It's also the only way they can "fundamentally transform" the nation. In order to build what they want, they first have to tear down 200+ years of what the American culture has built.Completely breaking the system is the only way they get people wanting single-payer. The clamoring or SP will come, just wait.
A friend of mine who is a big Obama supporter says that this was all a charade intended as a short way station en route to single payer. He's okay with that. The lying was the only way to get the American people to start that trip. Single payer is inevitable.What gets me is not so much that the figures they used, and promised, were incorrect. It's that they were outright lies from the beginning, and everyone from Obama on down knew it. That is, everyone except those it would effect both medically and financially.
That's reason enough to never ever trust them, or any other government entity, again.
If they truly believe single payer will fix the system, then who can blame them? As much as I detest many things going on in government, we all agree that the medical system is screwed up. So if they feel single payer is the only way to fix it, and this atrocity is the only way to usher in single payer, then I guess at least they have a logical plan.A friend of mine who is a big Obama supporter says that this was all a charade intended as a short way station en route to single payer. He's okay with that. The lying was the only way to get the American people to start that trip. Single payer is inevitable.
Of course, when we go to a single payer system, we will not be able to afford every procedure or drug for every sick person in the country. The Dismal Science will inevitably kick in and some form of rationing is going to take place or we will bankrupt the country. So maybe the voters are not that stupid after all.If they truly believe single payer will fix the system, then who can blame them? As much as I detest many things going on in government, we all agree that the medical system is screwed up. So if they feel single payer is the only way to fix it, and this atrocity is the only way to usher in single payer, then I guess at least they have a logical plan.
Don't believe there are any 90-10 plans on the exchanges, and most employer-provided ones will likely go away before 2018 due to the Cadillac Tax:WASHINGTON — For years, Harvard’s experts on health economics and policy have advised presidents and Congress on how to provide health benefits to the nation at a reasonable cost. But those remedies will now be applied to the Harvard faculty, and the professors are in an uproar.
Members of the Faculty of Arts and Sciences, the heart of the 378-year-old university, voted overwhelmingly in November to oppose changes that would require them and thousands of other Harvard employees to pay more for health care. The university says the increases are in part a result of the Obama administration’s Affordable Care Act, which many Harvard professors championed.
And check out the deductibles, which are lower than what you'd find on the exchanges and with most employer-provided insurance:Harvard’s new plan is far more generous than plans sold on public insurance exchanges under the Affordable Care Act. Harvard says its plan pays 91 percent of the cost of care for a typical consumer, while the most popular plans on the exchanges, known as silver plans, pay 70 percent, on average.
The university is adopting standard features of most employer-sponsored health plans: Employees will now pay deductibles and a share of the costs, known as coinsurance, for hospitalization, surgery and certain advanced diagnostic tests. The plan has an annual deductible of $250 per individual and $750 for a family. For a doctor’s office visit, the charge is $20. For most other services, patients will pay 10 percent of the cost until they reach the out-of-pocket limit of $1,500 for an individual and $4,500 for a family.
On "The Wire," cops made their crime rate look good by reclassifying serious crimes as less serious, or as accidents, which did nothing about the underlying problem but made the cops look much better. Unfortunately, we see the same behavior in doctors and hospitals. It's called "upcoding": rating conditions as more serious than they are in order to increase the reimbursement, or to improve their performance on those risk-adjusted mortality measures.
This can go beyond just massaging a few figures and do active harm. For example, consider what happened when New York state started measuring cardiology outcomes.
The idea was that they were "ending years of private, clubby surgeon culture." The public report cards "were intended to shine a light on poor surgeons and encourage a kind of best-practices ethic across the state. If the system worked, mortality rates would fall everywhere from Oswego to NYU." And at first glance, the system worked beautifully: Risk-adjusted mortality rates dropped by an astonishing two-thirds. But as New York magazine reports, it rapidly became clear that one way surgeons were achieving these advances was simply by refusing to treat the sickest patients:
This isn’t just about high-risk patients. It’s about doctors playing games with practically any patient to get better scores. Some surgeons look for ways to make their easy cases seem harder. Others make their hard cases appear so difficult that they place out of the state reporting system. When it comes to the sickest patients, some surgeons simply turn them away, asserting that they’re better off getting drug treatments, or waiting in the ICU. “The cardiac surgeons refer their patients to the cardiologists, and the cardiologists refer them to the intensive-care unit,” says Joshua Burack, a SUNY–Downstate surgeon in Brooklyn who in 1999 released a study revealing that nearly two-thirds of all heart-bypass surgeons in the state anonymously admitted to refusing at least one patient for fear of tainting their mortality rates. “Everyone’s going to pass along the hot potato to the person who’s not vulnerable to reporting.”
In the past five years, no fewer than five studies have been published in reputable journals raising the possibility that New York heart surgeons are not operating on certain cases for fear of spoiling their mortality rates. The clincher came in January, when, in an anonymous survey sent out to every doctor who does angioplasty in the state, an astonishing 79 percent of the responders agreed that the public mortality statistics have discouraged them from taking on a risky patient. If you’re a hard case, in other words, four out of five doctors would think twice before operating on you.
Megan McArdle has written another interesting article for Bloomberg. Looks like death panels have been implemented another way:
http://www.bloombergview.com/articles/2015-01-28/when-health-care-reforms-don-t-add-up
Megan McArdle has written another interesting article for Bloomberg. Looks like death panels have been implemented another way:
http://www.bloombergview.com/articles/2015-01-28/when-health-care-reforms-don-t-add-up
Any indication as to the party affiliation of the cardiac patients who tended to not be accepted? I'd need more information before I pass judgment on the policy.If you’re a hard case, in other words, four out of five doctors would think twice before operating on you.
LOL. On the required questionnaire, if you want treatment, you should check the no box next to "Obama Sucks?" Check yes box next to "Obama is our greatest President?"Any indication as to the party affiliation of the cardiac patients who tended to not be accepted? I'd need more information before I pass judgment on the policy.
“Effective next academic year, 2015-16, we will be introducing a student health fee for those not enrolled in the Cornell Student Health Insurance Plan (SHIP),” read the memo. “As a physician, parent and president, I am proud of our university's long history of providing quality medical, mental health, education and prevention services on campus. These essential services play a critical role in student well-being and, therefore, success. Yet funding these services — and creating access to them for all students — has been a growing fiscal challenge, and a personal concern of mine.”
I could easily see this turned into a racial issue if more black people are being turned down, especially since heart disease is more prevalent in that population.Any indication as to the party affiliation of the cardiac patients who tended to not be accepted? I'd need more information before I pass judgment on the policy.
Unless he was partying with Clinton on "Child Prostitute Airlines" or some other "we got you" moment.....that The King of the USA and his Court may have on Justice Roberts.I think Obamacare may be killed in June. This will be the last chance for it to be killed by the SC as it should have been from the outset. Regardless of your political affiliation this law breaches the Constitution so blatantly that it should not have survived even a cursory examination by the high court. This will be Roberts last chance at leaving with even a modicum of dignity remaining on his legacy.
Unless he was partying with Clinton on "Child Prostitute Airlines" or some other "we got you" moment.....that The King of the USA and his Court may have on Justice Roberts.
This is not a tedious rehash of my reasons for opposing Obamacare, though two years in, perhaps such a rehash is due. If it is, I will provide it in a different post. This is just a post on why I don't think that the argument for Obamacare can rest very securely on the argument that we are simply cleaning up some ugly negative externalities, in much the same way that we do with noise ordinance and anti-pollution laws.
I don't know if any or all of these explanations are the correct ones. There might be some other factor I haven't considered, and of course, health insurance may well reduce mortality rates, leaving us nothing to explain away. My intuition says it does, but the effect is probably very small, because if it were big, it should show up much more unambiguously in the data. But my read of the evidence includes the possibility that giving people insurance doesn't save any lives at all.
The point is that while Obamacare's supporters have an entirely understandable assumption that it's obviously saving lives, that assumption is still open to question. So my interlocutor is wrong on both counts: The Supreme Court has made rulings in the past that potentially involved large numbers of deaths, some of which the Illegitimators support with no apparent sense of irony. But it's not actually clear that this will be one of them.
Though supporters of President Obama's healthcare program tout its success in providing insurance to millions of Americans, recent rate filings from large insurers have revealed that the law is built on a shaky foundation.
In recent weeks, large insurers selling coverage through Obamacare have proposed massive rate increases for 2016 – even exceeding 40 percent – because they haven't been able to sign up enough young and healthy customers.
This is an ominous sign for the future of Obamacare, because two federal programs that were supposed to act as training wheels for insurers in the early years of Obamacare by absorbing excess risk are set to expire after 2016. If insurers don't do a better job of attracting a healthier risk pool, 2017 promises to be a rocky year for insurance markets, regardless of which party is in control of the White House.
In the first two years of the implementation of Obamacare's insurance exchanges (2014 and 2015), insurers set rates with the expectation that the government would absorb a certain degree of risk and they made assumptions about the medical costs of their enrollees.
Now that insurers have had more time to look at the claims coming in from those enrolling from Obamacare, they're finding that the pool of customers is older and sicker than originally projected, driving up medical costs. Meanwhile, federal help isn't what they anticipated.