Author Topic: Obamacare Repeal and Replacement  (Read 27656 times)

Pete at Home

  • Members
    • View Profile
Re: Obamacare Repeal and Replacement
« Reply #100 on: June 20, 2017, 03:35:12 PM »
I honestly, don't understand your confusion.

The fact that unwanted pregnancies have a net positive economic impact, would only control if economics is the only consideration.  Maybe the unstated criticism is what's confusing?  Economics should not be the sole basis for these decisions.  However, if you're going to make a utilitarian argument, you should include a full consideration of utilities not a cherry picked set.

Am I missing something?

What you said is precisely the argument I was responing to with:

Seriati, you don't see the problems inherent of a birth control regime where the persons with most resources that could be used to protect, raise, shelter, feed, and educate their kids are the only ones with easy access to birth control?  Do you really think that a generation of crack heroin and meth babies is going to provide that labor base to take care of an aging population?


In other words, birth control via the invisible hand of the market, changes the numbers on unwanted pregnancies being a net positive.  The subset of the unwanted pregnancies of those who cannot afford birth control, or are too drugged out to use it, are not, in themselves, an economic net positive.

When we talk about the economics of robotic cherry pickers, we're going to have to look at "cherry picked sets" as much as any other set. :)  I'm not pointing to the underclass in order to justify birth control for everyone; I'm pointing to them as a rationale for making birth control available to the underclass, period.
« Last Edit: June 20, 2017, 03:38:18 PM by Pete at Home »

Seriati

  • Members
    • View Profile
Re: Obamacare Repeal and Replacement
« Reply #101 on: June 20, 2017, 09:53:04 PM »
Of course I get the "problems." Which is exactly why I pointed out to you the other quote.  I personally have no problem with the government deciding to pay for birth control.  I fail to see what that has to do with the fact that even an unwanted pregnancy results in an economic net gain, or why that shouldn't be my response to a claim that birth control is more cost effective than pregnancy.

I'm also very pro second amendment, but that doesn't mean I ignore the fact that innocent people die from gun shots on occasion.

Pete at Home

  • Members
    • View Profile
Re: Obamacare Repeal and Replacement
« Reply #102 on: June 21, 2017, 02:43:31 AM »
Ah, ok. I see where we're misunderstanding. I thought you meant for the government. That the people who the govt pays bc for, would produce net producer kids.  That's what I responded to. 

I certainly would not tell people who could afford labor and delivery services that they should save $ and use birth control.

Wayward Son

  • Members
    • View Profile
Re: Obamacare Repeal and Replacement
« Reply #103 on: June 23, 2017, 10:49:37 AM »
Quote
Personally, I think Congress will go with the "Let the States Figure it Out" program.  I forget which Congressman talked about it.  Basically, they would tell the States to cover people, and probably give them a check to help cover it.  When the programs fail, they can then blame the States for not making it work. A masterfully weaselly way of avoiding blame, even if millions of people may end up uninsured. :)

Did I call it, or what?  ;D  :'(

Of course, it's wasn't much of a stretch, since they pretty much said that's what they were going to do.  :P

Wayward Son

  • Members
    • View Profile
Re: Obamacare Repeal and Replacement
« Reply #104 on: June 26, 2017, 06:34:01 PM »
Quote
Lol, maybe because it was a campaign promise by the great Obama that it would be pubilically posted for comment before passing it?  Maybe because the Democrats that passed it didn't know what was in it, and as well evidenced by the great Nancy Pelosi?

And just to keep our facts straight, here is exactly what the great Nancy Pelosi said at the time:

Quote
Imagine an economy where people could follow their aspirations, where they could be entrepreneurial, where they could take risks professionally because personally their families [sic] health care needs are being met. Where they could be self-employed or start a business, not be job-locked in a job because they have health care there, and if they went out on their own it would be unaffordable to them, but especially true, if someone has a child with a pre-existing condition. So when we pass our bill, never again will people be denied coverage because they have a pre-existing condition.

We have to do this in partnership, and I wanted to bring [you] up to date on where we see it from here. The final health care legislation that will soon be passed by Congress will deliver successful reform at the local level.  It will offer paid for investments that will improve health care services and coverage for millions more Americans. It will make significant investments in innovation, prevention, wellness and offer robust support for public health infrastructure.  It will dramatically expand investments into community health centers.  That means a dramatic expansion in the number of patients community health centers can see and ultimately healthier communities.  Our bill will significantly reduce uncompensated care for hospitals.

You’ve heard about the controversies within the bill, the process about the bill, one or the other.  But I don’t know if you have heard that it is legislation for the future, not just about health care for America, but about a healthier America, where preventive care is not something that you have to pay a deductible for or out of pocket.  Prevention, prevention, prevention–it’s about diet, not diabetes. It’s going to be very, very exciting.

But we have to pass the bill so that you can find out what is in it, away from the fog of the controversy.

Somehow, the "away from the fog of the controversy" phrase keeps getting omitted.  I wonder why? ;)

Seriati

  • Members
    • View Profile
Re: Obamacare Repeal and Replacement
« Reply #105 on: June 27, 2017, 09:16:25 AM »
Lol, given that the law did virtually nothing she claimed it was going to do, I'm not finding that persuasive that they knew what was in it.

Wayward Son

  • Members
    • View Profile
Re: Obamacare Repeal and Replacement
« Reply #106 on: July 27, 2017, 06:10:46 PM »
The Senate is going further and further down the rabbit hole.  Soon they'll meet the Mad Hatter.

Quote
Senate Minority Leader Chuck Schumer said on Wednesday night that Democrats will essentially stop participating until Senate Republicans show them whatever the bill is that the GOP ultimately wants senators to vote on.  Schumer called the current process a “sham” and called on McConnell to release the real bill so that the two parties can debate it.

Schumer is right: Once the “repeal and delay” and “repeal and replace” bills were defeated, the rest of the votes that happened on Wednesday (and will occur on Thursday) are almost certain to go down. Senators are essentially offering amendments to a bill that does not exist.

They've gone from creating a bill in a secret committee, not showing it to their own party until the last minute, to creating a bill entirely in secret and expecting their members to vote and amend it without knowing anything about it except the rough outlines.

You gotta wonder why they ever criticized Democrats for doing things "in secret."  ::)

Seriati

  • Members
    • View Profile
Re: Obamacare Repeal and Replacement
« Reply #107 on: July 28, 2017, 09:53:54 AM »
Not sure I wonder about that, can say for the first time ever I'm strongly considering donating to primary campaigns.  If Republicans can't even get the worst parts of this law repealed they are useless.

Fenring

  • Members
    • View Profile
Re: Obamacare Repeal and Replacement
« Reply #108 on: August 15, 2017, 11:00:52 AM »
Since this thread has been kicking around for years I thought I'd pose a question to Greg and Seriati about it, as you seem to be regular contributors on opposite sides of the issue. You each seem to be convinced the other is wrong about the effectiveness of the ACA and about its real costs, and it seems you also each believe different things about who benefits from it and who doesn't. I guess these are important technical facts to try to assess. And yet I get the feeling that each of you also believes differently about whether there should be a plan such as this, that happens to coincide with your assessment of its effectiveness. So here are my questions for each of you:

Greg: Even though you may believe that the government ought to be helping to organize national health care, if you learned for stone cold fact that the ACA was an economic bust and was less efficient than what came before it, would you then be in favor of repeal? There may be degrees to this, so maybe you could distinguish between it being more costly than expected but still affordable, versus a major boondoggle that screws people out of money for no reason.

Seriati: Although you may be in favor of the free market on principle, if you learned for stone cold fact that the ACA was a significant improvement over the system that existed prior to it, and that Americans on average have benefited from it more than just a little, would you change your position and accept it as a positive achievement from Obama's administration?

Seriati

  • Members
    • View Profile
Re: Obamacare Repeal and Replacement
« Reply #109 on: August 15, 2017, 11:59:28 AM »
Seriati: Although you may be in favor of the free market on principle, if you learned for stone cold fact that the ACA was a significant improvement over the system that existed prior to it, and that Americans on average have benefited from it more than just a little, would you change your position and accept it as a positive achievement from Obama's administration?

Don't mean to be difficult, but there's a lot of context that's missing in answering that question.

There's no way I'd view it as a positive achievement because of the damage it did to our freedom by incorporating the concept that the government can force us to buy a commercial product from a private actor into our Constitutional jurisprudence.  It's a big step down that path towards authoritarian government.  And its the kind of thing that 20 years from now the government will use to justify all kinds of abuses.

If you just mean whether I could get behind the ACA's medical results, some yes, some no. 

What kind of assumption would you make to determine that paying more out of pocket, having higher taxes and having a deductible that is unaffordable resulting in people not getting care and having less money is a better result for the poor who don't qualify for a subsidy?  I've already acknowledged that some people are better off with Obamacare, I just think that everyone else is worse and some people are very much worse off.

I'm not opposed to people choosing socialist medicine, I just think they should do so based on an understanding of what the trade offs actually are, and if they do so that we should jettison completely the "insurance company" model that the ACA propped up.

if you can refine how this comes about, I might be able to give you clearer answers.

Fenring

  • Members
    • View Profile
Re: Obamacare Repeal and Replacement
« Reply #110 on: August 15, 2017, 12:26:37 PM »
Seriati, I can't answer your questions in detail because it's clear to me you know more about this than I do anyhow.

Your first answer was a restatement of the fact that you don't agree with the spirit and method of its implementation, which I get. But let's put that aside for the moment and assert that maybe a good result can come from mangling the system as it is now. Maybe if socialized medicine is a good goal then the way to get there is by a messy, indecorous temporary patch that sort of combines the old system with potential to move to a new one. In fact, let's just assert that this was its stated goal, and for better or worse it wasn't possible to get to socialized medicine without this as an intermediary step. Let's give it maximum credit just as an hypothesis.

In terms of what details you would need to answer the question clearly, maybe you can provide those yourself? I know you think it's a bad plan economically and that individuals get screwed. But let's say you found out one day that your sources on that were all wrong or corrupt and that the real data was hidden from you until now. The REAL data says that overall people are benefiting from a lot and that at worst some people break even while others gain. You can fix the details any way you like to help with the premise. Basically, if it was working very well (even as a temporary measure) would you support it despite your moral objections to government intervention? Or at least, would you feel obliged to offer a concession in the form of "this isn't the type of system I would set up, but it's working as intended so congratulations to them for implementing their principles"? I'm trying to find out what portion of your dissatisfaction with it is with the principle of it, versus the implementation. I know it's both, but for a bystander like me sometimes it looks like the data barely even matters and that you and Greg would remain each on his side on principle regardless of how the facts came down.

Seriati

  • Members
    • View Profile
Re: Obamacare Repeal and Replacement
« Reply #111 on: August 15, 2017, 03:09:17 PM »
On the prior discussion re: insulin, attached is a great read from the Wall Street Journal (subscription).  https://www.wsj.com/articles/when-new-and-improved-fails-insulin-maker-stumbles-when-customers-balk-1502809045

It gets into a lot of detail on drug pricing that is normally opaque to us as consumers, using the specific example of the newest and best version of insulin, that health systems in Europe, and unusually America, are refusing to pay for because the older is effective enough.

Seriati

  • Members
    • View Profile
Re: Obamacare Repeal and Replacement
« Reply #112 on: August 15, 2017, 03:49:46 PM »
But let's put that aside for the moment and assert that maybe a good result can come from mangling the system as it is now.

A good result can come from mangling the system, this however is not it.  Let's say, to give you an analogy, there's a new entertainment product that has the unfortunate side effect of chopping off its users hand, and you're asking me to assume that people get more entertainment out of it than satisfaction they lose from losing their hand.  I don't understand how to respond to that.

If you want me to assume they keep their hand, then we're not talking about the ACA, and its not clear to me which provisions are supposed to stay in the analysis.

Do tax credits help the poor?  Well duh.

Does free healthcare help those who can't afford it?  Well duh.

Could we have helped those in need without breaking the Healthcare system?  Way easier than what we did.

Are the "non-controversial" things really non-controversial?  Letting 26 years stay on parents' insurance is almost universally loved and non-controversial, right?  Isn't Obamacare premised on forcing the young and healthy to overpay to fund care for the elderly and the sick?  Doesn't this provision directly undermine that?  Isn't this actually abusively regressive as it gives more to the haves (kids whose parents have healthcare) than the have nots (kids whose parents do not)?

Obama never paid for it.  Should I assume that we're talking about paying for it?  What are we trading out?  Cutting other services?  Taxing more?

Quote
Maybe if socialized medicine is a good goal then the way to get there is by a messy, indecorous temporary patch that sort of combines the old system with potential to move to a new one. In fact, let's just assert that this was its stated goal, and for better or worse it wasn't possible to get to socialized medicine without this as an intermediary step. Let's give it maximum credit just as an hypothesis.

The only reason I can see to do it in that manner is to deceive the voters.  Putting in place a deliberately harmful policy to force them to change to a policy you really want is just abusive and mean.  If it's an intermediary step, then state the final step and the timeline in the law, then ask what's the purpose in the intermediate step?

Quote
In terms of what details you would need to answer the question clearly, maybe you can provide those yourself? I know you think it's a bad plan economically and that individuals get screwed. But let's say you found out one day that your sources on that were all wrong or corrupt and that the real data was hidden from you until now.

The math doesn't work.  It's not "sources" that are wrong.  Health insurance has always been a controlled risk.  Like the lottery it can't pay out for all the users, and many people get far less back than they put in specifically to gain certainty.  By definition the majority are "losers" on the actual benefits received.

Where does it go from there?   How do you make them all winners?  Most advocates seem to believe people can get more out than they put in on average.  Show me any math that makes that work.

Quote
The REAL data says that overall people are benefiting from a lot and that at worst some people break even while others gain.

We could do it the way Congress does, and try to pretend this is true on a relative basis.  I just don't see any mechanism to get you there.  How do you make up for the monetary bleed of the lower middle class?  These are the consumers to whom every dollar matters the most. 

We don't have costs slowing, we had the illusion of costs slowing.  Ask yourself why rates would go up by 20% or more if the government stops with the subsidy payments.  It's cause the true cost is hidden from the consumers.

Quote
You can fix the details any way you like to help with the premise. Basically, if it was working very well (even as a temporary measure) would you support it despite your moral objections to government intervention?

We could have gotten there if the exchanges had been set up but the mandates on plans hadn't been included.  They had to have the mandates to achieve their political non-healthcare related goals, but they are the biggest drag preventing an exchange from working.  Flat out the system would work if they'd made the exchange requirement about access to clear information about the plans, but allowed people to choose plans that excluded coverage they neither wanted or needed.

As it is, it's like asking how forcing people to only buy 13 channel basic cable could be the best result for the people generally.

Quote
Or at least, would you feel obliged to offer a concession in the form of "this isn't the type of system I would set up, but it's working as intended so congratulations to them for implementing their principles"? I'm trying to find out what portion of your dissatisfaction with it is with the principle of it, versus the implementation.

I don't know what they intended.  If you believe Gruber it's working as intended, but the election did not (Hillary was supposed to be in power), so the thing is a disaster that would have gifted Dems the moral backing to force a bigger change.

If on the other you take what they claimed as what they intended, it's not doing that at all.

The implementation also violated my hard limit on politicians that they should have to bear the negative consequences of their plans and not be allowed to pass them on to their sucessors.  Obama delayed multiple negatives around election calendars and delayed the burden of paying for it to the next President.

Quote
I know it's both, but for a bystander like me sometimes it looks like the data barely even matters and that you and Greg would remain each on his side on principle regardless of how the facts came down.

Well, I think you need to focus on the goals and what are the irreducible problems.  One of my goals is to treat people like adults and generally let them allocate their own resources as they best determine.  That means allowing self insurance, and catastrophic coverage plans.  Any nanny state solution is suspect to me.  Not sure how that shows up in "data" but it sure shows up when you talk to people.

That said, I don't object in principal to full on socialized care, so long as people understand and accept what that means.  Flat out say you accept rationing, that you accept waiting lists and that you may not receive life saving treatment that is available because your local board deems the money better spent on treatments that save more people.  If you can accept lesser care for all, that's the trade off you're being asked to make.  Lying about it ticks me off.  Put it in hard numbers.  Are you willing to accept 60% care level for universal coverage?  Are you willing to double your taxes to get to 80%?  Triple (and add an AMT for all income levels) to get to 90%?  Are you willing to accept that a bureaucratic board makes a better decision about your care than your doctor or yourself?   Some believe that that can all be justified to get to universal care, lets have the debate.

And what about corruption?  People are completely distraught that the rich can buy better care, when history shows that this always brings the cost of care down and makes it more affordable.  But they seem to forget that when the state controls the healthcare there will still be people who get better care, it'll just be based on politics, or do you really think a Senator's wife will die on a waiting list?  Our historical examples of this never lead to broader access to care.

Greg Davidson

  • Members
    • View Profile
Re: Obamacare Repeal and Replacement
« Reply #113 on: August 16, 2017, 12:23:18 AM »
Quote
Greg: Even though you may believe that the government ought to be helping to organize national health care, if you learned for stone cold fact that the ACA was an economic bust and was less efficient than what came before it, would you then be in favor of repeal? There may be degrees to this, so maybe you could distinguish between it being more costly than expected but still affordable, versus a major boondoggle that screws people out of money for no reason.

If it cost more and had worse medical outcomes, than I am against it.  It the ACA brings about better medical outcomes for higher cost, then it's a question of bang for the buck. It appears as if we are actually close to the third option - that it both provides better medical outcomes and that the cost growth trend in net healthcare expenditures in the US has declined since the passage of the ACA.

Your question is specifically about efficiency - if we got fewer lives saved per dollar than the prior status quo, then that would be a strong reason to move away from the ACA and try to focus the efficiencies of the prior system on providing better healthcare outcomes.


yossarian22c

  • Members
    • View Profile
Re: Obamacare Repeal and Replacement
« Reply #114 on: August 18, 2017, 09:20:31 PM »
Quote
Greg: Even though you may believe that the government ought to be helping to organize national health care, if you learned for stone cold fact that the ACA was an economic bust and was less efficient than what came before it, would you then be in favor of repeal? There may be degrees to this, so maybe you could distinguish between it being more costly than expected but still affordable, versus a major boondoggle that screws people out of money for no reason.

If it cost more and had worse medical outcomes, than I am against it.  It the ACA brings about better medical outcomes for higher cost, then it's a question of bang for the buck. It appears as if we are actually close to the third option - that it both provides better medical outcomes and that the cost growth trend in net healthcare expenditures in the US has declined since the passage of the ACA.

I'm for the ACA over a repel but I will quibble over one point. The ACA has bent the cost curve down per capita (of people receiving care) while increasing the overall spending, because millions of more people are receiving care.  So it really does fall into the debating efficiency of dollars spent. In that case the ACA has been marginally successful in improving efficiency and modestly successful in expanding coverage. I hope the senate is actually interested in passing bills to continue improving the efficiency and expanding the coverage and drop the cut taxes for the wealthy while gutting medical care for the poor plans they started with.

Seriati

  • Members
    • View Profile
Re: Obamacare Repeal and Replacement
« Reply #115 on: August 21, 2017, 08:33:36 AM »
I'm for the ACA over a repel but I will quibble over one point. The ACA has bent the cost curve down per capita (of people receiving care) while increasing the overall spending, because millions of more people are receiving care.

I'd like to quibble on your quibble.  The per capita hasn't gone down at all, nor, even assuming the ACA stays in place is it going to go down, or even particularly slow.  All Obama did was slow economic growth and the health care expenditures slowed at the same time.

http://www.pbs.org/newshour/rundown/new-peak-us-health-care-spending-10345-per-person/

Just one easy to find source.

slipstick

  • Members
    • View Profile
Re: Obamacare Repeal and Replacement
« Reply #116 on: August 21, 2017, 09:47:29 AM »
"That said, I don't object in principal to full on socialized care, so long as people understand and accept what that means.  Flat out say you accept rationing, that you accept waiting lists and that you may not receive life saving treatment that is available because your local board deems the money better spent on treatments that save more people."

It is good to know that Seriati does not object in "principal" - so called as the word is principle, to mean a tenet or belief, and not a tenant who is someone occupying rental property - as that is what all Americans will probably get. At least Republican leaders called on members of Congress to sacrifice part of their summer vacations to work on repealing or replacing Obamacare, and could not do it. So the issue is dead for now, basically because millions of Americans like Obamacare at least enough to retaliate against members of Congress who take it away from them.

As for telling the truth about outcomes, politicians have never done so. If Jefferson had proclaimed the new Union would mean a civil war ending slavery in less than a century, the Constitution world never have been ratified. If Woodrow Wilson had promised to get America into World War I, he might have lost to even the divided Republicans. If Roosevelt had admitted he would do everything he could to get the US into WWII, he might not have won a third term in office. The first rule of politics is to get elected, and almost all else is secondary.

Seriati

  • Members
    • View Profile
Re: Obamacare Repeal and Replacement
« Reply #117 on: August 22, 2017, 02:53:24 PM »
So I was reading an article in the NY Times defending the CBO and it's important non-partisan role, when it cited that the CBO was going to save us from unrealistic 3% projections and insert 1.9% growth into evaluations of Trump legislation (keep in mind it used higher estimates for Obama's economy), when I thought I'd take a look back at how the CBO did on Obamacare.

If you do it yourself, one of the first things you'll find (factcheckers and others) touting is how the CBO was more right than everyone else about predicting the uninsured rate.  What they studiously avoid telling you is how terribly wrong they were about why we got to the rate, the costs of Obamacare and the impact of how they were wrong.

This was interesting to me, because they also make mistakes, and completely unrealistic assumptions when they evaluated the Republican replacement proposals, and surprise surprise the errors are all still in the same direction (they favored Obamacare and they disfavor its replacements).

Here's a Forbe's write up on the CBO vs. Obamacare.  I particularly love how the predictions overtime are grossly different than each other (and worse than predicted) and still grossly off from reality.

https://www.forbes.com/sites/theapothecary/2017/01/02/learning-from-cbos-history-of-incorrect-obamacare-projections/#1a439e3746a7

And here's the similar analysis for one of those failed Republican plans that the CBO tried to claim would kick 22 million off their insurance.

https://www.forbes.com/sites/theapothecary/2017/03/14/believe-it-or-not-cbos-score-of-house-gop-obamacare-replacement-is-better-than-expected/#216e39c05951

I can not see any rational basis for their assumption that the exchanges are going to double in enrollment in the near future for example, other than to inflate the number who "lose" insurance.

TheDrake

  • Members
    • View Profile
Re: Obamacare Repeal and Replacement
« Reply #118 on: August 23, 2017, 09:37:01 AM »
CBO didn't give higher estimates for Obama than 3% for most years. They did terribly with the recession, just like most financial analysis. Following that, they predicted 1.8, 2.5, 2.1 for 2010-2012.

As far as non-growth calculations, I have no opinion.

TheDrake

  • Members
    • View Profile
Re: Obamacare Repeal and Replacement
« Reply #119 on: August 23, 2017, 09:46:10 AM »
These estimates have significant error built in to them, especially since they project out five or more years. The "pick a number" style modelling is wholly inadequate. There should be a risk analysis that assigns percentages to different outcomes, at a minimum. Then worst-case scenarios and best case.

Seriati

  • Members
    • View Profile
Re: Obamacare Repeal and Replacement
« Reply #120 on: August 23, 2017, 10:52:47 AM »
CBO didn't give higher estimates for Obama than 3% for most years. They did terribly with the recession, just like most financial analysis. Following that, they predicted 1.8, 2.5, 2.1 for 2010-2012.

Did it read like I meant higher than 3%?  I meant higher than 1.9%.  Which given that Obama was widely seen as anti-business among the business community, with his emphasis on expensive regulation, and Trump is widely seen as exactly the opposite, seems odd.  In fact most measures of business spending and activity are widely up since the transition, which makes the 1.9 versus Obama's estimates stand out even more starkly.

When you consider that the rate decision virtually locks in whether you need 51 or 61 votes in the Senate, and the direction of error is always pro-Democrat, it leads to a very reasonable question about the agency.

Crunch

  • Members
    • View Profile
Re: Obamacare Repeal and Replacement
« Reply #121 on: August 23, 2017, 11:14:01 AM »
Iowa is filing for a waiver.
Quote
Under Obamacare, people making more than $48,240 for an individual and $98,400 for a family of four do not qualify for subsidies, so they feel the brunt of premium increases and sometimes forego coverage as a result. For instance, under current subsidy provisions a 55-year-old making $65,000 a year could pay as much as $33,000 for coverage, [Iowa Insurance Commissioner Doug Ommen] Ommen said.
50% of your income for insurance premiums. What a disaster.

D.W.

  • Members
    • View Profile
Re: Obamacare Repeal and Replacement
« Reply #122 on: August 23, 2017, 12:23:10 PM »
Iowa is filing for a waiver.
Quote
Under Obamacare, people making more than $48,240 for an individual and $98,400 for a family of four do not qualify for subsidies, so they feel the brunt of premium increases and sometimes forego coverage as a result. For instance, under current subsidy provisions a 55-year-old making $65,000 a year could pay as much as $33,000 for coverage, [Iowa Insurance Commissioner Doug Ommen] Ommen said.
50% of your income for insurance premiums. What a disaster.
That IS a disaster.  But it doesn't say, in premiums , it says "for coverage".  While it implies the same thing, are you sure that is accurate?  Is this a worst case out of pocket of A plan they could find?  A true "worst case hypothetical"?  Or is this a legitimate (though pathetic) plan on the market assuming someone selected it and was self employed, meaning they bear the full cost themselves?

Wayward Son

  • Members
    • View Profile
Re: Obamacare Repeal and Replacement
« Reply #123 on: August 23, 2017, 04:53:57 PM »
Crunch's quote comes from this article.

Of course, this this other article talks about the stabilization plan, too, with this interesting quote:

Quote
Minnesota-based Medica, the last carrier to offer statewide plans in Iowa's individual market, announced this month that increases to premium rates could be up to 56.7 percent.  The company said uncertainty from federal government led to the additional premium hikes.[/url](Emphasis mine.)

So the exorbitant hikes seem to be at least partially because the Trump Administration is being coy about what they will or will not pay to the system next year.

Seriati

  • Members
    • View Profile
Re: Obamacare Repeal and Replacement
« Reply #124 on: August 23, 2017, 05:03:07 PM »
Wayward, again this is because the ACA deliberately confuses people about the difference between costs and prices.  Costs are not changing. 

Labeling this as government uncertainty increasing the costs is a lie.  All that's changing is the price, because they government may no longer pay some of it for you (I note by the way, that those payments have never been authorized by or appropriated by Congress, which may rationally lead one to ask how they are currently being made?  Or if that doesn't bother you, why the Trump admin couldn't simply pay for his wall using the same work-around).

Wayward Son

  • Members
    • View Profile
Re: Obamacare Repeal and Replacement
« Reply #125 on: August 24, 2017, 10:54:05 AM »
Quote
Labeling this as government uncertainty increasing the costs is a lie.

And if anyone had said that government uncertainty increased the costs, you'd be right.

But I don't see anyone saying that.  Everyone is talking about premiums, aka the "price."

Quote
(I note by the way, that those payments have never been authorized by or appropriated by Congress, which may rationally lead one to ask how they are currently being made?  Or if that doesn't bother you, why the Trump admin couldn't simply pay for his wall using the same work-around).

Is there legislation that was passed by Congress that promised to pay for the wall?  How about the payments for the ACA?

If Congress passes a law that obliges them to pay for something, and then refuses to honor their own law, that's Congress' problem, don't you think? ;)

(And, BTW, what the heck is with Trump, threatening to shut the government down if Congress doesn't allocate funds to build The Wall that Mexico was going to pay for??  Let him get the money from Mexico first if he wants that Wall so much.  :P )

Seriati

  • Members
    • View Profile
Re: Obamacare Repeal and Replacement
« Reply #126 on: October 17, 2017, 12:45:48 PM »
I thought this was an interesting take on the oft discussed issue of American medical technology, though it's used as an example in the broader discussion of American IP.

https://www.creators.com/read/stephen-moore/10/17/nafta-20-must-strengthen-intellectual-property-rights

With those kinds of imbalances its easy to see why socialized is "working" in other places, how the US is subsidizing it on a global scale, and by reading between the lines realizing what would happen to the development of medicine if we go socialized too.

Wayward Son

  • Members
    • View Profile
Re: Obamacare Repeal and Replacement
« Reply #127 on: October 19, 2017, 04:03:43 PM »
Now that Trump has decided to undermine the ACA, rather than wait for Repeal and Replace, by ending cost-sharing subsidies, premiums are going to go up across the board.

Or only for certain plans.

Except where they won't. :)

FiveThirtyEight as a nice chart which shows cutting the subsidies will be handled by the different states.

So whenever someone tells how it will affect the market, remember to check to chart to see which market he is referring to. :D