Thanks to Obamacare Alive Today

[skypup]

Healthcare needs a fix. Obamacare isn't the answer. Not even close.

Amen!

Then what is your suggestion, Burntcookie? We need naysayers to start having some suggestions...

[skypup]

I am happy for anyone that has a good outcome or where preventative measures stopped a bullet.

.......... Laurettas: ... the real problem--the horrendous costs of healthcare

I agree with Laurettas, that the focus needs to be on cost effective medicine, which we are not normally being offered from the very first moment of "you have cancer". Like $500 per month chemo instead of $30-50,000 per month, with ¼ or ½ of the current attrition rate. Instead every provider, payer and patient seem set to resist substantial improvements already long available and Obamacare doesn't appear to change this either.

I completely agree on this front. However, happily there is a movement within the medical business to turn away from fee for service, I believe due to some of the penalties put in place by Obamacare. Where hospitals used to make more money off us if we were readmitted with hospital-acquired infections, that won't be the case much longer. This culture shift will, if seen through positive eyes, be the start of a medical culture where the patient is a customer (not some weird satellite caught in medicine's orbit) and the doctor will be customer to the medical center (instead of the other way around). Then we will begin to see a more results-oriented approach to the practice of medicine. It'll be easy to watch this play out in certain procedures like knee replacements. Every orthopod will have to follow a set best practice procedure, doctor as god diminished. Mayo has shown this to be good practice for the patient as well as the business side.

[Laurettas]

Thank you, Sarah, for being so informative. I am trying to see how we compare with our tax burdens as well as the quality of healthcare provided by the two systems.

Every time I read your reply, I have another question it seems! I thought I remembered reading something, but don't know if it was England, stating that there was basically a national sales tax as well. That would have to be factored in if that was the case also. If there is no national sales tax in England, then the US is paying similar tax per person when you factor in Social Security. Someone earning $80,000/yr here would pay $12,000 in SS alone.

I find it interesting that England does not factor in family size when taxing someone. So, in England, a family of 8 would pay the same tax as a single person earning the same money. Here, it would be substantially less for the large family--it would pay almost no income tax on the first $100,000 of income.

I think we in the US need to clarify something for our foreign friends here. First of all, it is not true that healthcare is available to only those who can afford it. Our government pays more in Medicare/Medicaid per year than France does for healthcare for all of its people. Medicare is for the retired/disabled and Medicaid is for the extremely poor. Over 100 million people receive this aid. One third of Americans are already on socialized medicine. We had a member on here recently who was on Medicaid and received the same treatment for his cancer as everyone else. In just as timely a fashion as well. Everyone who walks into an emergency room gets treated whether they pay or not. I remember when I was young that there were county hospitals where the poor would go for their medical needs. I believe it was free. Does anyone else remember that? Now the hospitals are all privately owned and are expected to absorb the cost of those being treated who do not pay. Hence, part of the reason the rest of us have to pay such large amounts.

It sounds to me like England is evolving into a rich/poor divide in its healthcare as well since those with money are buying insurance, getting treatment in a more timely fashion and the doctors there are paid better than those working for national healthcare. I have heard of other countries doing this as well. A six month waiting period for knee surgery sounds pretty extreme. I also read periodically about some countries with socialized medicine who are struggling with large deficits from their healthcare programs--France, Greece, Spain, etc. I know that in one South American country, the doctors could go for months without getting paid under their socialized medicine program. There was often a lack of the most basic healthcare items as well such as penicillin and syringes. And this is one of the countries with much wealth from oil.

Another thing we in the US do that needs to stop is the suing of everyone for everything. The commercials for the class action lawsuits against drug companies, etc. are ridiculous. I am assuming that in other countries when someone is harmed or killed by medical error, they just have to accept it since most countries don't allow law suits, right?

I also think that healthcare needs to be removed from employment again. I understand that happened when the government froze wages so companies started offering it as incentives to entice the best employees. That alone would make things much easier for many people. Also, we need to make all insurance available to all people, no matter where they live, instead of the differences we see from state to state. Some states, such as those attracting retirees or large numbers of immigrants, are going to have much higher healthcare costs. That should be shared by everyone in the country.

And another thing! Insurance companies shouldn't be able to quote you a price for insurance to entice you to join and then raise the rate by a huge amount in a year or two. That is one reason I am in the situation I am. I am getting insurance through my husband's former work place but they have a super cadillac plan and the premiums are killing me. But I don't trust that if I join a different insurance company, my rates won't sky rocket in a couple of years and I will have a huge deductible along with monthly rates as high as I had before.

Am I coming up with enough ideas, Anna and Skypup? You may regret you asked

[robinkaye]

Healthcare needs a fix. Obamacare isn't the answer. Not even close.

Amen!

Ok, so let's hear it!
What is the answer?
I'd listen to anything you have to offer.
I've seen many complaints here, but no suggestions of how to fix things.
Why is Romneycare (developed by the conservative Heritage Foundation) not the answer?
(in case you weren't aware, Obamacare=Romeycare...as a progressive, I think it's got all kinds of issues, namely that it's too conservative).

Anyway. The floor is open. This was the Dems' best guess at the health care crisis. The GOP have not offered anything.
I would love to hear what you guys think we should do. Seriously.
My vote is raise my taxes a bit and let's have Medicare for all.
My economist, business major husband who has run a family finance company for almost 30 years (and his father, the former president of this business that the family founded almost 100 years ago here in Seattle) are in agreement with this. They fully support the ACA as someplace to start, but feel that Medicare for all is actually a better route.
WHAT SOLUTIONS ARE YOU OFFERING IN PLACE OF THE ACA?
No more complaints...solutions.

ETA that here's what we have to fix:
Most expensive health care in the world.
Worst health outcomes in the first world.
Almost 70% of bankruptcies due to medical bills.
People literally DYING every day because they can't afford health insurance.
Massive bills to the taxpayers to cover all the folks who go to the ER because they can't afford healthcare.
Insurance companies allowed to drop cancer patients without warning just because they're...expensive.
Lifetime caps that mean that many of us will not have insurance 10 or 15 years down the road because our cancer care is so expensive.

Got all that? Now get ready...go! Let's hear those SOLUTIONS! Lots of smart people here, I'm excited to hear what you all have to say.

For starters, 70% of bankruptcies are not caused by medical bills. 29% of bankruptcies are caused primarily by medical bills, the others list a medical expense, no matter how small and is not the
primary reason for the bankruptcy. http://www.politifact.com/rhode-island/statements/2012/jul/29/patrick-kennedy/former-us-rep-patrick-kennedy-says-most-bankruptci/
The study you reference by the WHO saying the US has the worst outcomes is based on healthcare policy, not medical outcomes. The US is classified as worst because of lack of universal healthcare and the costs...this is not medical outcome. Our actual outcomes are depending on the category at the top or in the top tier amongst all developed countries.
As for people dying everyday because they can't afford insurance, not necessarily true or false:http://www.politifact.com/truth-o-meter/article/2013/sep/06/alan-grayson-claims-45000-people-die-year-because-/
It's estimated that after ten years of Obamacare there will still be 30 million people without insurance, combined with the many more who have insurance but can't find a primary or need off hour care, our emergency rooms will be even more clogged, by both the insured and uninsured. http://www.businessweek.com/articles/2013-05-30/under-obamacare-emergency-rooms-may-get-even-more-crowded

Where would I begin:

1) Cannot drop anyone from coverage due to illness
2) The last policy you were on must continue coverage and cannot discontinue coverage as long as premiums are paid. There should also be an allowance made for
hardship which allows re-instatement.
3) Coverage for pre-existing conditions if you have maintained coverage during a large portion of your lifetime. No, an insurance company should not have to accept a 60 year old cancer patient who
has willingly rejected coverage over their lifetime only wanting to be insured once they got sick. This is not insurance.

4) I would stop the insurance company state monopolies, allowing consumers to purchase insurance from whomever, wherever they like.
5) I would allow businesses and consumers to purchase cheap catastrophic policies with no government mandates...and
6) allow individuals to fund HSA's up to at least 10K/year with pre-tax dollars - they will fund HSA's with the money saved by buying a cheap policy or having it provided free by an employer.
7) The individual armed with their own HSA...their money, will now shop for the best prices. Hospitals knowing that they are now competing will
find it necessary to cut the exorbitant prices. This will be the only way you will see medical costs go down. Bargaining for good rates does not bring costs down, it just gets you a better discount, discounts are based on price/cost. Costs continue to go up so the discounted price will continue to rise...that's just math. The HSA carries over for the life of the person who owns it and is transferrable upon death.
Allow like businesses to come together and form a co-op for purchasing insurance. We belong to a industry co-op which has hundreds of members nationwide, they have tried but are unable to
purchase insurance as a groupl If Obamacare provides purchasing power, and you like that, why not allow private business the same option.
9) Address tort reform, the cost of medical malpractice insurance is killing the individual doctor. We are rapidly losing private general practioners, Obstetritions etc due to costs of insurance. Most are going to large hospital groups. No problem if you live in a heavily populated area but a lot of people don't and they are losing their care.

Whether you agree or disagree with these alternatives, most were suggested by the opposition many times over, so please at least stop with the no one has presented alternatives...it's just not true.

As for you husband, he has a business degree and owns a business...congrats. However, you have brought this up before with the implication he is so much more capable of understanding all of this as compared to the rest of us peons. So...husband with business degree and ongoing family business that is 127 years old. Son with masters in finance from top school, director of a hedgefund, son with finance degree who at 28 owns his on equity firm, son in media who experiences the monolithic mass think everyday from people who just spout soundbites and who are not the least bit interested in fact finding. Oh yeah, me...business and political science degree, running business with husband and stepping in while he has been sick. All are against Obamacare as it will wreck havoc on our individual freedoms and on the economy. Social Security is going bankrupt, medicare the same and wrought with fraud and abuse as any system of it's size will be. Seventeen trillion in debt with unfunded liablies of nearly 100 trillion dollars and we are doubling down with Obamacare.
All think Obamacare is a diaster.

[robinkaye]

I tried this morning to access the exchange for small business - after trying all week, finally could log on. However, there is no ability to compare plans, and networks until
I submit an application which must be mailed to KY. The only info available is the price per plan - there are many, but no way to tell why one is better than another, what benefits are offered and so on. The application contains all census data for the company, tax ID and other confidential information. I'm not going to do that just for the ability to compare our current insurance with what is available through the exchange. As a result, I tried to delete my account which is not an available option. Sorry, but whoever thunk this one up doesn't have two brain cells to rub together and they are going to be in charge of one of the biggest healthcare systems in the world...

From Politico regarding 'glitches' etc...interesting read

I do have to wonder why Homeland Security and the Justice Department are part of the Obamacare platform:

The Obamacare website must knit together platforms from five huge federal agencies — Homeland Security, the Social Security Administration, HHS, the Treasury Department and the Department of Justice —

Read more: http://www.politico.com/story/2013/10/obamacare-aca-tech-experts-glitches-issues-problems-98202.html#ixzz2hWaM6rQf

[Laurettas]

Oh, yes, I read also that one cannot really compare health outcomes from country to country because they tabulate things differently. One example would be that some countries classify any birth under so many weeks to be a stillbirth even though the baby might have been born alive and died later. In the US we would count that as a death of a newborn, thus raising our infant mortality rate.

[robinkaye]

Oh, yes, I read also that one cannot really compare health outcomes from country to country because they tabulate things differently. One example would be that some countries classify any birth under so many weeks to be a stillbirth even though the baby might have been born alive and died later. In the US we would count that as a death of a newborn, thus raising our infant mortality rate.

Correct: the US classifies all births in which a baby takes a breath as a live birth, infant mortatlity is calculated in the US based on that criteria. We are the only country that uses this as a classification, most don't consider an infant death prior to two months old as a live birth, some even longer. This skews not only infant mortality numbers, it skews life expectantcy numbers as well. We are not comparing apples to apples. There are a lot of goofy statistics that if you read further you know really are just that...goofy. It's sort of like when a new cancer drug comes on the market citing studies that say it significantly increases life expectancy...well, if your life expectancy is 2 months and the drug gives you another month that's statistically significant, but is it really?

[vickitwo]

Someone posted this on my facebook. I found it interesting.

www.upworthy.com
"His First 4 Sentences Are Intereresting. The 5th Blew My Mind And Made Me A Little Sick"

[skypup]

But I don't trust that if I join a different insurance company, my rates won't sky rocket in a couple of years and I will have a huge deductible along with monthly rates as high as I had before.

One of the ACA things that went into effect last year is that insurance companies can no longer raise rates however they like. A premium for any policy may not be raised higher than 10% above its cost of doing business. BCBS had to issue me two refunds because they had raised rates higher than that. So if you pick a good policy with a good company, you now have protection against the amount the premium can be raised. This is good, yes? Without the ACA, that wasn't likely to happen!

[Burntcookie]

Healthcare needs a fix. Obamacare isn't the answer. Not even close.

Amen!

Then what is your suggestion, Burntcookie? We need naysayers to start having some suggestions...

My course of action would be to have a completely free marketplace, free of any government intervention, which has been the main factor behind the rising healthcare costs dating back to the conception of medicare. (i.e. the great society of Lyndon Johnson).

Now that the IRS is enforcing Obamacare, how comfortable are you with that, knowing they share tax records with politicians and the administration. You probably won't care now, but when a Republican/non-Democrat president is elected some time in the future, you'll be singing a different tune.

P.S. - I'm Libertarian/Constitution-ist and believe in as little government oversight as possible. Not all conservatives are Republican. I'm still looking for John Galt.

[Laurettas]

A premium for any policy may not be raised higher than 10% above its cost of doing business.

I'm not completely sure what that means, Skypup. As an example, if an insurance company one year had numerous patients with large medical expenses and it increased their cost to do business by 200%, then they could increase premiums by 210%? Is that ultimately very helpful for anyone?

[robinkaye]

Proving once again how statistics can be deceiving...

[annalexandria]

On the issue of medical bankruptcies:

http://www.cnbc.com/id/100840148

"Medical Bills Are the Biggest Cause of US Bankruptcies: Study"

Was my % off by a bit? Possibly, but 2 million medical bankruptcies in a year is nothing to scoff at.
And because maybe it's slightly less than a person a day dying, that somehow makes it ok? You've got to be kidding me. I can't even have a conversation with someone who can make a statement like this.

Anyway, guess what? The GOP has now largely moved on from the issue of the ACA.
From CNN, "The proposal, led by Republican Sen. Susan Collins of Maine and Democratic Sen. Joe Manchin of West Virginia, would fund the government for six months, extend the debt limit and delay a medical device tax that is part of the Affordable Care Act."
So if it passes, that's all you get for this government shutdown...a delay on the medical device tax.
If it doesn't pass, well..there's a lot worse on the horizon, so better fasten your seat belts.
This essentially conservative policy was passed by House and Senate, signed by a two-term president who won by a solid %, and declared lawful by a conservative Supreme Court.
It's a done deal, and punishing the entire country because you didn't get your way is not the work of adults...it's the foot-stomping tantrums of foolish children who shouldn't be allowed anywhere near the halls of power (and probably won't be, come 2014, if the polls are accurate...the GOP is at its lowest point ever, and it's earned it).

My thanks to those of you who offered some possible solutions...they were interesting to read.

PS Robinkaye...it's not quite 127 years yet, but it will be. Thanks for the vote of confidence! They know how to run a business, and they vote for Democrats. Hard to fathom, huh?

[skypup]

A premium for any policy may not be raised higher than 10% above its cost of doing business.

I'm not completely sure what that means, Skypup. As an example, if an insurance company one year had numerous patients with large medical expenses and it increased their cost to do business by 200%, then they could increase premiums by 210%? Is that ultimately very helpful for anyone?

Okay, that's about it for me. You clearly are not versed in the mathematics of quantity. Keep arguing your way down this very sad path we are on, while enjoying your Cadillac insurance plan.

[annalexandria]

A premium for any policy may not be raised higher than 10% above its cost of doing business.

I'm not completely sure what that means, Skypup. As an example, if an insurance company one year had numerous patients with large medical expenses and it increased their cost to do business by 200%, then they could increase premiums by 210%? Is that ultimately very helpful for anyone?

Okay, that's about it for me. You clearly are not versed in the mathematics of quantity. Keep arguing your way down this very sad path we are on, while enjoying your Cadillac insurance plan.

That's smart, Skypup...I'm on your heels!
No one's ever changed anyone's mind in an online conversation anyway (in fact, recent research shows that when presented with actual facts that contradict previously-held beliefs, people will simply choose to cling more firmly than ever to inaccurate ideas, making this kind of debate pretty pointless).
What is sad is that people couldn't let those who have had POSITIVE experiences with the ACA just have their conversation. Why didn't you just go start your own "We Hate Obama Care" thread? Nobody was stopping you from doing that.