Obamacare is actually not so affordable

[djAdvocate]

Oct 5, 2015 16:45:40 GMT -5 @sroo4 said:

Oct 5, 2015 16:21:51 GMT -5 happyhoix said:

I scanned them. The one titled "The Downside of High Deductible Healthcare Plans" says that poor people will avoid going to a doctor more than a wealthy person will, if they have a HDHC plan, which is pretty much common sense. It ends with this:

The subsidies that will be available through Obamacare will provide some relief beginning in 2014, but plans might consider restructuring the deductible rate to encourage lower-income enrollees to seek appropriate care for serious conditions.

That was my point - the ACA provides some relief for the really poor people in meeting their deductibles, so they won't be as reluctant to go to the doctor. Maybe you got something else out of that article?

I'm not spending $40 so I can read your second source, but the abstract states that people with high deductible insurance are more likely to forego or delay treatment. Again, this seems to be to be common sense. Again, the ACA is supposed to help offset deductibles for poor people for just this reason.

The third source was a review of people in California in 2007 who had high deductible healthcare plans. Since the ACA wasn't enacted until 2010, I'm not sure why you included this one. Again, I don't think anyone will argue with you that, when a poor person has a HDHC policy, they are going to be less likely to go to the doctor than if they had a low deductible, or no deductible.

You're being coy with your point. What is it, exactly? Yes, I agree with you that HDHC plans discourage poor people from seeking treatment until they absolutely need it. Is your point that all the plans available through the ACA are HDHC plans, and therefore terrible for poor people? Are you saying that the poor aren't getting any assistance with their deductibles or premiums through the ACA, so the ACA isn't helping them? Do you think HDHC plans are so horrible we should outlaw them? Or only outlaw them for poor people? What are you saying?

I've done your required reading, now maybe you can explain to me what you think those articles actually said? Or do you have an ax to grind against Obamacare and you're reading into these articles findings that aren't there?

It was meant to answer this question: 

it ACCOMPLISHED that by "sticking it" to people. it was meant to stop uninsured people from showing up at the Emergency room and getting "free" care (which has been the law since Reagan signed it). i have no idea whether it has accomplished that. but i do know this:

The availability of these policies has not stopped uninsured and it hasn't lowered the rate that the newly insured use ER departments as primary care:   www.wsj.com/articles/u-s-emergency-room-visits-keep-climbing-1430712061

yeah, that makes sense, i guess.  why would people stop having emergencies?

but you are missing the other MORE IMPORTANT half of what i was asking:

AND GETTING "FREE" CARE.

the wsj article doesn't answer that question.

[djAdvocate]

Oct 5, 2015 17:02:00 GMT -5 @sroo4 said:

Do you call Medicare free?  

i put free in quotations.  let me try again.

since 1986 (?), when Reagan signed it into law, it is against the law to refuse emergency care, EVEN TO THOSE WITHOUT INSURANCE.  what that did was to socialize the cost of the insurance, by driving up the cost of insurance to everyone else (and increasing medical costs to cover the uninsured). 

the ACA is designed to PARTIALLY solve the INSURANCE part of that problem.  if more people are INSURED, then hospitals won't have to underwrite the cost of "FREE" medical care.  that is why i put "FREE" in quotations.  did you notice that?

Outside of the study I posted,  I saw one study from CA that showed a 7% drop in the uninsured ER visits,  with a corresponding rise in Medicare/calcare visits.   So to answer your question,  I think it's safe to extrapolate from the CA study (and from logic) that the uninsured ER visits have dropped but not been eliminated, and the medicare visits have risen.  

In other words the former uninsured are still using ER departments as their primary care source,  but medicare is picking up the tab. 

A bit of a shell game when you get down to it. 

i never suggested that the number of uninsured ER visits would be ELIMINATED.
after all, not all people are insured, and never will be under the ACA.

i would be interested in seeing the CA study, if you have it.  the wsj study is useless in terms of answering my question.

[djAdvocate]

Oct 5, 2015 18:18:48 GMT -5 @sroo4 said:

Oct 5, 2015 17:22:14 GMT -5 djAdvocate said:

i never suggested that the number of uninsured ER visits would be ELIMINATED.
after all, not all people are insured, and never will be under the ACA.

i would be interested in seeing the CA study, if you have it.  the wsj study is useless in terms of answering my question.

I'll have to see if I can find it in my browser history tomorrow. 

I guess i ssi I did miss the the quoted free.  If your question deals with only the costs that weren't covered by an insurance policy then yes, I would say that the number of 'free' visits are down...But I would counter that the taxpayer in either case is footing the bill for 'free' either by direct Medicare cost or loss in tax revenue from the uninsured right off...either way it's a wash. 

i kinda treat MC enrollment as a separate issue.  if they are covered by MC, then that is "insurance".  yes, it is PUBLIC insurance, but still insurance.

[The Walk of the Penguin Mich]

Oct 5, 2015 17:02:00 GMT -5 @sroo4 said:

Do you call Medicare free?   

Outside of the study I posted,  I saw one study from CA that showed a 7% drop in the uninsured ER visits,  with a corresponding rise in Medicare/calcare visits.   So to answer your question,  I think it's safe to extrapolate from the CA study (and from logic) that the uninsured ER visits have dropped but not been eliminated, and the medicare visits have risen.  

In other words the former uninsured are still using ER departments as their primary care source,  but medicare is picking up the tab. 

A bit of a shell game when you get down to it.  

Medicare or Medicaid?

Medicare is for those over 65.  It is not free, and they cover 80%, unless you have a supplemental policy, you pay the balance.  

Medicaid is for those under 65, who are low income.

[Deleted]

What people keep missing is... yes.. more people have an insurance card... BUT... the only value to that card is to use it to jimmy a door open if they are locked out.

The "Bronze" policies are basically worthless, and they are the ones that most of those "never had insurance before" people get. So, while yes, more people are insured than ever before... nothing has actually changed (except the insurance companies are getting paid BOATLOADS of money in subsidy payments), as far as people having actual access to healthcare.

Obamacare never was about "healthcare"... it was always "insurance reform"... whether that "reform" was good or bad is up for debate.

[djAdvocate]

Oct 5, 2015 19:19:07 GMT -5 @richardintn said:

What people keep missing is... yes.. more people have an insurance card... BUT... the only value to that card is to use it to jimmy a door open if they are locked out.

The "Bronze" policies are basically worthless, and they are the ones that most of those "never had insurance before" people get. So, while yes, more people are insured than ever before... nothing has actually changed (except the insurance companies are getting paid BOATLOADS of money in subsidy payments), as far as people having actual access to healthcare.

Obamacare never was about "healthcare"... it was always "insurance reform"... whether that "reform" was good or bad is up for debate.

it may surprise you to learn that i mostly agree with you on this.  especially the last point.

[Deleted]

Oct 5, 2015 20:02:17 GMT -5 djAdvocate said:

Oct 5, 2015 19:19:07 GMT -5 @richardintn said:

What people keep missing is... yes.. more people have an insurance card... BUT... the only value to that card is to use it to jimmy a door open if they are locked out.

The "Bronze" policies are basically worthless, and they are the ones that most of those "never had insurance before" people get. So, while yes, more people are insured than ever before... nothing has actually changed (except the insurance companies are getting paid BOATLOADS of money in subsidy payments), as far as people having actual access to healthcare.

Obamacare never was about "healthcare"... it was always "insurance reform"... whether that "reform" was good or bad is up for debate.

it may surprise you to learn that i mostly agree with you on this.  especially the last point.

LOL... doesn't surprise me at all. You have your moments of brilliance!

[happyhoix]

Oct 5, 2015 19:19:07 GMT -5 @richardintn said:

What people keep missing is... yes.. more people have an insurance card... BUT... the only value to that card is to use it to jimmy a door open if they are locked out.

The "Bronze" policies are basically worthless, and they are the ones that most of those "never had insurance before" people get. So, while yes, more people are insured than ever before... nothing has actually changed (except the insurance companies are getting paid BOATLOADS of money in subsidy payments), as far as people having actual access to healthcare.

Obamacare never was about "healthcare"... it was always "insurance reform"... whether that "reform" was good or bad is up for debate.

OK before the ACA, poor people waited as long as possible to go for treatment (to avoid medical bills) and then on death's door they went to the ER and either got free treatment (if they had no assets) and the charges got passed on to other customers of the hospital, in the form of higher hospital bills, or if they were 'working poor' and had some savings/assets, the hospital sued them and probably bankrupted them trying to get their money back.

After the ACA, poor people still wait as long as possible to go to for treatment (to avoid paying the high deductible) and finally on death's door they go to the ER and get treatment that gets paid by their insurance policy, the cost of which is partly off set by the government (depending on how poor they are) and the hospital either goes after the patient for the deductible or the hospital gets their money back by charging customers higher hospital bills.

I'm not in the hospital, healthcare, or insurance business and I have insurance provided by my company, so I'm not sure I'm understanding this right - and I'm sure people will be glad to tell me the errors.

[The Walk of the Penguin Mich]

OK before the ACA, poor people waited as long as possible to go for treatment (to avoid medical bills) and then on death's door they went to the ER and either got free treatment (if they had no assets) and the charges got passed on to other customers of the hospital, in the form of higher hospital bills, or if they were 'working poor' and had some savings/assets, the hospital sued them and probably bankrupted them trying to get their money back.

After the ACA, poor people still wait as long as possible to go to for treatment (to avoid paying the high deductible) and finally on death's door they go to the ER and get treatment that gets paid by their insurance policy, the cost of which is partly off set by the government (depending on how poor they are) and the hospital either goes after the patient for the deductible or the hospital gets their money back by charging customers higher hospital bills.

I'm not in the hospital, healthcare, or insurance business and I have insurance provided by my company, so I'm not sure I'm understanding this right - and I'm sure people will be glad to tell me the errors.

It's a difference as to how poor people use medical treatment.  With insurance, should they go to their doctor, they get billed the insurance discount for the office appointment.  They have to pay something, but not as much as they would have to pay without insurance.  Pre ACA, there was no insurance discount for self pay.

However, the problem is that you have to change the way that people use the medical care system.  If you have spent your life visiting the ER to deal with your medical problems (both small and large), you do what most people do.....have a primary care doctor, call and ask for an appointment as you are sick.  So they are needing to change a behavior that is ingrained in many.

Even those of us with insurance pay something for our medical treatment.  We don't walk into the doctor's office without needing to at least make a copay.  Maybe if a copay was required in ERs, for those who decide to use them (even with the highest deductible plans) like they require with my health insurance, then maybe this will change the behavior.  For instance (using my insurance as an example), I can pay $30 to my doctor's office as a copay, but if I go to the ER, it's going to be $200.  That $200 is waived if you are admitted, but at least it financially drives that person to use medical care differently.

[happyhoix]

Even those of us with insurance pay something for our medical treatment. We don't walk into the doctor's office without needing to at least make a copay. Maybe if a copay was required in ERs, for those who decide to use them (even with the highest deductible plans) like they require with my health insurance, then maybe this will change the behavior. For instance (using my insurance as an example), I can pay $30 to my doctor's office as a copay, but if I go to the ER, it's going to be $200. That $200 is waived if you are admitted, but at least it financially drives that person to use medical care differently.

I'm surprised it isn't already like that. I also have a 30 dollar copay at the doctor's office, and a $500 copay at the ER (add another $500 copay if I have to get there by ambulance).

Certainly keeps me out of the ER....

[Deleted]

Oct 6, 2015 12:08:56 GMT -5 happyhoix said:

Oct 5, 2015 19:19:07 GMT -5 @richardintn said:

What people keep missing is... yes.. more people have an insurance card... BUT... the only value to that card is to use it to jimmy a door open if they are locked out.

The "Bronze" policies are basically worthless, and they are the ones that most of those "never had insurance before" people get. So, while yes, more people are insured than ever before... nothing has actually changed (except the insurance companies are getting paid BOATLOADS of money in subsidy payments), as far as people having actual access to healthcare.

Obamacare never was about "healthcare"... it was always "insurance reform"... whether that "reform" was good or bad is up for debate.

OK before the ACA, poor people waited as long as possible to go for treatment (to avoid medical bills) and then on death's door they went to the ER and either got free treatment (if they had no assets) and the charges got passed on to other customers of the hospital, in the form of higher hospital bills, or if they were 'working poor' and had some savings/assets, the hospital sued them and probably bankrupted them trying to get their money back.

After the ACA, poor people still wait as long as possible to go to for treatment (to avoid paying the high deductible) and finally on death's door they go to the ER and get treatment that gets paid by their insurance policy, the cost of which is partly off set by the government (depending on how poor they are) and the hospital either goes after the patient for the deductible or the hospital gets their money back by charging customers higher hospital bills.

I'm not in the hospital, healthcare, or insurance business and I have insurance provided by my company, so I'm not sure I'm understanding this right - and I'm sure people will be glad to tell me the errors.

You forgot that the poor person loses everything and goes bankrupt with the ACA too. When you don't have $500 in the bank and live "paycheck to paycheck"... it doesn't matter if you have to "out of pocket" $6,500.00 or $650,000.00... it's still more than you can pay and you can still lose everything.

I don't deny that the ACA helps the financial end of things (see where I said it was "insurance reform"?). I deny that it helps the people that were supposedly "most in need of help".