"I guess those shovel ready projects weren't so shovel Ready"
Meanwhile there some red line that was crossed in the middle east and we're gonna get to the bottom of IRS targeting scandals.
The Affordable Care Act.
- Thread starter prlyles
- Start date
Meanwhile there some red line that was crossed in the middle east and we're gonna get to the bottom of IRS targeting scandals.
71 not trying to be a smart ass but really would love to see why he thinks this is so good. I work for/with a guy who basically is appointed by hedge funds to ramp up companies they purchase and really is the brightest guy in the room. Northwestern MBA. Believe it or not he really tries to help his employees through Retirement benefits, education , etc. he just really goes after the ACA and the overall negative effect it will ultimately have on those it was meant to help----those in the $30,000--$50,000 salary range.
Would love to understand a different perspective.
Would love to understand a different perspective.
Fair enough.
The first clarification worth making is that I never said the ACA is good. The ACA has ushered in the most significant changes in the healthcare industry since Medicare and Medicaid were enacted 50 years ago. As I've said many times before, there are winners and losers when a sweeping piece of legislation like the ACA is passed. Characterizing the law as simply good or bad is both reductionist and absurd.
Most of the people complaining here are the losers. All they know is that their premiums and deductibles have continued to rise because it's what directly affects them. I suppose it's human nature to complain about something that negatively affect you. The problem I have -- and why I sound like I'm defending the law -- is that a) they jump to the uninformed conclusion that the ACA is the sole reason for their premium/deductible increases and b) they completely ignore the hundreds of other impacts of the law and make asinine declarations that it was a "disaster from the start" or that we should "kill the planners."
The chart I posted on the last page shows that health insurance premiums have been steadily increasing since 1999 (longer, actually). That obviously predates the ACA. Want to know the real reason your healthcare costs keep going up every year? Then I strongly encourage you to read this article. Pay particular attention to #4, which points out that most Americans get their health insurance through their employers. Within the last few years, employers feeling the pinch from rising healthcare costs have figured out that they can shift the financial burden to their employees through benefit redesign, specifically by raising deductibles.
That article was written before the recent mergers of Aetna/Humana and Anthem/Cigna. While the impact of the mergers is complex, standard economic theory says that reduced choices for consumers generally leads to higher prices. When healthcare insurers consolidate, they not only gain more power over providers (hospitals, doctors, etc.) but also over enrollees (families, individuals, employers who negotiate coverage for their employees, etc.). Again, none of that has anything to do with the ACA but is affecting the cost of healthcare.
Among the many valid criticisms of the ACA is it has yet to curb the growth in premiums and deductibles described above. Obama is quick to take credit for the decline in healthcare spending growth over the last few years, but most analysts attribute the majority of the decline to overall economic conditions. I tend to agree although I've never done any analysis on the issue (nor am I qualified to).
The long-term impacts of the law won't be known for several years. The healthcare industry is an enormous ship that doesn't immediately change course just because somebody turned the wheel. But the ACA does attempt to tackle several problems engrained in the system by addressing everything from how care is delivered to how providers are paid.
I work for a large healthcare system. Over the last several months, I've been working on a pilot project that completely changes how Medicare pays for services (this is alluded to in #1 of the link above). It's too late to get into details, but here's the short of it: Medicare traditionally pays hospitals, doctors, and other providers separately based on the quantity of services they provide with little or no regard to quality. Under this new payment model, Medicare sets a price for an entire episode of care -- hospital, doctor, anesthesiologist, etc. plus any post-acute care like skilled nursing facilities and home health -- and the providers are responsible for coordinating care to keep their costs under that target price. If they don't, they eat the cost overrun. If they do, Medicare pays them the difference. The providers are also required to meet certain clinical quality metrics. This new payment model is a product of the Centers for Medicare and Medicaid Services (CMS) Innovation Center, which was created by the Affordable Care Act.
That's just one of many ways the ACA attempts to address the problems that are baked into the usual way of doing things in healthcare. And I think most reasonable people would agree that is a much more effective method of paying providers than just throwing money at a doctor for doing a bunch of diagnostic testing, for example, without any regard for whether the patient actually benefitted as a result.
This particular project shares several goals with other innovations that have been set in motion by the ACA: better coordination of care among providers, more efficient delivery of services, reduction of unnecessary tests and treatments, reduction of preventable complications, etc. That means better care at a lower cost, which ultimately benefits all of us as healthcare consumers.
[Edited this AM for clarity.]
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All the people getting it for free....
Only Medicaid and CHIP beneficiaries are eligible for free insurance. Everyone purchasing individual plans through the healthcare exchanges has to pay a premium.
NOPE, wrong again. I have written 7 plans since 1/1/14 that had ZERO premium...100% subsidized. You're right that Medicaid and CHIP folks don't pay either but there are a lot of folks riding our dime at the full rate. Most expensive one I've seen was a $623 monthly premium and $623 subsidy (single mom with 2 kids...driving a 2014 Camry and both kids toting iPads, classic).
All the people getting it for free....
Only Medicaid and CHIP beneficiaries are eligible for free insurance. Everyone purchasing individual plans through the healthcare exchanges has to pay a premium.
NOPE, wrong again. I have written 7 plans since 1/1/14 that had ZERO premium...100% subsidized. You're right that Medicaid and CHIP folks don't pay either but there are a lot of folks riding our dime at the full rate. Most expensive one I've seen was a $623 monthly premium and $623 subsidy (single mom with 2 kids...driving a 2014 Camry and both kids toting iPads, classic).
Again? Where was I wrong the first time?
You're splitting hairs. Those plans still have a premium but the premium is reduced by the amount of the subsidy.
You said:
"Everyone purchasing individual plans through the healthcare exchanges has to pay a premium."
That is NOT TRUE ... everyone purchasing individual plans DOES NOT have to pay a premium ... they're getting a 100% subsidy so their monthly invoice says ZERO .. NADA ... $0.00 ... can I be any clearer?
"Everyone purchasing individual plans through the healthcare exchanges has to pay a premium."
That is NOT TRUE ... everyone purchasing individual plans DOES NOT have to pay a premium ... they're getting a 100% subsidy so their monthly invoice says ZERO .. NADA ... $0.00 ... can I be any clearer?
