SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1, 183, 386, 590]

ttwtt78640 · Jul 2, 2012

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

grip said:
I've only got one question about insurance, what do they provide besides taking a slice of money out of the system? They're not a doctor, nurse, technician or any kind of health service they simply get in between the patient and their medical providers for a fee driving up medical costs. How would not eliminating them not bring down costs?

Eliminating them completely is not needed, reducing the paperwork overhead (woops, PPACA increases it) would help a lot. The primary difference in medical care insurance and ALL other forms of insurance is the frequency of claims. Insurance is for the rare, unexpected and expensive events in life. Auto insurance does not cover tune-ups, oil changes or flat tires, it is used for collision and injury claims only. Homeowners insurance doe s not cover a worn out sofa, broken clothes dryer or lawn maintanence, it is used for storm/fire damage and personal injury claims only. A "catastrophic" medical care policy would be much the same, a high annual deductable policy that pays 100% of claims above that amount is very affordable, and requires only minor paperwork overhead, much like auto/homeowners insurance.

274ina · Jul 2, 2012

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

Jetboogieman said:
Were the death panels ruled constitutional? :lol:

No - CEO death panels are banned after 2014. LMAO!!

Kandahar · Jul 2, 2012

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

ttwtt78640 said:
Eliminating them completely is not needed, reducing the paperwork overhead (woops, PPACA increases it) would help a lot.

This is incorrect. PPACA includes funding for helping the health care industry modernize its record-keeping system by moving to electronic records, and creating standardized forms that are common to *all* insurance companies rather than a patchwork system.

ttwtt78640 · Jul 2, 2012

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

Kandahar said:
Oh, I agree. I'm all for cutting private insurance companies out of the loop entirely, but there doesn't seem to be enough congressional support for that. Nevertheless, 20% is the MAXIMUM they're allowed to spend on things other than medical care, which is at least a step in the right direction. Prior to PPACA, there were no financial restrictions on them at all.

the PPACA INCREASES the use of insurance so if they were not yet at 20% overhead you can BET that they ALL will be now; it even OUTLAWED "catastrophic" medical care insuurance, the most affordable and lowest overhead medical care insurance policies offered.

grip · Jul 2, 2012

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

ttwtt78640 said:
Eliminating them completely is not needed, reducing the paperwork overhead (woops, PPACA increases it) would help a lot. The primary difference in medical care insurance and ALL other forms of insurance is the frequency of claims. Insurance is for the rare, unexpected and expensive events in life. Auto insurance does not cover tune-ups, oil changes or flat tires, it is used for collision and injury claims only. Homeowners insurance doe s not cover a worn out sofa, broken clothes dryer or lawn maintanence, it is used for storm/fire damage and personal injury claims only. A "catastrophic" medical care policy would be much the same, a high annual deductable policy that pays 100% of claims above that amount is very affordable, and requires only minor paperwork overhead, much like auto/homeowners insurance.

I'll agree that in the form of catastrophic coverage for automobile, home or medical it can be an advantage. But for all the years people pay for those coverages a majority will pay more into the system, then they'll ever recover. And that's where the insurance co's get their profit, and their profit, and their profit. There was a time there were few insurance companies and it wasn't such a problem paying for products and services. Too costly(?) people didn't pay for them. When a department store or retail electronics company tries to sell me extended warranties on their products I say out loud with faux outrage "you mean the products you sell are defective to the point, where I need INSURANCE because of a lack of WARRANTY!"

There is way too much gauging, waste, fraud and profiteering that shouldn't be.

ttwtt78640 · Jul 2, 2012

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

Kandahar said:
This is incorrect. PPACA includes funding for helping the health care industry modernize its record-keeping system by moving to electronic records, and creating standardized forms that are common to *all* insurance companies rather than a patchwork system.

So, it will be as effecient and fraud free as the GSA, census, medicaid, medicare, SS and the IRS sytems are? LOL

Kandahar · Jul 2, 2012

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

ttwtt78640 said:
So, it will be as effecient and fraud free as the GSA, census, medicaid, medicare, SS and the IRS sytems are? LOL

You certainly seem to have an irrational hatred for PPACA on any and all grounds you can think of...especially considering you 1) don't seem to understand what's in the law very well, and 2) would benefit from it immensely, given your circumstances.

Dr. Chuckles · Jul 2, 2012

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

Kandahar said:
Expand coverage and increase availability - By providing more people with health insurance.

Reduce costs - By giving the government more leverage over health care providers, by steering funding toward effective procedures, and by eliminating some of the hidden costs of having millions of uninsured people.

From my understanding, many of the cost saving measures are rather questionable. Like the assumption that what is driving ER use is a lack of coverage, when reality seems to point to a lack of primary care, and inadequate care for those with chronic conditions. This is why Massachusetts has seen an increase in er use, even when the general trend of increased er use is taken into account

ttwtt78640 · Jul 2, 2012

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

grip said:
I'll agree that in the form of catastrophic coverage for automobile, home or medical it can be an advantage. But for all the years people pay for those coverages a majority will pay more into the system, then they'll ever recover. And that's where the insurance co's get their profit, and their profit, and their profit. There was a time there were few insurance companies and it wasn't such a problem paying for products and services. Too costly(?) people didn't pay for them. When a department store or retail electronics company tries to sell me extended warranties on their products I say out loud with faux outrage "you mean the products you sell are defective to the point, where I need INSURANCE because of a lack of WARRANTY!"

There is way too much gauging, waste, fraud and profiteering that shouldn't be.

Unlike ANY other insurance product, medical care insurance is entirely run by cartels and monopolies secure in their state approved "exclusive" license agreements. Auto and homeowners markets are wide open and VERY competitive, advertising is rampant, so cost shopping is easy. Try that with medical care insurance and you get asked FIRST to enter your state or zip code. Hmm...

Link: http://www.statehealthfacts.org/comparemaptable.jsp?cat=5&ind=596

Dr. Chuckles · Jul 2, 2012

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

Kandahar said:
Oh, I agree. I'm all for cutting private insurance companies out of the loop entirely, but there doesn't seem to be enough congressional support for that. Nevertheless, 20% is the MAXIMUM they're allowed to spend on things other than medical care, which is at least a step in the right direction. Prior to PPACA, there were no financial restrictions on them at all.

Well, in fairness, Obama wasn't much help in pushing any such agenda, and seemed he was intent to avoid the health Care debate for as long as possible (IMO, his absence, and later lack of effective leadership, really highlighted some faults in this administration that seem to have defined his presidency)

clownboy · Jul 2, 2012

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

Kandahar said:
This is incorrect. PPACA includes funding for helping the health care industry modernize its record-keeping system by moving to electronic records, and creating standardized forms that are common to *all* insurance companies rather than a patchwork system.

This was already done with the HIPAA Act. I know, I've been helping doctors and hospitals convert to electronic records for almost a decade now.

The health insurance industry long ago created a system of standardized forms. The hospitals and doctors offices use them all the time now.

All the PPACA adds is more levels of bureaucracy.

Phys251 · Jul 2, 2012

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

So what's the latest Republican excuse for hoping that poor people get sick and die? Anything new, or is it the same-old same-old?

Bronson · Jul 2, 2012

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

Kandahar said:
No they have not. This is the most recent calculation that they have performed on the cost of all provisions.

Yes, Obamacare's costs have almost doubled | WashingtonExaminer.com

:roll:
I've already debunked this numerous times in this thread, but what the hell, I'll do it again. The ten-year *cost* increases each year as we get closer to the actual implementation in 2014 (as anyone who understands accounting/finance always knew that it would, including the CBO). But the *impact on the budget* does not. This is because revenues from the Affordable Care Act are projected to exceed the costs, for every year into the foreseeable future except for a small deficit in 2015-2018.

You're repeating Ezra Klein talking points

Health-care law will add $340 billion to deficit, new study finds - The Washington Post

Ezra makes a big deal about the fact the 2012 CBO report shows that the "net" costs of Obamacare actually went down $50 billion. But that "net cost" reduction comes almost entirely from increases in the mandate fines paid by individuals and employers. So in 2010, the CBO estimated that Americans would only pay $17 billion in individual mandate fines. The 2012 estimate has that number up to $54 billion. In 2010, the CBO estimated that American employers would pay only $52 billion in mandate fines. In 2012, that number is up to $113 billion.

CBO and JCT’s projections of health insurance coverage have also changed since last March. Fewer people are now expected to obtain health insurance coverage from their employer or in insurance exchanges; more are now expected to obtain coverage from Medicaid or CHIP or from nongroup or other sources. More are expected to be uninsured. The extent of the changes varies from year to year, but in 2016, for example, the ACA is now estimated to reduce the number of people receiving health insurance coverage through an employer by an additional 4 million enrollees relative to the March 2011 projections. In that year, CBO and JCT now estimate that there will be 2 million fewer enrollees in insurance exchanges. In the other direction, CBO and JCT now estimate that, in 2016, the ACA will increase enrollment in Medicaid and CHIP slightly more than previously estimated (but considerably more in 2014 and 2015), and it will reduce the number of people with nongroup or other coverage by 3 million less and the number of uninsured people by 2 million less than previously estimated.

Liberals are all trying to have the HC Debate again now that this turkey is once again under a microscope as a massive tax increase. They are failing miserably

So on the one hand, we have the CBO's estimates. On the other hand, we have your completely uninformed opinion.

The CBO also claims that fewer people will be covered than first thought. Are they uninformed?

ttwtt78640 · Jul 2, 2012

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

Kandahar said:
You certainly seem to have an irrational hatred for PPACA on any and all grounds you can think of...especially considering you 1) don't seem to understand what's in the law very well, and 2) would benefit from it immensely, given your circumstances.

I understand plenty. It is not personal greed, as you well know, that drives my skepticism, but knowledge of the CURRENT gov't run medical programs of medicaid, medicare and the VA. Having countless people tell me how wonderfull PPACA is, yet it does not REPLACE any (NOT ONE) of these cronically ill EXISTING gov't messes is not a good "first step", IMHO. Just as welfare started small and as a part of a single federal dept., it has now morphed into a HUGE expense, kept well hidden by spreading it accross numerous dept's and agencies, and now having 12 MAJOR components. PPACA is starting out like that, so it is sure to be mismanaged beyond belief, from day one, and get worse as it is "fixed". Using a small and incremental approach would be better method of "reform", starting with allowing medical care insurance to be sold nationwide, with MORE options, direct free market competition, fewer minimum and maximum benefit limits and allowing the PEOPLE to select what they want.

Bronson · Jul 2, 2012

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

Get Ready for the New Investment Tax - WSJ.com

AdamT · Jul 2, 2012

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

clownboy said:
This was already done with the HIPAA Act. I know, I've been helping doctors and hospitals convert to electronic records for almost a decade now.

The health insurance industry long ago created a system of standardized forms. The hospitals and doctors offices use them all the time now.

All the PPACA adds is more levels of bureaucracy.

Obamacare expanded existing electronic records requirements. My doctor's office just started using tablets and laptops last year to get ahead of the curve. Pretty cool, actually. All of you information is right there and easier to access than a paper file. Eventually this will reduce costs by eleminating a lot of clerical work, and it should improve care as doctors are able to share patient records and avoid drug interactions.

And ultimately it will hopefully provide a gigantic database that the medical community can use to study treatments and outcomes, thus improving health care and lowering costs.

Dr. Chuckles · Jul 2, 2012

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

ttwtt78640 said:
I understand plenty. It is not personal greed that drives my skepicism, but knowledge of the CURRENT gov't run medical programs of medicaid, medcare and the VA. Having countless people tell me how wonderfull PPACA is yet that it does not REPLACE any of these cronically ill EXISTING gov't messes is not a good "first step", IMHO. Just as welfare started small and as a part of a single federal dept., it has now morphed into a HUGE expense kept well hidden by spreading accross numerous dept's and agencies now having 12 MAJOR components. PPACA is starting out like that, so it is sure to be mismanaged beyond belief, from day one, and get worse as it is "fixed". Using a small and incremental approach would be better method of "reform", starting with allowing medical care insurance to be sold nationwide, with MORE options, fewer minimum and maximum benefit limits and allowing the PEOPLE to select what they want.

Have a friend who went to work at the va after 9/11 (he's a Muslim immigrant and saw it as a way of giving back and establish good interfaith relations), and the entire time he complained about how he felt prevented from adequately treating his patients, due to the unnecessary amounts paperwork and regulations

AdamT · Jul 2, 2012

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

Dr. Chuckles said:
Have a friend who went to work at the va after 9/11 (he's a Muslim immigrant and saw it as a way of giving back and establish good interfaith relations), and the entire time he complained about how he felt prevented from adequately treating his patients, due to the unnecessary amounts paperwork and regulations

Did he work in private hospitals before? I ask because a friend of mine was a radiologist in the VA system for years, and then went to work in a private hospital. She was astonished at the amount of paperwork she had to deal with in the private system. Makes sense when you think about it, because they have to deal with dozens of insurance companies and plans, all of which have their own procedures and 'death panels".

Dr. Chuckles · Jul 2, 2012

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

AdamT said:
Did he work in private hospitals before?

Yes, he worked in a private family practice and also did rounds at a hospital

AdamT · Jul 2, 2012

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

ttwtt78640 said:
I understand plenty. It is not personal greed, as you well know, that drives my skepticism, but knowledge of the CURRENT gov't run medical programs of medicaid, medicare and the VA. Having countless people tell me how wonderfull PPACA is, yet it does not REPLACE any (NOT ONE) of these cronically ill EXISTING gov't messes is not a good "first step", IMHO. Just as welfare started small and as a part of a single federal dept., it has now morphed into a HUGE expense, kept well hidden by spreading it accross numerous dept's and agencies, and now having 12 MAJOR components. PPACA is starting out like that, so it is sure to be mismanaged beyond belief, from day one, and get worse as it is "fixed". Using a small and incremental approach would be better method of "reform", starting with allowing medical care insurance to be sold nationwide, with MORE options, direct free market competition, fewer minimum and maximum benefit limits and allowing the PEOPLE to select what they want.

And yet, Medicare and the VA generally get higher satisfaction ratings than the private system....

For example: http://www.nationaljournal.com/njonline/who-s-afraid-of-public-insurance--20090629

ttwtt78640 · Jul 2, 2012

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

AdamT said:
And yet, Medicare and the VA generally get higher satisfaction ratings than the private system....

For example: Who's Afraid Of Public Insurance? - Mark Blumenthal - NationalJournal.com

LOL. More opinion and SLANTED surveys praising gov't programs, by those getting the benefit of gov't programs. Of COURSE I would like something free instead of having to pay for it. A free small order of fries is "better" than a paying for a large order of fries. Finding ANYONE with an OPINION that agrees with you PROVES that you were right. LOL

Phys251 · Jul 2, 2012

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

You know what hasn't been talked about enough about the mandate/tax/penalty/thingy/whatever? It's 100% a choice.

If you choose to have health insurance, you do not pay this penalty. Period. Some people prefer taxes where you can choose to pay it. And unlike sales taxes, where you can "choose" to eat or put gas in your car, this one actually is a genuine choice.

As a corollary, people who claim that it's going to be "the biggest tax increase in history" are significantly grasping at straws. Theoretically, if every American put aside his torch and pitchfork and--ooh! gasp! horror!--bought private health insurance, there would not be one dime of taxes raised by this.

AdamT · Jul 2, 2012

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

ttwtt78640 said:
LOL. More opinion and SLANTED surveys praising gov't programs, by those getting the benefit of gov't programs. Of COURSE I would like something free instead of having to pay for it. A free small order of fries is "better" than a paying for a large order of fries. Finding ANYONE with an OPINION that agrees with you PROVES that you were right. LOL

Rather, any poll or survey that disagrees with you is automaticall slanted and therefore invalid. :roll:

But in fact, Medicare is not FREE. People paid for it with their payroll taxes, and many pay significant additional premiums. I was shocked when my father told me how much he pays for he and my mother.

Albert Di Salvo · Jul 2, 2012

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

grip said:
I've only got one question about insurance, what do they provide besides taking a slice of money out of the system? They're not a doctor, nurse, technician or any kind of health service they simply get in between the patient and their medical providers for a fee driving up medical costs. How would not eliminating them not bring down costs?

Ultimately I think insurance bureaucracy will be replaced by govt. bureaucracy. Do you like the IRS? It's going to expand, and so will its intrusiveness.

Albert Di Salvo · Jul 2, 2012

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

Kandahar said:
Expand coverage and increase availability - By providing more people with health insurance.

Reduce costs - By giving the government more leverage over health care providers, by steering funding toward effective procedures, and by eliminating some of the hidden costs of having millions of uninsured people.

Your side's plans have a lot of moving parts don't they. What does your experience tell you about working with the federal bureaucracy? I used to be a federal bureaucrat. That experience helped shape my view on this subject.

The universe of health care is finite and exhaustible. Anything that is finite can be spread too thin when it is overwhelmed.

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