Dumb question about Obamacare. Hope someone can answer.....

catsareniice1

They are saying that millions of people have lost medical insurance due to Obamacare. Why is the fault of the ACA?

A friend of mine said it's not Obamacare's fault and that they are stricter with accepting Medicaid patients.  True or false?

 

vlagrl29

I don't know about the Medicaid thing but 5.5million individuals have lost their insurance plans because of ACA.  They are plans that were grandfathered in and don't meet up to ACA standards, such as they don't have all the benefits that they should have like maternity coverage and what not.  The grandfathered clause will be expiring at the end of this year so we will see a lot more people loosing their insurance as this goes on.  They are predicting 50-100 million corporate workers loosing their plans around election time of next year, when the employer mandate delay expires.  If you want to learn more about how ACA is affecting everyone watch Fox News Megan Kelly Show in the evenings at 8pm I think?

snp605

that doesn't make any sense. Obamacare or ACA opened the floodgates into Medicaid and not the other way around. There are several threads here that explain why people are losing their insurance due to Obamacare. Don't swallow the lie either that these people had "substandard" plans. That's just the excuse of the week.

clarke10

ACA created new standards for health insurance plans. There are certain elements that all plans must have now and those that were cancelled didn't meet the new standards. 

MommyLiberty5013

clarke10 said:

ACA created new standards for health insurance plans. There are certain elements that all plans must have now and those that were cancelled didn't meet the new standards. 

Yes, this is true. The plans got cancelled and now those people don't have ANY insurance and the ACA plans are way more expensive for them. They don't have any economical options.

chibiyui

So, like, can I just comment how scary it is that every time one of these threads come up people talk about "Maternity coverage" like its completely frivolous? What the hell happened to us that as a nation we don't believe insurance that doesn't have maternity coverage is substandard? 

Family values my barely insured ass. 

vlagrl29

chibiyui said:

So, like, can I just comment how scary it is that every time one of these threads come up people talk about "Maternity coverage" like its completely frivolous? What the hell happened to us that as a nation we don't believe insurance that doesn't have maternity coverage is substandard? 

Family values my barely insured ass. 

I kinda have to agree with you here.  I LOVE the fact that maternity is now covered.  We haven't had it for almost 3 years because we couldn't afford it on our individual family plan.  We buy our own insurance and maternity makes the premium go thru the roof if you add it on.  Not only that but only 1 company offered maternity coverage in our area on the individual plans, but you had to pay into it for 2 years before you got to take advantage of it!

snp605

chibiyui said:

So, like, can I just comment how scary it is that every time one of these threads come up people talk about "Maternity coverage" like its completely frivolous? What the hell happened to us that as a nation we don't believe insurance that doesn't have maternity coverage is substandard? 

Family values my barely insured ass.

Because it's ridiculous for a man to have to have maternity coverage as well as a woman who is in her 50s or even a woman in her 30s who has had a hysterectomy. Let's say all three have no children. They are also required to have pediatric care on their policies. Why can't they be trusted to know that they don't want a plan that has maternity coverage and don't want to pay for it?

Let's face it, they are paying for the benefits for someone else to make it affordable for someone else not because they need it. It's simple redistribution so let's be honest and call a spade a spade. This is also outside of the extra taxes that we are all paying for subsidies for coverage as well.


There is not a requirement that plans have coverage for hearing aids. Do you have any idea of what those cost? I do because my husband needs them and they start at around $1500 for the type that he needs (fortunately his loss is not as severe as some). If you were low income pregnant you could go to planned parenthood and get maternity care on a sliding scale as well as to many community health clinics and health departments. At the very least you could go to the emergency room. If you are poor and hard of hearing where do you go? This affects men, women, you and old and would severely affect the quality of your relationships and the type of employment you might be eligible for not to mention the safety issue.

My husband also has two cornea transplants. As you may know, transplants are not forever and must be redone every 10-20 years depending on the organ. He is slowly going blind again due to his medical condition. There is absolutely ZERO requirements for vision care for adults and certainly no requirement that this bazillion dollar a year "better" policy cover his new corneal transplants. In fact currently most plans don't cover part of many surgeries. When he had his ACL replaced they covered his surgery but not the cadaver ACL so in addition to co-pays, deductible, etc he had to pay $2k out of pocket for the cadaver part. He will have to pay out of pocket for the costs of the transplant part (somewhere in the neighborhood of $10K) Something similar happened to my brother inlaw who had to have a vertebra replaced. He paid $1600 for the vertebra but ins covered the surgery.  So I'm no longer having kids but I have maternity coverage. My husband is going blind and deaf with huge gaps in coverage to manage his conditions. Awesome. If you are poor you might get surgery coverage for your torn acl or broken vertebra but you have to walk in out of pocket on the actual parts needed to complete your surgery. Does this sound like great coverage to you?

There is also no requirement that plans cover providers with excellent treatment records such as Sloan Kettering or the Mayo Clinic. The only standard they must meet is that they cover  “essential community providers . . . that serve predominantly low-income, medically underserved individuals”. So you might have been low income but had access to great care but now you are shunted over to predominently medicaid served hospitals and clinics. Based on the amounts that Medicaid reimburses, are the low income people getting the best and brightest and newest technologies or something different? A recent study showed that Medicaid patients are 50% more likely to die after surgery rather than privately insured patients. Why do you think this is?

You are picking and choosing which things are important to other people based on your own agenda which is absolutely ludicrous.

The other myth that keeps getting spread aside from the  "substandard" coverage one is that insurers are now locked in at how much they can raise rates. That's hilarious. If you read closer it says that they are locked in at how much they can raise rates without justifying it (20% annually). However if they have a ton of claims or a larger than projected number of people with expensive chronic conditions, they can bring that to the insurance commissioners and raise rates however much they need to provided that their profit/claims ratio stays within a specified range. Seeing as how a disporportionate number of seriously ill and previously uninsurable people have signed up so far and a strong majority number of the projected young and healthy people have NOT signed up but were expected to, their projections for the upcoming year is completely screwed so far. That means they will pay out an extraordinary number of claims meaning that they could potentially raise rates way beyond the 20% the are allowed to without review provided they can account for the expenses. So people who are chafing now at 40,50, 60% increases could see those new higher premiums increased 40, 50, 60% again the next year and on after that. A person making $50K per year cannot pay $25K in health insurance premiums and prosper.

It's also weird how there was initially so much talk of defeating special interests and lobbyists but those are the same people gloating right now. In case you hadn't noticed, the stocks of the evil health insurance companies are soaring right now because their profits are protected and guaranteed now by law.

It seems like the lion's share of the focus is primarily on those with a functioning uterus rather access to necessary care by ALL people. A family is more than the uterus it came from so it's hard to find "family values" in a policy that caters to a specific determined group of women vs. all of the members of her family.

 If it's so awesome and going to be so great then why are they having to drag people kicking and screaming into it and why are so many organizations (unions, political donor employers) exempt from it?

clarke10

chibiyui said:

So, like, can I just comment how scary it is that every time one of these threads come up people talk about "Maternity coverage" like its completely frivolous? What the hell happened to us that as a nation we don't believe insurance that doesn't have maternity coverage is substandard? 

Family values my barely insured ass. 

I think maternity coverage should always be available, but I would be livid if I was a single male or an older woman (or even a woman who didn't want to have children) and I had to pay extra for maternity coverage. That's like forcing someone who is lactose intolerant to buy milk because even though they can't drink it, it builds strong bones. 

vlagrl29

clarke10 said:

chibiyui said:

So, like, can I just comment how scary it is that every time one of these threads come up people talk about "Maternity coverage" like its completely frivolous? What the hell happened to us that as a nation we don't believe insurance that doesn't have maternity coverage is substandard? 

Family values my barely insured ass. 

I think maternity coverage should always be available, but I would be livid if I was a single male or an older woman (or even a woman who didn't want to have children) and I had to pay extra for maternity coverage. That's like forcing someone who is lactose intolerant to buy milk because even though they can't drink it, it builds strong bones. 

very true.  i watched a video a couple weeks ago of a woman with bone cancer who was one of the unfortunate people who got her insurance cancelled and the replacement plan had maternity and all that jazz, too expensive for them to afford.  The lady was crying while she was being interviewed.  i felt so horrible for her

vlagrl29

people need to also be informed that you can buy your own plan privately and don't have to mess with the ACA crappy plans.

cincychick35

That is one of the reasons I don't support the ACA.  Insurance is so very personal and cannot be a one size fits all.  I certainly don't need maternity care anymore, I am older and my 2 children are almost grown.  I shouldn't be forced to purchase something I don't want or no longer need.

RedheadBaker

clarke10 said:

chibiyui said:

So, like, can I just comment how scary it is that every time one of these threads come up people talk about "Maternity coverage" like its completely frivolous? What the hell happened to us that as a nation we don't believe insurance that doesn't have maternity coverage is substandard? 

Family values my barely insured ass. 

I think maternity coverage should always be available, but I would be livid if I was a single male or an older woman (or even a woman who didn't want to have children) and I had to pay extra for maternity coverage. That's like forcing someone who is lactose intolerant to buy milk because even though they can't drink it, it builds strong bones. 

Can I be livid because I don't have a penis, but I can't opt out of prostate cancer coverage in my insurance plan? 

chibiyui

snp605 said:

chibiyui said:

So, like, can I just comment how scary it is that every time one of these threads come up people talk about "Maternity coverage" like its completely frivolous? What the hell happened to us that as a nation we don't believe insurance that doesn't have maternity coverage is substandard? 

Family values my barely insured ass.

Because it's ridiculous for a man to have to have maternity coverage as well as a woman who is in her 50s or even a woman in her 30s who has had a hysterectomy. Let's say all three have no children. They are also required to have pediatric care on their policies. Why can't they be trusted to know that they don't want a plan that has maternity coverage and don't want to pay for it?

Let's face it, they are paying for the benefits for someone else to make it affordable for someone else not because they need it. It's simple redistribution so let's be honest and call a spade a spade. This is also outside of the extra taxes that we are all paying for subsidies for coverage as well.


There is not a requirement that plans have coverage for hearing aids. Do you have any idea of what those cost? I do because my husband needs them and they start at around $1500 for the type that he needs (fortunately his loss is not as severe as some). If you were low income pregnant you could go to planned parenthood and get maternity care on a sliding scale as well as to many community health clinics and health departments. At the very least you could go to the emergency room. If you are poor and hard of hearing where do you go? This affects men, women, you and old and would severely affect the quality of your relationships and the type of employment you might be eligible for not to mention the safety issue.

My husband also has two cornea transplants. As you may know, transplants are not forever and must be redone every 10-20 years depending on the organ. He is slowly going blind again due to his medical condition. There is absolutely ZERO requirements for vision care for adults and certainly no requirement that this bazillion dollar a year "better" policy cover his new corneal transplants. In fact currently most plans don't cover part of many surgeries. When he had his ACL replaced they covered his surgery but not the cadaver ACL so in addition to co-pays, deductible, etc he had to pay $2k out of pocket for the cadaver part. He will have to pay out of pocket for the costs of the transplant part (somewhere in the neighborhood of $10K) Something similar happened to my brother inlaw who had to have a vertebra replaced. He paid $1600 for the vertebra but ins covered the surgery.  So I'm no longer having kids but I have maternity coverage. My husband is going blind and deaf with huge gaps in coverage to manage his conditions. Awesome. If you are poor you might get surgery coverage for your torn acl or broken vertebra but you have to walk in out of pocket on the actual parts needed to complete your surgery. Does this sound like great coverage to you?

There is also no requirement that plans cover providers with excellent treatment records such as Sloan Kettering or the Mayo Clinic. The only standard they must meet is that they cover  “essential community providers . . . that serve predominantly low-income, medically underserved individuals”. So you might have been low income but had access to great care but now you are shunted over to predominently medicaid served hospitals and clinics. Based on the amounts that Medicaid reimburses, are the low income people getting the best and brightest and newest technologies or something different? A recent study showed that Medicaid patients are 50% more likely to die after surgery rather than privately insured patients. Why do you think this is?

You are picking and choosing which things are important to other people based on your own agenda which is absolutely ludicrous.

The other myth that keeps getting spread aside from the  "substandard" coverage one is that insurers are now locked in at how much they can raise rates. That's hilarious. If you read closer it says that they are locked in at how much they can raise rates without justifying it (20% annually). However if they have a ton of claims or a larger than projected number of people with expensive chronic conditions, they can bring that to the insurance commissioners and raise rates however much they need to provided that their profit/claims ratio stays within a specified range. Seeing as how a disporportionate number of seriously ill and previously uninsurable people have signed up so far and a strong majority number of the projected young and healthy people have NOT signed up but were expected to, their projections for the upcoming year is completely screwed so far. That means they will pay out an extraordinary number of claims meaning that they could potentially raise rates way beyond the 20% the are allowed to without review provided they can account for the expenses. So people who are chafing now at 40,50, 60% increases could see those new higher premiums increased 40, 50, 60% again the next year and on after that. A person making $50K per year cannot pay $25K in health insurance premiums and prosper.

It's also weird how there was initially so much talk of defeating special interests and lobbyists but those are the same people gloating right now. In case you hadn't noticed, the stocks of the evil health insurance companies are soaring right now because their profits are protected and guaranteed now by law.

It seems like the lion's share of the focus is primarily on those with a functioning uterus rather access to necessary care by ALL people. A family is more than the uterus it came from so it's hard to find "family values" in a policy that caters to a specific determined group of women vs. all of the members of her family.

 If it's so awesome and going to be so great then why are they having to drag people kicking and screaming into it and why are so many organizations (unions, political donor employers) exempt from it?

I will agree with you 100% that vision should be mandatory coverage. I will also suggest the fact that vision coverage being considered an extra bonus is proof that health care in this country has been fucked for a long time now. 

Single payer would have alleviated many of the issues with ACA.  (I. E rates going up because not enough healthy people have signed up, well given that other special interests are dedicated to trying to make sure it fails) 

Part of the reason healthcare costs were rising was poor people going to the ER for stuff since they didn't have insurance. Before ACA my shitty insurance went up in price each year I've been employed at my job. This is the first year it hasn't. 

And you know what, Planned Parenthood does a great job, and is sorely needed in this country. But depending on where you live, you might not have access to one, in large part because "family values" special interests disagree with women having access to healthcare. So yeah, I'm glad the federal government is actually taking one small freaking baby step to acknowledging that by saying maternity coverage is mandatory. There are more parts to a family then just the "uterus" but without that, you don't have future families anyway. 

Hopefully, in the future there won't be crazy out of pocket expenses for parts necessary for surgery because yes, those expenses are absolutely insane. But my guess is that was under your old insurance, since ACA has just barely taken effect? So, insurance was broken before therefore let's not attempt to fix it?

clarke10

Considering the government gives funds to Planned Parenthood, I would say they're already taking steps. 

But it just goes back to the fact that they're forcing people to buy a service that many will never need. 

snp605

RedheadBaker said:

Can I be livid because I don't have a penis, but I can't opt out of prostate cancer coverage in my insurance plan?

This is not an apples to apples comparison because you would have coverage under general cancer coverage which applies to everyone since ANYONE not just one gender or stage of life has some change of developing some kind of cancer.  Most policies don't have a specific prostrate cancer provision or cost basis like maternity coverage does. Aside from that, prostrate cancer is not something you can choose or avoid like you can the need for maternity care. To further illustrate the difference, you might have coverage for certain aspects of your cancer care but not everything you might desire. There are policies (including Medicaid and Medicare) that don't pay for reconstructive surgery after an amputation or mastectomy or that pay only for bare bones resconstruction. Under the new laws that has no changed at all yet we have 100% wall-to-wall maternity coverage. So if you have to have your non-existent penis removed with your new "non-substandard plan"  you may have prostrate cancer coverage but may not receive a new prosthetic one if it is removed due to cancer at the expense of the insurance company.

We did need reform but we did not do anything to attack the things that are causing health care costs to keep going up nor did we systematically provide health CARE to more people through the ACA. Requiring someone to buy insurance and setting up exchanges does not actually provide someone with health care. There are people who will not be able to afford the deductibles and co-pays even with insurance and will still not have access to heath care. It almost seems with what was paid to defend the darn thing, build the non-working website, advertise what a jolly good thing it was, etc. we could have just thrown all of that money into creating an exchange for the previously uninsurable and subsidized their premiums and done more good.

sandsonik

 

That is one of the reasons I don't support the ACA.  Insurance is so very personal and cannot be a one size fits all.  I certainly don't need maternity care anymore, I am older and my 2 children are almost grown.  I shouldn't be forced to purchase something I don't want or no longer need.

But that is what insurance IS.  It's minimizing the cost and risk to the insurance company by pooling people together.  A 25 year old doesn't get to pick and choose that he doesn't want coverage for heart disease.  Medical care is personal, insurance is not.  Who do you think will be defraying your costs as you get older and sicker?  So why shouldn't you be defraying the costs of others' maternity?  (For that matter, don't you think you already are paying that bill, if they don't have insurance?  If they can't pay, their costs will get passed on, one way or another).

Personally, I would have preferred single payer because I really don't see why we're enriching the insurance companies, but I know a conservative would never agree with that.

Many of the people who had their insurance dropped are actually being replaced into different plans that meet the minimum, that's all.

cincychick35

sandsonik said:

 

That is one of the reasons I don't support the ACA.  Insurance is so very personal and cannot be a one size fits all.  I certainly don't need maternity care anymore, I am older and my 2 children are almost grown.  I shouldn't be forced to purchase something I don't want or no longer need.

But that is what insurance IS.  It's minimizing the cost and risk to the insurance company by pooling people together.  A 25 year old doesn't get to pick and choose that he doesn't want coverage for heart disease.  Medical care is personal, insurance is not.  Who do you think will be defraying your costs as you get older and sicker?  So why shouldn't you be defraying the costs of others' maternity?  (For that matter, don't you think you already are paying that bill, if they don't have insurance?  If they can't pay, their costs will get passed on, one way or another).

Personally, I would have preferred single payer because I really don't see why we're enriching the insurance companies, but I know a conservative would never agree with that.

Many of the people who had their insurance dropped are actually being replaced into different plans that meet the minimum, that's all.

I can see a general plan (such as an employer plan) covering general things, ie maternity for all persons covered under the employer plan.  But if one is purchasing an individual plan why can't it be personalized to his or her own needs. 

You said "Medical care is personal, insurance is not."  I disagree. If one purchases an individual plan, it most definitely should be personalized and geared towards the enrollees needs.  Defraying the costs has nothing to do with what is or isn't covered in a medical plan but the number of people enrolled in a plan.

Single payer health insurance? Oh goodness please don't get me started.   We see how well that has worked elsewhere.

http://www.heritage.org/research/lecture/buyer-beware-the-failure-of-single-payer-health-care

http://www.coalitionoftheobvious.com/Singlepayer.pdf

snp605

sandsonik said:

 

But that is what insurance IS.  It's minimizing the cost and risk to the insurance company by pooling people together.  A 25 year old doesn't get to pick and choose that he doesn't want coverage for heart disease.  Medical care is personal, insurance is not.  Who do you think will be defraying your costs as you get older and sicker?  So why shouldn't you be defraying the costs of others' maternity?  (For that matter, don't you think you already are paying that bill, if they don't have insurance?  If they can't pay, their costs will get passed on, one way or another).

Personally, I would have preferred single payer because I really don't see why we're enriching the insurance companies, but I know a conservative would never agree with that.

Many of the people who had their insurance dropped are actually being replaced into different plans that meet the minimum, that's all.

Yes but insurance is also pricing you by your risk factor. If I have 10 homeowner's insurance claims because I live somewhere that keeps having tornados drop trees on my house I'm going to pay more than you. My risk factors may or may not be my fault but it doesn't matter. This way of covering the costs of risk is being stripped from insurance so it's no longer really insurance. Also typically insurance does not cover maintenance or preventative services. I don't get  free electrical inspections for my house or tire rotations for my car. Also with the exception of very basic amounts of insurance to cover if I hit someone else, I'm not required to insure myself at all. Having tow  coverage, rental car coverage, no fault coverage etc, is all at my discretion because I apparently can be trusted with that financial ruin.

chibiyui

cincychick35 said:

sandsonik said:

 

That is one of the reasons I don't support the ACA.  Insurance is so very personal and cannot be a one size fits all.  I certainly don't need maternity care anymore, I am older and my 2 children are almost grown.  I shouldn't be forced to purchase something I don't want or no longer need.

But that is what insurance IS.  It's minimizing the cost and risk to the insurance company by pooling people together.  A 25 year old doesn't get to pick and choose that he doesn't want coverage for heart disease.  Medical care is personal, insurance is not.  Who do you think will be defraying your costs as you get older and sicker?  So why shouldn't you be defraying the costs of others' maternity?  (For that matter, don't you think you already are paying that bill, if they don't have insurance?  If they can't pay, their costs will get passed on, one way or another).

Personally, I would have preferred single payer because I really don't see why we're enriching the insurance companies, but I know a conservative would never agree with that.

Many of the people who had their insurance dropped are actually being replaced into different plans that meet the minimum, that's all.

I can see a general plan (such as an employer plan) covering general things, ie maternity for all persons covered under the employer plan.  But if one is purchasing an individual plan why can't it be personalized to his or her own needs. 

You said "Medical care is personal, insurance is not."  I disagree. If one purchases an individual plan, it most definitely should be personalized and geared towards the enrollees needs.  Defraying the costs has nothing to do with what is or isn't covered in a medical plan but the number of people enrolled in a plan.

Single payer health insurance? Oh goodness please don't get me started.   We see how well that has worked elsewhere.

http://www.heritage.org/research/lecture/buyer-beware-the-failure-of-single-payer-health-care

http://www.coalitionoftheobvious.com/Singlepayer.pdf

Right, cause health care here was just hunky-dory till Obama came and RUINED EVERYTHING. Nobody ever waited to be seen by a doctor before Obama, everything was punctual, there were no waiting lists for organ transfers, nobody went into debt to stay alive, everything was perfect cause of the free market! Nobody ever died in hospitals ever!

I have never heard a Canadian or Doctor who wasn't agenda pushing say anything along the lines that single payer was broken. I have heard many a (conservative, even) Doctor mention how insurance companies are broken and health care in America is broken. 

cincychick35

Right, cause health care here was just hunky-dory till Obama came and RUINED EVERYTHING. Nobody ever waited to be seen by a doctor before Obama, everything was punctual, there were no waiting lists for organ transfers, nobody went into debt to stay alive, everything was perfect cause of the free market! Nobody ever died in hospitals ever!

I have never heard a Canadian or Doctor who wasn't agenda pushing say anything along the lines that single payer was broken. I have heard many a (conservative, even) Doctor mention how insurance companies are broken and health care in America is broken. 

Please tell me where I said the healthcare system prior to the ACA was perfect?  I didn't.  I understand there are problems, I just don't believe the ACA or a Single Payer system is the answer.  There are many free market approaches that make more sense than the ACA or socialized medicine. Perhaps I will start another thread with my thoughts on those alternatives.

BTW, there are always going to be people who die in hospitals regardless of the kind of healthcare they have.  We are not immortal.

vlagrl29

How about opening insurance across state lines...I would have loved to be able to buy insurance say in california if it best fit my needs, plus it would lower costs.  I just heard a study that 40% of people would rather pay the fine than enroll in ACA.  I myself would be one of them

vlagrl29

we just went to a chiro for DH on monday and we paid cash.  The chiro gave a great discount if he didn't have to file an insurance claim.  I see more things like this happening.

chibiyui

cincychick35 said:

Right, cause health care here was just hunky-dory till Obama came and RUINED EVERYTHING. Nobody ever waited to be seen by a doctor before Obama, everything was punctual, there were no waiting lists for organ transfers, nobody went into debt to stay alive, everything was perfect cause of the free market! Nobody ever died in hospitals ever!

I have never heard a Canadian or Doctor who wasn't agenda pushing say anything along the lines that single payer was broken. I have heard many a (conservative, even) Doctor mention how insurance companies are broken and health care in America is broken. 

Please tell me where I said the healthcare system prior to the ACA was perfect?  I didn't.  I understand there are problems, I just don't believe the ACA or a Single Payer system is the answer.  There are many free market approaches that make more sense than the ACA or socialized medicine. Perhaps I will start another thread with my thoughts on those alternatives.

BTW, there are always going to be people who die in hospitals regardless of the kind of healthcare they have.  We are not immortal.

I think you should. I disagree with you on additional free market approaches, but mainly I took issue with your "sources" against single payer. Neither of those are unbiased, they have an agenda to push. I know it is very hard to find non-biased information on healthcare, but just like you wouldn't believe a Salon article, I'm not going to believe something from The Heritage Foundation. 

I'm also a bit cranky because single payer was scrapped as part of a compromise, and a lot of the current issues with ACA woudln't exist if single payer had gone through. So you know. It's frustrating when the side I agree with more often compromises on something really, really big, and the side I disagree with more often then not refuses to try and work with anything and just shuts down attempts. 

If Healthcare in this country was a sandcastle, one side is trying to patch it up, the other side is just throwing buckets of water on it cause they don't like the design. 

cincychick35

The bottom line regarding a single payer health system is this:

"The problem with socialism is that eventually you run out 
of other people's money."

—Margaret Thatcher

emily1004

vlagrl29 said:

we just went to a chiro for DH on monday and we paid cash.  The chiro gave a great discount if he didn't have to file an insurance claim.  I see more things like this happening.

Chiropractors should have never been allowed to take insurance in the first place. They should always be cash. They're not doctors. I understand people swear by them, but the treatment is controversial and in my experience you just got addicted to the treatment. There was no long term solution. I have to disagree with you, because most people simply won't be able to afford to pay outright for their medical care. It's too expensive, even when you're healthy.

To the OP, my H and I are part of those "millions" that lost our healthcare, yes it is the fault of the ACA. The terms in our policy did not comply with the law. However, the new law has giving us much better coverage, our monthly payment is pretty much the same and we have a lower deductible.  (But that's just our experience.)

vlagrl29

emily1004 said:

vlagrl29 said:

we just went to a chiro for DH on monday and we paid cash.  The chiro gave a great discount if he didn't have to file an insurance claim.  I see more things like this happening.

Chiropractors should have never been allowed to take insurance in the first place. They should always be cash. They're not doctors. I understand people swear by them, but the treatment is controversial and in my experience you just got addicted to the treatment. There was no long term solution. I have to disagree with you, because most people simply won't be able to afford to pay outright for their medical care. It's too expensive, even when you're healthy.

To the OP, my H and I are part of those "millions" that lost our healthcare, yes it is the fault of the ACA. The terms in our policy did not comply with the law. However, the new law has giving us much better coverage, our monthly payment is pretty much the same and we have a lower deductible.  (But that's just our experience.)

In my experience they can be much better than doctors depending on your condition.  I had major pelvic issues after I had DD.  The chiro I saw helped me with adjustments and PT exercises. 6 months later I was pain free and still am today.  Haven't seen her since, but IMO chiro's are doctors.  This chiro helped DH's pinched nerve, he was having severe vertigo because of it.  Last time he saw the MD about it she told him to rest and if it didn't get better she would give him a steroid....that's not helpful at all for what he had.

formerlyGDaisy09

Right, cause health care here was just hunky-dory till Obama came and RUINED EVERYTHING. Nobody ever waited to be seen by a doctor before Obama, everything was punctual, there were no waiting lists for organ transfers, nobody went into debt to stay alive, everything was perfect cause of the free market! Nobody ever died in hospitals ever!

I have never heard a Canadian or Doctor who wasn't agenda pushing say anything along the lines that single payer was broken. I have heard many a (conservative, even) Doctor mention how insurance companies are broken and health care in America is broken. 

Please tell me where I said the healthcare system prior to the ACA was perfect?  I didn't.  I understand there are problems, I just don't believe the ACA or a Single Payer system is the answer.  There are many free market approaches that make more sense than the ACA or socialized medicine. Perhaps I will start another thread with my thoughts on those alternatives.

BTW, there are always going to be people who die in hospitals regardless of the kind of healthcare they have.  We are not immortal.

The problem with free markets in healthcare is that the user/buyer is insulated from the actual cost of the care they use because of their insurance...so the free market doesn't work because the buyer is not sensitive to the cost. 

The fee-for-service model this country has, in combination with the uninsured and CMS reimbursement system, driven up the cost of health care. Insurance depends on having healthy people to defray the cost of the sick (it does not mean that healthy people get charged the same as unhealthy people....that would be like a car insurance company insuring someone with a clean record the same as someone with several accidents...or someone who drives a 2000 corolla the same as someone drivig a 2014 tesla...there are a lot of factors that go into determining cost). however insurance doesn't work if the young healthy people don't have it.

Hospitals and Doctors (at least at public or critical access facilities) have an ethical obligation to treat everyone who walks through their doors, regardless of their ability to pay...which means for the past several decades people with private insurance have been subsidizing the cost for the uninsured, underinsured, and people with medicare or medicaid.  CMS has a set fee structure for how much it will pay for certain services...often at 80% or less of the acual cost. providers have to make-up that loss to stay afloat financialy somewhere....that comes from insurance companies. BUT providers give insurance companies a discount on what they charge...this means when you see a bill the individual charges are often 300%-400% higher than the actual cost. So when you pay cash and get a discount you're still paying more than what insurance companies or CMS would pay (that should make you angry)

even with all that work many public hospitals operate at a 0% or less margin. 

By insuring everyone the costs are more spread out...and eventually that should result in lower premiums, or at least premiums that aren't increasing 6%-7% every year. the ACA is also rewarding or peanilizing hospitals and providers based on how valuable the care they deliver are...they're moving from fee-for-service payments to capitated payments, so doctors make more money if they're delivering care that is going to be more cost-effective for the patient, rather than getting paid more if they do more.  so instead of making money by keeping their MRI machines full hospitals (or ACOs) make more money by getting sick patients healthy and keeping them healthy. 

lifeguard

 Healthcare is expensive. "Somebody" has to pay it today or somebody has to pay it tomorrow with interest.  Nobody wants to be "Somebody".

Sillygirl45

Gdaisy09 said:

Right, cause health care here was just hunky-dory till Obama came and RUINED EVERYTHING. Nobody ever waited to be seen by a doctor before Obama, everything was punctual, there were no waiting lists for organ transfers, nobody went into debt to stay alive, everything was perfect cause of the free market! Nobody ever died in hospitals ever!

I have never heard a Canadian or Doctor who wasn't agenda pushing say anything along the lines that single payer was broken. I have heard many a (conservative, even) Doctor mention how insurance companies are broken and health care in America is broken. 

Please tell me where I said the healthcare system prior to the ACA was perfect?  I didn't.  I understand there are problems, I just don't believe the ACA or a Single Payer system is the answer.  There are many free market approaches that make more sense than the ACA or socialized medicine. Perhaps I will start another thread with my thoughts on those alternatives.

BTW, there are always going to be people who die in hospitals regardless of the kind of healthcare they have.  We are not immortal.

The problem with free markets in healthcare is that the user/buyer is insulated from the actual cost of the care they use because of their insurance...so the free market doesn't work because the buyer is not sensitive to the cost. 

The fee-for-service model this country has, in combination with the uninsured and CMS reimbursement system, driven up the cost of health care. Insurance depends on having healthy people to defray the cost of the sick (it does not mean that healthy people get charged the same as unhealthy people....that would be like a car insurance company insuring someone with a clean record the same as someone with several accidents...or someone who drives a 2000 corolla the same as someone drivig a 2014 tesla...there are a lot of factors that go into determining cost). however insurance doesn't work if the young healthy people don't have it.

Hospitals and Doctors (at least at public or critical access facilities) have an ethical obligation to treat everyone who walks through their doors, regardless of their ability to pay...which means for the past several decades people with private insurance have been subsidizing the cost for the uninsured, underinsured, and people with medicare or medicaid.  CMS has a set fee structure for how much it will pay for certain services...often at 80% or less of the acual cost. providers have to make-up that loss to stay afloat financialy somewhere....that comes from insurance companies. BUT providers give insurance companies a discount on what they charge...this means when you see a bill the individual charges are often 300%-400% higher than the actual cost. So when you pay cash and get a discount you're still paying more than what insurance companies or CMS would pay (that should make you angry)

even with all that work many public hospitals operate at a 0% or less margin. 

By insuring everyone the costs are more spread out...and eventually that should result in lower premiums, or at least premiums that aren't increasing 6%-7% every year. the ACA is also rewarding or peanilizing hospitals and providers based on how valuable the care they deliver are...they're moving from fee-for-service payments to capitated payments, so doctors make more money if they're delivering care that is going to be more cost-effective for the patient, rather than getting paid more if they do more.  so instead of making money by keeping their MRI machines full hospitals (or ACOs) make more money by getting sick patients healthy and keeping them healthy. 

Wow @Gdaisy09, that is one of the best explanations I've read. I'm so sick of people blaming obamacare for EVERYTHING, I have just stopped trying to explain why we need to overhaul the healthcare system. No one wants to hear it anyway. People are so hellbent one way or the other, they just won't listen to reason.  

formerlyGDaisy09

Thank you, at least my masters in health policy is useful for something