The Unaffordable Care Act

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Originally posted by: hoops2
Unless you count personal greed it doesn't explain why the people who wrote the law and supported the law want out.
This is so.

Although incorrect on some details Chilccot and pjstroh come close to describing Congress's reluctance to embrace Obamacare.

Under the Federal Health Benefits Plan Congressfolks got to choose one of several group health policies at one of several levels of coverage. DonDiego supposes Congressfolks chose very good coverage.
And just as unions or private/corporate employers "subsidize" health care plans, the Government covered pr'bly about two-thirds or so of the actual cost of the FHBP coverage, . . . just as the Government covers about two-thirds for every FEHB plan for everyone from the lowest level government employee to the highest,

Under Obamacare as legislated Congressfolks are required to obtain health care insurance through the Obamacare exchanges. And they are to be reimbursed exactly as all other Obamacare participants; and because of their salaries they do not qualify for a subsidy. The Law provides no means by which to provide any reimbursement to Congressfolks who purchase an Obamacare policy. This has been the understanding when the Bill was authored; this has been the understanding since the Bill was passed. This provision was placed into the Law by Republicans because they wanted to dissuade Congressfolks from voting for the Bill.

Democrats in Congress passed the Bill anyway. Now they are upset. Or more accurately they were upset for a brief interval.

To silence the whining from Congressfolks and in spite of the clear legal meaning of the provision to force Congressfolks to purchase an Obamacare policy without reimbursement, . . . President Obama ordered the Office of Personnel Management to rule that Congressfolks are entitled to a subsidy, . . . just like the reimbursement they had been receiving under the FEHB plans.

No one else in the Country is getting similar special treatment. Congressfolks are better than hoops2 and even DonDiego. Isn't that precious?

It is great to be the King.
No it isn't and here is why. Let's use your example of getting hit by a Drunk Driver and incurring 100k in medical bills. First off an injury of that magnitude is likely to stretch over more than one calendar year when you account for the rehabilitation period so let's say two years, but it could very well be much longer for that type of injury. So that would be $12,500 out of pocket they were looking at. However if the accident occurred in 2014 there out of pocket could be literally unlimited. They could get hit with 30k in co pays in that first year and it would be perfectly legal. The Obama care turns out to be a great deal for the Hospital in this example, but a poor one for the patient.

The bottom line is a younger person (statistically with a lower income) that gets hit with an injury or illness of that magnitude is not going to be able to come up with $12,500+ in co pays especially considering the work time they miss. It will be a bankrupting event for them. So they would have been money ahead if they had simply pocketed the $150 a month in extra income to begin with.


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Originally posted by: Chilcoot
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Originally posted by: malibber2
The problem for young folks is that the benefits are so poor with Obama care. Most young folks that need insurance need it because something sudden and usually unexpected has happened such as an accident, appendicitis, pregnancy and so on. To hit these young folks with a massive co-pay after paying for insurance for a sudden one time medical event isn't a good deal, and some would call it downright immoral.
You're not making any sense at all.

Insurance is to protect against the financial impact of the unknowable. It's easy to rack up $100,000 in medical bills after getting hit by a drunk driver, something no one can predict. You're telling me it's not a good deal for a young person to pay a $150 monthly premium to be prepared for that situation? And that a potential $6250 out-of-pocket for that person is immoral?

How is that not way better than having no insurance at all? Your argument is against the very notion of health insurance, not with the changes taking effect with the new law. Do you realize that?

If you're able to learn anything from the good information we've sent your way in this thread on how the new health law will help you and your family, you sure are good at concealing it.


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Originally posted by: malibber2
No it isn't an here is why. Let's use your example of getting hit by a Drunk Driver and incurring 100k in medical bills. First off an injury of that magnitude is likely to stretch over more than one calendar year when you account for the rehabilitation period so let's say two years, but it could very well be much longer for that type of injury. So that would be $12,500 out of pocket they were looking at. However if the accident occurred in 2014 there out of pocket could be literally unlimited. They could get hit with 30k in co pays in that first year and it would be perfectly legal. The Obama care turns out to be a great deal for the Hospital in this example, but a poor one for the patient.

The bottom line is a younger person (statistically with a lower income) that gets hit with an injury or illness of that magnitude is not going to be able to come up with $12,500+ in co pays especially considering the work time they miss. It will be a bankrupting event for them. So they would have been money ahead if they had simply pocketed the $150 a month in extra income to begin with.
But every word of that is equally true before Obamacare drops.

You're against health insurance, at least as its existed in the US for decades, with its premiums, copays, and deductibles, WHICH HAVE ALWAYS BEEN ANNUAL AND HAVE ALWAYS RESET EVERY TWELVE MONTHS.

Do you realize that?

Moreover, as we discussed earlier, starting in 2015 the $6,250 out-of-pocket cap only applies to those making 400% of the poverty line, making it less likely that there'll be a poor young person who has that cap and will be subject to bankruptcy. Another advancement for Obamacare. A young poor person will have a far smaller out-of-pocket cap.
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Originally posted by: Chilcoot

But under the exchanges, premiums can vary, based on a person’s age, tobacco use and place of residence. A person like Mr. Boehner, who turns 64 in November, might be charged three times as much as a 23-year-old. And as a smoker, he could be charged up to 50 percent more than a nonsmoker of the same age. None of that's true under his existing plan, which is one size and one price fits all.

So, f'rinstance, . . . would this mean that Speaker Boehner could be charged up to 4½ times the premium of a 23-year-old non-smoker?

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Originally posted by: DonDiego
So, f'rinstance, . . . would this mean that Speaker Boehner could be charged up to 4½ times the premium of a 23-year-old non-smoker?
Yes.
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Originally posted by: Chilcoot
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Originally posted by: DonDiego
So, f'rinstance, . . . would this mean that Speaker Boehner could be charged up to 4½ times the premium of a 23-year-old non-smoker?
Yes.

Umm, . . . well, . . . NO !

" . . . for unknown reasons, the Department of Health and Human Services (HHS) couldn’t figure out how to include both of these provisions into its computer system. For example, if you’re a 64-year-old who has smoked a pack a day for his entire life, in theory, the insurer is allowed to charge you 4.5 times what he charges a 19-year-old non-smoker (3 times 1.5). But the HHS computer rejects any insurance submissions in which anyone is charged more than 3x what the cheapest insured beneficiary pays.

'Because of a system limitation . . . the system currently cannot process a premium for a 65-year-old smoker that is…more than three times the premium of a 21-year-old smoker,' HHS reported on June 28 [2013] in a guidance document for insurers. Carriers who try to charge more than 3x to smokers 'will be rejected by the system.'

. . . it begs the question: if HHS can’t get the simplest things right, what else could go wrong?"

Ref: Forbes

Just to clarify the HHS computers cannot accept a submission which charges more than 3-times the cheapest cost. HHS says it will need a year to fix this glitch. A YEAR !

If they're still using FORTRAN, poor old DonDiego could pr'bly fix it in two weeks, . . . tops ! But this is the Government.

Good catch, that is nuts.
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Originally posted by: jatki99
Of course the whole thing won't fly w/o getting the young folks to fall ,er ,sign up for it. And of course the right is going to be fighting them every step of the way. I have to say they couldn't have come up with a creepier looking guy than this uncle sam.




Right wingers just can't stay away from those rapey references, can they? Not that I'm complaining. If the GOP did well with the woman vote, they would have beaten Obama - twice.
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Originally posted by: snidely333
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Originally posted by: esteskefauver
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Originally posted by: jatki99
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Originally posted by: esteskefauver
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Originally posted by: Moosehaven
Actual facts about American healthcare.


Anyone that believes the crap that guys selling is a complete moron. Heart disease and cancer are the #1 and #2 causes of death and the leading cause of both those diseases is obesity. Obesity is also a major factor in other diseases and health problems like diabetes, back pain, and high blood pressure.


Not entirely, it is true that americans are way way overcharged for hospital care. I remember when I left the hospital, an aide was loading me up with "goodie bag" and I remebr hercommenting on a pack of wet wipes that they charge $35 bucks for. I guess that after the millions already spent on me,my goodie bag was gratis (correct?). So there is no misconception about the ridiculous costs of simple items. BUT, the nurse need to be paid, and paid well, they do the bulk of the work. I know a few of them saved my life on more than one occasion a coupla nights. I digress(ed) sorry.I wasnt charged for the $35wipes.
J


No doubt Americans are charged much more than what the care should cost in an efficient market. It's almost criminal what hospitals charge some patients. It's my understanding that they will charge more if you have insurance because the insurance company won't contest while an uninsured will certainly contest any exorbitant charges.

Getting back to our poor eating habits. I have 3 friends(all under 50) diagnosed with cancer in the past year or so. One has died and the outlook is not great for the other two. Two of them are obese and one is morbidly obese. All three are on the potato chips/ice cream/hamburger diet and probably couldn't remember the last time they ate a vegetable that wasn't microwaved. In short, it's not just that we are gorging ourselves as a nation, it's also that we are eating crappy food even when we are not obese.


Insurance companies negotiate prices with hospitals. Charges are more if you don't have insurance. My health insurance pays very little of the total bill. For example, I had a visit to the ER. Hospital billed $9242. Insurance paid them $1154 and I paid $100.

It's immoral and should be illegal for the non-insured to be billed more than the insured.


I guess I'm wrong then. I'm basing it on what a friend told me about a recent dental visit to get 2 crowns. The dentist quoted him 40% less for no insurance. Medical care can be a lot more than dental care though. I could see where the hospital would want to inflate the charges for the uninsured since they know they are unlikely to collect for major procedures. Then they can charge off more at tax time. I did have a conversation one time with a man who had recently had major heart surgery at a cost of several hundred thousand. He told me he looked at the bill and called his insurance company to tell them about outrageous charges for bedpans and such. The insurance company told him the charges were no big deal.

I haven't been to the doctor since 1985 so forgive my medical insurance ignorance. Who picks up the remaining portion of the $9242 bill?
Vanderbilt Medical Center laying off 1,000. The Cleveland Clinic is slashing $330 million from their budget and laying off thousands.

https://www.wsmv.com/story/23456083/vanderbilt-medical-center-to-make-more-job-cuts

https://www.wkyc.com/news/article/314788/33/Cleveland-Clinic-layoffs-coming-as-part-of-cost-reductions

The nice folks at Investor's Business Daily have provided a list of Obamacare's job impact.

https://news.investors.com/politics-obamacare/091813-669013-obamacare-employer-mandate-a-list-of-cuts-to-work-hours-jobs.htm



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