Who's Sorry Now?

[Guinevere]

Don't forget about the lifetime limits removal too. People with serious chronic conditions couldn't get health care (or covered care) in the past. I cannot imagine what Mom's last stay will bill out at, but some quick research shows it could easily be 20-25k per day, then tack on the valve replacement, and then tack on rehab. All said and done it will be close to seven figures. Without the end of limits she could have reached the end of her coverage and be faced with giving up her home or not receiving care that saved her life.

[Lord Jim]

Let's have a little current events civics quiz:

Which group of folks do you think are most likely to vote in the highest percentages in the 2014 midterm elections:

A. People grateful for benefits (tangible or imagined in some future scenario) received under Obamacare...

B. People who are pissed off because they had the healthcare plans they liked eliminated (five million and counting) despite the President's promise they could keep their plan, or saw their premiums skyrocket to pay for "benefits" they had no interest in or need for, or saw those premiums rise so high they could no longer afford health insurance at all.

If you answered "A" then you should indeed be grateful that Obamacare mandates mental health coverage, because you clearly need it...

[Guinevere]

If they aren't mad at their insurance company then they are in even more need of mental health coverage.

Again, who are these people with coverage costs rising? Have they bothered to shop around? Did they check out the ACA plans available? I'd bet many of them could do better. I know that my premium went down for the same coverage.

And the "coverage they don't need" is a huge red herring. That's the whole freaking point of health insurance. But if we are going to be able to pick and chose, then please, stop charging me for Viagra and all of the research done principally on male subjects, ignoring the different health needs of women.

[Jarlaxle]

Thanks (entirely) to Obamacare, the health insurance offered by her employer has seen premiums TRIPLE. For worse coverage. (Deductible doubled.) Fortunately, she's covered by my insurance...but that will implode NEXT year.

I am forced (basically, at gunpoint) to pay for coverage I do not want, do not need, and have exactly zero chance of ever using.

[Guinevere]

And did her employer shop around? Or did they just pay the higher bill without question? How did my employer get us a better deal than we had before?

What coverage do you pay for now, that you didn't have before, that you have zero chance of using? And at what cost?

[Jarlaxle]

Yes, they shopped around, like they do every year. (Three different insurers in four years.) The problem being: the catastrophic-care plan that they used to offer is no longer legal...in other words: The Messiah lied!

Off the top of my head, I am forced to pay for maternity care. (Though I'm sure there are others we'll never use.) The chance of Liz or I needing it is, exactly, zero.

[Lord Jim]

But if we are going to be able to pick and chose, then please, stop charging me for Viagra

Let me go on the record as saying right here and now that you should not be charged under your insurance plan for Viagra...

Nor should post menopausal women be required to have coverage for birth control...

Have they bothered to shop around? Did they check out the ACA plans available? I'd bet many of them could do better. ...

And did her employer shop around? Or did they just pay the higher bill without question?...

The interesting thing about those kinds of arguments is the way they are completely detached from political reality...

Are you suggesting that a Democratic member of Congress, in a tough re-election race in a swing district, when confronted at a Town Hall meeting by someone making a point like Jarl's : "the health insurance offered by her employer has seen premiums TRIPLE. For worse coverage. (Deductible doubled.)"

Should essentially say, "Well if you're worse off it's because you're too stupid or lazy to 'shop around' or your employer is too lazy or stupid to 'shop around'...

Yes, I invite them to make that sort of argument...

I know that my premium went down for the same coverage.

As I have been honest enough to admit, we're one of the supposed "winners" under Obamacare. Our premiums have gone down by several hundred dollars a month...(same coverage, and we're able to see our same doctors)

But I view that entirely as a temporary windfall; one that will ultimately be gobbled up by much higher rates... I'm not naive enough to think this is going to last, because the numbers just don't add up...

The Administration refuses to reveal how many of the "paid enrollments" are actually paid, but based on the spread sheet rube so helpfully keeps providing us with, as of Jan 14th, the numbers for Washington state, (the only state apparently willing to give that breakdown,) the numbers are about 50-50 (in fact "non paid" is slightly higher)

That should be fairly instructive, since Washington state has a state run exchange that is considered to be one of the best in the country, and the entire political establishment in the state has been on board with this from the beginning. If anything, one should expect the national percentages (if they would tell us what they are) to be even worse...

On top of that, logic and commonsense would suggest (though again, the Administration refuses to provide these numbers) that of that 50% that haven't paid, (and therefore aren't truly "enrolled" even though they get counted in the number of enrollments) that the "young and healthy" are proportionately over represented since they are the folks with the least money, and least need....

So when dealing with actual paid enrollments the percentage of "young and healthy" is undoubtedly significantly less than the 24% the Administration claims, (which is already 50% lower than the 38% needed for the pools to support the open enrollment premium levels)

This is a cluster fuck being masked with phony numbers, and as the employer mandates kick in, the cluster is going to get even fuckier...

[Jarlaxle]

The only reason I haven't gotten reamed (yet) is because of the employer mandate delays.

[Lord Jim]

That's the next shoe to drop...

[Guinevere]

And have you ever had a plan that let you pick and chose what specific medicines or treatments were covered and what was not? Of course not. Again, that's a ridiculous red herring. If a plan covers prescriptions drugs, it's covers most prescriptions drugs of they are medically necessary (often on a tiered schedule).

Same with treatments and hospitalizations. If you have coverage, it covers much of those things, subject to medical necessity. How much you pay for a premium depends on your copays, deductibles, and the broad scope of coverage. Health insurance never has been a Chinese menu approach where you pick some from a, some from b, and pray to god you don't need anything from c. How could it be - do you know for a fact you will or won't develop heart disease this year? Or get hit by a bus? As I said earlier, that's the whole point of insurance and the ACA doesn't change anything in that regard.

[Guinevere]

Jarl, if you are comparing catastrophic care only with more complete coverage then you are comparing apples and oranges. It's not even close to a fair comparison.

[Scooter]

And I'm guessing that it wasn't even very good catastrophic coverage - probably lifetime limits and the like that would make it useless in the event of a REAL catastrophe.

[rubato]

Don't forget about the lifetime limits removal too. People with serious chronic conditions couldn't get health care (or covered care) in the past. I cannot imagine what Mom's last stay will bill out at, but some quick research shows it could easily be 20-25k per day, then tack on the valve replacement, and then tack on rehab. All said and done it will be close to seven figures. Without the end of limits she could have reached the end of her coverage and be faced with giving up her home or not receiving care that saved her life.

An excellent point and one which was invisible to most people until it was too late.


Many of the people driven into bankruptcy by health costs had what they thought was 'good' coverage and discovered how brutal the 'lifetime limits' can be at exactly the worst time.


The ACA is a huge improvement even if it is less than what I would like.


yrs,
rubato

[oldr_n_wsr]

1. The ACA eliminates exclusions for pre-existing conditions. This brings more people in, is a good thing, and everyone supports it.
2. The ACA allows people to be on their parents H.I. until 26. This brings more people in, is a good thing, and everyone supports it. (3.1 million more people are covered nationally)
3. The ACA allows people with low-income to have subsidized H.I. through the exchanges. This brings more people in, is a good thing, and everyone supports it.

I don't think many people argued against having these provisions made mandatory for all insurance plans. What they argued against is the cancelations of policies that led to moving to new doctors (if you like your doctor you cn keep your doctor, PERIOD) having higher premiums (average savings of $2500 per family) and the overall mess of a signup. It may be better now, but the backend, which actually pays the insurance companies the subsidized portion of the plan, has not even been designed yet.

The net effect is that more people are paying for H.I., even if it is subsidized, and fewer people will die because they are afraid to go to a hospital because of the financial consequences or because they are ashamed.

I am guessing that fewer people will be going for the "extra" care they need as their deductables have gone through the roof. Regular checkups are covered with only the co-pay, but when the doc says go for this test/procedure/consultation, the deductables kick in. People barely affording the plans (subsidized or not) will not be able to afford the upfront deductables they were saddled with under their new plans.

The big picture is that the exchanges are a success with large numbers signing up

Large numbers are debatable. Most of the signups are people who already had insurance and had to replace what they had BECAUSE thiers was cancelled. Many others were already eligeble for medicare before the ACA and hadn't bothered to get it either because of laziness or they didn't know. Sure there were many newly eligeble for medicare from the ACA but one cannot trumpet success or boast numbers of people who were covered previously. The "big picture" was to get those who were previously uninsured or not eligeble for medicare to sign up. When I see those numbers broken out, then it can be hailed a success or failure.

I read some 30million were previously uninsured (for whatever reason) and those were the target people. I have seen no evidence of that number being significantly reduced.

And it's really tough to see the big picture (more people covered with "better" policies) when all one sees is more of their money going bye bye for no tangible return. Higher premiums and higher deductables people see monthly. Having not cap on catastrophic illness does not affect them until or if one comes up to that problem. IT's good they have that coverage, but it usually does not have a daily impact for the majority of people. The majority of people only see less money they have to spend/save/whatever.

[rubato]

Exchange QHPs: 3.01M • Other QHPs: 293K • Medicaid/CHIP: 7.43M • Sub26ers: 3.10M

Total as of Jan 29, 2014: 13.84 Million

Enrollment Period Elapsed: 67.0% • CBO Exchange QHP Projection Attained: 44.3%

Given that these are policies and a conservative multiplier is 1.8 persons per policy that means that

25 Million people are now insured because of Obamacare. And that is a large number.

yrs,
rubato

[Crackpot]

wouldn't be so sure considering Repubs numbers aren't any better...

Yes, well my calculus is based on the hope that the Dems will embrace the Rubian strategy of running vigorously and aggressively on Obamacare, shouting about what a raving success it is... (in which case they will lose at least 20 and possibly as many as 30 seats in The House; there won't be a Democrat left in Congress who isn't from the most Blue of Blue gerrymandered districts)

And regarding the Senate, my hope is that we can avoid nominating lunatics and/or morons to run for easily winnable seats...

(That wouldn't seem like a particularly high bar, but our failure to meet it has cost us control of the Senate for the past two election cycles... )

So you're basing your strategy on the republican equivalent of giving control to te tea party?

[oldr_n_wsr]

Exchange QHPs: 3.01M • Other QHPs: 293K • Medicaid/CHIP: 7.43M • Sub26ers: 3.10M

Total as of Jan 29, 2014: 13.84 Million

Enrollment Period Elapsed: 67.0% • CBO Exchange QHP Projection Attained: 44.3%

Given that these are policies and a conservative multiplier is 1.8 persons per policy that means that

25 Million people are now insured because of Obamacare. And that is a large number.

yrs,
rubato

Got any links for that?
And any breakout of who had policies before the ACA and had those policies canceled because of the ACA and are included in that number?
And that 1.8 is a guestimate by you or a fact?
I have yet to see a number of 25million no matter how its compiled/guesstimated. But of course the breakdowns might tell a different story, like 10million already had insurance but were canceled (then multiply by 1.8 so it's now 18million), and 5million people who were eligeble for medicare before the ACA (multiplied by 1.8 so now it's 9 million) now that's 27million sign up, so we have a negative amount who are newly signed up.

[Lord Jim]

Oldr, I admire your tenacity, but you are attempting to have a fact based substantive discussion with a person who is interested only in shilling and propagandizing...

A "debate" where one side is bringing on-point legitimate questions, and the other ignores all of that and is just waving their pom poms and yelling "Go Team!" is not likely to lead anywhere that would be constructive or illuminating...

[oldr_n_wsr]

I try and constantly learn from everyone. Never know where your next opportunity to learn comes from. And I like to think I sometimes return the favor (that is, have others learn from my posts).

If one chooses not to respond or to respond negatively, or to respond with good (or bad) info, that's their choice. I cannot fret about how (they respond), what (they respond with), or who (they respond to).

If I am unclear in my thinking about what someone posted, I ask questions to try and clear it up.
If I think the info is suspect, I will ask for sources, explanations, etc. If the sources are suspect, I will do the same.
I can only control my part of the discussion.

But that's just me.

[Lord Jim]

So you're basing your strategy on the republican equivalent of giving control to te tea party?

Actually based on the Democratic equivalent...(which, you can correct me if I'm wrong, is what I think you meant...)

Personally, I was very disappointed that the whole "Occupy" thing wasn't more successful, and hasn't had the kind of impact on the Democratic Party that the "Tea Party" bunch has had on the GOP...

I would like nothing better than to see the "progressives" running rampant and pushing the Democrats further to the left, and causing all manner of mischief...

Let's have unelectable lefties knocking off responsible Democratic pragmatists in primaries, the way electable candidates in my party have been knocked off by our loony fringe...

Like Chairman Mao said, "Let a hundred flowers bloom..."

Works for me...