ObamaCare - exchanges ,report your states options!

[Phatscotty]

Obamacare ‘rate shock’ hits Ohio with 88 percent insurance hikes

State officials aren’t surprised. They’ve cautioned about the “rate shock” since the early days of Obamacare, Forbes reported.

“We have warned of these increases,” said Lt. Gov. Mary Taylor. “Consumers will have fewer choices and pay much higher premiums for their health insurance starting in 2014.

http://www.washingtontimes.com/news/201 ... -insuranc/

And yet, it is already working well in states like California, Oregon, and Washington...
http://www.forbes.com/sites/rickungar/2 ... ium-rates/

Cohn is saying that, despite the political naysayers, the healthcare exchange concept appears to be working very well indeed in states like California, Oregon and Washington—the first states to publish the expected health exchange prices for purchasing coverage. These are also states that are actually committed to seeing the program work as opposed to those states whose leaders have a vested political interest in seeing the Affordable Care Act fail.

One reason for the misplaced expectations may be that actuaries have been making worst-case assumptions, even as insurers—eyeing the prospects of so many new customers—have been calculating that it’s worth bidding low in order to gobble up market share.

So, it seems as though the government mandated exchanges are helping to increase competition among private insurers... isn't that exactly what some of you guys were saying that you wanted??

Not exactly. Competition works best in a free market. The competition I would like to see is between care providers, heck, even any aspect of HC.

A good example is a post I made a few pages back about doctors and providers who are starting to post their prices online. Of course you have to opt out completely from Obamacare or taking any medicare patients to do that, which reinforces my point.

It's the government that prevents competition. Health care is and has been heavily interfered in for a long time. The free market is long dead, and these double digits price increases year upon year are exactly what you should expect in an unfree marketplace.

I also heard about California. Now I have heard two separate stories. I'll bet it's a case where it's good for some people, and bad for others. As for me, I'm gonna wait and see how it end up in my state. We just got out exchange set up.

One thing we all know for sure is nobody's premium went down $2,500, and it certainly is not the average decline promised

[jj3044]

Not exactly. Competition works best in a free market.

"Not exactly" meaning "yes, it increased competition in this instance, I just don't want to admit it."?

A good example is a post I made a few pages back about doctors and providers who are starting to post their prices online. Of course you have to opt out completely from Obamacare or taking any medicare patients to do that, which reinforces my point.

I am in complete agreement with full price transparency, but you are incorrect in stating that these few examples you are citing are the ONLY instances of price transparency. Look up Castlight, for example. Many employers and insurers are employing services like Castlight so that consumers can see how much area docs and hospitals charge for certain services (even through insurance), so they can pick the lowest cost option.

Additionally:

Finally, the Patient Protection and Affordable Care Act (PPACA) of 2010 includes a provision that requires hospitals to provide charge information to the public annually.

Page 7 at: http://www.leapfroggroup.org/media/file ... nBrief.pdf

[Phatscotty]

Not exactly. Competition works best in a free market.

"Not exactly" meaning "yes, it increased competition in this instance, I just don't want to admit it."?

yeah yeah....I mean you can't increase competition in a market that just got taken over by the government with heavy new regulations. What is going on with the insurance companies is that the government is going to enforce making sure everyone buys their product and services, and the government is going to enforce the sectors monopoly. I'm just saying "competition" has no place in the new system. The companies that contributed to Obamacare got waivers up the wazoo. There is no way to "compete" with that. Obamacare picks winners and losers, I think that is crystal clear to all as well (AARP anyone?)

A good example is a post I made a few pages back about doctors and providers who are starting to post their prices online. Of course you have to opt out completely from Obamacare or taking any medicare patients to do that, which reinforces my point.

I am in complete agreement with full price transparency, but you are incorrect in stating that these few examples you are citing are the ONLY instances of price transparency. Look up Castlight, for example. Many employers and insurers are employing services like Castlight so that consumers can see how much area docs and hospitals charge for certain services (even through insurance), so they can pick the lowest cost option.

That's fine. I never said they were the only examples, nor do I even slightly believe that. It's just a couple examples off the top of my head. I already added a couple more .

[jj3044]

Fair enough. I rebutted your statement because of this:

Of course you have to opt out completely from Obamacare or taking any medicare patients to do that, which reinforces my point.

Which isn't the case.

[Phatscotty]

Fair enough. I rebutted your statement because of this:

Of course you have to opt out completely from Obamacare or taking any medicare patients to do that, which reinforces my point.

Which isn't the case.

It is in the case I stated and any others who posts their prices online. The only way you can make your own prices is to not accept patients who's insurance companies dictate the prices to the provider, private or public.

http://bangordailynews.com/2013/05/27/n ... es-online/

The family physician stopped accepting all forms of health insurance. In early 2013, Ciampi sent a letter to his patients informing them that he would no longer accept any kind of health coverage, both private and government-sponsored. Given that he was now asking patients to pay for his services out of pocket, he posted his prices on the practice’s website.

But the decision to do away with (all) insurance allows Ciampi to practice medicine the way he sees fit, he said. Insurance companies no longer dictate how much he charges. He can offer discounts to patients struggling with their medical bills. He can make house calls.

“I’m freed up to do what I think is right for the patients,” Ciampi said. “If I’m providing them a service that they value, they can pay me, and we cut the insurance out as the middleman and cut out a lot of the expense.”

[Nobunaga]

Funny thing happened at work today, goes to show how surprises await us all.

The HR office was running about confused and upset. They had just been informed that they need to file certain forms and pay a fee to the IRS because the company I work for has an HRA. Nobody knew this was coming. Turns out this is tucked in the Obamacare bill... someplace, and the fee doubles next year, then fluctuates "according to need" (who's need?) year to year.

The boss said he'll just move the plant to Mexico if it (Obamacare) gets too expensive for the company. That would suck.

[jj3044]

Fair enough. I rebutted your statement because of this:

Of course you have to opt out completely from Obamacare or taking any medicare patients to do that, which reinforces my point.

Which isn't the case.

It is in the case I stated and any others who posts their prices online. The only way you can make your own prices is to not accept patients who's insurance companies dictate the prices to the provider, private or public.

http://bangordailynews.com/2013/05/27/n ... es-online/

The family physician stopped accepting all forms of health insurance. In early 2013, Ciampi sent a letter to his patients informing them that he would no longer accept any kind of health coverage, both private and government-sponsored. Given that he was now asking patients to pay for his services out of pocket, he posted his prices on the practice’s website.

But the decision to do away with (all) insurance allows Ciampi to practice medicine the way he sees fit, he said. Insurance companies no longer dictate how much he charges. He can offer discounts to patients struggling with their medical bills. He can make house calls.

“I’m freed up to do what I think is right for the patients,” Ciampi said. “If I’m providing them a service that they value, they can pay me, and we cut the insurance out as the middleman and cut out a lot of the expense.”

You can still have competition with an insurance model, and that was what my point was trying to make.

Provider A has a negotiated rate for an endoscopy of $1000
Provider B has a negotiated rate for an endoscopy of $900

You choose provider B based on the new price transparency rules and tools available to allow you to see the difference.

Funny thing happened at work today, goes to show how surprises await us all.

The HR office was running about confused and upset. They had just been informed that they need to file certain forms and pay a fee to the IRS because the company I work for has an HRA. Nobody knew this was coming. Turns out this is tucked in the Obamacare bill... someplace, and the fee doubles next year, then fluctuates "according to need" (who's need?) year to year.

The boss said he'll just move the plant to Mexico if it (Obamacare) gets too expensive for the company. That would suck.

Do you know what for? There are certainly fees in the bill to help pay for it... i.e. Cadillac tax... but I believe that starts in 2014... let us know if you can find out specifically why there will be a fee for the HRA.

[Phatscotty]

Fair enough. I rebutted your statement because of this:

Of course you have to opt out completely from Obamacare or taking any medicare patients to do that, which reinforces my point.

Which isn't the case.

It is in the case I stated and any others who posts their prices online. The only way you can make your own prices is to not accept patients who's insurance companies dictate the prices to the provider, private or public.

http://bangordailynews.com/2013/05/27/n ... es-online/

The family physician stopped accepting all forms of health insurance. In early 2013, Ciampi sent a letter to his patients informing them that he would no longer accept any kind of health coverage, both private and government-sponsored. Given that he was now asking patients to pay for his services out of pocket, he posted his prices on the practice’s website.

But the decision to do away with (all) insurance allows Ciampi to practice medicine the way he sees fit, he said. Insurance companies no longer dictate how much he charges. He can offer discounts to patients struggling with their medical bills. He can make house calls.

“I’m freed up to do what I think is right for the patients,” Ciampi said. “If I’m providing them a service that they value, they can pay me, and we cut the insurance out as the middleman and cut out a lot of the expense.”

You can still have competition with an insurance model, and that was what my point was trying to make.

Provider A has a negotiated rate for an endoscopy of $1000
Provider B has a negotiated rate for an endoscopy of $900

You choose provider B based on the new price transparency rules and tools available to allow you to see the difference.

Can you show a real world example. I saw your link, but can you find something that uses your formula, or show wherever you got that from.

The example you are using has always existed and is not a new concept. What are these new transparency rules?

[jj3044]

Can you show a real world example. I saw your link, but can you find something that uses your formula, or show wherever you got that from.

The example you are using has always existed and is not a new concept. What are these new transparency rules?

I don't believe it is mandated until 2014, so currently, the data is sporadic at best. That article that I linked to also did a nice job at showing the barriers (and potential downside) of full price transparency.

Different providers already have different negotiated rates for a procedure through an insurer. Traditionally, this happens because of the size of an organization. Provider A is a 10 hospital network, so they have the power to negotiate a higher reimbursement for the procedure. Provider B is a small community hospital, so they don't have the negotiating power, and get a lower rate from the insurer. Traditionally, we wouldn't know this until after we get billed from the provider (i.e. if you have a high deductible health plan).

With the new price transparency rules, the hospitals have to release their rates. So, if I have a HDHP and are actually paying for the service out of pocket, I can now see that actually, I'll pay $100 less at the community hospital and go there. If enough people start doing that, the larger hospital systems will start losing customers, forcing them to lower their prices, or be more willing to negotiate a lower rate from the insurer. Competition.

[Phatscotty]

Can you show a real world example. I saw your link, but can you find something that uses your formula, or show wherever you got that from.

The example you are using has always existed and is not a new concept. What are these new transparency rules?

I don't believe it is mandated until 2014, so currently, the data is sporadic at best. That article that I linked to also did a nice job at showing the barriers (and potential downside) of full price transparency.

Different providers already have different negotiated rates for a procedure through an insurer. Traditionally, this happens because of the size of an organization. Provider A is a 10 hospital network, so they have the power to negotiate a higher reimbursement for the procedure. Provider B is a small community hospital, so they don't have the negotiating power, and get a lower rate from the insurer. Traditionally, we wouldn't know this until after we get billed from the provider (i.e. if you have a high deductible health plan).

With the new price transparency rules, the hospitals have to release their rates. So, if I have a HDHP and are actually paying for the service out of pocket, I can now see that actually, I'll pay $100 less at the community hospital and go there. If enough people start doing that, the larger hospital systems will start losing customers, forcing them to lower their prices, or be more willing to negotiate a lower rate from the insurer. Competition.

okay thanks. the way you said it here makes a lot more sense

[saxitoxin]

Faced with a budget shortfall, the Washington state senate - which is controlled by Republicans - has announced it will eliminate health insurance for all part-time state employees since they can all just go onto Obamacare.

Unions are protesting, saying it's unreasonable for their workers to go onto Obamacare since it's so crappy. One teacher is worried her child will go blind if the state stops paying her private health insurance and forces her onto Obamacare, since it would not treat her child's exotic, degenerative eye condition.

Thousands of part-time school employees and college instructors would be switched from state-funded health insurance to Affordable Care Act insurance exchanges under a complicated Senate budget proposal that backers say would save the state up to $57 million over the next two years.

But so many different groups oppose the measure — including some of the state’s most powerful unions — that some think the Senate is using it as a bargaining chip in budget negotiations.

http://seattletimes.com/html/localnews/ ... cexml.html

[BigBallinStalin]

But at least they would be insured!


Everyone else ITT reminds me of the following:

[saxitoxin]

California has become the first state to announce how much it will cost an individual who wants to be covered by Obamacare.

All the people who didn't buy health insurance because they couldn't afford it now get a stripped-down, bruises & scratches-only, first-aid plan for free just $5,842 per year!


http://money.cnn.com/2013/06/13/news/ec ... &hpt=hp_t3

IOW, a person making $50,000/year will pay more than 10-percent of their annual income to a corporation that donated to the Obama re-election campaign, like UnitedHealth or Aetna, for aspirin and bandaids (unless they actually get sick, then it's more) ... or they can choose to pay a $95 fine and just continue going without health insurance.

Healthcare crisis? Yeah, I solved that.

[john9blue]

so guys, apparently i'm going to be in charge of writing a few web pages and back-end software which will allow employers/exchanges to choose whether millions of people are going to "pay or play"

i wonder if i could sneak some subliminal messages in there... maybe have "obama sux" as a light watermark in the background, or have it flash across the screen for a millisecond

with great power comes great responsibility

[Woodruff]

so guys, apparently i'm going to be in charge of writing a few web pages and back-end software which will allow employers/exchanges to choose whether millions of people are going to "pay or play"

i wonder if i could sneak some subliminal messages in there... maybe have "obama sux" as a light watermark in the background, or have it flash across the screen for a millisecond

with great power comes great responsibility

Make sure you leave room for the NSA, cause they apparently can't break into shit.

[ooge]

I have avoided posting about heath care topic for the most part.The reason I have is highlighted with this video.Al Franken asks a conservative expert a question on heath care and she does not know the answer,I am no expert and yet I knew the answer to the question. note. Over 1 million bankruptcy a year due to heath care bills.

[Nobunaga]

This is great. The lawmakers who created the monster are being made to suffer.... Is this fair? They made these laws for the people, not for themselves and their staffs. They were to be exempted....

http://www.politico.com/story/2013/06/o ... html?hp=f2

[Nobunaga]

I have avoided posting about heath care topic for the most part.The reason I have is highlighted with this video.Al Franken asks a conservative expert a question on heath care and she does not know the answer,I am no expert and yet I knew the answer to the question. note. Over 1 million bankruptcy a year due to heath care bills.

Nobody ever said the system in place wasn't broken already.

Handing the whole thing to the government was an extreme solution....

[ooge]

I have avoided posting about heath care topic for the most part.The reason I have is highlighted with this video.Al Franken asks a conservative expert a question on heath care and she does not know the answer,I am no expert and yet I knew the answer to the question. note. Over 1 million bankruptcy a year due to heath care bills.

Nobody ever said the system in place wasn't broken already.

Handing the whole thing to the government was an extreme solution....

handing the whole thing to government,I wished they had,it would have been cheaper in the long run,as all the numbers show.

[Nobunaga]

I have avoided posting about heath care topic for the most part.The reason I have is highlighted with this video.Al Franken asks a conservative expert a question on heath care and she does not know the answer,I am no expert and yet I knew the answer to the question. note. Over 1 million bankruptcy a year due to heath care bills.

Nobody ever said the system in place wasn't broken already.

Handing the whole thing to the government was an extreme solution....

handing the whole thing to government,I wished they had,it would have been cheaper in the long run,as all the numbers show.

So we can be awesome, like the UK!

Forty-three hospital patients starved to death last year and 111 died of thirst while being treated on wards, new figures disclose today.

http://www.telegraph.co.uk/health/healt ... wards.html

[ooge]

I have avoided posting about heath care topic for the most part.The reason I have is highlighted with this video.Al Franken asks a conservative expert a question on heath care and she does not know the answer,I am no expert and yet I knew the answer to the question. note. Over 1 million bankruptcy a year due to heath care bills.

Nobody ever said the system in place wasn't broken already.

Handing the whole thing to the government was an extreme solution....

handing the whole thing to government,I wished they had,it would have been cheaper in the long run,as all the numbers show.

So we can be awesome, like the UK!

Forty-three hospital patients starved to death last year and 111 died of thirst while being treated on wards, new figures disclose today.

http://www.telegraph.co.uk/health/healt ... wards.html

and yet the people continue to support this system over an insuranced based system,if they hated it so much they would have elected a politician who would get rid of their system. U.K. life expectancy 80,U.S. life expectancy 79.

[BigBallinStalin]

I have avoided posting about heath care topic for the most part.The reason I have is highlighted with this video.Al Franken asks a conservative expert a question on heath care and she does not know the answer,I am no expert and yet I knew the answer to the question. note. Over 1 million bankruptcy a year due to heath care bills.

Nobody ever said the system in place wasn't broken already.

Handing the whole thing to the government was an extreme solution....

handing the whole thing to government,I wished they had,it would have been cheaper in the long run,as all the numbers show.

So we can be awesome, like the UK!

Forty-three hospital patients starved to death last year and 111 died of thirst while being treated on wards, new figures disclose today.

http://www.telegraph.co.uk/health/healt ... wards.html

Yeah, but the average cost (to the taxpayer) for "Health" is lower than the US rates!

What could we be leaving out if we keep touting about average costs????

[BigBallinStalin]

I have avoided posting about heath care topic for the most part.The reason I have is highlighted with this video.Al Franken asks a conservative expert a question on heath care and she does not know the answer,I am no expert and yet I knew the answer to the question. note. Over 1 million bankruptcy a year due to heath care bills.

Nobody ever said the system in place wasn't broken already.

Handing the whole thing to the government was an extreme solution....

handing the whole thing to government,I wished they had,it would have been cheaper in the long run,as all the numbers show.

So we can be awesome, like the UK!

Forty-three hospital patients starved to death last year and 111 died of thirst while being treated on wards, new figures disclose today.

http://www.telegraph.co.uk/health/healt ... wards.html

and yet the people continue to support this system over an insuranced based system,if they hated it so much they would have elected a politician who would get rid of their system. U.K. life expectancy 80,U.S. life expectancy 79.

A one-year difference complete with higher taxes and more expensive consumer goods (food, housing, etc.). Sounds derpalicious.

[thegreekdog]

If Al Franken asked a liberal about the Affordable Care Act, would the liberal know the answer? I'm confused as to why your video is relevant ooge. Didn't the speaker of the House say she didn't read the bill?

[saxitoxin]

U.K. life expectancy 80,U.S. life expectancy 79.

An 8-month difference in life expectancy in two nations with vastly different demographics is not really a basis for rational public policy formulation.

If it was, the U.S.' new corporate welfare Obamacare system of $5K band aid and aspirin policies would be even better still since it's identical to the Swiss system of private health insurance with purchase mandate. Swiss life expectancy - using an Obamacare model - is two years more than the UK, and yet you've stated you prefer the UK Factory Hospital model. This seems to indicate you don't really care about life expectancy at all - one system just feels better to you and so you're working backwards to find datapoints that reinforce that gut feeling.