Insurers Warn Losses From ObamaCare Are Unsustainable

[countryboy]

Honestly, they probably wouldn't even administer the insurance.

What do you mean?

 

[Greenbeard]

What do you mean?

The world tends to build on what already exists. Changes, even big policy changes, are limited by path dependence--where you go next is always constrained by where you are and where you've been.

If the U.S. moved toward "single-payer" I imagine we'd build on some version of the existing government insurance programs: Medicare and Medicaid. But the trend in those programs over the past several decades has been toward greater privatization and the evolution into a multi-payer landscape. The majority of Medicaid beneficiaries nationwide are enrolled in an insurance plan offered by a private insurer; in Medicare nearly a third of beneficiaries are enrolled in private plans and that number has been climbing steadily. The government largely doesn't even administer the insurance in the existing "single-payer" programs.

In other words, "government insurance" is big business for private insurers these days.

We could move toward a model in which everyone is in a system like Medicaid or Medicare, but the distinction between public and private insurance is already a lot murkier than most folks let on in these discussions.

 

[RetiredUSN]

The system didn't work before ObamaCare.

It doesn't work well under ObamaCare.

When are we going to realize we need to skip the profiteering insurance companies, and go for single-payer/private provider?

It sucks under Obama Care, and will suck worse under single payer when doctors start looking for new professions because they don't want to deal with government baby sitting and interference.

 

[countryboy]

The world tends to build on what already exists. Changes, even big policy changes, are limited by path dependence--where you go next is always constrained by where you are and where you've been.

If the U.S. moved toward "single-payer" I imagine we'd build on some version of the existing government insurance programs: Medicare and Medicaid. But the trend in those programs over the past several decades has been toward greater privatization and the evolution into a multi-payer landscape. The majority of Medicaid beneficiaries nationwide are enrolled in an insurance plan offered by a private insurer; in Medicare nearly a third of beneficiaries are enrolled in private plans and that number has been climbing steadily. The government largely doesn't even administer the insurance in the existing "single-payer" programs.

In other words, "government insurance" is big business for private insurers these days.

We could move toward a model in which everyone is in a system like Medicaid or Medicare, but the distinction between public and private insurance is already a lot murkier than most folks let on in these discussions.

Which doesn't mean the government plays no role in the direction or administration of such plans. If you want to play semantics to try and obfuscate the true nature of these things, go right ahead. It may fool the drones, but thinking people see through the ruse.

 

[Chomsky]

It sucks under Obama Care, and will suck worse under single payer when doctors start looking for new professions because they don't want to deal with government baby sitting and interference.

I don't see the healthcare providers giving-up shop; 40% are already single-payer.

 

[joG]

Insurers warn losses from ObamaCare are unsustainable.



Some companies have made good on their threats to leave markets already. United Healthcare, for example, left some states. Obama care supporters poo poo this, saying that it won't have a significant effect on the availability of health care, but United Healthcare is may only be the beginning. As other insurance companies fall there surely will be a crisis of availability.

The question will be what to do about that. The correct thing would be to remove government controls and let the market sort it out. No doubt, though, they will want to increase government control, and that will just mean more misery, more shortages, less availability. Liberals never give up on a bad idea.

Some have said that if you want to see what US government single payer health care is like then look at the VA. But this is wrong because the VA is not a single payer system. It bills Medicare and insurance, for example, and it relies heavily on physicians in training to keep costs down. This is fine, but there aren't enough physicians or nurses in training to run a full US single payer health care system. If the VA were really single payer it would cost a lot more, but you'd still have the disadvantages of the famously long wait lists, which has been ameliorated by sending vets out to private doctors. I'm not sure that option would still exist if we went to single payer.

Take an example. The share of health care costs in GDP in Germany are about 11.3 percent. An average German pays a little over 18 percent of his wages for coverage.
In the USA health care takes up 17 percent of GDP. What does that tell you?

 

[joG]

The system didn't work before ObamaCare.

It doesn't work well under ObamaCare.

When are we going to realize we need to skip the profiteering insurance companies, and go for single-payer/private provider?

It always depends on what one means, when one says "work".

 

[Vern]

I learned long ago that organizations who compile this "data", such as the WHO, are less than honest. And their rankings are based largely on intention, rather than actual results.

MAGIC PRESTO the facts disappear. Its so easy to be a conservative. mmmm, lets try this:CB, how did you learn their results are based on intention rather than actual results.

 

[eohrnberger]

cool. go out of business, and we'll expand medicare to cover everyone as we should have done in the first place.

Cool. And you too can enjoy VA quality level of care.

Thanks but no thanks, but I'll pass on that.

No, you say? Is this not the established track record for a US government run healthcare system?
You actually trust the government to do this? Look what's they've been able to achieve, and what their track record doing so is.
Why wouldn't a government run single payer system for civilians be any different?

 

[Chomsky]

It always depends on what one means, when one says "work".

I would state nearly 15% of Americans not having insurance, thereby limiting their access to healthcare, as a non-working system.

Or perhaps at the least, not working well.

 

[LowDown]

Take an example. The share of health care costs in GDP in Germany are about 11.3 percent. An average German pays a little over 18 percent of his wages for coverage.
In the USA health care takes up 17 percent of GDP. What does that tell you?

We are spending too much on health care in the USA. The question is how to get the cost down. What do you suggest? Rationing? Cost controls for pharm products? Limiting access to specialty care? No potential solutions I know of have any support. And forget about cutting waste and fraud; that's a chimera.

People in the UK are content to get by with less medical care, that is to say, with care that results in significantly shorter survival for cancer, for example, because everyone else there is in the same boat. But in the US if it's my rear that's on the line I want the absolute best care and I don't give a crap about cost if someone else is paying for it. That's pretty much everyone's attitude. It's difficult to overcome that except perhaps by leaving the burden of cost cuts on the shoulders of some "other" group, i.e., underprivileged minorities. Which is, in fact, the traditional American approach.

 

[eohrnberger]

I would state nearly 15% of Americans not having insurance, thereby limiting their access to healthcare, as a non-working system.

Or perhaps at the least, not working well.

Is there an issue with trying to address this aspect and only this aspect and leave the rest of the employer provided healthcare alone?

We have Obamacare, so apparently there is an issue with this approach, which makes me suspect that ObamaCare is driven more so by ideology rather than by logic.

I read someplace that if the US had just added those without healthcare insurance to Medicare, it would have been far less expensive to implement and run than what ObamaCare is turning out to be. Hmm. This only reinforces my suspicion.

 

[Vern]

It sucks under Obama Care, and will suck worse under single payer when doctors start looking for new professions because they don't want to deal with government baby sitting and interference.

are there any doctors left? I thought they all retired already because of Obamacare. it was one of the many lying conservative narratives about Obamacare that conservatives obediently believed.

In a survey by a top research firm, six in 10 physicians said it is likely many doctors will retire earlier than planned in the next one to three years. The same percentage say the practice of medicine is in jeopardy as medical experts lose control of their clinics and compensation with the implementation of the Affordable Health Care for America Act, or Obamacare.

Obamacare has doctors planning exit

Eighty-three percent of American physicians have considered leaving their practices over President Barack Obama’s health care reform law, according to a survey released by the Doctor Patient Medical Association.
83% of doctors have considered quitting over Obamacare | Restoring Liberty

As the concept of debate befuddles you, let me explain what I did. I pointed out that your completely unsubstantiated narrative "doctors will quit" is just a reformulation of a previous lying conservative narrative. So unless you have some knowledge that you haven't shared, I have to assume you're just posting your vague and hazy recollection of that narrative. In case you're still confused, please back up your claim.

 

[Greenbeard]

Which doesn't mean the government plays no role in the direction or administration of such plans.

If by "direction" you mean laws, of course those plans are subject to laws. But the government doesn't administer them. As I said, Medicaid and Medicare have been substantially privatized at this point.

I read someplace that if the US had just added those without healthcare insurance to Medicare, it would have been far less expensive to implement and run than what ObamaCare is turning out to be. Hmm. This only reinforces my suspicion.

An expansion of Medicare (via an optional buy-in) was put on the table in 2009. It was threatened with filibuster, didn't have 60 votes for cloture, and thus never happened.

 

[eohrnberger]

If by "direction" you mean laws, of course those plans are subject to laws. But the government doesn't administer them. As I said, Medicaid and Medicare have been substantially privatized at this point.



An expansion of Medicare (via an optional buy-in) was put on the table in 2009. It was threatened with filibuster, didn't have 60 votes for cloture, and thus never happened.

OK. That's how that legislative idea died. I was thinking of the over all expenses related to bringing healthcare options to those that don't have any insurance coverage. From my understanding, had all those without insurance been added to medicare, it would have present less cost to the US taxpayer than the fiasco we now have, so once again, stupid political elite.

 

[countryboy]

If by "direction" you mean laws, of course those plans are subject to laws. But the government doesn't administer them. As I said, Medicaid and Medicare have been substantially privatized at this point.



An expansion of Medicare (via an optional buy-in) was put on the table in 2009. It was threatened with filibuster, didn't have 60 votes for cloture, and thus never happened.

Like I said, semantics. Government control, is government control.

 

[Helix]

Cool. And you too can enjoy VA quality level of care.

Thanks but no thanks, but I'll pass on that.

No, you say? Is this not the established track record for a US government run healthcare system?
You actually trust the government to do this? Look what's they've been able to achieve, and what their track record doing so is.
Why wouldn't a government run single payer system for civilians be any different?

i'd prefer medicare over losing my insurance every time i change jobs. more accurately, i would absolutely swap health care coverage with Canada, though i've seen no evidence that Canadians would make a similar trade.

 

[eohrnberger]

i'd prefer medicare over losing my insurance every time i change jobs. more accurately, i would absolutely swap health care coverage with Canada, though i've seen no evidence that Canadians would make a similar trade.

While a good answer, it wasn't the question that I was asking.

Given the track record of a US government run healthcare, so that'd be the VA, and it's performance as an indicator of what a US government run single payer system would be like and perform like.

I am unwilling to accept that poor level of performance in the US healthcare system, and therefore am unwilling to accept a US government run single payer system.

You can imagine that you'd get Canada, but it's more realistic that you'd get the VA.

 

[Helix]

While a good answer, it wasn't the question that I was asking.

Given the track record of a US government run healthcare, so that'd be the VA, and it's performance as an indicator of what a US government run single payer system would be like and perform like.

I am unwilling to accept that poor level of performance in the US healthcare system, and therefore am unwilling to accept a US government run single payer system.

You can imagine that you'd get Canada, but it's more realistic that you'd get the VA.

so the US is incapable of delivering a Canadian level of coverage to its citizens, in your opinion? that's odd. i thought that we were the world's premier superpower.

if so, i would have to say that i disagree with your opinion. the main thing keeping us from doing that is a bunch of naysayers who threaten revolution every time we do anything to fix our ****ed up health care system. my opinion is that we should flat out ignore their protests and drag them kicking and screaming into first world health care. they aren't actually going to secede, and to their kids, single payer will be the status quo just like medicare is now for the elderly. also,

 

[joG]

I would state nearly 15% of Americans not having insurance, thereby limiting their access to healthcare, as a non-working system.

Or perhaps at the least, not working well.

I am not really so sure of that. The poor could get treatment and the old could. The US public sector probably spent more per beneficiary than the equivalent social systems in Europe. At least this was true of the German one. If one chose not to have insurance and went out to lunch, had a car instead oe some such? Don't forget, Germans for example paid a fluctuating portion of income over the decades of between 18 and 22 percent of their gross income. This is in a population that has always had around $ 10.000 per capita GDP less than the US citizen had, while the poor had about the same. So, yes. The US pays too much possibly. But half of it is paid privately. The people could chose insurance. That seems better than coercion to me. Especially as the social programs are reducing the care they pay for and the elderly can hardly get insurance to maintain the levels previous governments had promised.

 

[joG]

We are spending too much on health care in the USA. The question is how to get the cost down. What do you suggest? Rationing? Cost controls for pharm products? Limiting access to specialty care? No potential solutions I know of have any support. And forget about cutting waste and fraud; that's a chimera.

People in the UK are content to get by with less medical care, that is to say, with care that results in significantly shorter survival for cancer, for example, because everyone else there is in the same boat. But in the US if it's my rear that's on the line I want the absolute best care and I don't give a crap about cost if someone else is paying for it. That's pretty much everyone's attitude. It's difficult to overcome that except perhaps by leaving the burden of cost cuts on the shoulders of some "other" group, i.e., underprivileged minorities. Which is, in fact, the traditional American approach.

Educate people better would be a good place to start, if the property rights of health care payments is restructured so that the public refuses payments.

 

[Absentglare]

Like I said, semantics. Government control, is government control.

I don't think you're even trying to understand it.

 

[eohrnberger]

so the US is incapable of delivering a Canadian level of coverage to its citizens, in your opinion? that's odd. i thought that we were the world's premier superpower.

Being a super power on the world stage has very little to do with being able to deliver 'Canadian level of coverage to its citizens'. These two things are completely different. It's far more pertinent to ask how capable the US government is effectively administering, well, just about anything, and on that score, it's not good track record either.

if so, i would have to say that i disagree with your opinion. the main thing keeping us from doing that is a bunch of naysayers who threaten revolution every time we do anything to fix our ****ed up health care system. my opinion is that we should flat out ignore their protests and drag them kicking and screaming into first world health care. they aren't actually going to secede, and to their kids, single payer will be the status quo just like medicare is now for the elderly.

I won't disagree with you that the system ****ed up, and in need of change to improve. I disagree that government run single-payer is the way to do it, especially when we have such a clear track record of the VA, which is a US government run single payer system. You can dream that you'll get Canadian performance, but your more likely to end up with the VA performance, and do you really want that?

Your willingness to impose single payer by government force is very telling, and frankly, quite unacceptable in a Republic such as ours. The people are the masters of the government, not the government being the master of the people. Also most disturbing, is the typical leftist way of sneaking whatever they want in under the radar, having it in place, and expecting mute compliance in future generations.

also,

View attachment 67200314

Touting the EU style single payer systems such as this also means that you are welcoming of the same level of taxation to pay for it. So, like 40% of income or higher?

Also, what you are welcoming is even greater entitlement expenditures than what is already occurring:

Between the entitlement spending above, and the additional spending for a US government run single payer healthcare system that you are supporting, I think adding that additional spending would put pretty much every working adult in the nation in the cross hairs of a huuuuuge, economically debilitating tax increase.

I don't think you can have what you want, the EU healthcare model, without the punishing economically debilitating tax increases. They some of come hand in hand, don't they?

 

[Chomsky]

I am not really so sure of that. The poor could get treatment and the old could. The US public sector probably spent more per beneficiary than the equivalent social systems in Europe. At least this was true of the German one. If one chose not to have insurance and went out to lunch, had a car instead oe some such? Don't forget, Germans for example paid a fluctuating portion of income over the decades of between 18 and 22 percent of their gross income. This is in a population that has always had around $ 10.000 per capita GDP less than the US citizen had, while the poor had about the same. So, yes. The US pays too much possibly. But half of it is paid privately. The people could chose insurance. That seems better than coercion to me. Especially as the social programs are reducing the care they pay for and the elderly can hardly get insurance to maintain the levels previous governments had promised.

You are right, in that Americans pay far too much for their healthcare; and this is a huge problem, IMO.

And any effective solution will have to reign-in costs.

Good insight!

 

[joG]

You are right, in that Americans pay far too much for their healthcare; and this is a huge problem, IMO.

And any effective solution will have to reign-in costs.

Good insight!

What would help to reduce costs would be a population that was smart enough to buy minimum insurance, imbibe fewer drugs and loose weight.