Obamacare on Life Support article

[nosuchreality]

Single Payer is the best outcome

Yeah, look how well it's working out for the VA.  100 veterans dead in Los Angeles due to excessive wait times for care.

So every time my insurance kicks something back saying they need more documentation or we need to try some other procedure that my Doctor has already concluded would be a waste time, does that count as a delay in consult?

How about my kid?  Does it count as a delay of consult when I paid out of pocket to proceed with a medical procedure he needed while the insurance took six months trying to figure it out and authorizing it before reimbursing us?

 

[peppy]

Single Payer is the best outcome

Yeah, look how well it's working out for the VA.  100 veterans dead in Los Angeles due to excessive wait times for care.

People seem to like Medicare.

If VA is a problem, it would be up to Congress to fix that. Also, reading about that report you are citing "The report was unable to substantiate claims that patients died as a result of the delayed consults".

 

[morekaos]

Designed to fail...just as I have forseen.

Aetna to Obamacare: We're outta here

The insurance giant announced Wednesday that it would not offer policies in Nebraska or Delaware next year, completing its exit from the exchanges. Earlier this year, Aetna (AET) said it would pull out of Iowa and Virginia in 2018.
The company said it expects to lose more than $200 million in its individual business line this year, on top of nearly $700 million in losses between 2014 and 2016. Aetna withdrew from 11 of its 15 markets for 2017. It has 255,000 Obamacare policyholders this year, down from 964,000 at the end of last year.

http://money.cnn.com/2017/05/10/news/economy/aetna-obamacare/
https://youtu.be/LAf0QnLFS7Q

 

[nosuchreality]

The company said it expects to lose more than $200 million in its individual business line this year, on top of nearly $700 million in losses between 2014 and 2016.

It's called poor management.  They're losing money in their business policy lines.  Are you trying to say business policy holders were 'sicker' than expected?  That no-copay annual screenings were too much burden?  That covering birth control was an unforeseen excessive cost?

 

[riznick]

Yeah, look how well it's working out for the VA.  100 veterans dead in Los Angeles due to excessive wait times for care.

That's a hard comparison to make, though...  It would be much more like Australia or Canada.  We could then have additional insurance that would buy us better care as they do in Australia.

Our current system is putting too much of a strain on us financially.  If your company is paying for it, then it's putting a strain on your company.  Obamacare did nothing to curb prices.  It only helped make things affordable for some with subsidies paid for with additional taxes.

 

[riznick]

I think that if we want to begin tackling the price issue, we need to see exactly what our insurance premium $$ is spent on. 

Assume that the insurance companies take 10%.  That's just a fixed percent and it doesn't cause prices to rise or fall.  Attacking them isn't going to solve the rate in increases.

Is it medication?  How much money does insurance spend per person on medication?  Is it procedures?  Child birth?  ER care?

It would also be beneficial to see why the top items are so expensive.  Why is ER care so expensive?  Is it frivolous lawsuits?  Is it that people don't pay their bills?  Say medication is one of the top items.  Can we get those costs down?  Let's find the root cause of the problems and try to fix them.

 

[peppy]

Yeah, look how well it's working out for the VA.  100 veterans dead in Los Angeles due to excessive wait times for care.

That's a hard comparison to make, though...  It would be much more like Australia or Canada.  We could then have additional insurance that would buy us better care as they do in Australia.

Our current system is putting too much of a strain on us financially.  If your company is paying for it, then it's putting a strain on your company.  Obamacare did nothing to curb prices.  It only helped make things affordable for some with subsidies paid for with additional taxes.

It outlawed the practice of rescission and removed the dollar caps (or set rather high caps on grandfathered plans) on a number of essential benefits (that insurers had to provide) on new plans. I would say that these are things that are pretty big for anyone on the individual marketplace.

 

[Ready2Downsize]

I think that if we want to begin tackling the price issue, we need to see exactly what our insurance premium $$ is spent on. 

Assume that the insurance companies take 10%.  That's just a fixed percent and it doesn't cause prices to rise or fall.  Attacking them isn't going to solve the rate in increases.

Is it medication?  How much money does insurance spend per person on medication?  Is it procedures?  Child birth?  ER care?

It would also be beneficial to see why the top items are so expensive.  Why is ER care so expensive?  Is it frivolous lawsuits?  Is it that people don't pay their bills?  Say medication is one of the top items.  Can we get those costs down?  Let's find the root cause of the problems and try to fix them.

No idea what they spend per person but I know this: Premiums thru my hubby's work for two people are over $1500 per month which does not include vision or dental. Deductible is few thousand (we won't hit it). Copays for specialists are a "reasonable" $75 and regular doc is $50.

I have a few pills which we put thru insurance but are under our copay so they pay nothing.

Obamacare for us would be over $1400 per month (high deductible, high oop plan) and the copays for specialists would be $105. No need to put meds thru the plan because they won't cover them and labs are also completely oop.

Of my three docs (one is just for OB/GYN so I can go to anyone for a visit and no copay), two take only the highest plan (NOT the one over $1400 per month), one being the OB/GYN and the other takes NO Obamacare plan so there is no way I can get the plan I would have on Obamacare cover anything from any of them and ditto for my hubby's one doc. Were I to choose that high priced plan my couple visits would have a copay of $105.

So basically, I have to pay myself for all of my doctors or go to crappy docs who will take Obamacare and probably well above my plan.

Now since I know if I want Obamacare I'm paying for everything I asked what the "cash patient" pays and lo and behold $75 to see the doc. THIS IS WHAT I PAY NOW and $35 BELOW the copay of the best plan. No need to pay premiums to get those prices! AND paying cash for meds gets me my meds for way under the copays.

So............ why is it that I've been paying over $1500 per month now (and over $1400 if I wanted Obamacare and not a plan that is near what I have now) that basically I'm getting nothing that I wouldn't get if I paid cash?

I've come to the sad conclusion that like student loans and government subsidizing education for some that insurance and Obamacare subsidies is making it so that insurance companies can raise their prices. Were it not for those two things, everyone would be completely priced out of the market and very few would get insurance at all instead paying cash and we'd all see that we were stupid to pay those premiums when we could get the same thing by going without insurance.

The only thing it buys is peace of mind "in case" of a major illness/accident.

If insurance doesn't go up (hahahahaha) premiums of $1500 per month x 12 months x 10 years = $180,000 for two people. That's a whole lotta money.

Everyone who qualifies for an Obamacare subsidy costs me and you as taxpayers so the insurance company can profit. I could get that $1400+ plan with a $700 per month ($8400 per year) subsidy from Uncle Sam if I keep my income to under $64K for the two of us. But I still have to pay over $700 per month and I'm still better off paying cash which means I would pay over $8400 per year for a high deductible plan (peace of mind) that I probably won't use (and if I do I need to fork over another $6500-$13K+ per year for my deductibles) and the government gets to kick in another $8400 in premiums.

Nice chunk of change for the insurance companies. No wonder their stocks are at all time highs.

 

[nosuchreality]

I think that if we want to begin tackling the price issue, we need to see exactly what our insurance premium $$ is spent on. 

Assume that the insurance companies take 10%.  That's just a fixed percent and it doesn't cause prices to rise or fall.  Attacking them isn't going to solve the rate in increases.

Is it medication?  How much money does insurance spend per person on medication?  Is it procedures?  Child birth?  ER care?

It would also be beneficial to see why the top items are so expensive.  Why is ER care so expensive?  Is it frivolous lawsuits?  Is it that people don't pay their bills?  Say medication is one of the top items.  Can we get those costs down?  Let's find the root cause of the problems and try to fix them.

United Health Group spends 65% on COGS, 15% on SGA, 1% on Depreciation, 13% on other expenses, 5% on interest and 6% on profit (before taxes).

So basically, 35% is overhead.

 

[morekaos]

I've said this for years. This was a planned disaster, designed to fail so implementation of single payer becomes the only option....check mate

Only one hitch to the plan that I didn't even see at the time....Donald Trump.  Dem's thought Hillary would be in the White House when the whole thing fell apart as planned and she could take the next step into Single Payer land and claim to be the great savior....Wellllll, not so much. Now the fallback is blame the Repubs for not fixing the mess they alone created and foisted on us all.  Bizzarro world does really exist.

Blame dishonest Democrats who created Obamacare and lied about it

Again, Obamacare is circling the throat of the toilet and taking the economy, the American people and even insurance industry with it. And Mr. Schumer?s argument here is that Mr. Trump and Republicans are to blame for not FIXING the Obamacare that Mr. Schumer foisted on the American people?
Like I said, only the most dishonest weasels are capable of preening at times like this.
?He wants to throw up his hands rather than roll up his sleeves to work with us and solve the problem,? Mr. Schumer said of Mr. Trump as the sewage began filling in around him in the Senate chamber.
?The president is playing a dangerous game with the health care of this country,? he said.
No, Mr. Schumer, you and your democrats are to blame for this mess. And you are the ones who turned the American people into ?political pawns.?
Now we?ll just see who it is the American people blame for this whole mess.

http://www.washingtontimes.com/news/2017/jul/18/blame-democrats-who-created-obamacare-and-are-dish/

 

[Loco_local]

The Republicans also thought Hillary would win and she would take the blame when Ocare collapsed after they stopped funding the exchange. That's why they have absolutely no viable plan after 8 years of promising to repeal and replace. I bet they're pissed they actually have to work and write legislation instead of just saying no to everything.

 

[paperboyNC]

Everyone who qualifies for an Obamacare subsidy costs me and you as taxpayers so the insurance company can profit. I could get that $1400+ plan with a $700 per month ($8400 per year) subsidy from Uncle Sam if I keep my income to under $64K for the two of us. But I still have to pay over $700 per month and I'm still better off paying cash which means I would pay over $8400 per year for a high deductible plan (peace of mind) that I probably won't use (and if I do I need to fork over another $6500-$13K+ per year for my deductibles) and the government gets to kick in another $8400 in premiums.

Nice chunk of change for the insurance companies. No wonder their stocks are at all time highs.

My insurance is around $1400/mo out of my pocket as well. I have the premiums taken out before tax which is a $700 per month tax credit from Uncle Sam. What are you doing wrong where your premiums are not pre-tax?

One of the obvious fixes to the Exchanges is to give you the same tax deductability you get on a plan from work.

 

[Loco_local]

My insurance is around $1400/mo out of my pocket as well.

That's insane. For how many people?Does that include vision and dental too?

 

[paperboyNC]

My insurance is around $1400/mo out of my pocket as well.

That's insane. For how many people?Does that include vision and dental too?

It's for 4 healthy, young people (3 of them are under the age 9). Includes dental, not vision. It's the cheapest plan offered by my employer as well. I can only choose plans from my employer if I want the tax break.

My employer pays 100% for me and 0% for my family.

 

[Ready2Downsize]

Everyone who qualifies for an Obamacare subsidy costs me and you as taxpayers so the insurance company can profit. I could get that $1400+ plan with a $700 per month ($8400 per year) subsidy from Uncle Sam if I keep my income to under $64K for the two of us. But I still have to pay over $700 per month and I'm still better off paying cash which means I would pay over $8400 per year for a high deductible plan (peace of mind) that I probably won't use (and if I do I need to fork over another $6500-$13K+ per year for my deductibles) and the government gets to kick in another $8400 in premiums.

Nice chunk of change for the insurance companies. No wonder their stocks are at all time highs.

My insurance is around $1400/mo out of my pocket as well. I have the premiums taken out before tax which is a $700 per month tax credit from Uncle Sam. What are you doing wrong where your premiums are not pre-tax?

One of the obvious fixes to the Exchanges is to give you the same tax deductability you get on a plan from work.

Premiums would be pretax thru an employer, yes but the $1400 per month Obamacare that I was referencing is for TWO PEOPLE (ok, 50's but this is NOT a plan that pays anything for someone who goes to the doc several times a year and has a few meds.........  the docs cash price is less than the stinking copay! So obviously do NOT USE that Obamacare cuz the oop is higher than paying myself!) AND you can only make $64000 per year or there is NO SUBSIDY. Subsidy brings it down to $700 per month.

How can ANYONE in the OC afford that craziness? THIS IS A CATOSTROPHIC policy....... not technically but it is unless you happen to have some stupid ridiculous $13K oop or something like that ON TOP OF THE PREMIUMS!

It's not required to have Obamacare for $64K income with two people btw cuz......................... it's too expensive per the government and qualifies for a waiver. Just pay the docs cash price (u can charge it, it's just called cash price cuz there is no insurance). They even get sample meds and give them (entire prescription worth) to cash payers which allows them to get out of paying for some of their meds. Long as the reps have samples, they get them for free and so do cash payers. They make a list, give them to the reps and next time they come in they bring the samples with them.

And that $1400 is no dental/vision and crappy lab coverage too.

Crazy crap insurance Obamacare is. At least keep it under the subsidy level. Go over by a buck and u get NO SUBSIDY.

 

[peppy]

Everyone who qualifies for an Obamacare subsidy costs me and you as taxpayers so the insurance company can profit. I could get that $1400+ plan with a $700 per month ($8400 per year) subsidy from Uncle Sam if I keep my income to under $64K for the two of us. But I still have to pay over $700 per month and I'm still better off paying cash which means I would pay over $8400 per year for a high deductible plan (peace of mind) that I probably won't use (and if I do I need to fork over another $6500-$13K+ per year for my deductibles) and the government gets to kick in another $8400 in premiums.

Nice chunk of change for the insurance companies. No wonder their stocks are at all time highs.

My insurance is around $1400/mo out of my pocket as well. I have the premiums taken out before tax which is a $700 per month tax credit from Uncle Sam. What are you doing wrong where your premiums are not pre-tax?

One of the obvious fixes to the Exchanges is to give you the same tax deductability you get on a plan from work.

Premiums would be pretax, yes but the $1400 per month Obamacare that I was referencing is for TWO PEOPLE (ok, 50's but this is NOT a plan that pays anything for someone who goes to the doc several times a year and has a few meds.........  the docs cash price is less than the stinking copay! So obviously do NOT USE that Obamacare cuz the oop is higher than paying myself!) AND you can only make $64000 per year or there is NO SUBSIDY.

How can ANYONE in the OC afford that craziness? THIS IS A CATOSTROPHIC policy....... not technically but it is unless you happen to have some stupid ridiculous $13K oop or something like that ON TOP OF THE PREMIUMS!

t's not required to have it btw cuz......................... it's too expensive per the government and qualifies for a waiver. Just pay the docs cash price (u can charge it, it's just called cash price cuz there is no insurance). They even get sample meds and give them to cash payers who them get out of paying for some of their meds.

And the $1400 per month thru employer is no dental or vision same as Obamacare. Doesn't cover anything either but you are right........ pretax.

Crazy crap insurance Obamacare is.

Uhmmm ... Obamacare/ACA is not insurance.

 

[jmoney74]

Everyone who qualifies for an Obamacare subsidy costs me and you as taxpayers so the insurance company can profit. I could get that $1400+ plan with a $700 per month ($8400 per year) subsidy from Uncle Sam if I keep my income to under $64K for the two of us. But I still have to pay over $700 per month and I'm still better off paying cash which means I would pay over $8400 per year for a high deductible plan (peace of mind) that I probably won't use (and if I do I need to fork over another $6500-$13K+ per year for my deductibles) and the government gets to kick in another $8400 in premiums.

Nice chunk of change for the insurance companies. No wonder their stocks are at all time highs.

My insurance is around $1400/mo out of my pocket as well. I have the premiums taken out before tax which is a $700 per month tax credit from Uncle Sam. What are you doing wrong where your premiums are not pre-tax?

One of the obvious fixes to the Exchanges is to give you the same tax deductability you get on a plan from work.

Premiums would be pretax, yes but the $1400 per month Obamacare that I was referencing is for TWO PEOPLE (ok, 50's but this is NOT a plan that pays anything for someone who goes to the doc several times a year and has a few meds.........  the docs cash price is less than the stinking copay! So obviously do NOT USE that Obamacare cuz the oop is higher than paying myself!) AND you can only make $64000 per year or there is NO SUBSIDY.

How can ANYONE in the OC afford that craziness? THIS IS A CATOSTROPHIC policy....... not technically but it is unless you happen to have some stupid ridiculous $13K oop or something like that ON TOP OF THE PREMIUMS!

t's not required to have it btw cuz......................... it's too expensive per the government and qualifies for a waiver. Just pay the docs cash price (u can charge it, it's just called cash price cuz there is no insurance). They even get sample meds and give them to cash payers who them get out of paying for some of their meds.

And the $1400 per month thru employer is no dental or vision same as Obamacare. Doesn't cover anything either but you are right........ pretax.

Crazy crap insurance Obamacare is.

Uhmmm ... Obamacare/ACA is not insurance.

I guess technically it's insurance with Obamacare subsidies.  Gotta say.. that is a grip for the whole family I'm assuming. 

 

[peppy]

Everyone who qualifies for an Obamacare subsidy costs me and you as taxpayers so the insurance company can profit. I could get that $1400+ plan with a $700 per month ($8400 per year) subsidy from Uncle Sam if I keep my income to under $64K for the two of us. But I still have to pay over $700 per month and I'm still better off paying cash which means I would pay over $8400 per year for a high deductible plan (peace of mind) that I probably won't use (and if I do I need to fork over another $6500-$13K+ per year for my deductibles) and the government gets to kick in another $8400 in premiums.

Nice chunk of change for the insurance companies. No wonder their stocks are at all time highs.

My insurance is around $1400/mo out of my pocket as well. I have the premiums taken out before tax which is a $700 per month tax credit from Uncle Sam. What are you doing wrong where your premiums are not pre-tax?

One of the obvious fixes to the Exchanges is to give you the same tax deductability you get on a plan from work.

Premiums would be pretax, yes but the $1400 per month Obamacare that I was referencing is for TWO PEOPLE (ok, 50's but this is NOT a plan that pays anything for someone who goes to the doc several times a year and has a few meds.........  the docs cash price is less than the stinking copay! So obviously do NOT USE that Obamacare cuz the oop is higher than paying myself!) AND you can only make $64000 per year or there is NO SUBSIDY.

How can ANYONE in the OC afford that craziness? THIS IS A CATOSTROPHIC policy....... not technically but it is unless you happen to have some stupid ridiculous $13K oop or something like that ON TOP OF THE PREMIUMS!

t's not required to have it btw cuz......................... it's too expensive per the government and qualifies for a waiver. Just pay the docs cash price (u can charge it, it's just called cash price cuz there is no insurance). They even get sample meds and give them to cash payers who them get out of paying for some of their meds.

And the $1400 per month thru employer is no dental or vision same as Obamacare. Doesn't cover anything either but you are right........ pretax.

Crazy crap insurance Obamacare is.

Uhmmm ... Obamacare/ACA is not insurance.

I guess technically it's insurance with Obamacare subsidies.  Gotta say.. that is a grip for the whole family I'm assuming.

There is plenty of things to criticize on the ACA but this just sounds like they are getting screwed by the employer. For that kind of money you can get a gold level plan with has low/zero deductibles. It just doesn't add up.

 

[jmoney74]

Well if both adults are on the older side (just assuming).. you're already near 1K a month for the both of you.  Then the two teens I'm guessing or whatever.  I know my folks were paying about 1200 a month for the two of them at one point. This is before Obamacare. 

 

[peppy]

Well if both adults are on the older side (just assuming).. you're already near 1K a month for the both of you.  Then the two teens I'm guessing or whatever.  I know my folks were paying about 1200 a month for the two of them at one point. This is before Obamacare.

Sounds like employer is not pitching at all, though. These are prices similar to what you'd be paying in the individual marketplace.