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GOP Nightmare, Obamacare Popularity Soars

Threegoofs said:
From just practical observation, I can tell you that over the last few years, there has been a dramatic decrease in churning of borderline procedures such as excessive diagnostic testing.

This is a direct result of Medicare changes via the ACA of not allowing medical practices be reimbursed for certain diagnostic tests and having those procedures done under the ACO/hospital umbrella. This has led to most large cardiology groups to be sold to hospital systems, with a subsequent slowdown in procedures, as the cardiologists are now employees and not directly compensated for quantity.

This has been a dramatic change for specialty physicians as well as primary care docs.
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Frankly, among the health care policy wonks, as far as I can see, the A.C.A. is settled legislation and they are now working on best practices for reducing the cost of health care- which IS, after all, the point. They are debating whether "bundled payments" or "global capitation" is the way to procede. They are working on modernizing I.T. and giving physicians more incentives to work collaboratively.

This is a big old ocean liner of industry habits and incentives whose course cannot be changed over night. The Repub. obstinate doom and gloom prevents them from thinking how to improve the system. Going backward is not an option.
 
originally posted by Ludin
yep because obama mandated that this and this and this be covered you can't exceed this amount of OOC and deductable. also there is no cap on how much you can use. all of that drives prices upward not downward. which is the opposite of affordable.
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Yes, it provides great peace of mind to know there is a limit on out of pocket expenses and no lifetime cap! This is not a debatable point. I am risk averse. Maybe you disagree because you like taking risks..

MA has the most doctors per 1000 people in the entire nation. they also have the longest wait time to see a doctor both GP and specialist than any other state in the country. Those self employed fisherman and farmers haven't hit the business mandates yet. when obama finally stop his unconstitutional delay of the employer mandate we will see how happy they are. also once that hits there is an expected 80m people that are going to lose their insurance.
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I agree that Mass. has done an inadequate job of addressing the cost of care. However, the state has reduced the no. of uninsured, dramatically and premium costs are in line w other states.

Maine actually had the highest H.C. costs @ $8,521. in 2009, the median family income was about $46,000.
Compare that to Mass. per person spending was $9,278. but the median family income - $65,000.
And D.C. per person spending was $10,349. but median family income - double that of Maine. You cannot look at these numbers in a void.
 
Threegoofs said:
Interesting.


The CBO never seems to have wavered from their statement that the ACA will cut the deficit.


I keep hearing the opposite from some people on here....

Lower premiums (yes, really) drive down Obamacare
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Why should they ?

They made their projections using the law as it was exactly written.

Which is also the Law. The CBO can't take any extenuating circumstances into cosnideration.

The Original ACA Law includes huge cuts to providers, both to Doctors and Hospitals.

But in their report the CBO acknowledged that these cost saving parts of the law would probably have to be changed and didn't think they could be left as they were for long.

The original ACA Law reimburses Doctors at rate lower than the previous Medicare rates and cuts reimbursements to Hospitals by more than 60 percent lower than previous medicare reimbursements.

The ex-Director of the CBO did a second analysis where he was allowed to take REALITY into consideration and he came up with a 500 Billion dollar increase in the deficit over 10 years and a 2 Trillion dollar increase in the deficit in 20 years

The CBO had to take those " Savings", 500 Billion in Medicare savings, and roll it back into the cost of the law in order to claim it would lower the deficit but Democrats wanted to use it to keep Medicare solvent.

You cant use it for both.

You keep hearing the opposite from people here because this forum isn't a left wing chat room.

There are people here that are not influenced by the Obama administration's dishonest propaganda and his perpetual unedning string of simplton rhetoric sent out to low information Americans alll over the Country.
 
Cassandra said:
Frankly, among the health care policy wonks, as far as I can see, the A.C.A. is settled legislation and they are now working on best practices for reducing the cost of health care- which IS, after all, the point. They are debating whether "bundled payments" or "global capitation" is the way to procede. They are working on modernizing I.T. and giving physicians more incentives to work collaboratively.

This is a big old ocean liner of industry habits and incentives whose course cannot be changed over night. The Repub. obstinate doom and gloom prevents them from thinking how to improve the system. Going backward is not an option.
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Huh ???

Going backwards is a GUARANTEE !!

We're already going backwards. This laws a disaster.

Its wasted Billions in both Federal and State funds building exchanges that dont and wont work.

Oregon just gave up and trashed their entire 250 Million dollar exchange because they couldn't make it work.

Wasted revenue that could have been used for something important and its History

How are States like California, who are already up to their eyeballs in massive debt in the form of 500 Billion in State unfunded liabillities, going to fund their exchange when Obama cuts the Federal subsidies ?

Tax increases ?

Because they're not going to get the extfa revenue from a growing economy.

Unbelievable.
 
ludin said:
not reading the articles that i have show as usual has hurt your argument. the reason for the slow down is mostly given to the recession not obamacare.
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Mostly? What's the rest of the reason?

tres borrachos said:
But they specified technical changes as being opposed to legislative & economic changes, so I'm not sure how that fits into it being increased data.

Has the slowdown in spending come about due to a reduction in costs, or a reduction in the quantity of the spending? That's a far more important data point than reduced spending dollars.
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There need not be a significant difference between those things. If preventable hospital re-admissions fall (as they have under the ACA's new incentives) because hospitals do a better job of getting inexpensive post-discharge support to Medicare beneficiaries that negates the need for costly re-hospitalizations, then costs and quantity of spending are both reduced because the system is working better. That's an example of something that's already happened.
 
Fenton said:
Why should they ?

They made their projections using the law as it was exactly written.

Which is also the Law. The CBO can't take any extenuating circumstances into cosnideration.
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Actual Medicare spending has come in below the reductions required under the ACA. Which is why the CBO's Medicare spending projections keep sinking as more data comes in.
 
Fenton said:
Huh ???

Going backwards is a GUARANTEE !!

We're already going backwards. This laws a disaster.

Its wasted Billions in both Federal and State funds building exchanges that dont and wont work.

Oregon just gave up and trashed their entire 250 Million dollar exchange because they couldn't make it work.

Wasted revenue that could have been used for something important and its History

How are States like California, who are already up to their eyeballs in massive debt in the form of 500 Billion in State unfunded liabillities, going to fund their exchange when Obama cuts the Federal subsidies ?

Tax increases ?

Because they're not going to get the extfa revenue from a growing economy.

Unbelievable.
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You know I realize that you and the other anti- A.C.A. crowd are in a parallel universe when we converse. I am intensely interested in ways to reduce the cost of health care in ways other than rationing based on a person's income.

You are only fixated on the cost of health insurance- not the underlying, long standing problems with the system as a whole.
 
Because Obama did it. Nothing else matters.
Cassandra said:
You know I realize that you and the other anti- A.C.A. crowd are in a parallel universe when we converse. I am intensely interested in ways to reduce the cost of health care in ways other than rationing based on a person's income.

You are only fixated on the cost of health insurance- not the underlying, long standing problems with the system as a whole.
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Threegoofs said:
I guess when I repeat your exact words it's somehow an 'ad hominem'.

Let me try again:

YOU SAID: there is nothing on the ACA that controls costs.

I merely pointed out that this statement is comically ridiculous.
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there aren't cost cutting measures if they are they are invisible because they are not being seen or people are not benefiting from them.
i have shown that costs are increasing. if there were cost cutting measures in the bill then costs and premiums would be going down not up.

i proved my point you have yet to prove yours.

all you can do is ad hominem.
 
Cassandra said:
You know I realize that you and the other anti- A.C.A. crowd are in a parallel universe when we converse. I am intensely interested in ways to reduce the cost of health care in ways other than rationing based on a person's income.

You are only fixated on the cost of health insurance- not the underlying, long standing problems with the system as a whole.
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how about actually addressing the facts insead of ad hominems and dismissal arguments? or is that all you have to try and justify your position?
 
ludin said:
there aren't cost cutting measures if they are they are invisible because they are not being seen or people are not benefiting from them.
i have shown that costs are increasing. if there were cost cutting measures in the bill then costs and premiums would be going down not up.

i proved my point you have yet to prove yours.

all you can do is ad hominem.
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How can you argue with willful ignorance? The information is there, but your brain seems to be a semipermeable membrane into which it cannot penetrate.

However, ad hominem accusations appear to flow freely.
 
Threegoofs said:
How can you argue with willful ignorance? The information is there, but your brain seems to be a semipermeable membrane into which it cannot penetrate.

However, ad hominem accusations appear to flow freely.
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yep the information is that that costs are increasing thank you for finally acknowledging it your continued dismissal arguments are not arguments. you have presented nothing to refutes anything that i said.

yes your ad hominems do flow freely because that is the only thing you can do when faced with the truth of the situation.

costs are rising and so are premiums and there is more indication that they are only going to go higher.
 
ludin said:
how about actually addressing the facts insead of ad hominems and dismissal arguments? or is that all you have to try and justify your position?
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What ad hominems? what dismissals?

I have provided a pile of facts -maybe you overlooked them. I have also agreed w you on some things like reducing the cost of care is a big challenge not yet addressed- it won't happen overnight
 
ludin said:
yep the information is that that costs are increasing thank you for finally acknowledging it your continued dismissal arguments are not arguments. you have presented nothing to refutes anything that i said.

yes your ad hominems do flow freely because that is the only thing you can do when faced with the truth of the situation.

costs are rising and so are premiums and there is more indication that they are only going to go higher.
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Once again.

YOU said 'the ACA has no measures to control cost'

I showed some measures the ACA has to control costs.

Heck- I'll even throw in a New England Journal of Medicine article that discusses this comprehensively.

http://www.nejm.org/doi/full/10.1056/NEJMp1006571

Green beard has repeatedly shown how the real costs are decreasing already, quite possibly because of these measures.

But the more interesting point is how you can just see all this stuff and just pretend it doesn't exist.
 
Cassandra said:
OMG! Was it a big chocolate lab named Basel? Same thing happened to my brother-in-law.

I don't know what your premiums are like but mine went through the roof for one particular reason - I got older. I told the insurance co. I am only an alleged adult but they were not impressed.
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I don't recall the dog's name, but it should have been "surprise," because that's what he did to me. Everything happened in about 45 seconds - you know, say hello to the dog, then go to emergency at the hospital....:lol:

I bet you made somebody's day at the insurance company - I doubt they hear that one every day! :lamo:

Greetings, Casandra. :2wave:
 
eohrnberger said:
If you consider the term liberal to be an epithet, take if personally and get defensive about it, you're not going to have too much fun around here. It is bandied about with great frequency.
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I see you've totally given up trying to defend ludin's post.
 
tres borrachos said:
But they specified technical changes as being opposed to legislative & economic changes, so I'm not sure how that fits into it being increased data.

Has the slowdown in spending come about due to a reduction in costs, or a reduction in the quantity of the spending? That's a far more important data point than reduced spending dollars.
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Oy vey!!

You don't even realize that a reduction in the quantity of spending is the same exact thing as a reduction in costs.
 
Cassandra said:
What ad hominems? what dismissals?

I have provided a pile of facts -maybe you overlooked them. I have also agreed w you on some things like reducing the cost of care is a big challenge not yet addressed- it won't happen overnight
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Telling people they live in an alternate universe is an ad hominem.

That is just bias is a dismissal argument more so when you have failed to back it up with anything but your opinion.

You have provided nothing but your OPINION. OPINIONS are not facts. the articles that i have posted and others have posted and actually read are facts.
 
ludin said:
Telling people they live in an alternate universe is an ad hominem.
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With my husband I rarely have the opportunity to gloat in black and white : " THAT IS NOT WHAT I SAID!"

I said, you live in a "parallel universe". This is not a a personal attack. I am a very nice person ( for better or worse). I don't attack people , I take care of people, lots of them.

I said you post from a parallel universe because, not everyone debates from the same frame of reference. I don't want to punish people -even when their shortcomings have an element of personal responsibility. Some are just plain unlucky in a terrible way. There are certainly people on this forum who have no qualms about that. So you can see there is no point in a debate when your world view, your frame of reference is completely at odds w the person u are talking to..

It is intriguing. Sociologists have done some interesting studies on this question. Self proclaimed "conservatives" rate certain ethical attributes much higher than "liberals" and vice versa.

So authority, security, self-reliance- Repubs
jusitice, tolerance, environmental stewardship- Dems

Whatever. The fact is that my starting point is very different from yours. You seem positively triumphant that insurance rates are going up in some states. You ignore the good news. But you see, for you, the good news would be bad and vice versa. Get it?

Do you understand what I am trying to tell you??
 
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ludin said:
Telling people they live in an alternate universe is an ad hominem.

That is just bias is a dismissal argument more so when you have failed to back it up with anything but your opinion.

You have provided nothing but your OPINION. OPINIONS are not facts. the articles that i have posted and others have posted and actually read are facts.
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Fact: Mass. has done an excellent job of reducing the uninsured -it took years not months. Per person spending is in line w other states. I provided the numbers.

Fact: the enrollment rate on the exchange in Maine has been better than anticipated.

Fact: the A.C.A. has provided funds for upgrading hospital I.T. and payment incentive models that move away from Fee for service. This will take time. Neither you nor I can reliably predict the success of these changes.

Fact- in Maine it is impossible to make an Apples to Apples comparison of policy costs before and aft A.C.A. I wonder how many other states are similarly difficult to analyze?

PRESS HERALD:
That's because in Maine, a health care expert said, it will be nearly impossible to compare the new rates with current rates that people pay on the individual market.

According to preliminary numbers released by the Maine Bureau of Insurance in response to a Freedom of Access Act request by the Portland Press Herald, no plans offered on the exchange appear to be comparable to an existing plan on the individual market, said Joseph Ditre, executive director of Consumers for Affordable Health Care.

Ditre said Maine insurers in recent years have been increasingly offering high-deductible plans on the individual market, to the point that nothing else was available to individuals purchasing insurance. Often, people buying on the individual market were paying $10,000 or more in deductibles.

"All of the plans were high-deductible and the insurers were moving away from comprehensive coverage," Ditre said.

Under the Affordable Care Act, insurers are not permitted to offer such high-deductible plans, so there doesn't appear to be a comparable plan on the exchange, Ditre said. Deductibles at most will be a few thousand dollars, he said.

Even in the preliminary rates, there was a wide range of what people would pay, with factors depending on age, location and tobacco use. For comparable plans, older people who smoke and lived in northern Maine would pay hundreds more than a young nonsmoker living in Portland.
 
Greenbeard said:
Actual Medicare spending has come in below the reductions required under the ACA. Which is why the CBO's Medicare spending projections keep sinking as more data comes in.
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Huh ?

Medicare savings through the ACA is primarily the function of cutting provider reimbursements.

The original Law calls for huge cuts to providers which include a 60 percent cut to Hospitals.

And how do those medicare "savings" add up after the "Dr Fix" is passed ?

How do those savings add up after a 24 percent increase in Spending ?

Even the CBO admitted that the cost savings aspects of the law were not feasable for the long term.

I can't get an Honest answer out of you Liberals.

The ACA was sold on a Mountain of lies and is being perpetuated with a unending string of mitigations and half truths.

Don't you realize that this law has had a terrible impact on Millions of Americans ? Try to remember that when youre spouting your nonstop string of propaganda and partisan rhetoric.
 
Cassandra said:
You know I realize that you and the other anti- A.C.A. crowd are in a parallel universe when we converse. I am intensely interested in ways to reduce the cost of health care in ways other than rationing based on a person's income.

You are only fixated on the cost of health insurance- not the underlying, long standing problems with the system as a whole.
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Yes, reality and truth relates to a parallel universe for Liberals.

I'm fixated on the Truth, and not trying to mitigate away the damage caused by a law because I support the Political party that passed it.

COST is everything considering the name of the law is The AFFORDABLE Care Act.

The Democrat party has become so corrupt, so dishonest that they even included a LIE in the Title of their signature legislation.

I mean before one person signs up on the exchanges, before on penny is spent there exist a HUGE Lie.

Lol...I mean really, leave to the Democrats to install a Contradiction in terms in the Title of their signature legislation.

You need to put the welffare of your fellow American and your Country ahead of your loyalty to a Political Party.
 
ANYBODY who believes that Obamacare popularity is "SOARING" is smoking wacky tobaccy.
People are still VERY pissed about this thing.
 
Amazed said:
ANYBODY who believes that Obamacare popularity is "SOARING" is smoking wacky tobaccy.
People are still VERY pissed about this thing.
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Shhhh, dont burst their bubble... delusion is all they've got to hold onto.
 
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