Grandpa's Spells wrote:I haven't heard any crowing. The administration was rightly slammed for a bad roll-out. They appear to have hit their deadline though.
Moving targets are not deadlines.
Grandpa's Spells wrote:The GOP doesn't have a coherent alternative to a serious healthcare problem. The public is certainly open to something that's better than Obamacare. Republicans have, for a long time, dug their heels in very hard against any public healthcare initiative (Bush's unfunded expansion notwithstanding) and used the same language about future disasters that never came to pass.
Which of the major GOP predictions about Obamacare haven't come true? Job growth/labor participation? Medicare?
Grandpa's Spells wrote:There is a 0% chance this gets repealed without something better taking its place. Until that proposal shows up, complaints revolving around a mindset of "I wish this would go away" are yelling at the moon.
Any proposal would have to involve HHS and the IRS. Guess which branch those are run out of? Hint-- it ain't Congress.
"Liberalism is arbitrarily selective in its choice of whose dignity to champion." Adrian Vermeule
Grandpa's Spells wrote:The GOP doesn't have a coherent alternative to a serious healthcare problem.
This is true, but we know that coherent alternatives are hardly relevant in this case. The ACA isn't a coherent alternative either.
That's why the correct way forward, imo, was never trying to fix the whole system at once. It was going after smaller parts of the problem. For example, repealing the employer tax subsidies and funding a Medicaid expansion would have covered nearly as many people, improved efficiency in the market, and it would have been simple enough that some members of Congress might have been able to read the bill.
"The biggest problems that we’re facing right now have to do with George Bush trying to bring more and more power into the executive branch and not go through Congress at all."
Grandpa's Spells wrote:The GOP doesn't have a coherent alternative to a serious healthcare problem.
This is true, but we know that coherent alternatives are hardly relevant in this case. The ACA isn't a coherent alternative either.
Right, and people should reject the argument that the ACA now requires 'an alternative'. Repealing it and returning to the status quo is an alternative and, yes, it sucked but the only difference I see pre and post-ACA is who is getting screwed. Before, it was one group (the uninsured who were uninsured not by their own choice). Now, it's a slightly different group (the uninsured who had their policies cancelled). Lets not pretend the ACA solved or even significantly "helped" the uninsured numbers. For the price of the ACA, the federal goverment could've simply purchased policies for every uninsured American, and left everyone else alone.
But if you want an alternative, Bobby Jindal has proposed some ideas. And there are tons of ideas out there, all of which were rejected in 2009 and 2010 when the Democrats rammed the ACA through on a partisan vote.
A triumphant President Barack Obama declared Tuesday his signature medical insurance overhaul a success, saying it has made America's health care system 'a lot better' in a Rose Garden press conference.
But buried in the 7.1 million enrollments he announced in a heavily staged appearance is a more unsettling reality.
Numbers from a RAND Corporation study that has been kept under wraps suggest that barely 858,000 previously uninsured Americans – nowhere near 7.1 million – have paid for new policies and joined the ranks of the insured by Monday night.
T>1200 wrote:What's happened since 2000 that has destroyed our numbers?
T>1200 wrote:What's happened since 2000 that has destroyed our numbers?
Several potential answers to your question.
I wonder what's going to happen to the numbers when we "downsize" our military by 150K-200K people. Seems as if O likes to stimulus fund public servants as long as they're solidly Democrat voters as opposed to the military.
Mao wrote:Political power grows out of the barrel of a gun. Our principle is that the Party commands the gun, and the gun must never be allowed to command the Party
Turdacious wrote:Latest labor force participation numbers:
NOTHING TO SEE HERE!
There's a lot going on there that has nothing to do with healthcare "reform".
"The biggest problems that we’re facing right now have to do with George Bush trying to bring more and more power into the executive branch and not go through Congress at all."
DrDonkeyLove wrote:I wonder what's going to happen to the numbers when we "downsize" our military by 150K-200K people.
I wonder who I'd want as President if I were getting discharged. President Paul might offer copies of Atlas Shrugged with discharge papers.
It's pretty remarkable how opposed conservatives can be to unnecessary government jobs unless they're defense ones.
Unnecessary is in the eye of the beholder. The correct number of troops is beyond my ken.
My point is that the left believes O's gov't employee stimulus was great for the economy and is passionate about extending unemployment, and many other, benefits. The left 's government programs of every strip no matter how ineffective and bloated - except troops. I hear zero from them about the personal impact on the "downsized" troops coming home to a very substandard economy. If any major Dem has spoken about this, please feel free to enlighten.
Not showing a lot of love to some great young people IMO. Then again, they're not hard core Dem voters and shock troops like your typical NEA, SEIU, and AFSCME recipients of unending gov't largesse. Maybe the downsized troops can become Obamacare navigators.
Mao wrote:Political power grows out of the barrel of a gun. Our principle is that the Party commands the gun, and the gun must never be allowed to command the Party
Grandpa's Spells wrote:The GOP doesn't have a coherent alternative to a serious healthcare problem.
This is true, but we know that coherent alternatives are hardly relevant in this case. The ACA isn't a coherent alternative either.
Right, and people should reject the argument that the ACA now requires 'an alternative'. Repealing it and returning to the status quo is an alternative and, yes, it sucked but the only difference I see pre and post-ACA is who is getting screwed. Before, it was one group (the uninsured who were uninsured not by their own choice). Now, it's a slightly different group (the uninsured who had their policies cancelled). Lets not pretend the ACA solved or even significantly "helped" the uninsured numbers. For the price of the ACA, the federal goverment could've simply purchased policies for every uninsured American, and left everyone else alone.
But if you want an alternative, Bobby Jindal has proposed some ideas. And there are tons of ideas out there, all of which were rejected in 2009 and 2010 when the Democrats rammed the ACA through on a partisan vote.
That would only work if the administration had addressed the supply shortage that existed pre-Obamacare, otherwise it would simply have driven up prices/insurance rates when they increased demand for doctors.
How they expect Obamacare to work when:
1. They haven't seriously addressed the shortage
2. They're allowing exchange plans/Medicare to pay below market rates
3. They've done nothing significant to lower the cost of providing medical care
is beyond me. On top of that, when you consider average income of areas, the doctor supply is not exactly evenly distributed-- my guess is that poor areas nationwide have very low doctor/population rates.
"Liberalism is arbitrarily selective in its choice of whose dignity to champion." Adrian Vermeule
Politicians only care about cartels when the cartels cross them.
"The biggest problems that we’re facing right now have to do with George Bush trying to bring more and more power into the executive branch and not go through Congress at all."
Americans have recently been hit with some of the largest premium increases in years, according to a Morgan Stanley survey of insurance brokers.
The investment bank’s April survey of 148 brokers found that this quarter, the average premium increase for customers renewing an insurance plan is 12 percent in the small group market and 11 percent in the individual market, according to Forbes’ Scott Gottlieb.
The hikes — the largest in the past three years, according to Morgan Stanley’s quarterly reports — are “largely due to changes under the [Affordable Care Act],” analysts concluded. Rates have been growing increasingly fast throughout all of 2013, after a period of drops in 2012.
While insurers were hiking premiums since 2012 by smaller amounts, the lead-up to the Obamacare’s launch has seen the average rate at which premiums are growing fourfold.
Uncertain, slow, and poorly managed regulations raised risk for insurance companies and providers (and therefore cost).
No serious attempts at cost control, while mandating that small businesses and individuals (ie the most price sensitive part of the market) buy types of coverage they've never been required to buy before, all while taking away the ability of small businesses to share the cost with employees; taxes on medical devices which are passed on.
Purging the most experienced health care advisors from the WH (while ignoring their advice) and promoting inexperienced health care advisors (who in turn ignored that advice which turned out to be important).
17 pages of etc...
"Liberalism is arbitrarily selective in its choice of whose dignity to champion." Adrian Vermeule
Turdacious wrote:Uncertain, slow, and poorly managed regulations raised risk for insurance companies and providers (and therefore cost).
No serious attempts at cost control, while mandating that small businesses and individuals (ie the most price sensitive part of the market) buy types of coverage they've never been required to buy before, all while taking away the ability of small businesses to share the cost with employees; taxes on medical devices which are passed on.
Purging the most experienced health care advisors from the WH (while ignoring their advice) and promoting inexperienced health care advisors (who in turn ignored that advice which turned out to be important).
17 pages of etc...
I think the big one is that medical costs are increasing. Every new development in medicine is a new way to spend $$$. Not much money was spent on hip and knee replacements, dialysis clinics, or genetically engineered insulin with implanted pumps before they existed. People just limped or died.
Turdacious wrote:Uncertain, slow, and poorly managed regulations raised risk for insurance companies and providers (and therefore cost).
No serious attempts at cost control, while mandating that small businesses and individuals (ie the most price sensitive part of the market) buy types of coverage they've never been required to buy before, all while taking away the ability of small businesses to share the cost with employees; taxes on medical devices which are passed on.
Purging the most experienced health care advisors from the WH (while ignoring their advice) and promoting inexperienced health care advisors (who in turn ignored that advice which turned out to be important).
17 pages of etc...
I think the big one is that medical costs are increasing. Every new development in medicine is a new way to spend $$$. Not much money was spent on hip and knee replacements, dialysis clinics, or genetically engineered insulin with implanted pumps before they existed. People just limped or died.
AFAIK there are no major developments that explain the recent spike in specific sectors of the market. And my guess is that, statistically, hip and knee replacements are paid for primarily by Medicare, and insulin and pumps by Medicaid. Spikes in health care costs, at least in the US, are almost always caused by government action.
"Liberalism is arbitrarily selective in its choice of whose dignity to champion." Adrian Vermeule
Turdacious wrote:Uncertain, slow, and poorly managed regulations raised risk for insurance companies and providers (and therefore cost).
No serious attempts at cost control, while mandating that small businesses and individuals (ie the most price sensitive part of the market) buy types of coverage they've never been required to buy before, all while taking away the ability of small businesses to share the cost with employees; taxes on medical devices which are passed on.
Purging the most experienced health care advisors from the WH (while ignoring their advice) and promoting inexperienced health care advisors (who in turn ignored that advice which turned out to be important).
17 pages of etc...
I think the big one is that medical costs are increasing. Every new development in medicine is a new way to spend $$$. Not much money was spent on hip and knee replacements, dialysis clinics, or genetically engineered insulin with implanted pumps before they existed. People just limped or died.
AFAIK there are no major developments that explain the recent spike in specific sectors of the market. And my guess is that, statistically, hip and knee replacements are paid for primarily by Medicare, and insulin and pumps by Medicaid. Spikes in health care costs, at least in the US, are almost always caused by government action.
Sure the immediate noise in the signal is due to policy changes. But the long-term trend?
Somewhere in there, someone is actually getting healthcare that is paid for. All that money is not just swirling around in a circle.
Traditionally, insurers lost money by covering people with chronic illnesses, because they often ended up hospitalized with myriad complications as their diseases progressed. Today, the routine care costs of many chronic illnesses eclipse that of acute care because new treatments that keep patients well have become a multibillion-dollar business opportunity for device and drug makers and medical providers.
The high price of new treatments for diabetes, rheumatoid arthritis, colitis and other chronic diseases contribute mightily to the United States’ $2.7 trillion annual health care bill.
More than 1.5 million Americans have Type 1 diabetes and cannot survive without frequent insulin doses, so they are utterly dependent on a small number of producers of supplies and drugs, which have great leeway to set prices. (Patients with the far more common Type 2 diabetes — linked to obesity — still produce insulin and can improve with lifestyle changes and weight loss, or on oral medicines.)
That captive audience of Type 1 diabetics has spawned lines of high-priced gadgets and disposable accouterments, borrowing business models from technology companies like Apple: Each pump and monitor requires the separate purchase of an array of items that are often brand and model specific.
A steady stream of new models and updates often offer dubious improvement: colored pumps; talking, bilingual meters; sensors reporting minute-by-minute sugar readouts. Ms. Hayley’s new pump will cost $7,350 (she will pay $2,500 under the terms of her insurance). But she will also need to pay her part for supplies, including $100 monitor probes that must be replaced every week, disposable tubing that she must change every three days and 10 or so test strips every day.
That does not even include insulin, which has been produced with genetic engineering and protected by patents, so that a medicine that cost a few dollars when Ms. Hayley was a child now often sells for more than $200 a vial, meaning some patients must pay more than $4,000 a year. Other refinements have benefited a minority of patients but raised prices for all. There are no generics in the United States.
It all really depends on which insurance scheme pays the bulk of those costs. If those costs are primarily paid by Medicare (ex. arthritis), or by Medicaid (ex. diabetes)-- they affect state (Medicaid) and federal (Medicaid and Medicare) budgets, but will have little impact on private sector insurance rates. It's interesting data, but because they don't break it down, it's not particularly useful.
"Liberalism is arbitrarily selective in its choice of whose dignity to champion." Adrian Vermeule
In setting the 2015 calendar parameters for health plans and employers, Kathleen Sebelius, the secretary of health and human services, quietly did some creative but questionable arithmetic that forced taxpayers to give still more help to businesses and people who buy health insurance.
The Affordable Care Act is designed to encourage people to enroll in a health insurance plan and to shop around for value for their medical dollars.
On the first point, the law says large employers will be charged a penalty for not providing coverage to their full-time employees (and thereby helping their employees get taxpayer-subsidized coverage). The amount of the penalty was set to be economically significant relative to the costs of coverage.
On the second point, people enrolled in health plans are asked to pay part of their medical expenses – “cost-sharing,” as the law calls it. This is why the plans sold on healthcare.gov have high deductibles in comparison with traditional employer plans. The amount that plan participants are supposed to pay is supposed to be commensurate with the costs of medical care.
To achieve both of these goals, the law specifies that the cost-sharing rules and the employer penalty be indexed to health cost inflation. Specifically, the Affordable Care Act says that in each year after 2014, the employer penalty and cost-sharing parameters will exceed the value they have in 2014 by a percentage equal to the “premium adjustment percentage,” which is “the percentage (if any) by which the average per capita premium for health insurance coverage in the United States for the preceding calendar year (as estimated by the secretary no later than Oct. 1 of such preceding calendar year) exceeds such average per capita premium for 2013 (as determined by the secretary).” The “secretary” refers to the secretary of the Department of Health and Human Services, currently Ms. Sebelius.
The average per capita premium for health insurance coverage increased in 2013, especially in the individual market, because the Affordable Care Act required plans to provide more benefits. For example, the eHealth price index was about 40 percent greater during the first quarter of 2014 than it was for calendar year 2013 (see this chart, in which the dotted red line is the 2013 average). This is no surprise – more benefits mean higher premiums – and I presume that Congress understood this.
This is not to say that high-premium high-benefit plans are undesirable, just that, without subsidies, you get what you pay for, and pay for what you get.
But a political problem arises in that a premium increase that averages, say, 40 percent would require a 40 percent increase in the caps on what individuals with coverage can be asked to pay for their own medical expenses and increase the employer penalty by 40 percent (above what it would have been had it been enforced in 2014).
Among other things, the salary equivalent of the employer penalty next year, with a 40 percent premium adjustment percentage, would be almost $4,300 per employee per year.
To make matters (politically) worse, the increase in premiums from 2013 to 2014 is likely to be permanent, because the new rules on minimum benefits are permanent (as the law now stands). In other words, an increase in caps and penalties next year would be likely to last long into the future.
's government programs of every strip no matter how ineffective and bloated - except troops. I hear zero from them about the personal impact on the "downsized" troops coming home to a very substandard economy. If any major Dem has spoken about this, please feel free to enlighten.
