Author Topic: Obamacare survives  (Read 66428 times)

Blonde Lawyer

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Re: Obamacare survives
« Reply #150 on: June 27, 2015, 02:01:05 PM »
Quote
It's because of the $$$. All that money we spend (about 16% of GDP) on healthcare is someone's income. Judging from other nations, about half of that or more is wasted. All those people are going to fight to keep their income from being cut in half.

This is a very real issue.  While I would love to see the US have socialized medicine and get rid of for profit health insurance companies, I can't help to think about how many people are employed by health insurance companies.  Blue Cross Blue Shield alone for example.  There would be a very real crisis if all of those people were suddenly out of work.

I don't think socialized medicine would provide enough jobs to employ all those people.  I'm not sure how we could make the transition without causing a huge economic issue from all of the suddenly unemployed people.

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Re: Obamacare survives
« Reply #151 on: June 27, 2015, 02:16:08 PM »
Quote
It's because of the $$$. All that money we spend (about 16% of GDP) on healthcare is someone's income. Judging from other nations, about half of that or more is wasted. All those people are going to fight to keep their income from being cut in half.

This is a very real issue.  While I would love to see the US have socialized medicine and get rid of for profit health insurance companies, I can't help to think about how many people are employed by health insurance companies.  Blue Cross Blue Shield alone for example.  There would be a very real crisis if all of those people were suddenly out of work.

I don't think socialized medicine would provide enough jobs to employ all those people.  I'm not sure how we could make the transition without causing a huge economic issue from all of the suddenly unemployed people.
That's never stopped us from retiring entire industries before, or pushing for other industries to be outlawed. Nobody is going to be raising money for the homeless insurance adjusters or paper pushers outside your local grocery store.

sol

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Re: Obamacare survives
« Reply #152 on: June 27, 2015, 02:17:24 PM »
This is a very real issue.  While I would love to see the US have socialized medicine and get rid of for profit health insurance companies, I can't help to think about how many people are employed by health insurance companies.  Blue Cross Blue Shield alone for example.  There would be a very real crisis if all of those people were suddenly out of work.

I don't think socialized medicine would provide enough jobs to employ all those people.  I'm not sure how we could make the transition without causing a huge economic issue from all of the suddenly unemployed people.

How is this any different from saying that some mutual funds charge crazy high fees, and so we definitely shouldn't use Vanguard instead because then the employees of those high-fee companies will be out of work?  The lower cost more efficient option is a job killer in every sense.  Just like a single-payer health care system would be.  I'm still in favor of both.

forummm

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Re: Obamacare survives
« Reply #153 on: June 27, 2015, 02:44:12 PM »
Quote
It's because of the $$$. All that money we spend (about 16% of GDP) on healthcare is someone's income. Judging from other nations, about half of that or more is wasted. All those people are going to fight to keep their income from being cut in half.

This is a very real issue.  While I would love to see the US have socialized medicine and get rid of for profit health insurance companies, I can't help to think about how many people are employed by health insurance companies.  Blue Cross Blue Shield alone for example.  There would be a very real crisis if all of those people were suddenly out of work.

I don't think socialized medicine would provide enough jobs to employ all those people.  I'm not sure how we could make the transition without causing a huge economic issue from all of the suddenly unemployed people.

I'm not sure how much employment loss there would be. A lot of the excess is profits (e.g. pharmaceutical firms are perennially in the top 3 most profitable industries) or unreasonably high salaries or subsidizing rich foreign countries (see higher drug price post above). So that doesn't do much to the number of jobs here. You would still need similar amounts of care to be provided, so the actual care delivery jobs are still needed.

Typically when an industry evolves and gets more efficient, the workers get jobs elsewhere. See the buggy whip cliche.

But I think the economy would actually improve and create more jobs than were lost. Healthcare is an enormous hidden tax on the economy. It makes hiring someone so much more expensive. If we cut out all that inefficiency, employers and employees around the country suddenly have an extra $1-1.5 trillion jangling in their pockets--each year! That could do a lot of buying and hiring in other industries.

music lover

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Re: Obamacare survives
« Reply #154 on: June 27, 2015, 03:09:41 PM »
But I think the economy would actually improve and create more jobs than were lost. Healthcare is an enormous hidden tax on the economy. It makes hiring someone so much more expensive. If we cut out all that inefficiency, employers and employees around the country suddenly have an extra $1-1.5 trillion jangling in their pockets--each year! That could do a lot of buying and hiring in other industries.

How many mustachians would love to have the extra few thousand dollars every year in their pockets instead of paying an insurance company?

beltim

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Re: Obamacare survives
« Reply #155 on: June 27, 2015, 03:53:51 PM »
Quote
It's because of the $$$. All that money we spend (about 16% of GDP) on healthcare is someone's income. Judging from other nations, about half of that or more is wasted. All those people are going to fight to keep their income from being cut in half.

This is a very real issue.  While I would love to see the US have socialized medicine and get rid of for profit health insurance companies, I can't help to think about how many people are employed by health insurance companies.  Blue Cross Blue Shield alone for example.  There would be a very real crisis if all of those people were suddenly out of work.

I don't think socialized medicine would provide enough jobs to employ all those people.  I'm not sure how we could make the transition without causing a huge economic issue from all of the suddenly unemployed people.

I'm not sure how much employment loss there would be. A lot of the excess is profits (e.g. pharmaceutical firms are perennially in the top 3 most profitable industries) or unreasonably high salaries or subsidizing rich foreign countries (see higher drug price post above). So that doesn't do much to the number of jobs here. You would still need similar amounts of care to be provided, so the actual care delivery jobs are still needed.

Typically when an industry evolves and gets more efficient, the workers get jobs elsewhere. See the buggy whip cliche.

But I think the economy would actually improve and create more jobs than were lost. Healthcare is an enormous hidden tax on the economy. It makes hiring someone so much more expensive. If we cut out all that inefficiency, employers and employees around the country suddenly have an extra $1-1.5 trillion jangling in their pockets--each year! That could do a lot of buying and hiring in other industries.

Blonde lawyer was only talking about health insurance companies - which are in one of the least profitable industries.  There is substantially more overhead than government-run health insurance plans, however, which would account for where the savings - and job losses - would come from.

Also, I tend to agree that the net result of offering single-payer universal health care would be an increase in the number of jobs thanks to reduced drag on the economy.  I'm not sure how universal private insurance would compare on that axis (increased efficiency on one large organizations versus competitive pressures of different insurance companies).  However, there would inevitably be a transition period that would have higher unemployment due to the very nature of people needing to find new jobs, in necessarily different industries.

Lastly, your estimate of the inefficiencies in US health care is way off.  The total health care spending in the US is something like $3.0 trillion.  If we paid the amount corresponding to our GDP in line with other countries (remember the US has a very high GDP and health care spending as a percentage of GDP goes up as a function of GDP) we'd save something like $600 billion or 20%.
http://economix.blogs.nytimes.com/2008/11/21/why-does-us-health-care-cost-so-much-part-ii-indefensible-administrative-costs/?_r=0
« Last Edit: June 27, 2015, 03:57:08 PM by beltim »

forummm

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Re: Obamacare survives
« Reply #156 on: June 27, 2015, 04:39:22 PM »
Quote
It's because of the $$$. All that money we spend (about 16% of GDP) on healthcare is someone's income. Judging from other nations, about half of that or more is wasted. All those people are going to fight to keep their income from being cut in half.

This is a very real issue.  While I would love to see the US have socialized medicine and get rid of for profit health insurance companies, I can't help to think about how many people are employed by health insurance companies.  Blue Cross Blue Shield alone for example.  There would be a very real crisis if all of those people were suddenly out of work.

I don't think socialized medicine would provide enough jobs to employ all those people.  I'm not sure how we could make the transition without causing a huge economic issue from all of the suddenly unemployed people.

I'm not sure how much employment loss there would be. A lot of the excess is profits (e.g. pharmaceutical firms are perennially in the top 3 most profitable industries) or unreasonably high salaries or subsidizing rich foreign countries (see higher drug price post above). So that doesn't do much to the number of jobs here. You would still need similar amounts of care to be provided, so the actual care delivery jobs are still needed.

Typically when an industry evolves and gets more efficient, the workers get jobs elsewhere. See the buggy whip cliche.

But I think the economy would actually improve and create more jobs than were lost. Healthcare is an enormous hidden tax on the economy. It makes hiring someone so much more expensive. If we cut out all that inefficiency, employers and employees around the country suddenly have an extra $1-1.5 trillion jangling in their pockets--each year! That could do a lot of buying and hiring in other industries.

Blonde lawyer was only talking about health insurance companies - which are in one of the least profitable industries.  There is substantially more overhead than government-run health insurance plans, however, which would account for where the savings - and job losses - would come from.

Also, I tend to agree that the net result of offering single-payer universal health care would be an increase in the number of jobs thanks to reduced drag on the economy.  I'm not sure how universal private insurance would compare on that axis (increased efficiency on one large organizations versus competitive pressures of different insurance companies).  However, there would inevitably be a transition period that would have higher unemployment due to the very nature of people needing to find new jobs, in necessarily different industries.

Lastly, your estimate of the inefficiencies in US health care is way off.  The total health care spending in the US is something like $3.0 trillion.  If we paid the amount corresponding to our GDP in line with other countries (remember the US has a very high GDP and health care spending as a percentage of GDP goes up as a function of GDP) we'd save something like $600 billion or 20%.
http://economix.blogs.nytimes.com/2008/11/21/why-does-us-health-care-cost-so-much-part-ii-indefensible-administrative-costs/?_r=0

I was scaling our ~$3 trillion expenditures down to a per capita level similar to other industrialized nations. We spend about twice as much per capita as many other industrialized nations. And about 1/2 of about $3 trillion is in the $1-1.5T ballpark. If we were to have a Japan or Finland level of expenditure we could maybe even save as much as $2T per year.
https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_(PPP)_per_capita

In addition to cutting out insurance provider overhead, there could be savings on the costs of medical devices, drugs (both much higher in the US than abroad), incomes for certain providers (also much higher here), hospitals, etc, etc. There's way more fat than the 2008 study you pointed to (and even the 2014 update to it published in HA).

beltim

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Re: Obamacare survives
« Reply #157 on: June 27, 2015, 05:36:23 PM »
Lastly, your estimate of the inefficiencies in US health care is way off.  The total health care spending in the US is something like $3.0 trillion.  If we paid the amount corresponding to our GDP in line with other countries (remember the US has a very high GDP and health care spending as a percentage of GDP goes up as a function of GDP) we'd save something like $600 billion or 20%.
http://economix.blogs.nytimes.com/2008/11/21/why-does-us-health-care-cost-so-much-part-ii-indefensible-administrative-costs/?_r=0

I was scaling our ~$3 trillion expenditures down to a per capita level similar to other industrialized nations. We spend about twice as much per capita as many other industrialized nations. And about 1/2 of about $3 trillion is in the $1-1.5T ballpark. If we were to have a Japan or Finland level of expenditure we could maybe even save as much as $2T per year.
https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_(PPP)_per_capita

Yeah, you're ignoring the point I made earlier, that I bolded this time.  Here's a reference showing that we should be spending more than other OECD countries, because we're richer than other OECD countries: http://theincidentaleconomist.com/wordpress/sure-its-got-to-go-up-but-how-much/

forummm

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Re: Obamacare survives
« Reply #158 on: June 27, 2015, 05:51:22 PM »
Lastly, your estimate of the inefficiencies in US health care is way off.  The total health care spending in the US is something like $3.0 trillion.  If we paid the amount corresponding to our GDP in line with other countries (remember the US has a very high GDP and health care spending as a percentage of GDP goes up as a function of GDP) we'd save something like $600 billion or 20%.
http://economix.blogs.nytimes.com/2008/11/21/why-does-us-health-care-cost-so-much-part-ii-indefensible-administrative-costs/?_r=0

I was scaling our ~$3 trillion expenditures down to a per capita level similar to other industrialized nations. We spend about twice as much per capita as many other industrialized nations. And about 1/2 of about $3 trillion is in the $1-1.5T ballpark. If we were to have a Japan or Finland level of expenditure we could maybe even save as much as $2T per year.
https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_(PPP)_per_capita

Yeah, you're ignoring the point I made earlier, that I bolded this time.  Here's a reference showing that we should be spending more than other OECD countries, because we're richer than other OECD countries: http://theincidentaleconomist.com/wordpress/sure-its-got-to-go-up-but-how-much/

I see the point you were making, which is a good thing that people overlook. But our GDP *per capita* is pretty close to many (and even lower than some) of those EU countries. If you sort by the "Total health expenditure % of GDP" on that Wikipedia link I provided, you can see that we're still about double (some above and some below) the rate of other industrialized nations in terms of expenditures as a % of GDP. So, as I was saying, if we brought our spending down to a level on par with other nations, we could save half or even more of our current expenditure. And by providing a range of 33% to 50% savings, I was being on the conservative end of that estimate--although admittedly the whole idea of cutting our spending like that is highly unlikely for many reasons other than this fun speculative exercise.

Blonde Lawyer

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Re: Obamacare survives
« Reply #159 on: June 27, 2015, 08:55:47 PM »
I think I overestimated the number of people employed by health insurance companies.  This fortune article says "more than 240,000." I would have expected that many at just one company so I guess I was way off.

http://fortune.com/2014/10/20/health-insurance-future/

This article is also pretty interesting.  I didn't read the whole thing yet but it addresses a lot of the problems with our current model.

forummm

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Re: Obamacare survives
« Reply #160 on: June 28, 2015, 05:29:39 AM »
I think I overestimated the number of people employed by health insurance companies.  This fortune article says "more than 240,000." I would have expected that many at just one company so I guess I was way off.

http://fortune.com/2014/10/20/health-insurance-future/

This article is also pretty interesting.  I didn't read the whole thing yet but it addresses a lot of the problems with our current model.

And not all those jobs would go away. Some would be moved to other locations.

BTDretire

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Re: Obamacare survives
« Reply #161 on: June 28, 2015, 09:30:40 AM »

 Sorry, this is a little long, but it goes through what has happened to my premium since Obamacare regs started.


NOTE;  No Obamacare regs, first two years.
BLUE CROSS Policy Family of 4, $2,500 Deductible

   2-01-09 $720
                                   Yearly Premium
  To                                   $8,640

   7-01-09 $720

I received notice my premium was increasing to $825 per month.
 This is $9,900  per year.  I needed to do something.
To lower my premium I raised my deductible to $10,000.
This decreased my premium to $376 per month.
Saving my $5,388 per year. (crazy reduction)

  8-01-09 $376
 
            TO                  Yearly Premium
                                     $4,512     
  5-01-10 $376

               Received a 7.7% premium increase
  6-10-10 $405
 
           TO          Yearly Premium
                              $4,860
5-01-11 $405

              Received a 8.1% premium increase
  6-01-11 $438

     To                          Yearly Premium     
                                  $5,256
 5-01-12 $438

OBAMACARE REGULATIONS START---Received a 19.4% increase
  6-01-12 $523
     TO             Yearly Premium
                        $6,276
  5-01-13 $523


 MORE OBAMACARE POLICIES---Received 21% increase
  6-01-13 $633
 
            TO            Yearly Premium
                                $7,596
  3-01-14 $633
 Dropped my daughter off policy, Premium reduction of $89
  4-01-14 $544   Policy is now for 3 people
  5-01-14 $544
  6-01-14 $544
  7-01-14 $544

MORE OBAMACARE POLICIES---Received 18.8% increase
  8-01-14 $646

                         Yearly Premium
                              $7,752
          Note if my daughter was still included premium would be 
                              $8,952

At this time BLUE CROSS wants me to choose an Obamacare policy.

The cheapest ObamaCare premium is $1,142 per month or $13,700 a year.
Just  25 months  ago I was  paying  $438 per month or $ 5,256 a year.

My policy has a $10,000 deductible. Obamacare has a $12,500 deductible.
After I pay my $10,000 almost everything is covered 100%.
 I wrote all of the above in July of 2014.

 Today I did a check on Healthcare.gov, a policy equivalent to what I have is $13,500.
The generous hardworking Taxpayers will subsidize me with $9,360 to reduce my cost to $4140.
This would save me $4,308 a year.
 I have not went on Obamacare, my doctor doesn't accept it, I don't want the wellfare check,
I don't want it to succeed, and I think the subsidies will rise over time.
 I have a price were I will be bought, but I'm not there yet. If I was retired and dropped my income to $40,000,
my ACA premium would cost me $41 per month.
 Why should an ACA policy cost $13,500 when an equivalent private policy from the same company costs me $7,752.
Regarding the subsidy, If half of US families took Obamacare, 62 million with an average subsidy of $10,000
That would be a cost to the hardworking taxpayers of $620,000,000,000 or 17.7% of the Federal tax revenue.


forummm

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Re: Obamacare survives
« Reply #162 on: June 28, 2015, 10:01:27 AM »
Sorry, you're just wrong in some places here. Healthcare expenses have been going up like crazy for decades. There was no regulatory change that happened near many of your "OBAMACARE POLICIES" denotations--just medical cost inflation or BCBS raising your premiums because they could. And the older plans are exempt from most of the policy changes anyway, unless the insurer chooses to adopt them.

Those premiums sound very high. I'm guessing because you're getting somewhat older. Which explains some of the increase in premiums you've seen as well. The policies get much more expensive as you get near 60--because older people cost so much more.

And your back of the envelope math is assuming the average American is in your exact situation (ages, lower incomes, etc). Which obviously isn't the case. And the ACA was designed so that people would continue to have insurance through work, and are only available to those with a lower income, so that the subsidies wouldn't be for half of the US.

The ACA actually *decreases* the federal budget deficit.

beltim

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Re: Obamacare survives
« Reply #163 on: June 28, 2015, 10:04:56 AM »
Today I did a check on Healthcare.gov, a policy equivalent to what I have is $13,500.
The generous hardworking Taxpayers will subsidize me with $9,360 to reduce my cost to $4140.
This would save me $4,308 a year.
I have not went on Obamacare, my doctor doesn't accept it, I don't want the wellfare check,
I don't want it to succeed, and I think the subsidies will rise over time.
 I have a price were I will be bought, but I'm not there yet. If I was retired and dropped my income to $40,000,
my ACA premium would cost me $41 per month.
 Why should an ACA policy cost $13,500 when an equivalent private policy from the same company costs me $7,752.
Regarding the subsidy, If half of US families took Obamacare, 62 million with an average subsidy of $10,000
That would be a cost to the hardworking taxpayers of $620,000,000,000 or 17.7% of the Federal tax revenue.

Your statements in bold directly contradict each other.

Greenroller

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Re: Obamacare survives
« Reply #164 on: June 28, 2015, 10:40:11 AM »
It always gets me how a financially responsible community like MMM can have such a majority of it support essentially socialized, government run medicine. I would think the majority would be against and for the competition of the private industry that brings about the greatest responsibility and forces hospitals and insurers to compete for patients. You car insurance competes for you like crazy, imagine if health insurance had to do the same.

I know most here think obamacare is the greatest thing that ever came out of DC, but if that were true; then why did all the stocks of big hospitals and insurers soar after the ruling; because obamacare is making them more profitable and making your opitions less and less.

If Obamacare were so good, doctors wouldn't be quitting, Medicaid(essentially obamacare's prerunner) wouldn't be denied at some of the finest hospitals, doctors clinics that are run by fee for service wouldn't be popping up all over.

obamacare essentially increased the costs and put healthcare services on a permanent decline of 320 million for 10 million that the govt could have taken care of without throwing the healthcare system under the bus. it still looks good now, give it 10 years or read the stories on british healthcare.

^^^^^THIS 100%^^^^^^^

forummm

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Re: Obamacare survives
« Reply #165 on: June 28, 2015, 11:12:34 AM »
It always gets me how a financially responsible community like MMM can have such a majority of it support essentially socialized, government run medicine. I would think the majority would be against and for the competition of the private industry that brings about the greatest responsibility and forces hospitals and insurers to compete for patients. You car insurance competes for you like crazy, imagine if health insurance had to do the same.

I know most here think obamacare is the greatest thing that ever came out of DC, but if that were true; then why did all the stocks of big hospitals and insurers soar after the ruling; because obamacare is making them more profitable and making your opitions less and less.

If Obamacare were so good, doctors wouldn't be quitting, Medicaid(essentially obamacare's prerunner) wouldn't be denied at some of the finest hospitals, doctors clinics that are run by fee for service wouldn't be popping up all over.

obamacare essentially increased the costs and put healthcare services on a permanent decline of 320 million for 10 million that the govt could have taken care of without throwing the healthcare system under the bus. it still looks good now, give it 10 years or read the stories on british healthcare.

^^^^^THIS 100%^^^^^^^

None of this makes any sense at all.

The ACA is in no way a socialist, government run healthcare system. That's just false on its face. It's private insurance--which is why hospital and insurer stocks have tripled.

And the ACA *increases* competition by creating the Marketplaces.

Fee for service has been the standard for decades. But, in significant part due to the ACA, it's actually in rapid decline. The target is for 80% of Medicare to be value-based (not just FFS) and 80% of 1/3 of the states to be entirely value-based in the next 4 years.

You also have to understand nuance. I think the ACA is better than the hideously terrible system we had before. I think the ACA is less terrible--not sunshine and rainbows. By comparison, it's great. By comparison to <pick just about any other industrialized nation> it's crap. But many of those other industrialized nations have actual socialist, government run healthcare systems. And it's much cheaper (like half the cost per capita, even adjusting for GDP differences), and the outcomes are better in most cases.

It would be hard for your statements to be less reflective of reality.

Monkey Uncle

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Re: Obamacare survives
« Reply #166 on: June 28, 2015, 11:46:16 AM »
It's because of the $$$. All that money we spend (about 16% of GDP) on healthcare is someone's income. Judging from other nations, about half of that or more is wasted. All those people are going to fight to keep their income from being cut in half.

Hey, all that money is paying for the hospital CEO's new yacht!  How dare you call that waste!

Monkey Uncle

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Re: Obamacare survives
« Reply #167 on: June 28, 2015, 12:13:39 PM »

We once got an ointment prescribed by the doctor. 60g of the ointment retailed for $630. How is this even possible? What's even in it?
My question of what is in it was rhetorical.

Regardless of the amount of research and development, I'm pretty sure the prices are hyperinflated. I have less issues with companies making huge profits off consumable goods (i.e. Apple products), but this is medicine we're talking about.

What if my insurance company didn't cover any portion of the ointment?

Epipens for $300? This is an extra $300-$900 mandatory expense every year that some people have to pony up.

Might as well start billing people for ER before rolling them into the OR: "Sir, you'll have to pay before I can use the defibrillator on you."

Nobody should ever have to consciously choose to accept or reject basic treatment.

You just made an argument for the ACA - that everyone should have insurance that covers essentials like epipens. 

However, you shouldn't ask a question (even rhetorical) and then just disregard the answer.  You might think that drugs are hyperinflated, but if you completely removed profits from drug companies you'd only reduce prices by 10-20% (removing superfluous advertising would add a bit more).  And then you wouldn't have any new drugs because no one would bring them to market.  Projekt provided a link that discusses other ways to pay for research and development of new drugs, but that just shifts the cost - instead of paying an extra 20% on current drugs to fund research, maybe your taxes would go up a corresponding amount to fund research.

Actually, pharmaceutical companies have the highest profit margin in the health care industry (more like 20-30%).  Another problem is outrageous executive compensation, which gets subtracted from revenue before earnings are calculated.  Total executive compensation at the big 5 pharma companies ranges $38 - $66 million.

http://www.forbes.com/sites/danmunro/2015/05/26/pharma-trumps-all-healthcare-sectors-in-executive-compensation/
« Last Edit: June 28, 2015, 12:17:54 PM by Monkey Uncle »

BTDretire

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Re: Obamacare survives
« Reply #168 on: June 28, 2015, 03:14:43 PM »
Sorry, you're just wrong in some places here. Healthcare expenses have been going up like crazy for decades.
  Yes as I posted, I had a 7.2% increase and a 8.1% increase before 2012 when Obamacare policies started. Not the 18% to 21%
after Obamacare policies started.
Quote
There was no regulatory change that happened near many of your "OBAMACARE POLICIES" denotations--just medical cost inflation or BCBS raising your premiums because they could. And the older plans are exempt from most of the policy changes anyway, unless the insurer chooses to adopt them.
Obamacare polices started in 2012, but only some, they affected me since I'm self employed and buy my own policy. All increases waited until the anniversary date of my policy.
I think they have recently went after employer supplied policies, but haven't touched their union buddy Cadillac policies, yet. It is coming.
 
Quote
Those premiums sound very high. I'm guessing because you're getting somewhat older. Which explains some of the increase in premiums you've seen as well. The policies get much more expensive as you get near 60--because older people cost so much more.

 Yep, 60 years old.

Quote
And your back of the envelope math is assuming the average American is in your exact situation (ages, lower incomes, etc).
I think you are right about the Average American, because younger people have a lower premium, their premium will be lower and they  will get less subsidy amount. On the other hand the average American has a lower MAGI than I used for the calculation. I used $65k, the average US family earns around $53k with an even lower MAGI.
  I just ran a 20 year younger family,  with a $45k MAGI, the subsidy is only $399/mo as you expected, the premium is also lower $185/mo after the subsidy. Much lower than I expected.
Quote
Which obviously isn't the case. And the ACA was designed so that people would continue to have insurance through work, and are only available to those with a lower income, so that the subsidies wouldn't be for half of the US.
  I have plenty of people that tell me they are either paying more or the staff was trimmed so the company doesn't have to buy employees insurance. Two companies within a block of where I sit trimmed their staff. (restaurants) All employees must buy their own insurance or pay the penalty.
Quote
The ACA actually *decreases* the federal budget deficit.
  We'll see, a lot more people on Medicaid, the cost of insurance is up, a lot, the government is paying the subsidies to insurance companies. The only way it decreases the Federal budget is because it was loaded with tax increases.
I guess any boondoggle legislation could decrease the deficit, if you put enough tax increases in it.
 In the end Obamacare won, and it won't be long and I suspect I'll be on it.

milesdividendmd

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Re: Obamacare survives
« Reply #169 on: June 28, 2015, 03:23:41 PM »
You are already on it.

BTDretire

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Re: Obamacare survives
« Reply #170 on: June 28, 2015, 03:27:13 PM »
Quote

Your statements in bold directly contradict each other.

I have not went on Obamacare, my doctor doesn't accept it
and
Why should an ACA policy cost $13,500 when an equivalent private policy from the same company costs me $7,752.
I don't see the confusion, I have not bought an Obamacare policy, I have looked on the Healthcare.Gov website, the cost of a policy equivalent to the $7,752 policy I have now, is $13,500. Same company. Why? Who gets the extra money? For what?
« Last Edit: June 01, 2019, 02:13:25 PM by BTDretire »

BTDretire

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Re: Obamacare survives
« Reply #171 on: June 28, 2015, 03:32:22 PM »
You are already on it.

 Who are you referencing in your reply?

forummm

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Re: Obamacare survives
« Reply #172 on: June 28, 2015, 04:16:27 PM »
Sorry, you're just wrong in some places here. Healthcare expenses have been going up like crazy for decades.
  Yes as I posted, I had a 7.2% increase and a 8.1% increase before 2012 when Obamacare policies started. Not the 18% to 21%
after Obamacare policies started.
Quote
There was no regulatory change that happened near many of your "OBAMACARE POLICIES" denotations--just medical cost inflation or BCBS raising your premiums because they could. And the older plans are exempt from most of the policy changes anyway, unless the insurer chooses to adopt them.
Obamacare polices started in 2012, but only some, they affected me since I'm self employed and buy my own policy. All increases waited until the anniversary date of my policy.
I think they have recently went after employer supplied policies, but haven't touched their union buddy Cadillac policies, yet. It is coming.
 
Quote
Those premiums sound very high. I'm guessing because you're getting somewhat older. Which explains some of the increase in premiums you've seen as well. The policies get much more expensive as you get near 60--because older people cost so much more.

 Yep, 60 years old.

Quote
And your back of the envelope math is assuming the average American is in your exact situation (ages, lower incomes, etc).
I think you are right about the Average American, because younger people have a lower premium, their premium will be lower and they  will get less subsidy amount. On the other hand the average American has a lower MAGI than I used for the calculation. I used $65k, the average US family earns around $53k with an even lower MAGI.
  I just ran a 20 year younger family,  with a $45k MAGI, the subsidy is only $399/mo as you expected, the premium is also lower $185/mo after the subsidy. Much lower than I expected.
Quote
Which obviously isn't the case. And the ACA was designed so that people would continue to have insurance through work, and are only available to those with a lower income, so that the subsidies wouldn't be for half of the US.
  I have plenty of people that tell me they are either paying more or the staff was trimmed so the company doesn't have to buy employees insurance. Two companies within a block of where I sit trimmed their staff. (restaurants) All employees must buy their own insurance or pay the penalty.
Quote
The ACA actually *decreases* the federal budget deficit.
  We'll see, a lot more people on Medicaid, the cost of insurance is up, a lot, the government is paying the subsidies to insurance companies. The only way it decreases the Federal budget is because it was loaded with tax increases.
I guess any boondoggle legislation could decrease the deficit, if you put enough tax increases in it.
 In the end Obamacare won, and it won't be long and I suspect I'll be on it.

I'm telling you that you had a grandfathered policy (from pre-ACA) and there was almost nothing that changed for grandfathered individual market policies. That's why they were "grandfathered" because you could keep them almost entirely the way it was. Some insurers decided to stop offering them for business reasons. Some insurers used the ACA as a dishonest excuse to move people to more expensive plans. BCBS may have decided to change things of their own accord. They may have decided to charge you more because you got older. They may have decided to charge you more because your individual market risk pool was so small. They may have decided to charge you more because your alternative was to get an ACA-compliant plan (which costs more because it covers more).

Employers have been dropping health insurance coverage for the past couple decades because health care costs so much. I'm sure this will continue even with the ACA. Fortunately, workers without job-based coverage can get covered through the Marketplace now.

The ACA was primarily paid for by overpaying less to private insurers for Medicare Advantage plans. They were paying private insurers something like 15-20% (forget the exact number) more per person for Medicare Advantage plans as compared to the cost of traditional Medicare. Now they overpay them less than before, which saves about $70 billion per year. More than the tax credits cost.

MidWestLove

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Obamacare survives
« Reply #173 on: June 28, 2015, 07:28:35 PM »
Speaking of ACA - does it make a sticky thread for those of us in US and are considering FIRE? links to definitions (MAGI, federal poverty level by family size, list of States with expanded Medicare ,etc.) I think gootofgood have an excellent post on it but I am not sure who else is tracking this or how easy it is to reference http://rootofgood.com/affordable-care-act-subsidy/

what do you think?

Mod note: put something together and we'll take a look. As of now no informative thread exists to sticky.
« Last Edit: June 28, 2015, 08:03:22 PM by arebelspy »

BTDretire

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Re: Obamacare survives
« Reply #174 on: June 28, 2015, 08:30:23 PM »


I'm telling you that you had a grandfathered policy (from pre-ACA) and there was almost nothing that changed for grandfathered individual market policies. That's why they were "grandfathered" because you could keep them almost entirely the way it was.

 Yes, I do have a grandfathered policy. You did qualify your response with "almost nothing" and "almost entirely". So I guess you do realize the even my grandfathered policy had changes because of Obamacare. I don't know them all, but I now get a free physical each year, but I pay heavily for that. I get a free colonoscopy every 5 years, but I pay heavily for that. I now have unlimited lifetime cost cap, it was capped at 5 million, but I pay heavily for that. I have some additional mental health care coverage, but I pay heavily for that. I think there was some additional sustance abuse coverage also.  So I got a lot of free stuff, but I'm charged for it.
Quote
Some insurers decided to stop offering them for business reasons. Some insurers used the ACA as a dishonest excuse to move people to more expensive plans. BCBS may have decided to change things of their own accord. They may have decided to charge you more because you got older. They may have decided to charge you more because your individual market risk pool was so small. They may have decided to charge you more because your alternative was to get an ACA-compliant plan (which costs more because it covers more).

All of those are probably true, but the last one, they raised my premium so I would move to the ACA where they would get even more money because of the subsidy, sticks with me.
 As to, (which costs more because it covers more), my policy covers 100% after the 10k deductible, except for mental health and sustance abuse and a limit on ambulace service.
Quote
Employers have been dropping health insurance coverage for the past couple decades because health care costs so much. I'm sure this will continue even with the ACA. Fortunately, workers without job-based coverage can get covered through the Marketplace now.

 Just be sure to note that health insurance was available before the Market place, I've been buying it for at 30 years.
Quote
The ACA was primarily paid for by overpaying less to private insurers for Medicare Advantage plans. They were paying private insurers something like 15-20% (forget the exact number) more per person for Medicare Advantage plans as compared to the cost of traditional Medicare. Now they overpay them less than before, which saves about $70 billion per year. More than the tax credits cost.
Don't have any information about that, but if the government is paying I'm sure there is waste.

forummm

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Re: Obamacare survives
« Reply #175 on: June 29, 2015, 09:05:04 AM »


I'm telling you that you had a grandfathered policy (from pre-ACA) and there was almost nothing that changed for grandfathered individual market policies. That's why they were "grandfathered" because you could keep them almost entirely the way it was.

 Yes, I do have a grandfathered policy. You did qualify your response with "almost nothing" and "almost entirely". So I guess you do realize the even my grandfathered policy had changes because of Obamacare. I don't know them all, but I now get a free physical each year, but I pay heavily for that. I get a free colonoscopy every 5 years, but I pay heavily for that. I now have unlimited lifetime cost cap, it was capped at 5 million, but I pay heavily for that. I have some additional mental health care coverage, but I pay heavily for that. I think there was some additional sustance abuse coverage also.  So I got a lot of free stuff, but I'm charged for it.
Quote
Some insurers decided to stop offering them for business reasons. Some insurers used the ACA as a dishonest excuse to move people to more expensive plans. BCBS may have decided to change things of their own accord. They may have decided to charge you more because you got older. They may have decided to charge you more because your individual market risk pool was so small. They may have decided to charge you more because your alternative was to get an ACA-compliant plan (which costs more because it covers more).

All of those are probably true, but the last one, they raised my premium so I would move to the ACA where they would get even more money because of the subsidy, sticks with me.
 As to, (which costs more because it covers more), my policy covers 100% after the 10k deductible, except for mental health and sustance abuse and a limit on ambulace service.
Quote
Employers have been dropping health insurance coverage for the past couple decades because health care costs so much. I'm sure this will continue even with the ACA. Fortunately, workers without job-based coverage can get covered through the Marketplace now.

 Just be sure to note that health insurance was available before the Market place, I've been buying it for at 30 years.
Quote
The ACA was primarily paid for by overpaying less to private insurers for Medicare Advantage plans. They were paying private insurers something like 15-20% (forget the exact number) more per person for Medicare Advantage plans as compared to the cost of traditional Medicare. Now they overpay them less than before, which saves about $70 billion per year. More than the tax credits cost.
Don't have any information about that, but if the government is paying I'm sure there is waste.

If you have a grandfathered policy, it was entirely optional for your plan to add all the preventive care you mention. Before the Marketplace, many people could not by any "real" coverage because of pre-existing conditions, annual limits, lifetime limits, recissions, etc. It looked like insurance, but wasn't really truly insurance in many cases if you needed to actually use it for anything substantive.

beltim

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Re: Obamacare survives
« Reply #176 on: June 29, 2015, 10:02:17 AM »

Your statements in bold directly contradict each other.

I have not went on Obamacare, my doctor doesn't accept it
and
Why should an ACA policy cost $13,500 when an equivalent private policy from the same company costs me $7,752.

 I don't see the confusion, I have not bought an Obamacare policy, I have looked on the Healthcare.Gov website, the cost of a policy equivalent to the $7,752 policy I have now, is $13,500. Same company. Why? Who gets the extra money? For what?

My point was that it can't be an equivalent policy - if nothing else, your doctor doesn't accept it and therefore it's not the same policy.  The fact that the price is so different I think also indicates they're not equivalent.  I can't give you more details than that because I don't have the information, but I'm sure that you'd find differences when you looked at the actual plan documents.

klystomane

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Re: Obamacare survives
« Reply #177 on: June 29, 2015, 10:03:16 AM »
You just made an argument for the ACA - that everyone should have insurance that covers essentials like epipens. 

However, you shouldn't ask a question (even rhetorical) and then just disregard the answer.  You might think that drugs are hyperinflated, but if you completely removed profits from drug companies you'd only reduce prices by 10-20% (removing superfluous advertising would add a bit more).  And then you wouldn't have any new drugs because no one would bring them to market.  Projekt provided a link that discusses other ways to pay for research and development of new drugs, but that just shifts the cost - instead of paying an extra 20% on current drugs to fund research, maybe your taxes would go up a corresponding amount to fund research.

Where is the 10-20% figure from?

When my dentist charges $290 for a regular teeth cleaning, but offers it year-round at a special discounted price of $59, it makes me inclined to believe that their profit margins, at a MSRP of $290, are much much higher than 20%.


beltim

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Re: Obamacare survives
« Reply #178 on: June 29, 2015, 10:05:53 AM »
However, you shouldn't ask a question (even rhetorical) and then just disregard the answer.  You might think that drugs are hyperinflated, but if you completely removed profits from drug companies you'd only reduce prices by 10-20% (removing superfluous advertising would add a bit more).  And then you wouldn't have any new drugs because no one would bring them to market.  Projekt provided a link that discusses other ways to pay for research and development of new drugs, but that just shifts the cost - instead of paying an extra 20% on current drugs to fund research, maybe your taxes would go up a corresponding amount to fund research.

Actually, pharmaceutical companies have the highest profit margin in the health care industry (more like 20-30%).  Another problem is outrageous executive compensation, which gets subtracted from revenue before earnings are calculated.  Total executive compensation at the big 5 pharma companies ranges $38 - $66 million.

http://www.forbes.com/sites/danmunro/2015/05/26/pharma-trumps-all-healthcare-sectors-in-executive-compensation/

Branded pharma companies have profit margins that high, yes.  But generic pharmaceuticals are sold at much lower margins, and account for 84% of all drugs sold in the US.

beltim

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Re: Obamacare survives
« Reply #179 on: June 29, 2015, 10:11:58 AM »
You just made an argument for the ACA - that everyone should have insurance that covers essentials like epipens. 

However, you shouldn't ask a question (even rhetorical) and then just disregard the answer.  You might think that drugs are hyperinflated, but if you completely removed profits from drug companies you'd only reduce prices by 10-20% (removing superfluous advertising would add a bit more).  And then you wouldn't have any new drugs because no one would bring them to market.  Projekt provided a link that discusses other ways to pay for research and development of new drugs, but that just shifts the cost - instead of paying an extra 20% on current drugs to fund research, maybe your taxes would go up a corresponding amount to fund research.

Where is the 10-20% figure from?

When my dentist charges $290 for a regular teeth cleaning, but offers it year-round at a special discounted price of $59, it makes me inclined to believe that their profit margins, at a MSRP of $290, are much much higher than 20%.

It was an estimate - as Monkey Uncle pointed out, branded non-generic pharma companies can have 30% profit margins, but generics have much lower margins, and account for the vast majority of drugs sold in the US and worldwide.

I'm not sure what relevance your teeth cleaning cost has on pharma profit margins.

BTDretire

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Re: Obamacare survives
« Reply #180 on: June 29, 2015, 10:27:37 AM »


If you have a grandfathered policy, it was entirely optional for your plan to add all the preventive care you mention.

  It may have been optional, but it's a moot point, it wasn't  optional for me.
Quote
Before the Marketplace, many people could not buy any "real" coverage because of pre-existing conditions, annual limits, lifetime limits, recissions, etc.

I'm sure that's true of some, but many, have their new car, eat out three times a week, take a two week vacation, buy coffee at the mall, and buy their kids the latest electronics, but they can't afford insurance.
 
Quote
It looked like insurance, but wasn't really truly insurance in many cases if you needed to actually use it for anything substantive.

 I suggest that is just ignorance if they bought a policy that didn't fit their need.

 
 

forummm

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Re: Obamacare survives
« Reply #181 on: June 29, 2015, 10:34:59 AM »
If you have a grandfathered policy, it was entirely optional for your plan to add all the preventive care you mention.

  It may have been optional, but it's a moot point, it wasn't  optional for me.
Quote
Before the Marketplace, many people could not buy any "real" coverage because of pre-existing conditions, annual limits, lifetime limits, recissions, etc.

I'm sure that's true of some, but many, have their new car, eat out three times a week, take a two week vacation, buy coffee at the mall, and buy their kids the latest electronics, but they can't afford insurance.
 
Quote
It looked like insurance, but wasn't really truly insurance in many cases if you needed to actually use it for anything substantive.
I suggest that is just ignorance if they bought a policy that didn't fit their need.

You asserted the changes to your policy were because the ACA required them. I was pointing out that this assertion is incorrect. Your costs went up because BCBS decided that they should.

Pre-ACA, you were only able to purchase whatever an insurance company said you could purchase, and the benefits were very limited. This point is not related to whether someone was good with their money otherwise. Or someone's ability to understand what they were buying. Before the law was passed, the comprehensive coverage available post-ACA was not available to many, regardless of the price or their intelligence.

BTDretire

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Re: Obamacare survives
« Reply #182 on: June 29, 2015, 10:40:25 AM »

Your statements in bold directly contradict each other.

I have not went on Obamacare, my doctor doesn't accept it
and
Why should an ACA policy cost $13,500 when an equivalent private policy from the same company costs me $7,752.

 I don't see the confusion, I have not bought an Obamacare policy, I have looked on the Healthcare.Gov website, the cost of a policy equivalent to the $7,752 policy I have now, is $13,500. Same company. Why? Who gets the extra money? For what?

My point was that it can't be an equivalent policy - if nothing else, your doctor doesn't accept it and therefore it's not the same policy.  The fact that the price is so different I think also indicates they're not equivalent.  I can't give you more details than that because I don't have the information, but I'm sure that you'd find differences when you looked at the actual plan documents.

 Equivalent in that once I pay my deductible, everything is 100% covered.  Except, mental healthcare, substance abuse and ambulance
have additional costs.

beltim

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Re: Obamacare survives
« Reply #183 on: June 29, 2015, 10:45:46 AM »

Your statements in bold directly contradict each other.

I have not went on Obamacare, my doctor doesn't accept it
and
Why should an ACA policy cost $13,500 when an equivalent private policy from the same company costs me $7,752.

 I don't see the confusion, I have not bought an Obamacare policy, I have looked on the Healthcare.Gov website, the cost of a policy equivalent to the $7,752 policy I have now, is $13,500. Same company. Why? Who gets the extra money? For what?

My point was that it can't be an equivalent policy - if nothing else, your doctor doesn't accept it and therefore it's not the same policy.  The fact that the price is so different I think also indicates they're not equivalent.  I can't give you more details than that because I don't have the information, but I'm sure that you'd find differences when you looked at the actual plan documents.

 Equivalent in that once I pay my deductible, everything is 100% covered.  Except, mental healthcare, substance abuse and ambulance
have additional costs.

And your doctor doesn't accept it.  Thus, it's not the same policy.

Gin1984

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Re: Obamacare survives
« Reply #184 on: June 29, 2015, 11:00:07 AM »


I'm telling you that you had a grandfathered policy (from pre-ACA) and there was almost nothing that changed for grandfathered individual market policies. That's why they were "grandfathered" because you could keep them almost entirely the way it was.

 Yes, I do have a grandfathered policy. You did qualify your response with "almost nothing" and "almost entirely". So I guess you do realize the even my grandfathered policy had changes because of Obamacare. I don't know them all, but I now get a free physical each year, but I pay heavily for that. I get a free colonoscopy every 5 years, but I pay heavily for that. I now have unlimited lifetime cost cap, it was capped at 5 million, but I pay heavily for that. I have some additional mental health care coverage, but I pay heavily for that. I think there was some additional sustance abuse coverage also.  So I got a lot of free stuff, but I'm charged for it.
Quote
Some insurers decided to stop offering them for business reasons. Some insurers used the ACA as a dishonest excuse to move people to more expensive plans. BCBS may have decided to change things of their own accord. They may have decided to charge you more because you got older. They may have decided to charge you more because your individual market risk pool was so small. They may have decided to charge you more because your alternative was to get an ACA-compliant plan (which costs more because it covers more).

All of those are probably true, but the last one, they raised my premium so I would move to the ACA where they would get even more money because of the subsidy, sticks with me.
 As to, (which costs more because it covers more), my policy covers 100% after the 10k deductible, except for mental health and sustance abuse and a limit on ambulace service.
Quote
Employers have been dropping health insurance coverage for the past couple decades because health care costs so much. I'm sure this will continue even with the ACA. Fortunately, workers without job-based coverage can get covered through the Marketplace now.

Just be sure to note that health insurance was available before the Market place, I've been buying it for at 30 years.
Quote
The ACA was primarily paid for by overpaying less to private insurers for Medicare Advantage plans. They were paying private insurers something like 15-20% (forget the exact number) more per person for Medicare Advantage plans as compared to the cost of traditional Medicare. Now they overpay them less than before, which saves about $70 billion per year. More than the tax credits cost.
Don't have any information about that, but if the government is paying I'm sure there is waste.
It was available for you, it was not available for all Americans.

klystomane

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Re: Obamacare survives
« Reply #185 on: June 29, 2015, 11:06:04 AM »
You just made an argument for the ACA - that everyone should have insurance that covers essentials like epipens. 

However, you shouldn't ask a question (even rhetorical) and then just disregard the answer.  You might think that drugs are hyperinflated, but if you completely removed profits from drug companies you'd only reduce prices by 10-20% (removing superfluous advertising would add a bit more).  And then you wouldn't have any new drugs because no one would bring them to market.  Projekt provided a link that discusses other ways to pay for research and development of new drugs, but that just shifts the cost - instead of paying an extra 20% on current drugs to fund research, maybe your taxes would go up a corresponding amount to fund research.

Where is the 10-20% figure from?

When my dentist charges $290 for a regular teeth cleaning, but offers it year-round at a special discounted price of $59, it makes me inclined to believe that their profit margins, at a MSRP of $290, are much much higher than 20%.

It was an estimate - as Monkey Uncle pointed out, branded non-generic pharma companies can have 30% profit margins, but generics have much lower margins, and account for the vast majority of drugs sold in the US and worldwide.

I'm not sure what relevance your teeth cleaning cost has on pharma profit margins.

I'm lumping the ridiculousness that is the American medical system all together.


beltim

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Re: Obamacare survives
« Reply #186 on: June 29, 2015, 11:08:41 AM »
I'm not sure what relevance your teeth cleaning cost has on pharma profit margins.

I'm lumping the ridiculousness that is the American medical system all together.

So no relevance at all to the discussion at hand.  Got it.

klystomane

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Re: Obamacare survives
« Reply #187 on: June 29, 2015, 11:18:21 AM »
I'm not sure what relevance your teeth cleaning cost has on pharma profit margins.

I'm lumping the ridiculousness that is the American medical system all together.

So no relevance at all to the discussion at hand.  Got it.

Actually it is relevant.

You are estimating that pharma companies profit 10-20% (apparently 30% for some and who knows how much for others).

I am estimating that based on what I've seen (the dentist example was the first thing that came to mind), I'm inclined to believe that the profits in the medical industry as a whole are much higher than 10-30%.

It's just my personal observation though, I could be wrong.


beltim

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Re: Obamacare survives
« Reply #188 on: June 29, 2015, 11:41:19 AM »
I'm not sure what relevance your teeth cleaning cost has on pharma profit margins.

I'm lumping the ridiculousness that is the American medical system all together.

So no relevance at all to the discussion at hand.  Got it.

Actually it is relevant.

You are estimating that pharma companies profit 10-20% (apparently 30% for some and who knows how much for others).

I am estimating that based on what I've seen (the dentist example was the first thing that came to mind), I'm inclined to believe that the profits in the medical industry as a whole are much higher than 10-30%.

It's just my personal observation though, I could be wrong.

If you think that one anecdote about discounting at a dentist is at all relevant to the profit margins of pharma, or provides any pedagogical value to the larger question of profits in the medical industry, then this conversation isn't going anywhere.

I will point out, though, that total US drug sales are about $300 billion.  The total US spending on health care is something like $3 trillion.  So even if all drugs were free forever, the total savings to US consumers is a maximum of 10%. 

sixup

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Re: Obamacare survives
« Reply #189 on: June 29, 2015, 12:22:04 PM »
Ideologically I'm for a free market in medical care.

Just about every industry I can think of that doesn't have massive government involvement, efficiency goes up and costs go down over time. I wonder where medical prices would be if the government had it's hands out of it. (Same thing applies to education, and more recently housing.)

But realistically, I realize this will never happen. So at least ACA is a step towards smart laws. Hopefully.

iris lily

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Re: Obamacare survives
« Reply #190 on: June 29, 2015, 12:27:52 PM »
Quote
It's because of the $$$. All that money we spend (about 16% of GDP) on healthcare is someone's income. Judging from other nations, about half of that or more is wasted. All those people are going to fight to keep their income from being cut in half.

This is a very real issue.  While I would love to see the US have socialized medicine and get rid of for profit health insurance companies, I can't help to think about how many people are employed by health insurance companies.  Blue Cross Blue Shield alone for example.  There would be a very real crisis if all of those people were suddenly out of work.

I don't think socialized medicine would provide enough jobs to employ all those people.  I'm not sure how we could make the transition without causing a huge economic issue from all of the suddenly unemployed people.
That's never stopped us from retiring entire industries before, or pushing for other industries to be outlawed. Nobody is going to be raising money for the homeless insurance adjusters or paper pushers outside your local grocery store.
I agree that a whole legion of unemployed health insurance agents need to be considered in any industry change, but that's not enough reason to not make a change.

I think about this same issues with tax experts. Think of all of the people inthe income tax industry who sell their expertise, and what happens to them in a flat tax scenario? I am in favor of flat tax, but I always hate to see acvountants screwed over. Insurance agents, not so much.

music lover

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Re: Obamacare survives
« Reply #191 on: June 29, 2015, 12:34:51 PM »
Just about every industry I can think of that doesn't have massive government involvement, efficiency goes up and costs go down over time. I wonder where medical prices would be if the government had it's hands out of it. (Same thing applies to education, and more recently housing.)

Perhaps prices would be less. Your private health care cost is double that of other countries with government paid health care, many of which have a higher standard of care.

This has been pointed out several times already, yet some just can't be convinced.

sixup

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Re: Obamacare survives
« Reply #192 on: June 29, 2015, 12:39:21 PM »
Just about every industry I can think of that doesn't have massive government involvement, efficiency goes up and costs go down over time. I wonder where medical prices would be if the government had it's hands out of it. (Same thing applies to education, and more recently housing.)

Perhaps prices would be less. Your private health care cost is double that of other countries with government paid health care, many of which have a higher standard of care.

When was the last time health care was truly a free market? I don't know. Probably not in the last 60-100 years? Medical technology has come a long way in that time.

waltworks

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Re: Obamacare survives
« Reply #193 on: June 29, 2015, 12:47:22 PM »
Just about every industry I can think of that doesn't have massive government involvement, efficiency goes up and costs go down over time. I wonder where medical prices would be if the government had it's hands out of it. (Same thing applies to education, and more recently housing.)

Perhaps prices would be less. Your private health care cost is double that of other countries with government paid health care, many of which have a higher standard of care.

When was the last time health care was truly a free market? I don't know. Probably not in the last 60-100 years? Medical technology has come a long way in that time.

Well, it's much more "free" here than basically every other industrialized country, and it sucks. I would, as a person who holds himself to a libertarian-ish standard for personal resposibility, love to see a true free market for healthcare. But I also know that in reality,
A) it's politically impossible. Nobody likes to see a pregnant lady/handicapped veteran/child die because she can't pay, or worse because she's unconscious and nobody can figure out who she is/if she's insured quickly. See my earlier posts about EMTALA.
B) It would require some way of ensuring very transparent information for all parties on costs/benefits/outcomes. There is currently no such thing (and it's unlikely there ever will be) and as such consumers of health care can't really negotiate on an equal footing.

-W

forummm

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Re: Obamacare survives
« Reply #194 on: June 29, 2015, 12:48:54 PM »
Just about every industry I can think of that doesn't have massive government involvement, efficiency goes up and costs go down over time. I wonder where medical prices would be if the government had it's hands out of it. (Same thing applies to education, and more recently housing.)

Perhaps prices would be less. Your private health care cost is double that of other countries with government paid health care, many of which have a higher standard of care.

When was the last time health care was truly a free market? I don't know. Probably not in the last 60-100 years? Medical technology has come a long way in that time.

Health care cannot be a properly functioning free market. For a properly functioning free market you need things like full transparency of current pricing to everyone. You also need fully informed participants on both sides of the transaction. There's no way (in most cases) you are going to know as much about your healthcare needs as the physician does. Healthcare market failure is the reason why we have the situation we have now.

gillstone

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Re: Obamacare survives
« Reply #195 on: June 29, 2015, 01:03:33 PM »
I will add the current model of insurance-driven payments could never be a truly free market option.  When insurance companies view their purpose as generating returns for their owners, patients become liabilities and their  treatments are costs that offset the revenue from premiums.  In particular, for-profit insurers in a radically free market have every incentive to delay and deny payment for as long as possible to ensure the greatest return per client.    In the pre-ACA market that allowed recision, retroactive cancellations and pre-existing condition exclusions, this was the practice of companies that placed the bottom line over basic ethics.
 

forummm

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Re: Obamacare survives
« Reply #196 on: June 29, 2015, 01:08:59 PM »
Speaking of ACA - does it make a sticky thread for those of us in US and are considering FIRE? links to definitions (MAGI, federal poverty level by family size, list of States with expanded Medicare ,etc.) I think gootofgood have an excellent post on it but I am not sure who else is tracking this or how easy it is to reference http://rootofgood.com/affordable-care-act-subsidy/

what do you think?

Mod note: put something together and we'll take a look. As of now no informative thread exists to sticky.

I started a thread that could serve this purpose. I'll add more to it as I have time or think of important things to know. Feel free to submit your questions.

http://forum.mrmoneymustache.com/welcome-to-the-forum/information-on-the-affordable-care-act-with-a-focus-on-early-retirees/

sixup

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Re: Obamacare survives
« Reply #197 on: June 29, 2015, 01:58:57 PM »
Just about every industry I can think of that doesn't have massive government involvement, efficiency goes up and costs go down over time. I wonder where medical prices would be if the government had it's hands out of it. (Same thing applies to education, and more recently housing.)

Perhaps prices would be less. Your private health care cost is double that of other countries with government paid health care, many of which have a higher standard of care.

When was the last time health care was truly a free market? I don't know. Probably not in the last 60-100 years? Medical technology has come a long way in that time.

Well, it's much more "free" here than basically every other industrialized country, and it sucks. I would, as a person who holds himself to a libertarian-ish standard for personal resposibility, love to see a true free market for healthcare. But I also know that in reality,
A) it's politically impossible. Nobody likes to see a pregnant lady/handicapped veteran/child die because she can't pay, or worse because she's unconscious and nobody can figure out who she is/if she's insured quickly. See my earlier posts about EMTALA.
B) It would require some way of ensuring very transparent information for all parties on costs/benefits/outcomes. There is currently no such thing (and it's unlikely there ever will be) and as such consumers of health care can't really negotiate on an equal footing.

-W

I agree completely. I think it's -possible- to solve problem B, but we all can agree it's not going to happen.

Kris

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Re: Obamacare survives
« Reply #198 on: June 29, 2015, 03:18:31 PM »
Speaking of ACA - does it make a sticky thread for those of us in US and are considering FIRE? links to definitions (MAGI, federal poverty level by family size, list of States with expanded Medicare ,etc.) I think gootofgood have an excellent post on it but I am not sure who else is tracking this or how easy it is to reference http://rootofgood.com/affordable-care-act-subsidy/

what do you think?

Mod note: put something together and we'll take a look. As of now no informative thread exists to sticky.

I started a thread that could serve this purpose. I'll add more to it as I have time or think of important things to know. Feel free to submit your questions.

http://forum.mrmoneymustache.com/welcome-to-the-forum/information-on-the-affordable-care-act-with-a-focus-on-early-retirees/

How very timely.  I was just thinking of posting a question related to this.  Thanks, Forummm!

Blonde Lawyer

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Re: Obamacare survives
« Reply #199 on: June 30, 2015, 09:09:16 AM »
Regarding the poster with the $59 dental cleaning special - that is very likely a loss leader.  Get a new patient in, they are more likely to come back.  Attorneys offer free consultations for this very reason.  It is also why we accept some legal insurance plans.  We will absolutely lose money on some of the cases but make it back up when that person gets in a car accident and hires us as their personal injury lawyer. That's how groupon and all those other social networking coupon things work. 

As for free market healthcare - my problem with it is health care is generally a need not a want. I take medication because I need it, not because it is fun.  If I lost my insurance, I would continue taking it so long as I could afford to pay for it.  If I stopped taking it, it isn't because I decided the cost wasn't worth it.  It is because I decided it was more important to feed my family and pay my mortgage - to the major detriment to my health.  It's not really a choice if you will.

One plan I heard about that does work on free market principals is where the insurance company shares with the insured when they save the company money.  If two pharmacies are in network and one is $50 cheaper than the other, and you show them you did your homework and switched, they give you 50% of the savings.  That same program was also sharing with the insured when they caught and reported medical billing errors.

I will admit that for my uninsured pet meds, I call around and go to the cheapest pharmacy.  For my meds, I go to the most convenient one either right next to my house or work.  If it was easier to get the answer though, I'd consider going to the cheaper one.  There is no quick online database and some pharmacies won't even give you a quote over the phone unless they have your prescription in their system.  It's ridiculous.