What the hell happened to insurance?

Go back an ask your broker about INDV insurance. We all had our clients on group policies (even single business owners) prior if the client had health issues because it was way cheaper. He's right that the ACA removed one individual groups going forward as eliminating this segment padded the number of new enrollees into CoveredCA in order help long term viability of the program and insurance companies lobbied hard to get this written in because those groups were a negative profit. CoveredCA actually emailed us on this tactic. But you can buy INDV policy now as its essentially the same plans. Remember they are mirrored. If you make more than the subsidy cap, go of-exchange. Most of my single owner groups were Kaiser and they just moved them over to INDV plans for cheaper than the old group. Pre-existing conditions are gone and will never be calculated into your insurance premium until after 2016 (this will probably change though).

 

You must have forgot who the program was created for.

 

Administration is a necessary evil I'm afraid. The way to constrain rent-seeking administrators is to make this broken market more like a real market. If one bike shop treats you like crap, you go to a different one. The nice bike shop makes more money and all is well with the world. If you try to go single payer you end up with the VA scandal. Tell me the VA administrators weren't being greedy. The insurers are greedy too, but the key is to create a balance of greed that rewards serving the customer, not to make us beg for mercy from a VA-style national health care system.

The current law subsidizes high-priced insurance for the upper middle class and public employees through the tax deduction, and it subsidizes crap care for the poor through Medicaid, and the lower middle class through Covered Ca. The typical middle class family doesn't vote for the right people, so they get screwed. The insurance companies didn't literally write the ACA, but it's not far off to make that claim.

How do end the subsidy for insurers? Make company health insurance taxable, and give the $ raised back out as an explicit subsidy to everyone. If the feds want to subsidize health care, the way to do it is to subsidize the first dollar--give everyone a fixed amount that's enough to buy a medicaid-level plan, then let us pay more if we want more. By instead offering a tax deduction, we're encouraged to spend more on health insurance than we otherwise might.

Targeted tax deductions are the devil's work. Straight-up subsidies to big business. Don't get me started on the mortgage interest deduction. I get econo-nerdy very fast. But the way we do Medicaid, where it phases out if you make more money, totally punishes folks who want to work and creates dependents. And then we go reward high earners for over-paying for premium insurance, by offering a tax break that covers half the price in some cases. For some politicians that's a feature, but for the country that's a bug. Marginal tax rates people, marginal tax rates.

TL, DR I know. pardon me as I kill time writing for my own catharsis.

 

First, stop watching FOX news. If you signed up for Covered CA, you will get to see a doctor. They don't sell insurance if there are no doctors in the network.

Second, yes you can become a freeloader. As long as they continue to treat people without insurance in ER, there will be freeloaders. Can't prevent that. It's a moral issue...to be a freeloader or not. And sounds to me, you are planning to become one just so you can stick it to Obama. And if you do become a freeloader what makes you different than all those democrats on welfare?

 

First, I don't watch fox news, or any other television news. I like to know what's really going on in the world, so I read, from a variety of sources. Second, "Get to see a doctor" is relative. Yes, eventually I will get to see a doctor. Might even be in the same county. But, as we've learned from this thread, doctors that take one form of Blue Shield don't take the CC version of Blue Shield. While there may be doctors in the network, they may or may not be the doctors I'd choose if I had a choice in insurance.

Finally, becoming a freeloader would be less a matter of choice than force. I have had health insurance since I was 18 years old, even when people I knew that made the same amount of money I did complained they couldn't afford it (yet could afford every premium cable channel known to man, which cost about the same as my catastrophic health insurance plan that I had at the time). The point is, I have insurance. I would like to keep that insurance, yet people who are convinced they're smarter than I am tell me I'm not intelligent enough to decide the healthcare needs for me and my family (sure glad I have pre-natal care!).

As for ER use, it's not those without insurance causing the rise, it's the newly insured. So the ACA didn't solve that problem, it exacerbated it. Just like it's not solving many problems (such as the "evil" insurance companies) that the authors claimed they were going to fix.

For those who would hold up other countries as an example, let me share this: I wrecked my shoulder two years ago. I had to wait for surgery for three months for the bone to heal. Three months in pain. Then surgery by the best doctor in the county (because I chose my insurance, not someone else). I asked my British friends how long they would have to wait in pain for such "non-emergency" surgery. Their answer? "Years." No thank you.

 

You do realize that Hoag Hospital only takes Blue Shield and Healthnet Bronze. That's an entire hospital. CoveredCA plan have created very limited in-network hospitals because hospitals are trying to limit the lower profit business.
READ THIS http://www.hoag.org/Patients-And-Visitors/Pages/Insurance/Covered-California.aspx

What would happen if BigTex bought BlueCross? Just think a minute for yourself and not along your party line. Lets say BigTex had BlueCross before but it got cancelled due to the ACA, so he purchased BlueCross again through the exchange knowing that he liked his previous insurance. Do you honestly believe CoveredCA or even BlueCross informed him that he wouldn't be able to go to the same hospital he's been going to for most of his life? GiantSchwinn, the professionals on here have refuted most of what you have been saying. Please stop with the political post and calling us Fox News watchers and just listen and start thinking for yourself. You are also a fool if you don't realize that less than 3 out of 10 doctors in OC accept CoveredCA. Our area is heavily impacted with higher costs to do business so many docs aren't accepting low pay.

One thing of advice to anyone looking to change in the next open enrollment is to NEVER TRUST THE LIST. I predict everyone will go through open enrollment and make their changes only to find that as of 2015 even less establishments will accept coveredCA. Its unfortunate but the reality.

 

Fox news is biased, the more you watch it the more you get brain washed. I'll say the same thing about MSNBC. Your logic makes no sense. This is like saying "I have been going to Path bike shop all my life, I won't go to any other bike shop even though they are just as qualified to serve me". I don't believe you have to only see a particular doctor. There are many qualified doctors out there. Just because your doctor is not in the network you signed up for, this doesn't mean the exchange is broken. Perhaps, your doctor now belongs to another insurance network in the exchange. Perhaps, you should have asked your doctor which network he belongs to before you signed up for a particular network. If he opts out of the exchange, well find another doctor to treat you, there are plenty of qualified doctors out there. Come on people, think logically not what a network tells you to think.

3 out of 10 doctors in OC accepts CoveredCA now doesn't mean the numbers won't increase. Doctors are holding back joining and trying to negotiate a better pay rate (they are in it for the money and I don't blame them). Eventually, one of the two sides will have to give in. I predict in 2015, the number of doctors in the network will only increase.

Personally I take what the "healthcare professionals" have to say with a grain of salt. These are people in the industry and have a vast interest in keeping the status quo. If this Obamacare works, they stand to lose money because the run away train of healthcare cost is no longer. Of course they want to see it fail and talk bad about it on a forum. So when these professionals tell you that they are not making as much money as before, this is a good thing. It means it's working.

 

the fact that you (giantschwinn) keep bringing up fox news and other networks is killing your credibility. you're assuming that that's where they are getting their info just because they don't agree with you. the people in this thread have first hand experience. you're trying to defend a broken system. you say you take what "healthcare professionals" have to say with a grain of salt, yet it's clear that you believe everything that the politicians along your party line have to say. I guess ignorance is bliss. You have missed the whole point from the beginning, which is there are less and less doctors accepting Covered CA. Your argument that there are other qualified doctors out there is true, there are other doctors, but if you have the best doctor in the world and all of the sudden you had to see a mediocre doctor you wouldn't be pissed? Let's put it in a different way, if you needed a lawyer would you want the option to choose or just be given a public defender? I don't think you have had to deal with this mess and for that reason you are unable to empathize with the people who have.

 

It's actually very simple. If the insurance companies will pay the same contracted rate to the providers that they pay with employer sponsored plans the drs will accept it.
That's it.
If you normally work for 10/hr and your cost to work is $5, you make 5.00.
Now the want to pay you 4.00. You'll lose $1/hr.
Are you going to continue working at that rate? No. I wouldn't work at a loss and neither will the providers.

 

This right here tells me everything I need to know about your point of view. I don't know what you do for a living, but I wonder what your reaction would be if other people besides you and your employer should decide how much you should make? Doctors should make a damn good living. They're doing important work, studied long hours for many years (by the way, have you ever smelled formaldehyde? It makes me ill. Anybody that can work around that smell for years while learning their profession ought to be well paid) and worked their asses off to be a doctor. Who the hell am I to decide how much they should make? Who the hell is some government bureaucrat to tell me what doctor I can see? The whole point of this is the ACA is not making healthcare more affordable or more accessible, which was allegedly the whole purpose.

As far as the numbers of doctors accepting CC increasing, how is that going to happen when the number of doctors overall is decreasing? Who wants to go through years of school and internship only to not even make enough to pay off their student loans and have people like you deciding how much money they can make?

You say, "If this Obamacare thing works..." First of all, shouldn't they have been certain it would work before they passed it? But, then again, how can you know if legislation will work when you don't even know what's in it? But it can't work. I'll state this again: You cannot make something more affordable by making it more expensive. And you cannot make something more accessible by limiting the supply.

 

Don't waste your precious time. GS is convinced that this is the right thing and the only thing to do. There is no debating this topic with those that believe this. Because this idealogy is in power, we are all subject to this grand social and economic experiment. I could work, but as far as my own experience is concerned, it is certainly costing me more and making my life difficult. I pay for insurance, and have had to pay what I believe is more than the cash price for medical attention the two times I needed it.

I asked him a straight forward question, "do you have Covered CA and have you used it?" and got no reply. To those that want to get this in place, individuals are not a concern. Its the ideology. My situation isn't even life threatening. I shudder at the thought that I would have to screen hospitals and doctors while I am having a stroke because it could make a $ 20,000 difference in what I have to pay.

Bloomberg is a fairly progressive news source. Even they don't think "it's working". http://www.bloombergview.com/articles/2014-06-26/obamacare-s-prognosis-grows-dimmer?cmpid=yhoo

"..the data show that people insured through the law’s exchanges have higher rates of serious medical conditions. Of the enrollees who have seen a doctor or other health-care provider in the first quarter of this year, 27 percent have significant medical problems, including diabetes, cancer, heart trouble and psychiatric conditions. .......the data suggest that insurers will respond to having to cover more people who are relatively sicker by raising premiums in 2015 and beyond. As Chet Burrell, the chief executive officer of CareFirst BlueCross BlueShield, concluded, “Over a period of time, the rates have to go up to catch up with the reality of who enrolled.”

 

This thread is a good read but I will steer very clear of commenting too much.. anyone who actually "earns" their money should have no use for Obama nor anything Obama supports.. I will leave it at that. I won't use a bike forum to further my political stance but hearing GS and his view scares me a little!!

 

This will never happen because 99% of the doctors are "not in it for the money"...that's if you believe what the good doctor says. Somebody wrote healthcare professionals are all against it therefore it's a bad system and we should keep what we had before. Think about why they are against it, I mean if I get to charge a $540 setup fee for doing my work, I would be against any changes as well.

But I take what healthcare professional say with a grain of salt. Doctors are in it for the money like the rest of us. The lack of doctors in the network now is a negotiating tactic these doctors use to force the insurance company to raise their pay. They first refuse to join the network, the insurance company is forced to raise their pay. Doctors can only hold out for so long and will have to compromise eventually. They have mortgages too you know. Look at medicare, most of them take medicare. They bitch and moan in the beginning but eventually they have to take it. It's a game of dare. One side is going to blink first. And when that happens, the number of network doctors are going to increase.

You people are complaining because somebody "changed" your healthcare plan. Suck it up and deal with it. Better days are coming. This is the only way we are going to fix a broken system.

 

I'm curious what you do for a living?

Better days?
http://www.bloombergview.com/articles/2014-06-26/obamacare-s-prognosis-grows-dimmer?cmpid=yhoo

 

Why is that a good thing. Docs have to make many sacrifices to be able to even practice on their own. after high school its a minimum of 8 years of school and 3 years of training. Medical school is also not guaranteed, in undergrad you're competing with other students who have very impressive stats. Once you are a doc, the stress level is very high. You have to deal with people who are dying, angry family members, non compliant patients, taking phone calls in the middle of the night, etc. Patients will come to you and tell you things they wouldn't even tell their own husband/wife and you are bound to not letting anyone else know about these things.

Not many people can handle being a doc, not even docs themselves. They have the highest rate of suicide compared to any other profession.

Docs put a lot on the line to be able to do their job, why not compensate them well.

Or we could just start paying everyone the same amount for every job... oh wait.

 

I never said Docs shouldn't make good money. I was referring to the run away healthcare cost we experienced in recent years. To hear that the healthcare professionals cry that they don't make so much money as before means the cost is down and put in check. It's a good thing. How can you not agree with that?

 

where are you seeing this reduction in cost? http://www.usatoday.com/story/money/business/2014/03/30/health-care-spending/7007987/

"Health care spending growth hits 10-year high"

If want anecdotal evidence, check out 1Q GDP. It's down 2.9% due in large part to healthcare spending. Do the math. Everyone paid for insurance, but the policies arent paying out. Ergo, GDP crashes. How is that a good thing?

 

http://www.census.gov/compendia/statab/2012/tables/12s0160.pdf

Healthcare as a whole reported $5,620,728,000,000 revenue in 2009.

http://kff.org/other/state-indicator/total-active-physicians/

Total number of physicians in 2012 was 834,769.

http://www.payscale.com/research/US/People_with_Jobs_as_Physicians_/_Doctors/Salary

Median doctor salary is $199524.

Total cost of doctors = $166,556,450,000

Percentage of doctors cost relative to healthcare revenue = 2.96%

Going after the doctors salaries is the wrong argument. Pick a new one.

 

Bing, you have to read the article first. You just posted something that supports my points. Nothing in the article supports your headline "Health care spending growth hits 10-year high". In fact, it mentions the cost has slowed down from double digit increases to single digit.
The shift towards consumerism (code word for high deductible plans) is keeping cost in check.

The fact that healthcare portion of the GDP is down means we spend less on healthcare. People are shopping around for healthcare, everybody is price conscious about how much things cost because they have to pay up to their deductibles before the insurance will kick in.

It's a very Republican concept right? People are made to shop around for healthcare. It's free market at work.

LOL, what if I tell you I am not going after doctor salaries, I am going after the $540 setup fee his office charges. I am sure he doesn't report this $540 setup fee in his salary. How can you not be agreeable to go after these unjust $540 setup fees?

Just imagine, someone sitting on the Obamacare death panel. He is reviewing Bing's claim and sees this $540 setup fee. With a bold stamp, he stamped the bill "DENIED". How satisfying is that?

 

SMH. Take in the data and take a deep breath. BTW, do you have Covered CA and have you tried using it?