The US is going to Hell, Health Care for Everyone...

[SimonSez]

I'm in the social work sector, and I was at a health insurance seminar the day that the "Obamacare" decision went through. The room was full of insurance reps and salesmen, guys that each make way over $100k a year selling insurance to small companies. When that supreme court decision was announced in the room, there was a gasp and groan you could hear through the entire crowd. When those assholes are upset by something, I am a happy guy and I know the right decision has been made. The CEO won't be making FUCK YOU money anymore. The company won't be leaking money all over the place, now they will have to keep track of where and when they spend their money. And, holy shit, poor people will be able to get healthcare now without the hospitals having to pay for it, so maybe healthcare costs will go down.

 

[scorpio01169]

Loren, you can't blame what your insurance company does ahead of Obamacare on this new law. This new law is designed to three things. 1, make sure more Americans are insured. and that most of them will be able to pay their own. more Americans pay their own insurance, hospitals wont charge insurance companies more to compensate for people who don't have the ability or just don't give a fuck about paying their bills. and then insurance companies wont charge people who have insurance out the ass to make up the cost they have to pay out to hospitals. 2. To protect you as a consumer, this law makes sure that 80% of what you pay to your insurance company actually goes to your care and not the pockets of the company execs. I would think people would like that. Imagine getting more for your money. 3. get Americans healthier. sick and dead people are a drain on our econemy.

 

[Loren Littlejohn]

Hey lets bump this shit since it's been a year and this law went full out just recently.

Some things I have been thinking about, or scenarios.

1. What if a company, who employs more than 50 employees decides "fuck you AHCA we will just pay the fine since it's cheaper" and tells all of it's employees they are on their own?

2. Since insurance companies by law can't refuse anyone for any reason anymore, what would keep them from passing the cost on to the healthy of those who are going to be sick more (smokers, diabetics etc...)? In this case wouldn't this be a shit deal for those who are healthy?

3. What would keep a company from getting rid of full time employees and knocking them down to part time so they don't have to provide insurance? Actually I hear the company I work for is considering dropping insurance for part timers next year. We haven't had our benefits meetings yet though.

 

[JeffTD]

1. They can, but via the health exchanges the employees should be able to get decent, affordable coverage on their own. That's the plan, at least.

2. That happens already with people who don't have insurance when they end up not paying hospital bills or declaring bankruptcy to clear up debt caused by health issues.

3. Nothing, aside from the fact that part time employees have a way quicker turnaround rate and the cost of constantly hiring/training new people and then losing them is more expensive than you'd think.

 

[updog]

Fuck me, I thought this whole thread was new.

I only try to stay on top of US politics a *little* more than an average american would on my country's... That's not a lot, so:

I thought free healthcare never actually happened in the US?

 

[Loren Littlejohn]

2. That happens already with people who don't have insurance when they end up not paying hospital bills or declaring bankruptcy to clear up debt caused by health issues.

Insurance companies prior to the ACA didn't have to cover the super sick unless their employer offered that insurance though.

Now that they do no matter what, what is to keep them from jacking prices to compensate?

I guess what I am asking is prior, we payed with taxes right, and now we pay with higher premiums?

 

[JeffTD]

Correct, but paying higher premiums to cover preventative medicines for those with pre-existing conditions will end up being far cheaper than paying for their emergencies that they come to the ER with down the road.

It's pretty basic math - the insurance pool was widened, and needs to grow accordingly. Yes, it will increase premiums. No, we weren't paying enough before to insure everyone given the current setup. Yes, insurance companies and hospitals are price gouging to the point where we could afford to insure literally everybody in the country and still be paying less than we are now in both premiums and taxes if we weren't being systematically bled dry. This is why we need a single-payer system; it eliminates the possibility for that kind of price gouging and creates an actual competitive marketplace for costs to be driven down in.

 

[Loren Littlejohn]

1. They can, but via the health exchanges the employees should be able to get decent, affordable coverage on their own. That's the plan, at least.

I wanted to plug some real life numbers for this scenario but NYS insurance info website is down (of fucking course).

Scenario would be individual living in my county (Cayuga) in NYS, lets say 30yr old who smokes working a full time job grossing $25,920. Dude went to community college so his student loan debt is only $12,000 since he has been paying it down for a while. Has no other debt. Rents a place for $600 a month, utilities average $120 a month. Bought a car and pays $250 a month for that and pays $80 a month for renters and car insurance.

I have other numbers to add like grocery, gas, internet, and taxes but I would first need to figure out what the fuck an insurance policy would cost him if he was on the hook for it entirely. I'll pick a bronze package since I doubt he is going to be able to afford much else. But I need to get that number since health insurance costs are pre tax as far as I know.

I have actually not done the math before so I'm interested to see how doable that above scenario is.

 

[Loren Littlejohn]

This is why we need a single-payer system; it eliminates the possibility for that kind of price gouging and creates an actual competitive marketplace for costs to be driven down in.

I totally don't disagree with the single payer concept. It seems to work for other countries and if the USA would stop hemorrhaging money into other countries on foreign interests and the UN (I think it's nuts how much more money than everyone else the US pumps into the UN) I think this would be totally feasible.

My only question is how a single payer system would effect innovation in medicine. I mean, Cialis and Viagara weren't brought to the market through other countries for a reason it seems.

 

[Loren Littlejohn]

Well it's back up this morning (NY), but to much information has to be given just to get rates so fuck that. Looks like it takes a boat load of time just to get some fucking information.

 

[Jind]

Scenario would be individual living in my county (Cayuga) in NYS, lets say 30yr old who smokes working a full time job grossing $25,920.

The part I bolded above will play a major role in the premium he will pay. Smokers will see up to a 50% increase in what the insurer can change for the premium under the ACA. Mind you, prior to the ACA this amount was not limited to 50%, it could have been higher.

So - say a non-smoking person earned about $20,000 a year with a premium that worked out to be $4000 a year plus they qualifies for a $3000 tax subsidy bringing down their out of pocket cost to $1000 per year.

If that very same person smoked, they would be subject (by the insurer) to a 50 percent surcharge on their premium making it $6000 per year (original $4000 + the 50% markup) and while they would still be eligible for the $3000 tax subsidy because of their income, only $2000 of that tax subsidy can be applied to the policy as savings because subsidies cannot be applied to the smoking penalty - end scenario is a smoker would have maximum out of pocket premiums of $1000 dollars, the same person as a smoker will have that number be $3000 ($4000 premium + 50% smoker = $6000) minus the portion of the tax subsidy that can be applied only to the premium and not the penalty ($2000 of $4000) results in the premium for the smoker being $3000 per year.

Mind you - these are not real numbers just using them as an example of the difference between someone who smokes and someone who does not - in this example $3000 for the smoker, $1000 for the non-smoker.

Prior to the ACA insurers did not have to insure smokers and/or could jack up the premiums much higher than the ACA's set 50% max penalty so this is not a case of "horrible government intervention" other than the reality that it is forcing insurers to offer insurance to everyone regardless whether they smoke or not, whether they have had cancer, diabetes, ...

Tip of the day - stop smoking :Smokin:

 

[Loren Littlejohn]

I don't smoke.

I just needed an example.

I did find a bronze plan from MVP last night that is similar to what I have at work that started at $1,100 a month (ish). Had a cap of $1,500 a year out of pocket for singles and had a $0 deductible. Drug card was $10/$35/$70. And copays, with the exception of the E.R. were 50% and not covered out of network.

I was going to use that plan for the example.

I have no idea how someone could have half their gross pay hacked off and live on the rest though, especially after taxes and the essentials of living.

 

[He's Dead, Jim]

I think it's nuts how much more money than everyone else the US pumps into the UN

That amount is determined by the ability of member states to pay, and the UN sets a cap on it for each member state. The US pays 22%, which was reduced recently from 25%. It still only costs us about $7 billion/year, iirc. That includes the headquarters, which we volunteered to have in New York City where real estate is pretty expensive.

Even with the sequester, the Pentagon budget is $527 billion.

And don't even get me started on people who say we spend too much on foreign aid. We spend ONE PERCENT of the US budget (not GDP, the BUDGET) on foreign aid. The UK spends 10 percent. lawl.

 

[Loren Littlejohn]

Bump. Wanted to share what a judge said Monday about the affordable care act.

Judge Brian Cogan:

Tens of millions of people are exempt from the Mandate (birth control), under exemptions for grandfathered health plans, small businesses, and “religious employers” like the Diocesan plaintiffs here. Millions of women thus will not receive contraceptive coverage without cost-sharing through the Mandate. Having granted so many exemptions already, the Government cannot show a compelling interest in denying one to these plaintiffs.

Basically the way I read that is the government has exempted so many people from this kind of thing already, they can't argue the only way for it to work is to enforce it across the board. Which I understand was the argument.

Also apparently (and this seems arbitrary and silly to me) he also doesn't think non profits should agree to the mandate on paper even though they don't actually have to "agree" to the mandate, or something like that. Basically mandatory paperwork that is meaningless is dumb.

Here, the Government implicitly acknowledges that applying the Mandate to plaintiffs may in fact do nothing at all to expand contraceptive coverage, because plaintiffs’ TPAs aren’t actually required to do anything after receiving the self-certification. In other words, the Mandate forces plaintiffs to fill out a form which, though it violates their religious beliefs, may ultimately serve no purpose whatsoever. A law that is totally ineffective cannot serve a compelling interest.

And the last quote I don't get at all. I'm inclined to believe that if the Executive branch botches then there is no other solution but to have congress pass corrective law.

The Government first argues that the alternatives above are infeasible because the defendants lack statutory authority to enact some of them. This argument makes no sense; in any challenge to the constitutionality of a federal law, the question is whether the federal government could adopt a less restrictive means, not any particular branch within it. It would set a dangerous precedent to hold that if the Executive Branch cannot act unilaterally, then there is no alternative solution. If defendants lack the required statutory authority, Congress may pass appropriate legislation.

 

[drew_drummer]

It's quite amazing how many provisions the act has for women, versus men, when men are worldwide suffering from lack of medical attention and diagnosis.

But yeah... pour some money into rhinoplasty biatch!!

 

[Loren Littlejohn]

But yeah... pour some money into rhinoplasty biatch!!

 

[sjcortese]

I'm ok with it but for me "Obama care" has not helped the cost of healthcare for me personally. My insurance ajusted this past year to start the transition to pleasing the demands of the bill. The result is my out of pocket cost has gotten significantly higher. Last year, other than my preimiums ($960 pre tax, this is the annual figure) I literally paid nothing else for anything. This year, including what I have paid in preimiums I'm already at $800.

My maintenence drug has become to expensive even with insurance ($1250 a year apposed to $380 a year last year) I had to go off it.

The $1200 the company used to give us for use toward anything (including OTC stuff like tylenol) has gone down to $200 this year and they got rid of having it be able to cover OTC stuff.


So yay free health care, but I have yet to see how it will (or most likely will not) affect me possitivly in any way.

I'm in a very similar situation^

Not only has the AHCA been looming over head but the company that I've been employed at for 23yrs has had it's health care benefits crippled by the company that just bought us. The affordable coverage I once had is now a thing of the past. I can't even have my wife on my policy anymore because where she works offers health care but at a very high cost. So between my new shit high deductible plan, my wife's crappy high deductible plan, and the fact that we're still paying into a system still that enables low lifes to make careers out of entitlements I'm a happy real camper. There's been no positive impact of the AHCA here for most hard working folks. Our company has already been dropping the hint that within 5yrs, like a lot of companies will do, they won't even offer health care and we'll all be part of the market place. Not a place I want to be. I don't know what the solution is, I just don't believe that the AHCA is it. Very frustrating when it feels like I'm taking it from both ends.

 

[Loren Littlejohn]

Ah I feel ya man. I used to enjoy some nicer perks at work that had to be axed under the AHA.

For example the example I gave where the company was putting money into an account for health crap is now gone due to some sloppy wording in the new law. Basically under the law the account was looked at like an additional insurance plan so anything submitted to it couldn't be denied.

The account was used for glasses, doctor copays, RX copays... you know shit that didn't go away when the AHA took total effect.

I also found out my rescue inhaler (have had asthma since I can remember) is a tier 2 drug. My insurance copay for tier 2 drugs is $60. The actual cost of the drug is $48 and change. So I went to look for a tier 3 since those are $5... yeah nothing exists. No alternate therapies what so EVA.

But anyhow, it is what it is and such is life. I much more interested in how this law is being challenged in court now than anything. Now non profits are exempt from certain aspects of the law or at least that is how it seems.

 

[JHA]

 

[Aaron Smith]

I had been paying out of pocket for my own individual plan over the last two years (high deductible, catastrophic-only coverage kind of thing, you know—actual "insurance" in the real sense of the word, not the idea that "insurance"=someone else paying for nearly all medical costs like clockwork), and then this AHCA shit forced my provider to cancel the plan, despite the fact that prior to the passing of this law, it had been a perfectly acceptable, and mutually beneficial private arrangement between my provider and myself. Now the cheapest coverage I can get is over twice as much, with lower deductibles that I simply don't want to pay for. Crock of shit. I hate that the government feels it has the right to destroy a perfectly functioning relationship between a willing insurer and a willing consumer, and then leave behind only options that don't fit the actual desires of either party. Fuck any politician who is pretentious enough to say that the plan I had before wasn't "good enough".