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Post by Moses on Nov 22, 2013 22:26:55 GMT -5
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Post by Moses on Nov 22, 2013 22:27:46 GMT -5
Health policy experts said the momentum from state exchanges is encouraging.
California, which has had about 80,000 sign-ups, is now reporting about 2,000 enrollments per day. New York and Washington state reported enrollment numbers in the tens of thousands as of this week.
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Post by drjohnnyfever on Nov 22, 2013 23:09:48 GMT -5
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Post by kemmer on Nov 22, 2013 23:39:59 GMT -5
Enrollment and receiving quality care are not synonymous.
Anyone else here old enough to remember the HMO experiment of the late 1970's/early 1980'S? Same deal:
--capitation instead of fee for service (hospitals and doctors' PA's both hated that. It took hospitals close to bankruptcy.)
--getting people to see the doctor often for "preventive care." (Did not reduce costs as expected.)
--communication between primary care doctors and specialists. (Shades of what making all records electronic is supposed to do. Did not make care more cost-efficient.)
--"Gate-keeping" to make sure patients weren't rushing straight to a specialist (or going to the ER without permission.)
At first, patients loved it. Everything FREE! No co-pays (although they had to be added later). Every runny nose or gas pain investigated in hopes of hearing zebra hooves. Lots of attention and testing. Lots of expense. (Few zebras found.)
Later, patients got really annoyed about the "gate-keeping" thing, along with rising co-pays and premiums.
Then, everyone on Medicaid was pushed into an HMO, to give them a "medical home" and keep them out of the ER. They HATED it-- and still went to the ER. (Obamacare may reduce some Medicaid costs by getting everyone eligible signed up BEFORE they need any care. Typically, Medicaid came into play when someone needed care and found out he/she qualified. 'Course, savings to taxpayers will be decreased due to the much higher income levels that now qualify one for 100% free care.)
HMO's did NOT deliver the promised lower costs from early diagnosis, nor from capitation. Even the free "well-baby" check-ups didn't help. Well babies tended to remain well, whether seen by a doctor or not. Sick babies tended to be sick and in need of the same kind of care they'd been getting prior to the proliferation of of HMO's.
Bottom line, Obamacare is the failed HMO experiment writ large. The True Believers learned NOTHING from experience.
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Post by Moses on Nov 23, 2013 0:01:15 GMT -5
It hasn't failed yet no matter how many times you say. It may fail. It may not.
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Post by Deleted on Nov 23, 2013 0:03:27 GMT -5
Any way you want to crunch the numbers, Obamacare is nothing more than a cost sharing plan. If they ever try and do car insurance this way, a lot more of us will be walking or riding bikes.
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Post by Moses on Nov 23, 2013 0:05:12 GMT -5
Any way you want to crunch the numbers, Obamacare is nothing more than a cost sharing plan. If they ever try and do car insurance this way, a lot more of us will be walking or riding bikes. Yes there is a lot of uncertain unknowns how this will play out. I wish Obama had focused on other issues more. |
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Post by Deleted on Nov 23, 2013 0:25:49 GMT -5
Any way you want to crunch the numbers, Obamacare is nothing more than a cost sharing plan. If they ever try and do car insurance this way, a lot more of us will be walking or riding bikes. Yes there is a lot of uncertain unknowns how this will play out. I wish Obama had focused on other issues more. There's nothing uncertain about it. Costs will go up because Obamacare does nothing to address that issue and it never intended to. Its goal is to charge roughly the same price to everyone despite the fact that everyone has different expected costs. That is known as cost sharing. After all, it isn't fair that sickly people have to pay more for insurance than healthy folks. But in order to correct this so-called injustice, younger, healthier people (who typically need less medical care) have to buy coverage or be subject to a penalty. What other service or product is sold this way? Think if utility companies suddenly decided that it wasn't fair to charge people more who blast the heat and air conditioning, leave lights on all over the house, and generally use energy like it's going out of style, than those who try and use it wisely? Costs would skyrocket since there would be no financial incentive to moderate usage. Fairness? There's really no such thing since in order to achieve it, certain people have to be treated unfairly. |
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Post by drjohnnyfever on Nov 23, 2013 0:31:17 GMT -5
When do I get the $2,500?
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Post by kemmer on Nov 23, 2013 0:35:24 GMT -5
Ummm... let's do some arithmetic. Obamacare supporters have been touting how young people can stay on their parents' plans until they're 26 as a major benefit already out there. (This has been an applause line in every one of Obama's preening speeches on how great Obamacare is.) The population 26-35 is smaller than the population 18-35. A LOT smaller. Then there are those, like both my children, who have had their own health insurance since they graduated from college. They are not alone, so the population of "young and uninsured" is less than the population of "young people." It took twenty years of women having babies to produce the number of people now between 45 and 64 (inclusive). Women only had ten years to produce all the people now aged between 26 and 35 (inclusive). See the problem? [General query: articles do tend to focus on 18-35 vs 45-65. What? Everyone between 36 and 44 vanishes *poof* from the equations--maybe because they are on the cusp between sick and well? It is a bit wierd, though, no?] |
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Post by Moses on Nov 23, 2013 0:36:08 GMT -5
Yes there is a lot of uncertain unknowns how this will play out. I wish Obama had focused on other issues more. There's nothing uncertain about it. Costs will go up because Obamacare does nothing to address that issue and it never intended to. Its goal is to charge roughly the same price to everyone despite the fact that everyone has different expected costs. That is known as cost sharing. After all, it isn't fair that sickly people have to pay more for insurance than healthy folks. But in order to correct this so-called injustice, younger, healthier people (who typically need less medical care) have to buy coverage or be subject to a penalty. What other service or product is sold this way? Think if utility companies suddenly decided that it wasn't fair to charge people more who blast the heat and air conditioning, leave lights on all over the house, and generally use energy like it's going out of style, than those who try and use it wisely? Costs would skyrocket since there would be no financial incentive to moderate usage. Fairness? There's really no such thing since in order to achieve it, certain people have to be treated unfairly. The people that support this tell me otherwise. They are just as passionant as you are and flood me with their facts. It will be interesting to see what happens. |
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Post by Deleted on Nov 23, 2013 0:36:36 GMT -5
When do I get the $2,500? Mine was in the mail until yesterday.... you should get yours tomorrow.   |
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Post by Moses on Nov 23, 2013 0:41:16 GMT -5
Really if democrats has their way they would enact a free health care program more like Canada's.
This could just be a foot in the door.
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Post by drjohnnyfever on Nov 23, 2013 0:47:24 GMT -5
Really if democrats has their way they would enact a free health care program more like Canada's. This could just be a foot in the door. So they achieve by guile and deceit what they could never achieve by suasion. What's that called in the business world? Noble-and their hearts are pure because their motive is good. |
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Post by kemmer on Nov 23, 2013 0:48:34 GMT -5
It hasn't failed yet no matter how many times you say. It may fail. It may not. Ummm... could you elaborate on bow the HMO model hasn't failed? Because my reading of history says it already has. It failed to deliver either the expected savings from "capitation", or the expected savings from early diagnosis of chronic conditions. |
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Post by kemmer on Nov 23, 2013 0:54:27 GMT -5
Really if democrats has their way they would enact a free health care program more like Canada's. This could just be a foot in the door. Whoa! Remember that Canada is like the USA, separated from the world by two huge oceans. If we go that way, where will the Canadians go when they need health care RIGHT NOW??? :eek: |
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Post by Deleted on Nov 23, 2013 1:21:40 GMT -5
Fool said "free health care" tee hee, free huh?  Hospitals work for free now? |
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Post by middleoftheroad on Nov 23, 2013 6:31:41 GMT -5
There's nothing uncertain about it. Costs will go up because Obamacare does nothing to address that issue and it never intended to. Its goal is to charge roughly the same price to everyone despite the fact that everyone has different expected costs. That is known as cost sharing. After all, it isn't fair that sickly people have to pay more for insurance than healthy folks. But in order to correct this so-called injustice, younger, healthier people (who typically need less medical care) have to buy coverage or be subject to a penalty. What other service or product is sold this way? Think if utility companies suddenly decided that it wasn't fair to charge people more who blast the heat and air conditioning, leave lights on all over the house, and generally use energy like it's going out of style, than those who try and use it wisely? Costs would skyrocket since there would be no financial incentive to moderate usage. Fairness? There's really no such thing since in order to achieve it, certain people have to be treated unfairly. The people that support this tell me otherwise. They are just as passionant as you are and flood me with their facts. It will be interesting to see what happens. It's not going to be so much interesting as it is sad, moses. As both Kemmer and mdrunning have explained, whether this web portal ever gets fully up and running or not, the basic business model behind the Affordable Care Act is fatally flawed. It's business rules operate against its own success. A model that depends on young, healthy people signing up for a program they don't normally use and gives them a choice between paying hundreds of dollars a month in premiums for joining or $95 a year for not joining is self-defeating. The model has worked to limit competition between insurance companies, thereby taking the most powerful cost restraint out of the equation. Perhaps even worse, it has expanded subsidies into the medical economy, ensuring that costs will continue to grow at an escalating pace, as programs tend to do whenever the government's "free money" gets into the mix. |
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Post by breakingbad on Nov 23, 2013 7:52:10 GMT -5
It hasn't failed yet no matter how many times you say. It may fail. It may not. Can you please provide your definition of failure. I just looked it up in the dictionary, and there was a picture of Obama. |
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Post by Evil Yoda on Nov 23, 2013 9:41:02 GMT -5
Really if democrats has their way they would enact a free health care program more like Canada's. This could just be a foot in the door. Nothing about Canada's healthcare system is free. What they did up there was change who pays. Which is what Dems want to do here: they want people who "have" to pay for the lifestyles of those who "have not". Socially, this is irresponsible to the extent that it provides a disincentive for people to care for themselves. Starting in college when they think it's a good idea to major in "green tourism" (I s**t you not, someone actually majored in that) because it's what they want to do, instead of majoring in a skill someone will pay for. And continuing through life. |
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Post by Moses on Nov 23, 2013 10:05:44 GMT -5
The people that support this tell me otherwise. They are just as passionant as you are and flood me with their facts. It will be interesting to see what happens. It's not going to be so much interesting as it is sad, moses. As both Kemmer and mdrunning have explained, whether this web portal ever gets fully up and running or not, the basic business model behind the Affordable Care Act is fatally flawed. It's business rules operate against its own success. A model that depends on young, healthy people signing up for a program they don't normally use and gives them a choice between paying hundreds of dollars a month in premiums for joining or $95 a year for not joining is self-defeating. The model has worked to limit competition between insurance companies, thereby taking the most powerful cost restraint out of the equation. Perhaps even worse, it has expanded subsidies into the medical economy, ensuring that costs will continue to grow at an escalating pace, as programs tend to do whenever the government's "free money" gets into the mix. My friends who disagree explain just as eloquently as mdrunning and Kemmer. Dont forget this forum is not the best of the best. Lol Some good scientists here tho! Lol |
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Post by Evil Yoda on Nov 23, 2013 10:29:06 GMT -5
The people who support Obamacare speak from a perspective of people who regard healthcare as a "right" and do not consider increasing taxes to any extent necessary to provide it wrong. You can be really eloquent in defense of that if it's what you believe, but it doesn't make the position socially responsible or morally right... or economically sound.
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Post by drjohnnyfever on Nov 23, 2013 11:00:55 GMT -5
The people who support Obamacare speak from a perspective of people who regard healthcare as a "right" and do not consider increasing taxes to any extent necessary to provide it wrong. You can be really eloquent in defense of that if it's what you believe, but it doesn't make the position socially responsible or morally right... or economically sound.When has any of that mattered when social and economic justice are at stake? |
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Post by redleg on Nov 23, 2013 12:03:07 GMT -5
Health policy experts said the momentum from state exchanges is encouraging. California, which has had about 80,000 sign-ups, is now reporting about 2,000 enrollments per day. New York and Washington state reported enrollment numbers in the tens of thousands as of this week. And how many of those are actually signing up for Medicaid instead of Puppettax? And what happens in 3 years when the Feds stop handing our tax dollars over to those states to pay for that exploded Medicaid? CA is bankrupt already, what happens when the trillions more in Medicaid come home to roost? |
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Post by redleg on Nov 23, 2013 12:05:48 GMT -5
It hasn't failed yet no matter how many times you say. It may fail. It may not. Waivers, delays to keep Democrats from being lynched next Nov, rewriting Senate rules to keep the adults from stopping the 'fun' the delinquents are having, yes, it's failed. The only act left is the throwing of trillions and trillions more dollars at it to keep the serfs from realizing how badly it's failed. And that's starting to happen now. |
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Hospitals work for free now? 
