The Money Mustache Community
General Discussion => Post-FIRE => Topic started by: Exflyboy on September 11, 2015, 05:21:57 PM
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Ugh, one step forward to a single payer system that actually works.. one step back.
http://finance.yahoo.com/news/pelosi-judges-ruling-health-care-lawsuit-astounding-151716828--finance.html
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I'm really sweating the upcoming presidential election, also my state's gubernatorial election. I never vote, but this cycle I'm hoping for a Democratic sweep.
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Wonderful. I'm not even mad, I'm just disappointed. What a waste of time and energy.
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Here's a link to an in-depth analysis of the judgement in question.
http://healthaffairs.org/blog/2015/09/10/implementing-health-reform-house-can-sue-president-over-aca-cost-sharing-reduction-payments/
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Here's a link to an in-depth analysis of the judgement in question.
http://healthaffairs.org/blog/2015/09/10/implementing-health-reform-house-can-sue-president-over-aca-cost-sharing-reduction-payments/
Good article. Thanks for posting.
Interesting that the CSR payments were not made mandatory spending by the ACA.
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I'm really sweating the upcoming presidential election, also my state's gubernatorial election. I never vote, but this cycle I'm hoping for a Democratic sweep.
If Trump gets in I'm emigrating.. again.
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Good article. Thanks for posting.
Interesting that the CSR payments were not made mandatory spending by the ACA.
I'll second that. Great overview of the legal arguments involved and the possible ramifications. Thanks proto!
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Ugh, one step forward to a single payer system that actually works.. one step back.
http://finance.yahoo.com/news/pelosi-judges-ruling-health-care-lawsuit-astounding-151716828--finance.html
I've been totally screwed by Obamacare!
In 2010 I had a $4,300 policy covering 4 people.
In 2012 when Obamacare policies started I got a 19.4% increase,
2013 I got a 21% increase and in 2014 an 18.8% increase.
Today I pay $8448 for 3 people, an equivalent Obamacare Silver
plan is $12,621 for my family of 3.
Then to make it worse, the government is going to take your money,
give it me as an insurance subsidy of about $8,000 which I then give
to the insurance company.
Also, my Doc won't deal with Obamacare.
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Ugh, one step forward to a single payer system that actually works.. one step back.
http://finance.yahoo.com/news/pelosi-judges-ruling-health-care-lawsuit-astounding-151716828--finance.html
I've been totally screwed by Obamacare!
In 2010 I had a $4,300 policy covering 4 people.
In 2012 when Obamacare policies started I got a 19.4% increase,
2013 I got a 21% increase and in 2014 an 18.8% increase.
Today I pay $8448 for 3 people, an equivalent Obamacare Silver
plan is $12,621 for my family of 3.
Then to make it worse, the government is going to take your money,
give it me as an insurance subsidy of about $8,000 which I then give
to the insurance company.
Also, my Doc won't deal with Obamacare.
Insurance companies raise prices all the time and doctors opt in and out and get throw out of all kinds of insurance networks and always have What you experienced were private sector market decisons.
Befire you were "screwed" by omabacare millions were screwed out of insurance, out of health care and out of life itself specifically because you had the deal you had. You're still getting the long straw.
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Ugh, one step forward to a single payer system that actually works.. one step back.
http://finance.yahoo.com/news/pelosi-judges-ruling-health-care-lawsuit-astounding-151716828--finance.html
I've been totally screwed by Obamacare!
In 2010 I had a $4,300 policy covering 4 people.
In 2012 when Obamacare policies started I got a 19.4% increase,
2013 I got a 21% increase and in 2014 an 18.8% increase.
Today I pay $8448 for 3 people, an equivalent Obamacare Silver
plan is $12,621 for my family of 3.
Then to make it worse, the government is going to take your money,
give it me as an insurance subsidy of about $8,000 which I then give
to the insurance company.
Also, my Doc won't deal with Obamacare.
Insurance companies raise prices all the time and doctors opt in and out and get throw out of all kinds of insurance networks and always have What you experienced were private sector market decisons.
Befire you were "screwed" by omabacare millions were screwed out of insurance, out of health care and out of life itself specifically because you had the deal you had. You're still getting the long straw.
You sir, disgust me. Someone with a middle class job is screwing other folk out of insurance, health care, and life itself? Do you even think about that garbage before you repeat it? I'm in the same boat as the above poster, and I'm in excellent health. Over the last decade+ I've had an employer provided insurance policy that cost roughly 10-14k a year for just myself. I have probably used about 2,000 dollars worth of care during that period. Do you know what that means? Over the last decade I have subsidized other people's healthcare for a six figure amount...am I also part of the reason people were "screwed out of life?"
I think you should hang your head in shame an apologize to Qmavam for even suggesting he has cheated someone out of life...that is an absolutely disgusting accusation to make, especially when Obamacare hasn't actually lowered the cost of care at all, it just taxed those of us already paying into the system so they could hand out subsidies to those who aren't.
Wait until they change Obamacare to be means tested instead of income based...there is going to be a hilarious amount of sniveling of Obamacare fans on this forum, and I'll be right here laughing my ass off reminding you all there is no such thing as a free lunch.
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Ugh, one step forward to a single payer system that actually works.. one step back.
http://finance.yahoo.com/news/pelosi-judges-ruling-health-care-lawsuit-astounding-151716828--finance.html
I've been totally screwed by Obamacare!
In 2010 I had a $4,300 policy covering 4 people.
In 2012 when Obamacare policies started I got a 19.4% increase,
2013 I got a 21% increase and in 2014 an 18.8% increase.
Today I pay $8448 for 3 people, an equivalent Obamacare Silver
plan is $12,621 for my family of 3.
Then to make it worse, the government is going to take your money,
give it me as an insurance subsidy of about $8,000 which I then give
to the insurance company.
Also, my Doc won't deal with Obamacare.
Insurance companies raise prices all the time and doctors opt in and out and get throw out of all kinds of insurance networks and always have What you experienced were private sector market decisons.
Befire you were "screwed" by omabacare millions were screwed out of insurance, out of health care and out of life itself specifically because you had the deal you had. You're still getting the long straw.
You sir, disgust me. Someone with a middle class job is screwing other folk out of insurance, health care, and life itself? Do you even think about that garbage before you repeat it? I'm in the same boat as the above poster, and I'm in excellent health. Over the last decade+ I've had an employer provided insurance policy that cost roughly 10-14k a year for just myself. I have probably used about 2,000 dollars worth of care during that period. Do you know what that means? Over the last decade I have subsidized other people's healthcare for a six figure amount...am I also part of the reason people were "screwed out of life?"
I think you should hang your head in shame an apologize to Qmavam for even suggesting he has cheated someone out of life...that is an absolutely disgusting accusation to make, especially when Obamacare hasn't actually lowered the cost of care at all, it just taxed those of us already paying into the system so they could hand out subsidies to those who aren't.
Wait until they change Obamacare to be means tested instead of income based...there is going to be a hilarious amount of sniveling of Obamacare fans on this forum, and I'll be right here laughing my ass off reminding you all there is no such thing as a free lunch.
We'll never see means testing. Do you have any idea what it will cost in additional man hours to process all that information? I have $1,000 that says the number of people who are "taking advantage" of the system because it isn't means tested costs less than the amount of money it would take to implement means testing. And that's why it'll never happen.
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Ugh, one step forward to a single payer system that actually works.. one step back.
http://finance.yahoo.com/news/pelosi-judges-ruling-health-care-lawsuit-astounding-151716828--finance.html
I've been totally screwed by Obamacare!
In 2010 I had a $4,300 policy covering 4 people.
In 2012 when Obamacare policies started I got a 19.4% increase,
2013 I got a 21% increase and in 2014 an 18.8% increase.
Today I pay $8448 for 3 people, an equivalent Obamacare Silver
plan is $12,621 for my family of 3.
Then to make it worse, the government is going to take your money,
give it me as an insurance subsidy of about $8,000 which I then give
to the insurance company.
Also, my Doc won't deal with Obamacare.
Insurance companies raise prices all the time and doctors opt in and out and get throw out of all kinds of insurance networks and always have What you experienced were private sector market decisons.
Befire you were "screwed" by omabacare millions were screwed out of insurance, out of health care and out of life itself specifically because you had the deal you had. You're still getting the long straw.
You sir, disgust me. Someone with a middle class job is screwing other folk out of insurance, health care, and life itself? Do you even think about that garbage before you repeat it? I'm in the same boat as the above poster, and I'm in excellent health. Over the last decade+ I've had an employer provided insurance policy that cost roughly 10-14k a year for just myself. I have probably used about 2,000 dollars worth of care during that period. Do you know what that means? Over the last decade I have subsidized other people's healthcare for a six figure amount...am I also part of the reason people were "screwed out of life?"
I think you should hang your head in shame an apologize to Qmavam for even suggesting he has cheated someone out of life...that is an absolutely disgusting accusation to make, especially when Obamacare hasn't actually lowered the cost of care at all, it just taxed those of us already paying into the system so they could hand out subsidies to those who aren't.
Wait until they change Obamacare to be means tested instead of income based...there is going to be a hilarious amount of sniveling of Obamacare fans on this forum, and I'll be right here laughing my ass off reminding you all there is no such thing as a free lunch.
I fail to see how Hank Sinatra was accusing Qmavam of personally screwing anyone?
The way I interpreted it, he was pointing out that the system giving Qmavam a better deal was the same system that denied others any meaningful coverage.
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Ugh, one step forward to a single payer system that actually works.. one step back.
http://finance.yahoo.com/news/pelosi-judges-ruling-health-care-lawsuit-astounding-151716828--finance.html
I've been totally screwed by Obamacare!
In 2010 I had a $4,300 policy covering 4 people.
In 2012 when Obamacare policies started I got a 19.4% increase,
2013 I got a 21% increase and in 2014 an 18.8% increase.
Today I pay $8448 for 3 people, an equivalent Obamacare Silver
plan is $12,621 for my family of 3.
Then to make it worse, the government is going to take your money,
give it me as an insurance subsidy of about $8,000 which I then give
to the insurance company.
Also, my Doc won't deal with Obamacare.
Insurance companies raise prices all the time and doctors opt in and out and get throw out of all kinds of insurance networks and always have What you experienced were private sector market decisons.
Befire you were "screwed" by omabacare millions were screwed out of insurance, out of health care and out of life itself specifically because you had the deal you had. You're still getting the long straw.
You sir, disgust me. Someone with a middle class job is screwing other folk out of insurance, health care, and life itself? Do you even think about that garbage before you repeat it? I'm in the same boat as the above poster, and I'm in excellent health. Over the last decade+ I've had an employer provided insurance policy that cost roughly 10-14k a year for just myself. I have probably used about 2,000 dollars worth of care during that period. Do you know what that means? Over the last decade I have subsidized other people's healthcare for a six figure amount...am I also part of the reason people were "screwed out of life?"
I think you should hang your head in shame an apologize to Qmavam for even suggesting he has cheated someone out of life...that is an absolutely disgusting accusation to make, especially when Obamacare hasn't actually lowered the cost of care at all, it just taxed those of us already paying into the system so they could hand out subsidies to those who aren't.
Wait until they change Obamacare to be means tested instead of income based...there is going to be a hilarious amount of sniveling of Obamacare fans on this forum, and I'll be right here laughing my ass off reminding you all there is no such thing as a free lunch.
I fail to see how Hank Sinatra was accusing Qmavam of personally screwing anyone?
The way I interpreted it, he was pointing out that the system giving Qmavam a better deal was the same system that denied others any meaningful coverage.
That's also how I interpreted it. The only personal thing was pointing out that Qmavam was benfiting from the systemic failure to provide for people who couldn't afford any coverage at all, but weren't completely destitute. Lots of people were benefiting from the system as it existed before ACA.
Wailing and gnashing of teeth and fighting tooth and nail to preserve a system is completely natural when you're benefiting from it without actually seeing the consequences. ACA changes the system in a bunch of different ways to try to expand the system-wide benefits of comprehensive health insurance to a large group of people who haven't previously been able to get it. Some people see higher prices, and those people are going to be upset.
The thing to try to keep in mind is just how many people are able to do things they weren't able to do before. Start business. Get better jobs. Lead more productive lives because they're not constantly worried about medical bankruptcy. I'm one of them. Before ACA I would not have been able to start my incredibly successful business because of pre-existing conditions. I personally know people who had no health insurance at all and suffered for decades because they had known, untreated chronic illnesses, but now they have coverage and can actually get better and be more productive in society.
Also, for the record, since ACA was enacted the rate of medical inflation has dropped by almost half, matching the general inflation rate instead of vastly outpacing it.
http://ycharts.com/indicators/us_health_care_inflation_rate
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Thanks for the chart - I had heard this was happening.
My insurance costs have gone up too, but they were already going up really fast in the years prior to the ACA.
Decoupling health insurance from employment is one of the good things that's happened. Preventing exclusions for pre-existing conditions is a good thing too.
The OP proves that there's still a long way to go.
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Ugh, one step forward to a single payer system that actually works.. one step back.
http://finance.yahoo.com/news/pelosi-judges-ruling-health-care-lawsuit-astounding-151716828--finance.html
I've been totally screwed by Obamacare!
In 2010 I had a $4,300 policy covering 4 people.
In 2012 when Obamacare policies started I got a 19.4% increase,
2013 I got a 21% increase and in 2014 an 18.8% increase.
Today I pay $8448 for 3 people, an equivalent Obamacare Silver
plan is $12,621 for my family of 3.
Then to make it worse, the government is going to take your money,
give it me as an insurance subsidy of about $8,000 which I then give
to the insurance company.
Also, my Doc won't deal with Obamacare.
Insurance companies raise prices all the time ctor market decisons.
Yes, and before 2012 Obamacare Regulations started, I had 7% and 8% increases, not 19% 3 years in a row.
and doctors opt in and out and get throw out of all kinds of insurance networks and always have What you experienced were private se
Yep, but my doc accepted BCBS for the 21 years I have used him.
Before you were "screwed" by omabacare millions were screwed out of insurance, out of health care and out of life itself specifically because you had the deal you had. You're still getting the long straw.
In 2009 when my insurance hit $9,900 for a family of 4 with a $2,500 deductible I went shopping.
I couldn't find anything cheaper, but I did find if I raised my deductible to $10,000, my premium dropped to $4,300.
That was amazing to me! A $5,600 drop in my premium. So I did that. Everyone thought I was crazy for having a $10,000
deductible. (They didn't know what was coming down the line with Obamacare.)
All was great, I had a good but inexpensive policy, and was fully funding my HSA.
2010, I had a 7.2% premium increase, 2011, I got an 8.1%.
Then 2012 Obamacare regulations started and I got three huge increases in a row.
With 3 years of upheaval in the insurance market and we have now covered only 3.65% of the population.
http://www.hhs.gov/news/press/2015pres/03/20150310a.html
That's 11.7M/320M = 3.65% of the population.
So now we get to my policy with premium of$8,448 equivalant to the Bronze plan at a cost of
$12,661. The government mandated private insurance plan is 49.9% more expensive than existing plans.
Who gets that extra $4,213. The insurance company. Do you think It costs the insurance company
49.9% more to cover that 3.65% of the population. I don't!
Then you need to consider the subsidies to those on an Obamacare plan. I don't have an average
dollar amount for the subsidies, but mine calculates to $9,054, which is 71% of the policy cost.
Not only do we have increased insurance costs, we have an increased tax bill to cover the subsidies.
Were there people with problems? Yes, have they been corrected? Maybe some, but at a very high cost.
The complaint I hear from most lower income people on the plan is, where am I going to get $6,500 to pay
my deductible, or $12,500 if two in my family get sick.
We now cover prexisting conditions, we didn't need Obamacare to do that.
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You sir, disgust me. Someone with a middle class job is screwing other folk out of insurance, health care, and life itself? Do you even think about that garbage before you repeat it? I'm in the same boat as the above poster, and I'm in excellent health. Over the last decade+ I've had an employer provided insurance policy that cost roughly 10-14k a year for just myself. I have probably used about 2,000 dollars worth of care during that period. Do you know what that means? Over the last decade I have subsidized other people's healthcare for a six figure amount...am I also part of the reason people were "screwed out of life?"
I don't now about before 2009 but since then I have not reached my $10,000 deductible so NONE of my premium was spent directly on my families healthcare. I did benefit from the insurance companies fee negotiation.
Wait until they change Obamacare to be means tested instead of income based...there is going to be a hilarious amount of sniveling of Obamacare fans on this forum, and I'll be right here laughing my ass off reminding you all there is no such thing as a free lunch.
We may get means testing, but the thing I see are the subsidy amounts decreasing with time.
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buncha stuff
The only way medical underwriting was going away is if insurers were able to cover bigger risk pools, and the only way to do that is to force people to get insurance, but forcing people to pay for insurance is pretty terrible, thus the subsidies and cost sharing payments.
You can't eliminate medical underwriting without the other two bits. It just doesn't work. Elimination of medical underwriting does also lead to higher premiums, because the risk across each pool is greater. Premiums jumped up three years in a row because insurers were trying to get raises in under the gun. New provisions came online a few years ago that limited cost increases at the same time the medical underwriting for adults went away. Now that that's stabilized we should see things normalize a bit. Our premiums actually went down in 2015 for the same coverage, for example.
About the additional taxes to cover the subsidies, that's complete bunk for the vast majority of people. The subsidies are paid for in two ways. First, by optimizing Medicare payments and reducing waste. Second, by an additional Medicare tax on people with incomes greater than $250k. I don't know how may people that actually applies to, but among people in this forum it's probably very low. You say you get subsidies so by definition you are not paying this particular tax.
And yes, I think it's absolutely worth it to insure an additional eleven million people against catastrophic medical bills and/or death. This is how a functional society works, as opposed to the "fuck you got mine" system that existed prior. That said, reducing costs will likely be a focus for the next Congress that can actually get anything done.
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I fail to see how Hank Sinatra was accusing Qmavam of personally screwing anyone?
The way I interpreted it, he was pointing out that the system giving Qmavam a better deal was the same system that denied others any meaningful coverage.
I'm not sure if the point is I personally got a better deal, or if the poster thinks the whole population should have paid more for their policies.
Since I have paid 100% of my families healthcare costs since at least May 2009, I'm not sure
anyone could say I got a good deal on our insurance premium.
The good deal we have, is that our healthcare expenses have been low. We are blessed.
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And yes, I think it's absolutely worth it to insure an additional eleven million people against catastrophic medical bills and/or death.
But we didn't really cover 11 million more people, many people that had insurance got booted off and had to get Obamacare, others
when they figured in the subsidy found it was much cheaper to get Obamacare.
This is how a functional society works, as opposed to the "fuck you got mine" system that existed prior. That said, reducing costs will likely be a focus for the next Congress that can actually get anything done.
It's not black and white, The cost to me is to high, there had to be a better way than Obamacare.
$50,000 is enough for any family, should the government take the rest and give it to those making under
$50,000? Should we also give it to those that don't want to work? Where is the line?
Also, the way Obamacare was passed was very poor form. Then the slow implementation, affecting only small groups
at a time, which prevented a mass outcry from the citizenry. We still haven't got to taxing the Cadillac policies of the union workers.
But then, they're Obama's buddies.
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I don't know one person that has benefitted under Obamama care. Everyone with whom I have spokeen on the subject has had cost for healthcare rise, including my aging parents on fixed incomes. As I see it, Obamacare is another government run (poorly) social program that will cost taxpayers billions. Kind of like the war on poverty whose social programs cost tax payers billions yet poverty numbers changed little.
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http://www.cnbc.com/2015/09/11/expatriates-choosing-to-leave-the-us-rather-than-pay-taxes.html
Thanks Obamacare.
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http://www.cnbc.com/2015/09/11/expatriates-choosing-to-leave-the-us-rather-than-pay-taxes.html
Thanks Obamacare.
Why do you think the content of that link has anything to do with "Obamacare"? US citizens and residents are not required to make the individual "shared responsibility payment" if they reside outside the US as defined in 26 USC § 5000A(f)(4)(A). If your sole concern is avoiding "Obamacare", there is no need to relinquish your US citizenship (or, for aliens, to terminate your US lawful permanent residency).
The "crackdown" referred to in the link is presumably Subtitle A of Title V of PL 111-146 (http://www.gpo.gov/fdsys/pkg/PLAW-111publ147/pdf/PLAW-111publ147.pdf), which subtitle is commonly referred to as the Foreign Account Tax Compliance Act ("FATCA"). This legislation contained various measures designed to make it harder for US citizens and residents to evade their pre-existing tax responsibilities. Although it was enacted back on March 18, 2010, it has only relatively recently taken effect as the Treasury department had to negotiate agreements with foreign governments to implement it.
FATCA is unpopular among many US citizens and residents (especially, although not limited to, those citizens and residents who were not paying the tax they owed), but it's wholly separate from "Obamacare".
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I have certainly benefited from Obamacare, so now you know one person. Before Obamacare and its provision that pre-existing conditions cannot be excluded, my husband could not get insurance for love or money. He has a condition that requires monitoring (expensive tests) four times a year because there is a 30% chance that it will develop into cancer. So he was on my company insurance for many years. But then the marriage broke up, for very good reasons, but those are irrelevant here. I took him off my insurance in preparation for the divorce, but he found he could simply not get new insurance. He is self-employed and thus gets no corporate insurance. He tried to get a job so that he could get insurance, but a 56-year-old man who has been self-employed his whole life turns out not to be all that employable. He could only get jobs that didn't include benefits. He went a year with no insurance, unable to afford his quarterly tests. His health declined. I saw the writing on the wall and put him back on my insurance. So I have refrained from divorcing him for more than ten years so that he could get insurance and so that, frankly, he doesn't die. When Obamacare was passed, hallelujah! I am finally free to divorce without worrying that I am signing his death sentence. He got insurance and we are home free. I know several other people who have been uninsured for years who have also finally been able to get insurance. Thanks heavens, is all I can say.
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I don't know one person that has benefitted under Obamama care. Everyone with whom I have spokeen on the subject has had cost for healthcare rise, including my aging parents on fixed incomes. As I see it, Obamacare is another government run (poorly) social program that will cost taxpayers billions. Kind of like the war on poverty whose social programs cost tax payers billions yet poverty numbers changed little.
Maybe not but I know two that went bankrupt with crippling medical debt after they couldn't get insurance due to pre-exisiting conditions.
The ACA is not the root cause of the problem in any case.. the real problem is we pay 100% more than most of the developed western world. In fact in the UK they spend $3500/person a year on HC.. with their evil socialist system..in the US we spend $10,000. No system is perfect but I can tell you from experience the UK provides pretty good care.
But of course there are plenty of corporations paying for soundbites on Fox "News" to tell us that the ACA will cause us all ruin.
Just like they did when Social Security was invented.
The sooner the ACA becomes a single payer "Medicare for all" system the better.
Did you know that Medicare is also the most cost effective way the US pays for HC?... Go figure!
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FATCA is unpopular among many US citizens and residents (especially, although not limited to, those citizens and residents who were not paying the tax they owed), but it's wholly separate from "Obamacare".
It was passed through the HIRE act ramrodded through around the same time as Obamacare which isn't by coincidence. It is 577 pages of regulation garabage that has unintended conciquences just like Obamacare. They purposely hide these little gems in the ACA and HIRE acts as they would never pass on their own. So to me ACA and HIRE are no different as they came out of the same play book. Remember you have to pass the bill to see what is in it. That is a total joke.
Both acts might do some good but the unintended conciquences of the bills is what I have a problem with. When you put pages and pages of regulation garbage out this is what you get. The IRS tax code is no different.
I just got my letter the other day from a great doctor.
"Because of some of the recent dramatic changes in the health care world; most notably "Obamacare", Electronic Health Records and the new diagnosis coding system, the administrative aspects of solo practice have become impossible."
I finaly found this doctor after going to multiple doctors about high blood pressure. The last doctor was a Kidney specialist which like the others put me on some latest and greatest new drug. It worked for a while then slowly lost effectiveness. What was his answer... increase the dose. The specialists wouldn't listen to what I was saying so I moved on. Now I am back to the same problem trying to find a good doctor that works with their patient.
I am sure neither bill meant for citizens or doctors to leave but when you regulate it so that it is no longer worthwhile to deal with then this is what happens.
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If you were getting employer paid health insurance for years, you were actually getting a subsidy and didn't know it. That $10,000 your employer paid for your health insurance was not taxed as income to you.
Someone who had to buy their insurance with their own money likely paid $2500 more because they were not getting the $2500 subsidy you got with your employer paid health insurance (assume both pay about 25% in taxes).
So really it isn't like the ACA is the first case of taxpayer subsidized health insurance.
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If you were getting employer paid health insurance for years, you were actually getting a subsidy and didn't know it. That $10,000 your employer paid for your health insurance was not taxed as income to you.
Someone who had to buy their insurance with their own money likely paid $2500 more because they were not getting the $2500 subsidy you got with your employer paid health insurance (assume both pay about 25% in taxes).
So really it isn't like the ACA is the first case of taxpayer subsidized health insurance.
That's a big part of it. If you happened to be employed by a company that had a large enough pool to get good rates, and then they subsidized it for you, it was a great deal. My wife has worked for the same small (30-ish people) company for the last 10 years and the premiums they offered have always sucked when expanded beyond the employee to a spouse or children. That tells me they simply aren't subsidizing that part of the premium much.
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My health insurance rates have been skyrocketing since Obamacare was implemented. It is the gift that keeps on giving. It has not worked out for me and my family. That's not politics, just family economics. It makes me wonder how much longer I can afford to stay insured. I already have a bare bones catastrophic plan. No place to go down from here, i.e. take a cheaper plan.
OTOH if you were previously uninsurable, ACA has been a godsent. I get that.
I started to get worried when I saw that the private health care industry and the pharmaceutical industry were so excited about ACA that they were aggressively lobbying for it. That kind of made me nervous and now I can see why they were so excited. If medical costs are flattening out so much, why are my premiums skyrocketing? We are all healthy with no significant health issues.
The Medicare arguments are interesting. My doctor is refusing new medicare patients. He just cannot afford to take them. No, he is not a filthy rich doctor. Just a guy trying to keep his practice afloat. He is drowning in administrative work and low reimbursements. I think that if you create a single payer system you also need to make the docs all federal employees. Who will be paying back those huge student loans then?
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I don't know one person that has benefitted under Obamama care. Everyone with whom I have spokeen on the subject has had cost for healthcare rise, including my aging parents on fixed incomes. As I see it, Obamacare is another government run (poorly) social program that will cost taxpayers billions. Kind of like the war on poverty whose social programs cost tax payers billions yet poverty numbers changed little.
Congratulations, you win the target of my rant! I am sick and tired of analytically challenged people who somehow can ignore the decades long history of sometimes double-digit annual medical inflation that FAR outstripped overall inflation pre-ACA and then see some premiums go up after ACA and decide that the ACA raised their healthcare costs. Healthcare costs too damn much and due to the complete market failure we have in this country, providers and manufacturers can charge almost whatever they want to with very little restriction. So big shocker when they keep jacking up rates. The system we have is terrible and expensive. The ACA actually works to make it less terrible and less increasingly expensive. But it doesn't go nearly far enough. It's also not a huge government program--it's mostly helping people afford private insurance. And if your parents are on Medicare, the ACA has nothing to do with their costs. And if they aren't on Medicare, then their costs are going up because they are "aging" and old people just cost a LOT more wrt health care. The ACA has actually been associated with a reduction in the increase of medical expense (whether it's the cause is unclear). So things have actually gotten better since the ACA. But analytically challenged people just can't figure that out.
And I am not a big ACA fan. It's not what I would have proposed. But it's definitely better than what we had before. We are still a long way from a good situation.
Oh, and the ACA helped out my brother and his family (including his children) and my parents. They were all uninsured for years because they couldn't afford insurance.
And why does it matter if anyone you know was helped or not? The country is bigger than just you and your particular social circle. And maybe people just don't want to talk about how it's helped them because they fear the bile-soaked attitudes of all the people who are so irrationally and uninformedly opposed to the legislation.
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I've benefited from Obamacare. My insurance premiums didn't rise and I have better insurance due to the minimum standards enacted by the ACA. I have a friend who could not get insurance prior to Obamacare because she had a pre-existing condition. She thinks Obamacare is awesome.
We've had friends tell us that they can't afford to retire because health insurance premiums will be too high. They've bought into this notion that Obamacare raised prices for everyone. When they hear what we pay, they're comforted to know that it's not bad at all. My husband has reasonably priced Platinum insurance and I have a cheap HSA-eligible plan.
We get no subsidies because our income it too high.
When Obamacare got passed, I hated it. I thought it was a terrible idea. But it looks good to me now.
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Socialized medicine is sure popular with those not paying the bills.
I don't understand you socialists, forcing me to pay for other people's problems. What's up with that? Get your dam' hands out of my pockets!
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Socialized medicine is sure popular with those not paying the bills.
I don't understand you socialists, forcing me to pay for other people's problems. What's up with that? Get your dam' hands out of my pockets!
More proof of the fact that no matter what DATA you provide, there will always be those who will hate because it doesn't align with their political philosophy.
Like I said earlier.. the root cause is HC is at least 2X as expensive as many systems around the world that provide equivalent care. The for profit HC system has been jacking up rates long before the ACA was ever thought of.
And now the ACA is proven to be showing a reduction in the rate of cost increase.
I suppose we should repeal Social Security as well???
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Socialized medicine is sure popular with those not paying the bills.
I don't understand you socialists, forcing me to pay for other people's problems. What's up with that? Get your dam' hands out of my pockets!
Your sig says you have six mini mustaches. If that means kids, I wonder if you put them through private school? If not, get your hands out of MY pocket, as I went to a private school and we have no children ourselves.
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I don't understand you socialists, forcing me to pay for other people's problems. What's up with that? Get your dam' hands out of my pockets!
How is it that society not letting others DIE because of the inability to get insurance is so hard to comprehend? I mean, I really honestly have never gotten this argument. So your answer is for people to D-I-E? I get the vicious "hands out of my pockets" for many things, tons of topics that don't include people dying, but this seems to me to be one clear case of not being a jerk who is only concerned about you. People are DYING because they can't get insurance. DYING! I feel like repeating myself again because I just can't figure out this idea that your extra money in your own pockets is more important than people DYING. I just, I just can't figure out this argument. Sure, I can argue all the logic about how Obamacare is good in this way or bad in that way but fundamentally if you're going to insure people who are in ill health (preexisting, old, whatever) you are going to have cost sharing (aka socializing). Period. So yeah, with my very good employer subsidized health insurance plan which yes, will go up in cost, here's me STILL not being a jerk about the fact that there are other people who need insurance. You can argue around the edges about ways to improve it but I can't understand the argument that its better to just let anyone who can't afford insurance die. No, that I refuse to accept as a valid argument that any rational HUMAN being would make. Because "others peoples problems" yeah, death is kinda of a problem I'm willing to help other people with.
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Socialized medicine is sure popular with those not paying the bills.
I don't understand you socialists, forcing me to pay for other people's problems. What's up with that? Get your dam' hands out of my pockets!
The problem with this line of thinking is that it's basically a big fuck you to all the sick people. More often that not, people who have major illnesses were uninsurable pre-ACA. Those illnesses also tend to result in those folks having lower income. They either can't hold a job, or their performance is impacted by their illness and that results in them making less money than a healthy person.
Despite being all about keeping what I've earned, I believe healthcare is one of the few areas where the system should be socialist. Treating major illnesses will always be some kind of expensive, likely more than a sick person can afford. So there will always need to be some type of subsidy unless you willing to say that everyone who gets sick should figure out how to pay for it or die. Plenty of people feel that way until it's their mother, brother, or child who becomes sick. Then the opinion changes.
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My health insurance rates have been skyrocketing since Obamacare was implemented. It is the gift that keeps on giving. It has not worked out for me and my family. That's not politics, just family economics. It makes me wonder how much longer I can afford to stay insured. I already have a bare bones catastrophic plan. No place to go down from here, i.e. take a cheaper plan.
You can always go on the dole, sign up for Obamacare and get the subsidy. I'm very close to doing that, I need to see how my taxes
work out this year. I have poked all my data into the Marketplace and see a Bronze plan for a family of 3 is $12,661 and I will receive
$9054 as a subsidy from the hard working taxpayers. The leaves a premium for me of $3,607 vs $8448 that I pay now. That is a big chunk of change to save at $4,841. Probably won't be quite that much, I'll lose some tax deduction on my premium and I suspect my
income will be higher next year. I'll need to find a new doc. :-(
OTOH if you were previously uninsurable, ACA has been a godsent. I get that.
Yep, I know one couple with a cancer survivor that couldn't get insurance, they were very happy.
I started to get worried when I saw that the private health care industry and the pharmaceutical industry were so excited about ACA that they were aggressively lobbying for it. That kind of made me nervous and now I can see why they were so excited. [/quote
Yes, i'm kicking myself for not buying a healthcare EFT.
If medical costs are flattening out so much, why are my premiums skyrocketing? We are all healthy with no significant health issues.
Ya, Why?
The Medicare arguments are interesting. My doctor is refusing new medicare patients. He just cannot afford to take them. No, he is not a filthy rich doctor. Just a guy trying to keep his practice afloat. He is drowning in administrative work and low reimbursements. I think that if you create a single payer system you also need to make the docs all federal employees. Who will be paying back those huge student loans then?
The usual 51%, The Hardworking Taxpayers.
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Apparently if you link to a Yahoo! article, the comments section comes with it.
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My friend has benefited from the ACA. She has a medically fragile child and was formerly paying 1500+ month for insurance just on the child as well as tens of thousands in out of pocket expenses. She had spent her 401(k) down to nothing to keep her kid alive and her parents were getting ready to raid their bank accounts too. She couldn't leave her job because she'd lose her insurance and she couldn't risk her kid not being covered due to pre-existing conditions.
The ACA has reduced her premiums to an affordable level (she still pays a significant amount, but it's no longer bankrupting her) and gave her the option to leave her unpleasant job and start a new business, which is thriving.
And I'll benefit from the ACA. DH and I are going to semi-retire soon, and that means giving up our corporate plan. We won't be eligible for any subsidies, which is fine, we don't need them, but our ACA plan will indeed be affordable to us. About 550/mo to cover both of us, plus some out of pocket costs we are also budgeting for. That's not even the cheapest plan, but one that offers an HSA and a large physician network.
I'm happy to read about the rate of uninsured Americans dropping so steadily. The idea of having an ill loved one and no means to get good care for them breaks my heart. Emergency Rooms may stabilize people, but that's not the same thing as getting care.
Any politician who says they want to repeal or gut the ACA loses my vote, in a blink.
SIS
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The government needs to get in on healthcare is that public health is a critical health issue. The more people stay out of emergency rooms and see their doctor, the healthier they are. The healthier and sick for a shorter amount of time prevents the likelihood of widespread sickness.
When you couple that common good risk with a private market that is increasingly oligopolistic, its incumbent on the government to step in.
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Socialized medicine is sure popular with those not paying the bills.
I don't understand you socialists, forcing me to pay for other people's problems. What's up with that? Get your dam' hands out of my pockets!
The problem with this line of thinking is that it's basically a big fuck you to all the sick people. More often that not, people who have major illnesses were uninsurable pre-ACA. Those illnesses also tend to result in those folks having lower income. They either can't hold a job, or their performance is impacted by their illness and that results in them making less money than a healthy person.
Despite being all about keeping what I've earned, I believe healthcare is one of the few areas where the system should be socialist. Treating major illnesses will always be some kind of expensive, likely more than a sick person can afford. So there will always need to be some type of subsidy unless you willing to say that everyone who gets sick should figure out how to pay for it or die. Plenty of people feel that way until it's their mother, brother, or child who becomes sick. Then the opinion changes.
Not just major illnesses. I locked my traps and poof, no insurance for me.
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My friend has benefited from the ACA. She has a medically fragile child and was formerly paying 1500+ month for insurance just on the child as well as tens of thousands in out of pocket expenses. She had spent her 401(k) down to nothing to keep her kid alive and her parents were getting ready to raid their bank accounts too. She couldn't leave her job because she'd lose her insurance and she couldn't risk her kid not being covered due to pre-existing conditions.
The ACA has reduced her premiums to an affordable level (she still pays a significant amount, but it's no longer bankrupting her) and gave her the option to leave her unpleasant job and start a new business, which is thriving.
And I'll benefit from the ACA. DH and I are going to semi-retire soon, and that means giving up our corporate plan. We won't be eligible for any subsidies, which is fine, we don't need them, but our ACA plan will indeed be affordable to us. About 550/mo to cover both of us, plus some out of pocket costs we are also budgeting for. That's not even the cheapest plan, but one that offers an HSA and a large physician network.
I'm happy to read about the rate of uninsured Americans dropping so steadily. The idea of having an ill loved one and no means to get good care for them breaks my heart. Emergency Rooms may stabilize people, but that's not the same thing as getting care.
Any politician who says they want to repeal or gut the ACA loses my vote, in a blink.
SIS
Short, I am with you. I'm not planning to get any subsidies but being able to buy insurance not through employer at a decent rate (which yes I consider $500/month reasonable at the income level many of us are at) is great!
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The ACA has actually been associated with a reduction in the increase of medical expense (whether it's the cause is unclear). So things [costs] have actually gotten better worse at a slower rate since the ACA. But analytically challenged people just can't figure that out.
FTFY :-)
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My health insurance rates have been skyrocketing since Obamacare was implemented... I already have a bare bones catastrophic plan. No place to go down from here, i.e. take a cheaper plan.
...
If medical costs are flattening out so much, why are my premiums skyrocketing? We are all healthy with no significant health issues.
I am guessing this is apples to oranges to a certain extent.
Pre-ACA you could get a catastrophic plan that didn't cover preventive services. Post ACA, there is a long list of preventive services that must be covered by insurance with no cost sharing. This means premiums have to go up because more things are being paid for.
Also, insurers can no longer exclude people with pre-existing conditions (i.e. expensive patients). Those costs need to be covered somehow, and insurers get their money to cover additional costs by raising premiums.
Increasing coverage costs money. The hope was to offset those costs by enrolling low risk, healthy young people. I am not sure how much those have balanced out the increase in costs for the reasons above.
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If medical costs are flattening out so much, why are my premiums skyrocketing? We are all healthy with no significant health issues.
Ya, Why?
This is how life works. Neither the marketplace nor society itself exist to give anyone a personally sweet deal. The purpose of a society is to maintain and further its existence and that means the people who comprise it. It's major function is to ensure all members have access to the things that Society has deemed necessary and essential. To that end the marketplace is merely a tool at The People's disposal. There are other tools just as legitimate.
If you don't like the price increase work harder and make more money. As for the rest of society they can manage these things any way they'd like to. That is what a free society is all about. Not making sure some Joe Blow gets his ass kissed.
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Thanks for the chart - I had heard this was happening.
My insurance costs have gone up too, but they were already going up really fast in the years prior to the ACA.
Decoupling health insurance from employment is one of the good things that's happened. Preventing exclusions for pre-existing conditions is a good thing too.
The OP proves that there's still a long way to go.
My family insurance premiums nearly doubled when the ACA took effect, and my coverage did not measurably improve. Of course, the coverage didn't deteriorate, either; but most of the difference was, in effect if not in fact, a tax upon my family in order to subsidize another person or family.
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It's major function is to ensure all members have access to the things that Society has deemed necessary and essential. To that end the marketplace is merely a tool at The People's disposal. There are other tools just as legitimate.
If you don't like the price increase work harder and make more money. As for the rest of society they can manage these things any way they'd like to. That is what a free society is all about.
Just don't forget how this thing was passed.
Not making sure some Joe Blow gets his ass kissed.
Ya, that Joe Blow is nearly 100 million Hardworking Taxpayers.
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Once I left the Corporate Teet, I was uninsurable pre-ACA (Tourette's Syndrome). I used an "indemnity plan" as a stop gag substitute but was very exposed to something major like MS or Parkinson's. Now I have insurance that only costs about 20% more than my indemnity plan and has no lifetime limit. I do not qualify for subsidies and am plenty happy with ACA.
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Once I left the Corporate Teet, I was uninsurable pre-ACA (Tourette's Syndrome). I used an "indemnity plan" as a stop gag substitute but was very exposed to something major like MS or Parkinson's. Now I have insurance that only costs about 20% more than my indemnity plan and has no lifetime limit. I do not qualify for subsidies and am plenty happy with ACA.
Thanks for the chart - I had heard this was happening.
My insurance costs have gone up too, but they were already going up really fast in the years prior to the ACA.
Decoupling health insurance from employment is one of the good things that's happened. Preventing exclusions for pre-existing conditions is a good thing too.
The OP proves that there's still a long way to go.
My family insurance premiums nearly doubled when the ACA took effect, and my coverage did not measurably improve. Of course, the coverage didn't deteriorate, either; but most of the difference was, in effect if not in fact, a tax upon my family in order to subsidize another person or family.
People that were otherwise healthy and could count on getting health insurance will unfortunately probably never understand these competing points of view. To them, the ACA is simply a "tax" on the healthy. The fact of the matter is, there's not really any other way. There is no such thing as a free lunch. My perspective is from that of a health care worker. I, for one, am glad to be now getting paid for the work I do. Pre-ACA, people were generally of the mind that healthcare should be "free". Now at least we can be reasonably assured of getting paid for the hard work we do without having to resort to charities.
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All private plans "tax" you, if you're healthy, so that unhealthier people are covered. Other insurance does this too. If your house never burns down, your payments go to fund people whose houses do burn down. You are either subsidizing others or the one being subsidized. In health care, all of us will probably be both — the subsidizers when we're young, and the subsidized when we're older and have health problems. (Because however healthy and responsible we are, very few of us get to our last day without any health problems.) Some people subsidizing other people is how insurance systems work.
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Thanks for the chart - I had heard this was happening.
My insurance costs have gone up too, but they were already going up really fast in the years prior to the ACA.
Decoupling health insurance from employment is one of the good things that's happened. Preventing exclusions for pre-existing conditions is a good thing too.
The OP proves that there's still a long way to go.
My family insurance premiums nearly doubled when the ACA took effect, and my coverage did not measurably improve. Of course, the coverage didn't deteriorate, either; but most of the difference was, in effect if not in fact, a tax upon my family in order to subsidize another person or family.
At what point does Atlas shrug?
I read that book, because someone suggested it. I thought it sucked.
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All private plans "tax" you, if you're healthy, so that unhealthier people are covered. Other insurance does this too. If your house never burns down, your payments go to fund people whose houses do burn down. You are either subsidizing others or the one being subsidized. In health care, all of us will probably be both — the subsidizers when we're young, and the subsidized when we're older and have health problems. (Because however healthy and responsible we are, very few of us get to our last day without any health problems.) Some people subsidizing other people is how insurance systems work.
To one degree or another, yes they do. But I had, and still have, an HSA; so the majority of my premiums before the ACA taking effect were to fund the risk pool of my family needing more than $6500 in actual medical costs in a year. After the ACA taking effect, roughly $100 per month of my premium costs were to cover the regulatory costs of the plan; in other words, to subsidize people who receive federal subsidies. The basic principle of insurance, that all members within a risk pool share the costs equally, has been undermined by law; because those people that qualify for subsidies are protected from the full risk of equal sharing by the letter of the ACA itself. That actually has much to do with the lawsuit that this thread starts with. Furthermore, I'm not just risk sharing with other families that use HSA's anymore, because I'm now paying more to subsidize plans that are better than my own; i.e. silver and higher quality plans.
To put it bluntly, the burden of risk is no longer even across the risk pool, and that is not fair to those of us who actually had insurance to begin with. As happens so often with the complex laws that come out of Washington, DC these days; the greatest long term effects that the ACA will have will be it's unintended consequences on the economy.
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Or maybe it will be so painful that we finally realize that HC just costs too much and there might finally be the political will to stop providers for behaving like cartels and gouging all of us.
Then maybe we'll finally get to a medicare for all plan and pay the same rate the rest of the Western world does.. i.e HALF or less than what we pay.
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Socialized medicine is sure popular with those not paying the bills.
I don't understand you socialists, forcing me to pay for other people's problems. What's up with that? Get your dam' hands out of my pockets!
Your sig says you have six mini mustaches. If that means kids, I wonder if you put them through private school? If not, get your hands out of MY pocket, as I went to a private school and we have no children ourselves.
And all those tax deductions and credits I'm paying for!
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Or maybe it will be so painful that we finally realize that HC just costs too much and there might finally be the political will to stop providers for behaving like cartels and gouging all of us.
Then maybe we'll finally get to a medicare for all plan and pay the same rate the rest of the Western world does.. i.e HALF or less than what we pay.
Almost certainly not. The insurance system in the US is pretty screwed up, but it's still not the main reason that health care insurance is expensive here. The VA is pretty much the closest thing to a single payer system in the US, and it costs about as much as the private system does and is lucky to provide equal quality of care.
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Or maybe it will be so painful that we finally realize that HC just costs too much and there might finally be the political will to stop providers for behaving like cartels and gouging all of us.
Then maybe we'll finally get to a medicare for all plan and pay the same rate the rest of the Western world does.. i.e HALF or less than what we pay.
Is that why healthcare costs so much? All of us providers that are getting fantastically wealthy? From my own view here on the ground, one of the big reasons why healthcare costs so much is the same reason that conservatives often rave about our own system versus the "evils" of single payer. Namely that you have to wait oh so long for a procedure in that terrible bastion of communism, aka Canada, whereas in America you can often have your procedure done the same day. Isn't America great?! Yeah, until you realize that you're basically paying a guy like me to sit around and play video games on his phone until some work comes across his plate. Sure I'm busy sometimes, but Americans don't like to wait, so somebody is always on duty when maybe they don't necessarily need to be.
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Apparently if you link to a Yahoo! article, the comments section comes with it.
Literal LOL.
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Or maybe it will be so painful that we finally realize that HC just costs too much and there might finally be the political will to stop providers for behaving like cartels and gouging all of us.
Then maybe we'll finally get to a medicare for all plan and pay the same rate the rest of the Western world does.. i.e HALF or less than what we pay.
Almost certainly not. The insurance system in the US is pretty screwed up, but it's still not the main reason that health care insurance is expensive here. The VA is pretty much the closest thing to a single payer system in the US, and it costs about as much as the private system does and is lucky to provide equal quality of care.
This to my mind is one GOOD thing about the ACA.. Its PAINFUL.. Yes, but it gets us talking about the cost of care!
So whatever the reason.. lets sit down and find out why the UK spends $3500 per person and the US $10,000.. We (ordinary folks) simply can't afford this and it (was) rising at least double the rate of inflation.
When I say ordinary folks can't afford it.. of course they can't that's why there are massive subsidies.. Either we put up with the subsidies (like RE taxes that go to schools even though I don't have kids).. Or we take care of the root cause find out WTF is going and who is gouging who.. Cus somebody sure as hell is!
The US is a WONDERFUL place to be.. I wouldn't go back to the UK, too many other problems... BUT.. the UK and almost EVERYBODY else has figured the problem of high cost HC out.. Why can't we?
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Our country pays 17% of GDP for healthcare; that is far and away much higher than the vast majority of developed countries, which pay 11% on down. (Canada 10.9%, Denmark 10.6%, Iceland 9.1%, Germany 11.3%, New Zealand 9.7%, Australia 9.4%, UK 9.1% — http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS). Much of this excess is due to our bewildering excessive bureaucracy, where a typical doctors' practice will have two or three people on staff whose full-time job it is to sort out the claims between the myriad health insurance companies. Add the insurance companies' own bureaucracies, including the entire floors dedicated to finding ways to deny people's claims. (I have posted before about how I used to work for an insurance company.) Then the fact that they are for-profit companies, as are many hospitals, and have to take a slice off every transaction for the shareholders. Then also the fact that the set-up means many people, such as the insured and those who have trouble paying deductibles, don't get preventive health care. Then add the cost of treating the uninsured when they have health emergencies and rely on emergency room care for when the abcess, infection, etc. has finally gotten out of control. It all adds costs that single-payer or centrally organized not-for-profit systems don't have.
So first let's look at the fact that 35% of health care costs (17% instead of 11% of GPD) is spent on this crazy for-profit bureauracy. All our premiums and healthcare expenses could be 35% cheaper if we had a sane system.
The other issue is that under ACA (as actually under all current insurance systems) some people are subsidizing the healthcare of others. Yup. That's how it works. That's how schooling works, that's how the highway system works, that's how national defense works, that's how paying for all infrastructure and law enforcement and all of it works. Those who can afford more are asked to pay more. I get that those who can afford more don't always like it. There are arguments as to why those with more should contribute more, and how those with more have benefited from the system in invisible ways, and how there should be a safety net because even those with lots of money can lose it. But I get that some people just want to hang on to their dollars.
To me, it's crazy that we've developed this system around healthcare rather than around schooling. Healthcare is more essential than schooling. Why not assure free healthcare for everyone, and let people's schooling have deductibles and fees, and depend on their parents' jobs (some jobs will subsidize it, some not), and whether they can afford schooling to pay the $10,000 per year themselves or get some corporation or group to do it for them, and when they lose jobs they have to give up their kids' right to free schooling until they get another job, unless they can pay for COBRA. And poor people have a harder time affording schooling, but that's their problem; at least people who have worked and saved don't have to pay for other people's schools. At least then nobody would die from this system. But somehow we accept that schooling should be available at no cost for all citizens, but not treatments to keep them healthy and alive. Beats me.
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At what point does Atlas shrug?
Atlas isn't bearing the burden. If he shrugs, it's out of boredom.
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Our country pays 17% of GDP for healthcare; that is far and away much higher than the vast majority of developed countries, which pay 11% on down. (Canada 10.9%, Denmark 10.6%, Iceland 9.1%, Germany 11.3%, New Zealand 9.7%, Australia 9.4%, UK 9.1% — http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS). Much of this excess is due to our bewildering excessive bureaucracy, where a typical doctors' practice will have two or three people on staff whose full-time job it is to sort out the claims between the myriad health insurance companies. Add the insurance companies' own bureaucracies, including the entire floors dedicated to finding ways to deny people's claims. (I have posted before about how I used to work for an insurance company.) Then the fact that they are for-profit companies, as are many hospitals, and have to take a slice off every transaction for the shareholders. Then also the fact that the set-up means many people, such as the insured and those who have trouble paying deductibles, don't get preventive health care. Then add the cost of treating the uninsured when they have health emergencies and rely on emergency room care for when the abcess, infection, etc. has finally gotten out of control. It all adds costs that single-payer or centrally organized not-for-profit systems don't have.
So first let's look at the fact that 35% of health care costs (17% instead of 11% of GPD) is spent on this crazy for-profit bureauracy. All our premiums and healthcare expenses could be 35% cheaper if we had a sane system.
The other issue is that under ACA (as actually under all current insurance systems) some people are subsidizing the healthcare of others. Yup. That's how it works. That's how schooling works, that's how the highway system works, that's how national defense works, that's how paying for all infrastructure and law enforcement and all of it works. Those who can afford more are asked to pay more. I get that those who can afford more don't always like it. There are arguments as to why those with more should contribute more, and how those with more have benefited from the system in invisible ways, and how there should be a safety net because even those with lots of money can lose it. But I get that some people just want to hang on to their dollars.
To me, it's crazy that we've developed this system around healthcare rather than around schooling. Healthcare is more essential than schooling. Why not assure free healthcare for everyone, and let people's schooling have deductibles and fees, and depend on their parents' jobs (some jobs will subsidize it, some not), and whether they can afford schooling to pay the $10,000 per year themselves or get some corporation or group to do it for them, and when they lose jobs they have to give up their kids' right to free schooling until they get another job, unless they can pay for COBRA. And poor people have a harder time affording schooling, but that's their problem; at least people who have worked and saved don't have to pay for other people's schools. At least then nobody would die from this system. But somehow we accept that schooling should be available at no cost for all citizens, but not treatments to keep them healthy and alive. Beats me.
And your numbers are per unit of GDP.. have a look at the same data that lists costs per person... Its much worse than 17% vs 9.1% example for the UK.
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http://www.cnbc.com/2015/09/11/expatriates-choosing-to-leave-the-us-rather-than-pay-taxes.html
Thanks Obamacare.
The fumes are getting to you. That stuff causes leukemia ya know. Obamacare has nothing to do with this. It's been going on a long time. And ya know what? I know about a dozen of these people who have either done it or are always talking about doing it. They always expat to countries like Germany, UK, Canada, Switzerland, Ireland etc. NONE of these sorest of winners and pants-crappers ever move to Sudan or Yemen or some other place that has a weak small government you can drown in the bathtub and likes he-Man "Achievers". NO WAY! They always go to evil, socialist, communist, dictatorships that take away their freedom with universal healthcare! And don't allow every swingin' law-abiding citizen to carry a gun everywhere. What a bunch of lying losers. Now, how can they be truly free and safe with healthcare and no guns?
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Our country pays 17% of GDP for healthcare...
The costs of the bureaucracy aside for a moment, I recently heard (on Freakonomics Radio podcast,Are You Ready for a Glorious Sunset? on Aug 26th, to be precise) that roughly 40% (iirc) of medical expenses are incurred in the last 2 years of life. The argument there is, are we doing this the right way? The US system basicly tries to save everyone's life to whatever extent is possible with current technology, and the costs of doing so (both in terms of actual monetary fees, and quality of life during those final years) are actually a secondary consideration. Whereas it is much more common in Europe for elder Europeans to enter into 'hospice' style care at a much earlier stage in many terminal conditions. Said another way, is it really in the best interests of grandpa, or his grandchildren, to spend $500K to have even an 80% chance that grandpa can suppress that cancerous tumor for another 2 years?
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Our country pays 17% of GDP for healthcare...
The costs of the bureaucracy aside for a moment, I recently heard (on Freakonomics Radio podcast,Are You Ready for a Glorious Sunset? on Aug 26th, to be precise) that roughly 40% (iirc) of medical expenses are incurred in the last 2 years of life. The argument there is, are we doing this the right way? The US system basicly tries to save everyone's life to whatever extent is possible with current technology, and the costs of doing so (both in terms of actual monetary fees, and quality of life during those final years) are actually a secondary consideration. Whereas it is much more common in Europe for elder Europeans to enter into 'hospice' style care at a much earlier stage in many terminal conditions. Said another way, is it really in the best interests of grandpa, or his grandchildren, to spend $500K to have even an 80% chance that grandpa can suppress that cancerous tumor for another 2 years?
The ACA tried to do something about that. But then somebody started to literally scream bloody murder about death panels.
It's already well known that the way to save money in healthcare is rationing. But Americans love their all you can eat healthcare buffet, in sparkling healthcare palaces, and equal access for all at all times of day and night.
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Certainly the insurance companies want rationing. Until now they've done it by disallowing pre-existing conditions. Now they'll be looking for other ways to cut costs. But the profits won't go. That's how we could really cut healthcare costs — by switching to a system that is not full of for-profit insurance companies and for-profit hospitals and all of that. But in effect Americans would rather have a for-profit system than cheaper healthcare, and would rather have the "death panel" decisions of the insurance companies than cheaper non-profit healthcare.
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Certainly the insurance companies want rationing. Until now they've done it by disallowing pre-existing conditions. Now they'll be looking for other ways to cut costs. But the profits won't go. That's how we could really cut healthcare costs — by switching to a system that is not full of for-profit insurance companies and for-profit hospitals and all of that. But in effect Americans would rather have a for-profit system than cheaper healthcare, and would rather have the "death panel" decisions of the insurance companies than cheaper non-profit healthcare.
I'm all on board with cutting out the insurance companies, but I'm with Moonshadow on this one. It's not going to be a panacea either...just look at the VA. And just how far down the rabbit hole do you want to go to cut out the profit motivation? Pharmaceutical companies? Medical device companies? How about clinical laboratories? That's my line of work. Constantly chasing down the fat reimbursement cash from the endlessly changing and schizophrenic Medicare. Sure, Medicare has way lower overhead then the profit driven insurance companies. But then you have to put up with a booming business in motorized medical scooters. And in the meantime the good old hospital based CBC hasn't seen a reimbursement increase in like 15 years.
The real problem in healthcare costs are the expectations of Americans. And the ACA is just a reflexive result of that. It's just an attempt to find a way to pay for everything that's been either mandated or expected of healthcare since pretty much Saint Ronald Reagan past the Emergency Medical Treatment Act requiring everybody that shows up at an ER is to receive care. But didn't provided a means to pay for that care. When Americans are ready to compromise on the quality, timeliness, or access of the care they receive, then we can talk cost. Otherwise, be ready to pay up.
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Certainly the insurance companies want rationing. Until now they've done it by disallowing pre-existing conditions. Now they'll be looking for other ways to cut costs. But the profits won't go. That's how we could really cut healthcare costs — by switching to a system that is not full of for-profit insurance companies and for-profit hospitals and all of that.
We had such a system of non-profit hospitals and health care institutions once upon a time, but they were slowly undermined because most of them were associated with religious groups, which could not receive federal funding due to separation of church and state issues.
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. And just how far down the rabbit hole do you want to go to cut out the profit motivation? Pharmaceutical companies? Medical device companies? How about clinical laboratories? That's my line of work. Constantly chasing down the fat reimbursement cash from the endlessly changing and schizophrenic Medicare.
Also, while cutting out the bureaucratic fat from the industry is a fine goal in it's own right, using the hammer of government regulation and legislation is the least effective way to do this. Such regulatory bureaucracies, if not outright captured by the industry players they are intended to regulate; are always reactionary in nature, always responding to the latest crisis of the system and never accurately predicting the full effects of changes in regulatory policy.
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Our country pays 17% of GDP for healthcare...
The costs of the bureaucracy aside for a moment, I recently heard (on Freakonomics Radio podcast,Are You Ready for a Glorious Sunset? on Aug 26th, to be precise) that roughly 40% (iirc) of medical expenses are incurred in the last 2 years of life. The argument there is, are we doing this the right way? The US system basicly tries to save everyone's life to whatever extent is possible with current technology, and the costs of doing so (both in terms of actual monetary fees, and quality of life during those final years) are actually a secondary consideration. Whereas it is much more common in Europe for elder Europeans to enter into 'hospice' style care at a much earlier stage in many terminal conditions. Said another way, is it really in the best interests of grandpa, or his grandchildren, to spend $500K to have even an 80% chance that grandpa can suppress that cancerous tumor for another 2 years?
True. One of the reasons the UK NHS is good value for money is that is is pretty ruthless in spending money on what has best bang for the buck - in terms of "QOL" (Quality of Life Years)
So prenatal care is a big focus
Healthy lifestyle education is a big focus.
A&E (ER in US speak) is a big focus.
But a cancer drug that cost 90,000 pounds, but only extended patients' lives six months hasn't been approved.
If you are over 55, you don't get a kidney transplant, only dialysis.
My father died a few years ago, and had dementia in the end. The NHS were fantastic in helping my mother look after him at home. Subsidies for adapting the bathroom, a "dementia day care" centre where he could go to give my mother a break, weekly visits from district nurse, financial help for things like adult diapers, loan of an electric seat (so he could get up unaided), an inflatable cushion device (and training) that made it much easier to get him up after falling down etc, panic buttons etc.
But when he finally went into hospital, following a silly accident (swallowing his dentures) frankly, he was allowed to die of the pneumonia he then caught in hospital. He probably could have been saved, but it wouldn't have been worth it. Allowing him to die in peace, with his family around him, recognising some of us now and again, and in no pain, vs putting him into a very expensive intensive care unit for, maybe, a few months more? It was the right decision.
A couple of days in the ICU would have cost as much, if not more, than all the relatively cheap help he had got before that. And things like building a disabled friendly bathroom had much more impact on his (and my mother looking after him!) QOL than trying to extend his life.
So, yeah, death panels are a thing. But they are rational.
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We're acting like we have to reinvent the wheel here. Every developed country in the world except us has universal health care, and all of them do it at significantly lower cost. They don't do it through happenstance and private enterprise, either, but through national laws and national coordination. There are a number of different systems out there. Pick which one you like and see how they do it. And what do we get for our extra 35% in costs? To quote Forbes, "The U.S. ranks last overall [of the ten countries studied] with poor scores on all three indicators of healthy lives — mortality amenable to medical care, infant mortality, and healthy life expectancy at age 60." (http://www.forbes.com/sites/danmunro/2014/06/16/u-s-healthcare-ranked-dead-last-compared-to-10-other-countries/). And we act as if we just don't have any choices about it. But of course we have choices. If we want to get what other countries have — better outcomes, universal coverage, and lower costs — we're going to have to do something differently. Many ways of doing it differently and well are already out there.
I'll just add one anecdote that will undoubtedly not change anyone's mind, but will illustrate the ways in which Americans have just automatically regarded some options as unthinkable. You know how you can be incredibly ill and miserable, and yet you're supposed to drag yourself into the doctor's office, potentially spreading your germs around, when it finally opens in the morning? In the UK, when you're having a bad problem in the middle of the night or on a weekend, you call a central number and a professional assesses your situation. If it warrants it, a doctor phones and talks to you. If you're in an emergency, of course an ambulance comes and gets you. (At no charge to you, let's remember.) But if you're just in a bad way and need attention, the doctor comes to you. When I had food poisoning, the doctor came twice in the middle of the night. Of course I was all panicking, "Oh my God, how am I going to pay for this?" Then I remembered. I pay through my taxes. Not the $1000 per month I pay for healthcare when I live in the States, but some. So I don't have to pay any more. I don't have to forgo healthcare because I'm scared of the cost. It's safe to call the doctor.
They all, of course, think our wild-west healthcare system is insane.
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We had such a system of non-profit hospitals and health care institutions once upon a time, but they were slowly undermined because most of them were associated with religious groups, which could not receive federal funding due to separation of church and state issues.
That's a giant load of horse shit.
I realize you have a political agenda, but please pay us the courtesy of making your lies sort of plausible. Otherwise it you just come across as both across as both condescending and dishonest. One or the other is bad enough, but both at the same time is just too much.
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We had such a system of non-profit hospitals and health care institutions once upon a time, but they were slowly undermined because most of them were associated with religious groups, which could not receive federal funding due to separation of church and state issues.
That's a giant load of horse shit.
I realize you have a political agenda, but please pay us the courtesy of making your lies sort of plausible. Otherwise it you just come across as both across as both condescending and dishonest. One or the other is bad enough, but both at the same time is just too much.
We all have an agenda, but that is not what this is about. While I did really over-simplify the causes; as they are complex and not just due to separation of church and state issues, that is certainly one contributing factor to the overall trend...
http://usatoday30.usatoday.com/money/economy/2003-09-16-nonprofits2_x.htm
"But for possibly the first time since Ronald Reagan attacked the public welfare state, non-profits face the very real prospect of significant, continuing declines in government funding, their second-largest source of revenue. Many state and local governments, facing budget shortfalls, have already pared back. Congress, staring down $500-billion-plus annual deficits, is beginning to debate cuts or slower spending in some social programs."
http://www.medicarenewsgroup.com/news/medicare-faqs/individual-faq?faqId=31a98723-ad91-4801-9bd8-1f968a7c0f1b
"But in recent years, investor-owned hospitals have expanded nationally, purchasing often financially distressed facilities or stand-alone hospitals that are in need of access to capital for expansion. Depending on economic conditions, for-profit hospitals can have better access to capital than nonprofits that expand by issuing debt through tax-exempt bonds."
(Non-profit hospitals cannot issue tax-exempt bonds)
http://www.hcpro.com/MSL-307899-871/Nonprofit-hospitals-income-continues-to-decline.html
"According to the report of 383 hospitals and health systems, the median revenue growth was just 3.9%. The low rate can be partially attributed to the fact that nonprofit hospitals have had difficulty negotiating higher payment rates from insurers and are receiving smaller federal payments."
https://www.aeaweb.org/assa/2006/0106_0800_0204.pdf
" In
1960, U.S. nonprofit hospitals maintained on average
more than three times as many beds per hospital as
their for-profit counterparts; following a monotonic
decline in relative size, by 2000, the average
nonprofit hospital was only 32% larger than the typical
for-profit hospital. Hospital level data indicate
that this convergence was driven primarily by en
try, exit and ownership conversions, rather than
expansions or downsizing of existing hospitals. Th
ese findings suggest that hospitals may in fact
strategically choose their ownership type and hence,
their regulatory environment"
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We had such a system of non-profit hospitals and health care institutions once upon a time, but they were slowly undermined because most of them were associated with religious groups, which could not receive federal funding due to separation of church and state issues.
That's a giant load of horse shit.
I realize you have a political agenda, but please pay us the courtesy of making your lies sort of plausible. Otherwise it you just come across as both across as both condescending and dishonest. One or the other is bad enough, but both at the same time is just too much.
Yeah, I was wondering about that too, lol. I worked for a non-profit Catholic hospital at one point and we received all sorts of government cheese.
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We had such a system of non-profit hospitals and health care institutions once upon a time, but they were slowly undermined because most of them were associated with religious groups, which could not receive federal funding due to separation of church and state issues.
That's a giant load of horse shit.
I realize you have a political agenda, but please pay us the courtesy of making your lies sort of plausible. Otherwise it you just come across as both across as both condescending and dishonest. One or the other is bad enough, but both at the same time is just too much.
We all have an agenda, but that is not what this is about. While I did really over-simplify the causes; as they are complex and not just due to separation of church and state issues, that is certainly one contributing factor to the overall trend...
http://usatoday30.usatoday.com/money/economy/2003-09-16-nonprofits2_x.htm
"But for possibly the first time since Ronald Reagan attacked the public welfare state, non-profits face the very real prospect of significant, continuing declines in government funding, their second-largest source of revenue. Many state and local governments, facing budget shortfalls, have already pared back. Congress, staring down $500-billion-plus annual deficits, is beginning to debate cuts or slower spending in some social programs."
http://www.medicarenewsgroup.com/news/medicare-faqs/individual-faq?faqId=31a98723-ad91-4801-9bd8-1f968a7c0f1b
"But in recent years, investor-owned hospitals have expanded nationally, purchasing often financially distressed facilities or stand-alone hospitals that are in need of access to capital for expansion. Depending on economic conditions, for-profit hospitals can have better access to capital than nonprofits that expand by issuing debt through tax-exempt bonds."
(Non-profit hospitals cannot issue tax-exempt bonds)
http://www.hcpro.com/MSL-307899-871/Nonprofit-hospitals-income-continues-to-decline.html
"According to the report of 383 hospitals and health systems, the median revenue growth was just 3.9%. The low rate can be partially attributed to the fact that nonprofit hospitals have had difficulty negotiating higher payment rates from insurers and are receiving smaller federal payments."
https://www.aeaweb.org/assa/2006/0106_0800_0204.pdf
" In
1960, U.S. nonprofit hospitals maintained on average
more than three times as many beds per hospital as
their for-profit counterparts; following a monotonic
decline in relative size, by 2000, the average
nonprofit hospital was only 32% larger than the typical
for-profit hospital. Hospital level data indicate
that this convergence was driven primarily by en
try, exit and ownership conversions, rather than
expansions or downsizing of existing hospitals. Th
ese findings suggest that hospitals may in fact
strategically choose their ownership type and hence,
their regulatory environment"
One in six hospital beds in the United States is affiliated with a Catholic health system, so no, none of your statements agree with facts. And I am betting that if I went through your sources I would find that you cherry picked enough to be inaccurate, just like every other time I have.
In December 2013, the ACLU published a report on the rise of Catholic health systems and the impact on reproductive health nationwide. In 2011, about one in nine hospital beds was affiliated with a Catholic health system. As of February 2015, that figure is one in six.
Between 2001 and 2011, the number of Catholic-affiliated or -sponsored acute care hospitals increased by 16%, a far greater increase than any other type of non-profit hospital. In 2011, the 10 largest Catholic-sponsored health systems together controlled 330 acute-care hospitals — about one-third of all the hospitals and beds in the 25 largest systems. According to the ACLU, if these 10 Catholic systems were viewed as one, they would make up the largest health system in the country.
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I don't have a dog in this fight about the trajectory of non-profit hospitals, apart from the fact that I think they should all be non-profit. This article (http://www.huffingtonpost.com/dr-andrew-agwunobi/catholic-hospitals-versus_b_3567095.html) says that there are "over 630" Catholic hospitals in the U.S., and 5724 hospitals in total. Figuring 640 Catholic hospitals, that means 11.18% are Catholic. However, according to this article (healthnetpulse.com/broker/2013/10/11/did-you-know-for-profit-versus-nonprofit-hospitals/), "According to the AHA, about 18 percent of U.S. hospitals are private, for-profit hospitals, while 23 percent are owned by state and local governments. The rest are private, nonprofit facilities."
That doesn't say what percentage of beds are at for-profit hospitals, but I imagine it's similar.
An interesting corollary question is what's happened to non-profit insurance companies, of which I believe Blue Cross/Blue Shield is the giant. They have given up their non-profit status in a number of markets. Wikipedia says: "In 1994, BCBS changed to allow its licensees to be for-profit corporations.[4] During 2010, Health Care Service Corporation, the parent company of BCBS in Texas, Oklahoma, New Mexico, Montana and Illinois, nearly doubled its income to $1.09 billion in 2010, and began 4 years of billion-dollar profits." California BCBS lost its tax-exempt non-profit status this year.
Again, I don't know why healthcare is regarded as a for-profit business and K-12 schooling is not. Maybe because people could just opt out of schooling, but beyond a certain point they're compelled to get healthcare? But that doesn't seem like a good reason.
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We'll never see means testing. Do you have any idea what it will cost in additional man hours to process all that information? I have $1,000 that says the number of people who are "taking advantage" of the system because it isn't means tested costs less than the amount of money it would take to implement means testing. And that's why it'll never happen.
The fact that it's wildly impractical is no guarantee it won't happen. How many states have spent more money on drug testing the recipients of social programs than they've saved in denying benefits to those who fail?
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Once I left the Corporate Teet, I was uninsurable pre-ACA (Tourette's Syndrome). I used an "indemnity plan" as a stop gag substitute but was very exposed to something major like MS or Parkinson's. Now I have insurance that only costs about 20% more than my indemnity plan and has no lifetime limit. I do not qualify for subsidies and am plenty happy with ACA.
Interesting. I have Tourette's as well but never heard of it causing insurance issues before. I'm quite surprised because everything I learned about Tourette's made it seem like other than the nervous ticks there are no health effects like shortened longevity or increased risks of developing other health problems.
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Or maybe it will be so painful that we finally realize that HC just costs too much and there might finally be the political will to stop providers for behaving like cartels and gouging all of us.
Then maybe we'll finally get to a medicare for all plan and pay the same rate the rest of the Western world does.. i.e HALF or less than what we pay.
Almost certainly not. The insurance system in the US is pretty screwed up, but it's still not the main reason that health care insurance is expensive here. The VA is pretty much the closest thing to a single payer system in the US, and it costs about as much as the private system does and is lucky to provide equal quality of care.
This to my mind is one GOOD thing about the ACA.. Its PAINFUL.. Yes, but it gets us talking about the cost of care!
So whatever the reason.. lets sit down and find out why the UK spends $3500 per person and the US $10,000.. We (ordinary folks) simply can't afford this and it (was) rising at least double the rate of inflation.
When I say ordinary folks can't afford it.. of course they can't that's why there are massive subsidies.. Either we put up with the subsidies (like RE taxes that go to schools even though I don't have kids).. Or we take care of the root cause find out WTF is going and who is gouging who.. Cus somebody sure as hell is!
The US is a WONDERFUL place to be.. I wouldn't go back to the UK, too many other problems... BUT.. the UK and almost EVERYBODY else has figured the problem of high cost HC out.. Why can't we?
You can start right here.
http://time.com/198/bitter-pill-why-medical-bills-are-killing-us/
If you take the time to read the article in its entirety as I did when it first came out, you'll likely find yourself shocked and fairly disgusted. While the article isn't dealing with the insurance industry directly, it's pretty eye opening regarding the shenanigans that are going on at hospitals across the country, particularly where companies own numerous hospitals and operate them all under the auspices of "saving money by sharing overhead costs."
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The simplest solution is to just hire Japan, Germany, the UK or Canada to run our health system. It is a no brainer. We obviously can't run it half as good as them.
We are losers in the sickness care business.
And just for something to chew on ---- All the Medicaid clients I work with pay zero in premiums and have zero deductible. I literally have to be creative to make sure they don't go above the cap for liquid assets that would exempt them. So they take vacations, eat out lots and have closets full of clothes.
My guess is that many of the "liberal" readers of this forum are looking forward to the day when their none asset tested FIRE allows them to pay $25 in premiums.
So yeah, those with lots of assets and no earned income and those "poor" folks with low earned income can have their golden insurance paid for by the working poor middle class.
As far as Trump's proposal. The only thing I've heard from him is that he will open the state borders and allow bidding across state. lines. It is a complete joke that this isn't already happening.
Regarding the rate of medical inflation --- it appears that since most people's annual deductible are now in the stratosphere that the use of medical care of people with actual money will continue to decrease. Thus demand down, price down. I hope this turns into a virtuous cycle and prices continue to decrease.
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Or maybe it will be so painful that we finally realize that HC just costs too much and there might finally be the political will to stop providers for behaving like cartels and gouging all of us.
Then maybe we'll finally get to a medicare for all plan and pay the same rate the rest of the Western world does.. i.e HALF or less than what we pay.
Almost certainly not. The insurance system in the US is pretty screwed up, but it's still not the main reason that health care insurance is expensive here. The VA is pretty much the closest thing to a single payer system in the US, and it costs about as much as the private system does and is lucky to provide equal quality of care.
Provide your evidence for this.
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Certainly the insurance companies want rationing. Until now they've done it by disallowing pre-existing conditions. Now they'll be looking for other ways to cut costs. But the profits won't go. That's how we could really cut healthcare costs — by switching to a system that is not full of for-profit insurance companies and for-profit hospitals and all of that.
We had such a system of non-profit hospitals and health care institutions once upon a time, but they were slowly undermined because most of them were associated with religious groups, which could not receive federal funding due to separation of church and state issues.
Provide your evidence for this. The random links you provided upthread when others called you on this were not evidence at all. Non-profit hospitals issue bonds all the time, and get tax benefits for investors of those bonds. And "non-profit" hospitals are insanely profitable, and get probably most of their revenue from the government in most states.
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LOL. I just got my company's open enrollment letter for this year and my premium is going up 45%.
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LOL. I just got my company's open enrollment letter for this year and my premium is going up 45%.
Your premium went up 45%, how did the COBRA cost change (aka the real cost of your insurance).
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One in six hospital beds in the United States is affiliated with a Catholic health system, so no, none of your statements agree with facts. And I am betting that if I went through your sources I would find that you cherry picked enough to be inaccurate, just like every other time I have.
In December 2013, the ACLU published a report on the rise of Catholic health systems and the impact on reproductive health nationwide. In 2011, about one in nine hospital beds was affiliated with a Catholic health system. As of February 2015, that figure is one in six.
While you make some good points here that have forced me to reconsider my position, there are still some mitigating factors you have 'cherrypicked' yourself. For example, while a for-profit hospital is certainly not supported by or ran by religious institutions; the fact that a non-profit hospital identifies with a particular religion is not a certain fact that they actually are. Often-times those religious affiliations are simply historical in nature, and have little or no effect on the actual nature of the hospital itself. For example; Jewish founded and inspired hospitals have numbered over 100 in the history of the United States, but only 22 still retain a Jewish identity across the country, and most of those are simply in name only....
http://www.ncbi.nlm.nih.gov/pubmed/22450187
Likewise among Catholic founded hospitals, "in 1968, there were 770 religious CEOs and only 26 lay CEOs running Catholic hospitals. Today, four religious CEOs and 626 lay CEOs lead those institutions.
http://ncronline.org/news/peace-justice/challenges-ahead-catholic-health-care-keehan-says
And despite much evidence of a resurgence of Catholic hospitals nationwide, even the Catholic church itself acknowledges that the religious nature of health care is either declining, or simply being diluted by regulatory directives as well as the diverse and generally non-secular culture of employees of these hospitals...
"As their efforts to care for the sick expanded, the sisters invested in the construction of hospitals, where they served as nurses and administrators. They integrated explicit religious practice into clinical care, and their habits were reminders of their Catholicity. In these times, no one questioned what made their institutions Catholic. The Catholic identity engrained and sustained through the presence of the sisters was so obvious that it was not a topic of conversation.
Today, the Catholic health ministry has grown to include 642 hospitals and 1,600 continuing care facilities in all 50 states. One sixth of the patients in U.S. health care are treated in Catholic systems. With this expansion, the proportion of non-Catholic patients and employees has grown dramatically, and far fewer vowed religious hold leadership positions. Fifty years ago, religious women led 98 percent of Catholic hospitals. Currently, only four Catholic hospitals have religious CEOs. Meanwhile, structural dimensions of U.S. health care have pushed Catholic systems to embark on more partnerships and collaborative endeavors with non-Catholic organizations and their employees.
The rise of lay leadership, growing proportions of non-Catholic employees, and an increasingly interdependent and collaborative health care system create a question that the early sisters did not face: What does it mean for a health care organization to hold a “Catholic identity”?"
http://www.uscatholic.org/articles/201503/what-makes-catholic-hospital-catholic-29861
Furthermore, the actual not-for-profit nature of non-profit hospitals has been challenged as a "legal fiction" in our modern world, which is arguablely true to some degree or another with all of them.
http://nonprofitquarterly.org/2015/07/07/judge-terms-modern-nonprofit-hospitals-a-legal-fiction/
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One in six hospital beds in the United States is affiliated with a Catholic health system, so no, none of your statements agree with facts. And I am betting that if I went through your sources I would find that you cherry picked enough to be inaccurate, just like every other time I have.
In December 2013, the ACLU published a report on the rise of Catholic health systems and the impact on reproductive health nationwide. In 2011, about one in nine hospital beds was affiliated with a Catholic health system. As of February 2015, that figure is one in six.
While you make some good points here that have forced me to reconsider my position, there are still some mitigating factors you have 'cherrypicked' yourself. For example, while a for-profit hospital is certainly not supported by or ran by religious institutions; the fact that a non-profit hospital identifies with a particular religion is not a certain fact that they actually are. Often-times those religious affiliations are simply historical in nature, and have little or no effect on the actual nature of the hospital itself. For example; Jewish founded and inspired hospitals have numbered over 100 in the history of the United States, but only 22 still retain a Jewish identity across the country, and most of those are simply in name only....
http://www.ncbi.nlm.nih.gov/pubmed/22450187
Likewise among Catholic founded hospitals, "in 1968, there were 770 religious CEOs and only 26 lay CEOs running Catholic hospitals. Today, four religious CEOs and 626 lay CEOs lead those institutions.
http://ncronline.org/news/peace-justice/challenges-ahead-catholic-health-care-keehan-says
And despite much evidence of a resurgence of Catholic hospitals nationwide, even the Catholic church itself acknowledges that the religious nature of health care is either declining, or simply being diluted by regulatory directives as well as the diverse and generally non-secular culture of employees of these hospitals...
"As their efforts to care for the sick expanded, the sisters invested in the construction of hospitals, where they served as nurses and administrators. They integrated explicit religious practice into clinical care, and their habits were reminders of their Catholicity. In these times, no one questioned what made their institutions Catholic. The Catholic identity engrained and sustained through the presence of the sisters was so obvious that it was not a topic of conversation.
Today, the Catholic health ministry has grown to include 642 hospitals and 1,600 continuing care facilities in all 50 states. One sixth of the patients in U.S. health care are treated in Catholic systems. With this expansion, the proportion of non-Catholic patients and employees has grown dramatically, and far fewer vowed religious hold leadership positions. Fifty years ago, religious women led 98 percent of Catholic hospitals. Currently, only four Catholic hospitals have religious CEOs. Meanwhile, structural dimensions of U.S. health care have pushed Catholic systems to embark on more partnerships and collaborative endeavors with non-Catholic organizations and their employees.
The rise of lay leadership, growing proportions of non-Catholic employees, and an increasingly interdependent and collaborative health care system create a question that the early sisters did not face: What does it mean for a health care organization to hold a “Catholic identity”?"
http://www.uscatholic.org/articles/201503/what-makes-catholic-hospital-catholic-29861
Furthermore, the actual not-for-profit nature of non-profit hospitals has been challenged as a "legal fiction" in our modern world, which is arguablely true to some degree or another with all of them.
http://nonprofitquarterly.org/2015/07/07/judge-terms-modern-nonprofit-hospitals-a-legal-fiction/
Actually I did not cherry pick. The counsel of Bishops is quite clear on what a Catholic hospital must do (and what religious rules they must follow). Including refusal of basic medical care based on Catholic beliefs. The CEO does not matter in this case, the rules they operate under do.
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Non-profit hospitals issue bonds all the time, and get tax benefits for investors of those bonds.
This time you need to show your evidence. I never claimed that religious non-profit hospitals can't issue bonds, only that they cannot be tax exempt. Tax exempt bonds are tax exempt because they fund the construction of public (municipal) infrastructure, and government funding of a religious institution, even something as generally beneficial as a hospital, is certainly a violation of separation of church and state, and would be challenged in court. So either the hospitals don't actually get state support (i.e. a tax exempt status for their construction bonds) or their religious affiliation is in name or history only.
And "non-profit" hospitals are insanely profitable, and get probably most of their revenue from the government in most states.
That true, and I'd wager that the majority of those same 'non-profit' hospitals are religious in name or history only, and are not a present fact. When I said above that non-profit hospitals were in decline, I should have said that religious non-profit hospitals, with actual religiously motivated employees, volunteers and sponsorship, have been in decline. I believe that this statement, corrected, is likely still true; although I can't prove it. The age that a Catholic hospital in the US actually staffed nuns as nurses, with a religious conviction for caring for the sick rather than a registered nurse with a personal profit motive, is a bygone concept. I literally can't remember the last time I saw an actual nun working as a nurse in a Catholic hospital, nor the last time I saw a nun working as a teacher in a Catholic school. How about yourself?
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Non-profit hospitals issue bonds all the time, and get tax benefits for investors of those bonds.
This time you need to show your evidence. I never claimed that religious non-profit hospitals can't issue bonds, only that they cannot be tax exempt. Tax exempt bonds are tax exempt because they fund the construction of public (municipal) infrastructure, and government funding of a religious institution, even something as generally beneficial as a hospital, is certainly a violation of separation of church and state, and would be challenged in court. So either the hospitals don't actually get state support (i.e. a tax exempt status for their construction bonds) or their religious affiliation is in name or history only.
Instead of providing any evidence you ask for some from me? You don't make it easy to have a useful conversation. I literally googled catholic hospital and this one popped up first.
http://www.upmc.com/locations/hospitals/mercy/about/Pages/catholic-health-care.aspx
What Does It Mean to be a Catholic Hospital?
There is one fundamental commandment for a Catholic hospital: All life, from conception to the moment of natural death, is profoundly sacred. All life must therefore be treated with awe, respect, and dignity. This fundamental commandment comes without a “but,” “if,” or “however.” There is no qualification, no exception.
To put that into practice, a Catholic hospital operates according to the directives established by the United States Conference of Catholic Bishops. Directives for Catholic Heath Care Services are contained in a 12-page document that interested readers may read.
The Catholic understanding of health care is rooted in the basic scriptural understanding, outlined in the bishops’ document, that the healing mission of Jesus “touched people at the deepest level of their existence: He sought their physical, mental, and spiritual healing.” Throughout its history, the church has dedicated herself in service to the sick and all those in need.
The social responsibility of Catholic health care services is guided by five essential principles outlined in the bishops’ document:
To promote and defend human dignity: The right to life of every human being means the right as well to adequate health care and must be basic to every Catholic institution involved in medical service and science.
To care for the poor: No one can ever be turned away from a Catholic hospital because of an inability to pay. This attention to the poor, the underinsured, and the uninsured must be paramount at a Catholic hospital.
To contribute to the common good: Catholic health care services are meant for the entire community. These services should be instigators of social change that lead to a greater respect for fundamental human rights and for the economic, social, political, and spiritual health of the entire community.
To exercise responsible stewardship: As the bishops state, “Catholic health care ministry exercises responsible stewardship of available health care resources. A just health care system will be concerned both with promoting equity of care – to assure the right of each person to basic health care is respected – and with promoting the good health of all within the community.”
Adherence to the moral teachings of the Church: In our society today, any Catholic health care service will be approached, or even pressured, to provide medical procedures that are contrary to Catholic teaching. But by refusing to provide or permit such medical procedures, Catholic health care affirms what defines it: a commitment to the sacredness and dignity of human life from conception until death.
Reprinted with permission by Catholic Diocese of Pittsburgh, 2008
The hospital exists to provide "faith based care". And they are nonprofit (also googled nonprofit hospital tax exempt religious).
http://www.stltoday.com/business/columns/jim-doyle/dispute-grows-over-tax-exemptions-for-nonprofit-hospitals/article_f3ff8917-8b17-5edd-85fc-c1e7ab1ce30c.html
Why do you so frequently assert as fact stuff that you have no basis in fact to support? Not cool.
Where's your evidence about your VA claim (which I also know is not true)?
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snip...
That true, and I'd wager that the majority of those same 'non-profit' hospitals are religious in name or history only, and are not a present fact. When I said above that non-profit hospitals were in decline, I should have said that religious non-profit hospitals, with actual religiously motivated employees, volunteers and sponsorship, have been in decline. I believe that this statement, corrected, is likely still true; although I can't prove it. The age that a Catholic hospital in the US actually staffed nuns as nurses, with a religious conviction for caring for the sick rather than a registered nurse with a personal profit motive, is a bygone concept. I literally can't remember the last time I saw an actual nun working as a nurse in a Catholic hospital, nor the last time I saw a nun working as a teacher in a Catholic school. How about yourself?
The number of nuns visible in hospitals and schools may not be related to this discussion at all.
- http://www.pewresearch.org/fact-tank/2014/08/08/u-s-nuns-face-shrinking-numbers-and-tensions-with-the-vatican/ (http://www.pewresearch.org/fact-tank/2014/08/08/u-s-nuns-face-shrinking-numbers-and-tensions-with-the-vatican/)
"Globally, the number of nuns also is declining, but not nearly as fast as it is in the U.S. In 1970, U.S. nuns represented about 16% of the world’s religious sisters; now, American nuns are about 7% of the global total (just over 700,000), also according to CARA."
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Actually I did not cherry pick. The counsel of Bishops is quite clear on what a Catholic hospital must do (and what religious rules they must follow). Including refusal of basic medical care based on Catholic beliefs. The CEO does not matter in this case, the rules they operate under do.
I guess we are done here, then. You asked for more support, and I provided it. Apparently you don't consider my perspective valid, and I consider yours to be as debatable as my own. Carry on with your belief that the CEO doesn't actually matter.
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Non-profit hospitals issue bonds all the time, and get tax benefits for investors of those bonds.
This time you need to show your evidence. I never claimed that religious non-profit hospitals can't issue bonds, only that they cannot be tax exempt. Tax exempt bonds are tax exempt because they fund the construction of public (municipal) infrastructure, and government funding of a religious institution, even something as generally beneficial as a hospital, is certainly a violation of separation of church and state, and would be challenged in court. So either the hospitals don't actually get state support (i.e. a tax exempt status for their construction bonds) or their religious affiliation is in name or history only.
Instead of providing any evidence you ask for some from me? You don't make it easy to have a useful conversation. I literally googled catholic hospital and this one popped up first.
http://www.upmc.com/locations/hospitals/mercy/about/Pages/catholic-health-care.aspx
What Does It Mean to be a Catholic Hospital?
There is one fundamental commandment for a Catholic hospital: All life, from conception to the moment of natural death, is profoundly sacred. All life must therefore be treated with awe, respect, and dignity. This fundamental commandment comes without a “but,” “if,” or “however.” There is no qualification, no exception.
To put that into practice, a Catholic hospital operates according to the directives established by the United States Conference of Catholic Bishops. Directives for Catholic Heath Care Services are contained in a 12-page document that interested readers may read.
The Catholic understanding of health care is rooted in the basic scriptural understanding, outlined in the bishops’ document, that the healing mission of Jesus “touched people at the deepest level of their existence: He sought their physical, mental, and spiritual healing.” Throughout its history, the church has dedicated herself in service to the sick and all those in need.
The social responsibility of Catholic health care services is guided by five essential principles outlined in the bishops’ document:
To promote and defend human dignity: The right to life of every human being means the right as well to adequate health care and must be basic to every Catholic institution involved in medical service and science.
To care for the poor: No one can ever be turned away from a Catholic hospital because of an inability to pay. This attention to the poor, the underinsured, and the uninsured must be paramount at a Catholic hospital.
To contribute to the common good: Catholic health care services are meant for the entire community. These services should be instigators of social change that lead to a greater respect for fundamental human rights and for the economic, social, political, and spiritual health of the entire community.
To exercise responsible stewardship: As the bishops state, “Catholic health care ministry exercises responsible stewardship of available health care resources. A just health care system will be concerned both with promoting equity of care – to assure the right of each person to basic health care is respected – and with promoting the good health of all within the community.”
Adherence to the moral teachings of the Church: In our society today, any Catholic health care service will be approached, or even pressured, to provide medical procedures that are contrary to Catholic teaching. But by refusing to provide or permit such medical procedures, Catholic health care affirms what defines it: a commitment to the sacredness and dignity of human life from conception until death.
Reprinted with permission by Catholic Diocese of Pittsburgh, 2008
The hospital exists to provide "faith based care". And they are nonprofit (also googled nonprofit hospital tax exempt religious).
And this is evidence of what? That Catholics prefer that Catholic hospitals act like Catholics? Is this actual evidence that even a majority, much less all, such Catholic hospitals actually follow such rules and guidelines in practice? But this is already deep into 'inside baseball' territory. I'm not debating with you what percentage of Catholic hospitals actually run like Catholic hospitals. My comment was about the decline of real religiously based non-profit hospitals, and the idea that separation of church and state issues contributed to such a decline. I have already been shown evidence that this trend has reversed, but not any evidence contradicting the second half of that statement. Were you able to find any evidence that faith-based non-profit hospitals can issue tax-exempt municipal bonds?
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Where's your evidence about your VA claim (which I also know is not true)?
From the Obamafacts website...
http://obamacarefacts.com/single-payer/
"Defining Single Payer
The term “single payer” describes the funding mechanism (health care financed by a single public body from a single fund) not specify the type of delivery, or for whom doctors work. Given this there are many different examples of single payer systems throughout the world that employ different tactics in terms of insurance, delivery of services, and funding. Some of these systems look a lot like the mix of private and public systems we find in “ObamaCare”, while others use both public insurance and public healthcare.
FACT: A true single payer system eliminates private insurance, but in most countries they haven’t actually implemented a true single payer system. Keep reading to understand different ways different types of single payer systems have been implemented around the world and how supplemental coverage, cost sharing, and tiered systems can remain in place in a single payer system.The US already has a number of Government run health care systems such as: Medicare, Medicaid, Veterans Affairs, military, federal employee benefits, state and local government benefits. That hasn’t stopped us from spending more per-capita on healthcare than any other nation on earth and suggests single payer won’t magically solve our health care spending problems alone."
<snip>
What Would A Single Payer System Look Like In America?
A universal single payer health care system would be paid for in part through taxes based on income replacing insurance premiums, copays, deductibles, etc. All plans would have the same benefits and networks and would eliminate our current multi-tiered system (our current system rewards income with quality).
<snip>
The US already has a number of Government run health care systems such as: Medicare, Medicaid, Veterans Affairs, military, federal employee benefits, state and local government benefits. That hasn’t stopped us from spending more per-capita on healthcare than any other nation on earth and suggests single payer won’t magically solve our health care spending problems alone."
So the website put up to promote Obamacare, which is obviously not some right wing rag, gives the VA as an example of a (limited in scope) single payer system, that single payer being the government. It also describes Medicare as being such a (also limited in scope) system.
So, Forummm; are you about to prove the Obamafacts website to be false?
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Yes, I've found Obamacarefacts to be wrong on multiple occasions. It's just a website put up by some anonymous people who want web traffic so they can direct people to buy health insurance outside the Marketplace (presumably higher cost plans). And what you provided wasn't proof of anything.
You said :
The VA is pretty much the closest thing to a single payer system in the US, and it costs about as much as the private system does and is lucky to provide equal quality of care.
First off, we do have an actual single-payer system: Medicare. People love it. And it's run much more inexpensively than private insurance. The VA is just a place that people can go to get some care, and the levels of benefits they are eligible for varies, but it's frequently not a comprehensive benefits package. The VA has limited funding and they just provide as much care as they get an appropriation for each year. And the people eligible to go there commonly have another source of insurance and just get some care at the VA because the VA provides that service better or is cheaper or more inviting in some way. So it's not a single payer system--it's like a public health clinic with limited access and a much broader service portfolio.
And you also provided no evidence that it "costs about as much as the private system". Which of course you can't because it's not really comparable to a private insurer due to the operating model.
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And you also provided no evidence that it "costs about as much as the private system". Which of course you can't because it's not really comparable to a private insurer due to the operating model.
If you were at all concerned about context, Forummm; you would have noticed I said that in the context of medical care costs in the United States compared to other countries. So while the VA care might actually be somewhat cheaper than in the US private system (which I actually don't doubt, because the quality of care is of a lower standard, in addition to being delayed, which is one reason I don't really bother going to the VA myself) that is still not evidence that privately funded care is the root cause of the generally higher costs of American health care. I think you would have a hard time showing that the VA, or even Medicare, is as cheap per capita as the British single payer system, as an example. The growing medical tourism industry alone is likely enough to undercut the idea that the VA is cheaper than any private health care system.
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Actually I did not cherry pick. The counsel of Bishops is quite clear on what a Catholic hospital must do (and what religious rules they must follow). Including refusal of basic medical care based on Catholic beliefs. The CEO does not matter in this case, the rules they operate under do.
I guess we are done here, then. You asked for more support, and I provided it. Apparently you don't consider my perspective valid, and I consider yours to be as debatable as my own. Carry on with your belief that the CEO doesn't actually matter.
Actually no. I corrected your incorrect statement, you now have made another one. This is not about opinions, or perspectives, this is about basic facts. The counsel of bishops controls the actions of the hospitals under their control. Period.
http://www.propublica.org/article/catholic-bishops-weigh-tightening-rules-for-health-care-partnerships
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If you read the article I posted a link to you'll find that in general hospitals are masking their huge profit margins by building new buildings and in some cases buying new equipment, not necessarily because it'w worth it but because they have money to spend. After all, they're nonprofit so they have to do something with this money to keep it from looking bad. I don't know whether Catholic hospitals are in on the game too, but I would venture to guess many of them are.
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If you read the article I posted a link to you'll find that in general hospitals are masking their huge profit margins by building new buildings and in some cases buying new equipment, not necessarily because it'w worth it but because they have money to spend. After all, they're nonprofit so they have to do something with this money to keep it from looking bad. I don't know whether Catholic hospitals are in on the game too, but I would venture to guess many of them are.
Why yes they are.
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This just in, number of uninsured in America drops by 8.8 million:
http://www.nytimes.com/2015/09/17/us/politics/census-bureau-poverty-rate-uninsured.html?hp&action=click&pgtype=Homepage&module=first-column-region®ion=top-news&WT.nav=top-news&_r=0
I went to grad school (health policy) back in 1994 and the uninsured was somewhere around 36 million at the time. Despite all the hand wringing, Hillary's health care council (under Pres. Clinton), and political discourse the needle never moved in a positive direction and, in fact, just continued getting worse -- until now.
I think the gains for society will accrue, steadily, over time. The ship doesn't turn quickly, but I have to say that this is an impressive step.
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So first let's look at the fact that 35% of health care costs (17% instead of 11% of GPD) is spent on this crazy for-profit bureauracy. All our premiums and healthcare expenses could be 35% cheaper if we had a sane system.
1) I don't believe there is 35% going to shareholders.
2) We have greater access to procedures and equipment (this where part of that 35% goes)
3) Private business is more efficient than government, so,
if you cut out profit, you will gain inefficiency, waste and fraud.
4) you add another layer of government to monitor, regulate generaly F%^& around with
providers and hospitals.
Point being some of those extra costs bring us benefits.
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3) Private business is more efficient than government, so,
if you cut out profit, you will gain inefficiency, waste and fraud.
Maximum shibboleth. Saying or believing this is on the same level as "masturbation causes hair to grow on the palm of one's hand".
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This just in, number of uninsured in America drops by 8.8 million:
http://www.nytimes.com/2015/09/17/us/politics/census-bureau-poverty-rate-uninsured.html?hp&action=click&pgtype=Homepage&module=first-column-region®ion=top-news&WT.nav=top-news&_r=0
I went to grad school (health policy) back in 1994 and the uninsured was somewhere around 36 million at the time. Despite all the hand wringing, Hillary's health care council (under Pres. Clinton), and political discourse the needle never moved in a positive direction and, in fact, just continued getting worse -- until now.
I think the gains for society will accrue, steadily, over time. The ship doesn't turn quickly, but I have to say that this is an impressive step.
It is just in, but from what I gleen from it, it is all 2013 and 2014 data written up and released Sept. 2015.
I did see it, so I wonder if the data included those that went on Medicaid.
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This just in, number of uninsured in America drops by 8.8 million:
http://www.nytimes.com/2015/09/17/us/politics/census-bureau-poverty-rate-uninsured.html?hp&action=click&pgtype=Homepage&module=first-column-region®ion=top-news&WT.nav=top-news&_r=0
I went to grad school (health policy) back in 1994 and the uninsured was somewhere around 36 million at the time. Despite all the hand wringing, Hillary's health care council (under Pres. Clinton), and political discourse the needle never moved in a positive direction and, in fact, just continued getting worse -- until now.
I think the gains for society will accrue, steadily, over time. The ship doesn't turn quickly, but I have to say that this is an impressive step.
It is just in, but from what I gleen from it, it is all 2013 and 2014 data written up and released Sept. 2015.
I did see it, so I wonder if the data included those that went on Medicaid.
You can read the full report yourself, if you like, right here:
http://www.census.gov/content/dam/Census/library/publications/2015/demo/p60-253.pdf
On page 4 there's a graphic with a breakdown between the different types of medical coverage and percentage-point change from 2013 to 2014. The number of people covered by Medicare went up a little less than two points, while people covered by direct purchase plans (both from the exchange and off-exchange) went up about three. I think each percentage point represents about 3 million people (page 3 first column "In 2014, the percentage of people without health insurance coverage for the entire calendar year was 10.4 percent or 33.0 million").
Edit: There's a table on page 5. Medicaid-covered people went from 54.9 million to 61.6 million, a difference of 6.7 million people, with a ~0.9 million margin of error on both years.
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So first let's look at the fact that 35% of health care costs (17% instead of 11% of GPD) is spent on this crazy for-profit bureauracy. All our premiums and healthcare expenses could be 35% cheaper if we had a sane system.
1) I don't believe there is 35% going to shareholders.
You're right. It's more like 10-15% going to shareholders and 20-25% going into "infrastructure and technology" to hide that fact that their real profit margin is 30-35%.
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So first let's look at the fact that 35% of health care costs (17% instead of 11% of GPD) is spent on this crazy for-profit bureauracy. All our premiums and healthcare expenses could be 35% cheaper if we had a sane system.
1) I don't believe there is 35% going to shareholders.
You're right. It's more like 10-15% going to shareholders and 20-25% going into "infrastructure and technology" to hide that fact that their real profit margin is 30-35%.
The amount going to shareholders is much smaller than that. The amount going to "overhead" is high. Much higher than Medicare. The medical loss ratio on private plans is 15-20%. It's about 3% for Medicare.
http://healthaffairs.org/blog/2011/09/20/medicare-is-more-efficient-than-private-insurance/
http://www.urban.org/publications/411762.html
http://www.gao.gov/products/GAO-09-132R
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This just in, number of uninsured in America drops by 8.8 million:
http://www.nytimes.com/2015/09/17/us/politics/census-bureau-poverty-rate-uninsured.html?hp&action=click&pgtype=Homepage&module=first-column-region®ion=top-news&WT.nav=top-news&_r=0
I went to grad school (health policy) back in 1994 and the uninsured was somewhere around 36 million at the time. Despite all the hand wringing, Hillary's health care council (under Pres. Clinton), and political discourse the needle never moved in a positive direction and, in fact, just continued getting worse -- until now.
I think the gains for society will accrue, steadily, over time. The ship doesn't turn quickly, but I have to say that this is an impressive step.
It is just in, but from what I gleen from it, it is all 2013 and 2014 data written up and released Sept. 2015.
I did see it, so I wonder if the data included those that went on Medicaid.
The number is actually about 20 million overall with coverage because of the ACA including early 2015 numbers and the young adults in 2010. It's mostly from private insurance. I'm not sure why this Census report made so much news using older data.
http://www.cdc.gov/nchs/data/nhis/earlyrelease/insur201508.pdf
(http://i.imgur.com/8ChF736.png)