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Obamacare Has Driven Health Spending Up, While Covering Fewer Than Expected

jmotivator

jmotivator

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What you are going to find is people defending who benefit from ACA in some way arguing with people who have had increased costs in some way because of ACA. At a high level ACA did most of what it was intended to politically speaking, the problem is to appease certain groups (namely the Health Insurance Industry) there are real faults to it.

What we should be talking about is the future.

Your quote from the article says it all, but with a twist. Odds are ACA will cause enough headache where eventually the solution offered will be something along the lines of single payer systems. It is unlikely that we will go backwards to some other solution where everyone is covered under some other mechanism, and the GOP to date has not offered much that will realistically handle the goal of more coverage, for more people, at less cost. There may be a talking point level solution out there somewhere, but ultimately their plans have just as many faults as ACA if not more.

So we are stuck. We remove ACA there is a huge fallout, odds are back to the days where insurance companies excluded from the pool whom they wanted. If we improve on ACA, odds are it would mean going after the Health Insurance Industry that round one of ACA appeased. As a percentage of GDP for 2014, it turns out health related spending hit 17% (or more... sources vary on this.) We are talking about influencing spending that is in the $Trillions per year (more than just what the government spends on this.)

Whatever the next move, we might want to be more careful than what ACA has done to things. Take this coming from one who fell into the latter of Americans, my healthcare insurance costs are out of control with no end in sight. And now that I have lost my plan I might be losing some of my doctors as well, highly confusing and at a cost.
 
OrphanSlug said:
What you are going to find is people defending who benefit from ACA in some way arguing with people who have had increased costs in some way because of ACA. At a high level ACA did most of what it was intended to politically speaking, the problem is to appease certain groups (namely the Health Insurance Industry) there are real faults to it.

What we should be talking about is the future.

Your quote from the article says it all, but with a twist. Odds are ACA will cause enough headache where eventually the solution offered will be something along the lines of single payer systems. It is unlikely that we will go backwards to some other solution where everyone is covered under some other mechanism, and the GOP to date has not offered much that will realistically handle the goal of more coverage, for more people, at less cost. There may be a talking point level solution out there somewhere, but ultimately their plans have just as many faults as ACA if not more.

So we are stuck. We remove ACA there is a huge fallout, odds are back to the days where insurance companies excluded from the pool whom they wanted. If we improve on ACA, odds are it would mean going after the Health Insurance Industry that round one of ACA appeased. As a percentage of GDP for 2014, it turns out health related spending hit 17% (or more... sources vary on this.) We are talking about influencing spending that is in the $Trillions per year (more than just what the government spends on this.)

Whatever the next move, we might want to be more careful than what ACA has done to things. Take this coming from one who fell into the latter of Americans, my healthcare insurance costs are out of control with no end in sight. And now that I have lost my plan I might be losing some of my doctors as well, highly confusing and at a cost.
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The solution being offered by the author of the article isn't single payer, it is something akin to school vouchers that give each citizen a certain block grant to buy their own insurance (presumably their share of the current per-capita public health care expenditure of $4500). I'm not entirely opposed to this plan so long as they can manage to make it so that there isn't a subsidy penalty on low end earners for making more money.

So, using only the current money funding public health programs, a family of 4 would receive a block grant of $18,000 a year to buy health insurance.
 
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jmotivator said:
The solution being offered by the author of the article isn't single payer, it is something akin to school vouchers that give each citizen a certain block grant to buy their own insurance. I'm not entirely opposed to this plan so long as they can manage to make it so that there isn't a subsidy penalty on low end earners for making more money.
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I understand what the article offers, I am talking about political direction.

The argument has been made by plenty of others that ACA was a designed stepping stone towards single payer systems, or socialized medicine, or something of the like. What I am trying to say to you is until the GOP comes up with a realistic plan to do what the article hints at (as well as plenty of other things that a counter to ACA would have to handle) we have more political momentum to end up further left when it comes to healthcare.

What I am really challenging is a GOP plan to move us back to a market based system, with some props to help people that prior to ACA were purposefully excluded from healthcare coverage in a general sense.
 
OrphanSlug said:
I understand what the article offers, I am talking about political direction.

The argument has been made by plenty of others that ACA was a designed stepping stone towards single payer systems, or socialized medicine, or something of the like. What I am trying to say to you is until the GOP comes up with a realistic plan to do what the article hints at (as well as plenty of other things that a counter to ACA would have to handle) we have more political momentum to end up further left when it comes to healthcare.

What I am really challenging is a GOP plan to move us back to a market based system, with some props to help people that prior to ACA were purposefully excluded from healthcare coverage in a general sense.
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The article doesn't hint at anything. There is a link in the article to a plan for health insurance that has already been written. In a representative government we the people read such proposals and then pass the idea on to our representatives to tell them the kind of change we would actually like, rather than the congress and president act as our superiors and hand down BS programs that the majority of Americans didn't want.
 
I can provide an even simpler plan:

Without raising taxes one penny write a new law that:

1) Abolishes VA, Medicaid and Medicare
2) Issues a block grant of $4200 to every US citizen for the purpose of buying health insurance
3) The portion of that $4200 that is spent on health care costs is tax exempt, be it for insurance, a health savings plan, or medical bills.
4) Current massive government health programs would be allowed to privatize like Ma Bell, and left to live or die by market competitiveness.

Done.

There, I just cut 7% from US public healthcare costs per year, provided universal coverage, and saved businesses, large and small, a huge chunk of money currently being spent on employee healthcare in one fell swoop while maintaining the competitive nature of the American health care system.
 
jmotivator said:
I can provide an even simpler plan:

Without raising taxes one penny write a new law that:

1) Abolishes VA, Medicaid and Medicare
2) Issues a block grant of $4200 to every US citizen for the purpose of buying health insurance
3) The portion of that $4200 that is spent on health care costs is tax exempt, be it for insurance, a health savings plan, or medical bills.
4) Current massive government health programs would be allowed to privatize like Ma Bell, and left to live or die by market competitiveness.

Done.

There, I just cut 7% from US public healthcare costs per year, provided universal coverage, and saved businesses, large and small, a huge chunk of money currently being spent on employee healthcare in one fell swoop while maintaining the competitive nature of the American health care system.
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That is a horrible idea. First of all, health insurance prices aren't static, and there's a reason we have medicaid/medicare. LOL. Do you honestly think $4200 will be enough for people? Don't kid yourself.
 
jmotivator said:
I can provide an even simpler plan:

Without raising taxes one penny write a new law that:

1) Abolishes VA, Medicaid and Medicare
2) Issues a block grant of $4200 to every US citizen for the purpose of buying health insurance
3) The portion of that $4200 that is spent on health care costs is tax exempt, be it for insurance, a health savings plan, or medical bills.
4) Current massive government health programs would be allowed to privatize like Ma Bell, and left to live or die by market competitiveness.

Done.

There, I just cut 7% from US public healthcare costs per year, provided universal coverage, and saved businesses, large and small, a huge chunk of money currently being spent on employee healthcare in one fell swoop while maintaining the competitive nature of the American health care system.
Click to expand...

Actually, the plan hardly does anything you suggest.

As just one example, issuing "block grants" to every US citizen to buy a product does not guarantee the effectiveness of that product. Without standards on what that product has to do it becomes effectively worthless.
 
David_N said:
That is a horrible idea.
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Says you.

First of all, health insurance prices aren't static
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I never said the subsidy would be static. Nor did I outlaw supplemental insurance paid for voluntarily by the individual. This would provide more than enough money for a bronze health insurance plan.

and there's a reason we have medicaid/medicare
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They provide insurance for the aged and indigent. The extra cost for insuring the aged would be wrapped into the larger risk pools.

Do you honestly think $4200 will be enough for people?
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The current average family plan is $16,800, this block grant would cover the average family plan for a family of 4 for a silver level plan, or more than would be needed for an HMO or other Bronze plan

Don't kid yourself.
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You have provided no substantive argument against the plan.
 
OrphanSlug said:
Actually, the plan hardly does anything you suggest.

As just one example, issuing "block grants" to every US citizen to buy a product does not guarantee the effectiveness of that product. Without standards on what that product has to do it becomes effectively worthless.
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The states provided that level of bureaucracy for a very long time. The individual who buys insurance also has some say in what they will and will not accept. As much as you argue I ignore regulation, you ignore market pressures to not provide crap.

It may make sense for an young individual or family to buy catastrophic insurance and divert the rest of the money to a health savings plan, others may direct more to a bronze plan and so on.
 
jmotivator said:
The current average family plan is $16,800, this block grant would cover the average family plan for a family of 4 for a silver level plan, or more than would be needed for an HMO or other Bronze plan
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What do you think the average insurance premium would become when every family of 4 has a "free" 16,800 to use for insurance? Hint: it will skyrocket. What will that do to medical spending in the country?

Having said that, I have pointed out in the past to people on this forum that the slow down in medical spending occurred prior to Obamacare and was, in large part, due to the recession. The information provided by CMS supports that, which I thought was a pretty obvious conclusion.

“The return to faster growth,” they wrote, “was largely influenced by the coverage expansions of the Affordable Care Act.”
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jmotivator said:
Obama Administration: Obamacare Has Driven Health Spending Up, While Covering Fewer Than Expected

"Obamacare has bent the cost curve upward

In 2014, U.S. government spending on health care neared $1.4 trillion. That’s over $4,500 for every man, woman and child in the country: far more than we would ever need to achieve universal coverage in a rational, market-based system."

When will people stop defending this awful legislation?
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Yeah..........they said the same thing about Social Security.................and then Medicare.................and we all know the end of that story
 
buck said:
What do you think the average insurance premium would become when every family of 4 has a "free" 16,800 to use for insurance? Hint: it will skyrocket. What will that do to medical spending in the country?

Having said that, I have pointed out in the past to people on this forum that the slow down in medical spending occurred prior to Obamacare and was, in large part, due to the recession. The information provided by CMS supports that, which I thought was a pretty obvious conclusion.
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If not every family is forced to spend in the same way it will do little. Do you think the insurance companies will price their services such that families can't afford it with $16.8k? The insurers would leave money on the table. What stops Apple from charging $10k for a MacBook?
 
jmotivator said:
If not every family is forced to spend in the same way it will do little. Do you think the insurance companies will price their services such that families can't afford it with $16.8k? The insurers would leave money on the table. What stops Apple from charging $10k for a MacBook?
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Nope. I do think 16,800 will become the cheapest policy available for a family of four. An insurance company would have zero incentive to offer a policy with lower premium and the new insureds would want to maximize their benefit and spend at least that much.

If the previously average premium is now the cheapest... The average price will be increasing.
 
buck said:
Nope. I do think 16,800 will become the cheapest policy available for a family of four. An insurance company would have zero incentive to offer a policy with lower premium and the new insureds would want to maximize their benefit and spend at least that much.

If the previously average premium is now the cheapest... The average price will be increasing.
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I don't think so. Educated consumers and competition would manage to keep the insurers honest in the same way they do all other goods and services. Remember that in this system it doesn't mandate that all consumers spend all the money on health care. There will always be people who, for various reasons, don't want to dump all that money into their insurance, and the insurers would all still compete for that market as well.
 
jmotivator said:
I don't think so. Educated consumers and competition would manage to keep the insurers honest in the same way they do all other goods and services. Remember that in this system it doesn't mandate that all consumers spend all the money on health care. There will always be people who, for various reasons, don't want to dump all that money into their insurance, and the insurers would all still compete for that market as well.
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The grant could only be used for insurance. What would the incentive be for someone (especially an "educated consumer") to take less generous insurance and benefits when they could have had better insurance and benefits for "free"? Or are you envisioning a system where the "insurance grant money" they don't use for insurance, can be used for a new TV. Otherwise, only a dummy would take cheaper insurance while turning down a large portion of that newly "free" government benefit.

Let's make it personal. You get a grant of $4,500.00 to spend on insurance.

Company A says you can buy their insurance policy, which will pay 50% of any medical bills for $2,000.00 per year - you've now saved the government $2,500.00.

Company B says you can purchase their policy, which will pay 90% of any medical bills for $4,500.00 per year.

All other benefits being the same, which would you, the educated consumer, choose?
 
buck said:
The grant could only be used for insurance. What would the incentive be for someone (especially an "educated consumer") to take less generous insurance and benefits when they could have had better insurance and benefits for "free"? Or are you envisioning a system where the "insurance grant money" they don't use for insurance, can be used for a new TV. Otherwise, only a dummy would take cheaper insurance while turning down a large portion of that newly "free" government benefit.
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Because it entirely depends on a persons own plan for managing their funds. As I said, in this plan it may make much more sense for a young person to opt for a catastrophic plan and an HSP that rolls over year over year. These people will usually go years without a doctor's visit, so dumping all of their money into insurance makes absolutely no sense. Likewise, a person making $15k a year might not see the value in spending every dime on insurance they may use once or twice a year when to cover a few hundred in doctors bills when a bronze HMO plan and pocketing the difference is better for them.

Let's make it personal. You get a grant of $4,500.00 to spend on insurance.

Company A says you can buy their insurance policy, which will pay 50% of any medical bills for $2,000.00 per year - you've now saved the government $2,500.00.

Company B says you can purchase their policy, which will pay 90% of any medical bills for $4,500.00 per year.

All other benefits being the same, which would you, the educated consumer, choose?
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It depends on how I use insurance. If I am under the age of 40 and see the doctor only when I am sick, then I would take the first plan and put the $2500 in an HSP and pay for doctors bills out of it, probably clearing over $2+k every year. If I were older and planned on incurring a few grand in health care costs in an average year then I would opt for the second plan and sock away what I could each year into an HSP for larger costs down the road.

The other option you didn't list would be a catastrophic plan that pays only for serious illness and injury at 90% but costs about $2000 a year, since it doesn't funds routine care, allowing you to stash even more money into a rollover HSP to cover the cost of catastrophic care not covered by insurance. A 90% plan and a $2500 in an HSP is enough to cover a $25,000 hospital bill in the first year, + another $25,000 with each year without a catastrophic health event.
 
jmotivator said:
Because it entirely depends on a persons own plan for managing their funds. As I said, in this plan it may make much more sense for a young person to opt for a catastrophic plan and an HSP that rolls over year over year. These people will usually go years without a doctor's visit, so dumping all of their money into insurance makes absolutely no sense. Likewise, a person making $15k a year might not see the value in spending every dime on insurance they may use once or twice a year when to cover a few hundred in doctors bills when a bronze HMO plan and pocketing the difference is better for them.



It depends on how I use insurance. If I am under the age of 40 and see the doctor only when I am sick, then I would take the first plan and put the $2500 in an HSP and pay for doctors bills out of it, probably clearing over $2+k every year. If I were older and planned on incurring a few grand in health care costs in an average year then I would opt for the second plan and sock away what I could each year into an HSP for larger costs down the road.
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OK, I did miss number 3 in your initial "proposal".
 
buck said:
OK, I did miss number 3 in your initial "proposal".
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I made no proposal on what the insurers would offer, but #3 was a plan that insurers offered before O-Care outlawed it for people over 30. Granted, the outcry from the general population, and as a bandaid for a DOA program I believe the catastrophic plans are available again, but they are shadows of their former selves.
 
jmotivator said:
When will people stop defending this awful legislation?
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I can answer that: when the right stops lying about Obamacare and conservatives don't rush to the board to post the latest lying and spinning editorial about it. Lets look at the factoid that you highlighted.

"In 2014, U.S. government spending on health care neared $1.4 trillion. That’s over $4,500 for every man, woman and child in the country: far more than we would ever need to achieve universal coverage in a rational, market-based system."

As I've pointed out to you just the other day, your magic plan of universal coverage has ZERO SUPPORT from the right. And why do you post what we spend as if its a flaw or creation of Obamacare? oh that's right, you think dems passed Obamacare to get more control. That's just another example of a conservative posting ideology in place of reality.

I think its very easy to defend 16 million have gaining insurance, improving the quality of healthcare and lowering the deficit. In your world that just cant be true so you continue to look for lying editorials to tell you what to believe. See con, until you stop believing the lies and spin you will never understand why people defend it.
 
jmotivator said:
Obama Administration: Obamacare Has Driven Health Spending Up, While Covering Fewer Than Expected
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2014 was always going to see an enrollment-fueled bump in health spending growth as millions got care they couldn't before. Once enrollment growth stops, that effect goes away. That's why a temporary bump was predicted five years ago.

What's lacking here is perspective. That bump was supposed to push NHE growth to 9.2% this year. Obviously this number is well below that.

This is what was supposed to happen to health spending growth back when the law passed in 2010 (from "National Health Spending Projections: The Estimated Impact Of Reform Through 2019"):

29ynpxf.png


The red bump is due to the coverage expansions under the ACA (relative to the blue ACA-less alternate reality). Now in green I've added what actually happened:

245f3oo.png


Health spending growth below even what would've been expected if we hadn't covered 12 million additional people last year.

Trainwreck!
 
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Vern said:
I can answer that: when the right stops lying about Obamacare and conservatives don't rush to the board to post the latest lying and spinning editorial about it. Lets look at the factoid that you highlighted.

"In 2014, U.S. government spending on health care neared $1.4 trillion. That’s over $4,500 for every man, woman and child in the country: far more than we would ever need to achieve universal coverage in a rational, market-based system."

As I've pointed out to you just the other day, your magic plan of universal coverage has ZERO SUPPORT from the right. And why do you post what we spend as if its a flaw or creation of Obamacare? oh that's right, you think dems passed Obamacare to get more control. That's just another example of a conservative posting ideology in place of reality.

I think its very easy to defend 16 million have gaining insurance, improving the quality of healthcare and lowering the deficit. In your world that just cant be true so you continue to look for lying editorials to tell you what to believe. See con, until you stop believing the lies and spin you will never understand why people defend it.
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Vern, you have no clue what you are talking about, and like to use terms like "magic plan" in place of real arguments.

Are you disagreeing with the article I posted, if so, give particulars that aren't simply biased hand waving.

Thanks in advance.

If you don't want to do that then come back after the adults are done talking.
 
Greenbeard said:
2014 was always going to see an enrollment-fueled bump in health spending growth as millions got care they couldn't before. Once enrollment growth stops, that effect goes away. That's why a temporary bump was predicted five years ago.

What's lacking here is perspective. That bump was supposed to push NHE growth to 9.2% this year. Obviously this number is well below that.

This is what was supposed to happen to health spending growth back when the law passed in 2010 (from "National Health Spending Projections: The Estimated Impact Of Reform Through 2019"):

29ynpxf.png


The red bump is due to the coverage expansions under the ACA (relative to the blue ACA-less alternate reality). Now in green I've added what actually happened:

245f3oo.png


Health spending growth below even what would've been expected if we hadn't covered 12 million additional people last year.

Trainwreck!
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HAHAHAH!! The growth of healthcare spending declined in the years before before anyone was enrolled. The decline from 2010 through 2013 were mostly cutts Medicare (what you libs like to call "killing grandma")

Care to guess when the "cost saving" insurance programs started? Yep, 2014, the year it jumped to 5.5%
 
jmotivator said:
Care to guess when the "cost saving" insurance programs started?
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Most officially launched in 2011-12 (i.e., the payment and delivery system reforms that've been re-shaping health care), though it's obvious many providers and system started preparing prior to that.
 
Greenbeard said:
Most officially launched in 2011-12 (i.e., the payment and delivery system reforms that've been re-shaping health care), though it's obvious many providers and system started preparing prior to that.
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The first year where everyone had to have a compliant insurance plan was 2014 (healthcare.gov "launched" in October of 2013), the year that the healthcare cost spiked.
 
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