writing the bill.

Some of my solutions:

1) Competition. Dismantle the state-by-state regulation patchwork so that everyone is free to compete everywhere; dismantle insurance networks; make pricing transparent (if you call hospitals for quotes on procedures, a lot of them won't even provide you with one) and provide consumers with incentives to comparison shop for healthcare services; reduce and/or eliminate the generous antitrust exemptions currently enjoyed by insurance companies, hospitals, doctors, and other healthcare industry participants.

2) Force the AMA to allow more doctors to be minted. The AMA has rigged the medical education system in this country to impose exceedingly strict limits on how many people can attend medical schools every year; lots of perfectly qualified people are turned away every year in the application process. Their goal is not to give us better doctors but to keep doctor salaries sky high, which they do by artificially restricting the supply (yet another antitrust problem).

3) Limit punitive damages for lawsuits. No cap on actual damages, but permitting huge punitive awards increases costs for everyone else.

4) Impose new taxes to price externalities. Increase the excise taxes on tobacco and alcohol, which account for substantial healthcare costs; impose new excise taxes on certain food contents, such as sugar and refined grains, where there is scientific consensus that the contents result in expensive future health problems.

5) Alter the payment for service model. Our current healthcare system only pays people for treating the sick, and they get paid regardless of the outcome. Consequence: we don't focus on prevention and waste tons of money on bad outcomes.

6) Fight fraud. Every dollar spent fighting healthcare fraud returns more dollars; the existing government programs pay out huge sums for care that was unnecessary or never even happened.

7) Limit spending where there's little or no evidence of efficacy. $100,000 for a cancer drug that might not even work? Neither the government nor insurance companies should be paying for that.

Do all of these things and our healthcare system could provide a lot more care to a lot more people for a lot less money.

see4 said:

Don't put words in my mouth and think you've made a valid argument. Try again.

I was trying to be polite and only provide you with the information I could. You clearly want to go down the douchebag rabbit-hole. So we can go that route.

re: deluding yourself into believing events -- Do you even have a full grasp of the English language? You dumb fuck.

I actually pay less for almost the exact same insurance. My deductible is $2000 a year now, and it was 6 years ago. My copay is $50 now, it was $25 then. All else is equal, except I pay less per month.

You slimy prick, you have nothing to argue so you attempt to put words in my mouth in the hopes that I won't notice. Piece of shit. You are as worthless as the glasses I put on your moms face right before I spackle her in the eye with my jizz.

Now, if you would like to return to a civil debate, we can. Totally up to you sport.

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There's little point in trading anecdotal stories about what certain families or certain individuals are paying for health insurance. There are too many variables at work to make any meaningful conclusions from the anecdotal accounts.

lifegoesonbrah said:

Oh I see, I have been looking at charts that span over a longer period seeing pretty substantial increases in healthcare costs, I did not look at the last 3 years independently. So costs have grown at 4% the past 3 years, which isn't bad. Now, have premiums increased more than this 4% per year over the past 3 years?

My knowledge of healthcare is limited, will continue tomorrow. Good night!

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It depends on which source you lack at. If we go by Kaiser, cited above, the increase in healthcare premiums almost exactly matched the actual growth in healthcare costs: approximately 4% and approximately 4%.

When people say "healthcare costs have decreased" they tend to actually mean that the rate of cost increases has decreased. The two statements mean totally different things, and the former one is false and misleading.

ChesusRice said:

Absolutly the number one cause of healthcare cost increases is Free market hospitals. The medical industry is still building hospitals at more than capacity. This should decrease the cost of healthcare but it doesnt. There are only so many doctors and nurses and you still have to support the infrastructure. Add into the equation that no one "prices" medical care and medical practices dont advertise. It is not really a free market. If I go to a doctor here with a stubbed toe I am looking at a 400 dollar medical bill after the initial visit, lab work, xrays and referral to a stubbed toe doctor.

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Healthcare is presently a laissez-faire wet dream.

tokeprep said:

Healthcare is presently a laissez-faire wet dream.

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I hope you are being sarcastic (I think you are).
EMTALA, HIPAA, Stark, HITECH, Meaningful Use, Medicare fee schedules, etc.

ginwilly said:

I hope you are being sarcastic (I think you are).
EMTALA, HIPAA, Stark, HITECH, Meaningful Use, Medicare fee schedules, etc.

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I didn't mean that it was unregulated, only that anti-competitive behavior is tolerated to a far greater extent than is typical. That's why the prices are sky high, because the market has been carved into monopolistic little kingdoms with no one willing to force competition because "People will die!"

tokeprep said:

I didn't mean that it was unregulated, only that anti-competitive behavior is tolerated to a far greater extent than is typical. That's why the prices are sky high, because the market has been carved into monopolistic little kingdoms with no one willing to force competition because "People will die!"

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It's not that the market helped with those monopolies. The health care industry needs government approval to open competition in the form of certificates of need. If I wanted to open a home health agency, I would file my CON, send in my non-refundable check, and wait and see if the gov decides if my town "needs" another agency or not. It's difficult to force competition with this environment. We are forced to work with the market that's created, not natural.

Anti-competitive behavior is not just tolerated, it's encouraged in health care by the central planners. These are the same people who brought us employee provided healthcare through wage freezes.

Health care is the opposite of lase-fairre.

ginwilly said:

It's not that the market helped with those monopolies. The health care industry needs government approval to open competition in the form of certificates of need. If I wanted to open a home health agency, I would file my CON, send in my non-refundable check, and wait and see if the gov decides if my town "needs" another agency or not. It's difficult to force competition with this environment. We are forced to work with the market that's created, not natural.

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There are significant states (California and Texas) that don't have certificate of need requirements. Is there a meaningful cost difference between the states that have such requirements and the ones that don't? As a practical matter, if a company is incapable of proving that a new facility is necessary, I doubt it would even be interested in building a facility at all.

Anti-competitive behavior is not just tolerated, it's encouraged in health care by the central planners. These are the same people who brought us employee provided healthcare through wage freezes.

Health care is the opposite of lase-fairre.

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I agree that entry is restricted in most states, but if you're already in business, you get away with anti-competitive behavior that would be unthinkable and inexcusable in almost any other industry.

tokeprep said:

I agree that entry is restricted in most states, but if you're already in business, you get away with anti-competitive behavior that would be unthinkable and inexcusable in almost any other industry.

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I'm on your page now, I missed this point earlier. Yes, the hospital/insurance/Big Pharma lobbies have done an amazing job of stifling competition through central planners. With each government intrusion, there was a compromise (like fee schedules with EMTALA) that benefited the most connected and largest of the corporations. The small, independent hospitals and health care sources are being regulated into joining the hospital cartel or closing. Competition in health care is lobbied and regulated away. I'm not sure more regulations and less competition is the answer, but it's what we chose as our solution.

tokeprep said:

There are significant states (California and Texas) that don't have certificate of need requirements. Is there a meaningful cost difference between the states that have such requirements and the ones that don't? As a practical matter, if a company is incapable of proving that a new facility is necessary, I doubt it would even be interested in building a facility at all.

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When I have to PROVE that what I want to open is necessary, who decides? Do you trust the deciders to not be corrupt? Should my competition have a right to petition against me saying "nah, we got this".

Imagine if Burger King were told they couldn't open because there was already a McDonald's so we don't NEED Burger King. Hell, there is a subway on every corner practically, maybe we should close half? This is the logic used toward the health care industry.

Tokeprep,

Do you have a definition of Public Goods and if so, why doesn't healthcare qualify (by your definition) as such?