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newcountryman • 8 years ago

I guess the administration is finally owning up to the fact that there is a problem. That's a new one.

Tammo • 8 years ago

Can't use, "I inherited it from George Bush"?

JenniferGranholm • 8 years ago

Applications are not enrollees.

It should be noted insurance companies are also reporting multiple enrollments by same person. Can you spell ACORN?

SemperCogitens • 8 years ago

For those who don't understand why he's referencing the long-defunct government agency, that agency was discredited for encouraging illegal acts and blatant abuse of government services. Many people were fired after their actions were exposed by a conservative sting operation and fed to the media. Eventually, the agency was shut down because it was too corrupt to save. Now, many of those former ACORN employees have been rehired to help run ACA - people with a history of corruption, abuse of authority, and absolutely no scruples about giving away your tax dollars to anyone who walks into their doors. This is a problem.

That said:
"It should be noted insurance companies are also reporting multiple enrollments by same person."
[citation needed]

This is a strong allegation here, given the circumstances, and needs to be validated by facts. From which legitimate source can I find a report of the multiple sign-ups?

briefal • 8 years ago

Odd you should ask for verification from a legitimate source when you yourself make a series of very grave allegations with no supporting source. How about this for unsupported allegations "Now, many of those former ACORN employees have been rehired to help run ACA - people with a history of corruption, abuse of authority, and absolutely no scruples about giving away your tax dollars to anyone who walks into their doors."

paulnbrowne • 8 years ago

Do you have employee lists from ACORN and the ACA?........ right, didn't think so.

Librarian53 • 8 years ago

That doesn't make sense, as social security numbers would prevent anyone from enrolling twice. The companies would be guarding against this.
Another far right conspiracy non fact?

SniperFire • 8 years ago

The one who can't even spell it. LOL

KansasGirl • 8 years ago

O needs 7 million young, healthy suckers to pay for the democrat (base) non-working takers.

Guest • 8 years ago
SemperCogitens • 8 years ago

A third of the country's getting government benefits. Of course poor people who have conservative views are going to be receiving them. The money's there and it's legal. Why would they not accept it? Does this really negate their views on personal responsibility and fiscal sanity? Not really, because putting food on the table for the kids is much more important.

Dems need to realize that the argument against government benefits is not a racist or classist statement. It's a statement that the social safety net we have is too expensive. It is a promise we can't afford to keep, which is why we keep having these debt ceiling crises. If we were able to afford these social programs, we wouldn't have to borrow and we'd never reach the debt ceiling. Conservatives argue that these programs must be cut to a level we can afford, and they back it by suggesting literally hundreds or government programs and projects that many might consider less important than helping a struggling family put food on the table to feed their kids - like bridges to nowhere, studies of shrimp on treadmills, etc.

We should be making these kinds of choices in government. Liberals would love to argue that we could have a few less tanks to help a senior make rent. Most would agree. Conservatives might suggest that the Dept of Education is entirely redundant with State level agencies that already do the same thing and do it without unpopular and unsuccessful programs like NCLB. Perhaps those could be cut to keep Medicaid payments going so a poor person could get preventative medical care.

We used to do this with a budget. I seriously wish people would take Paul Ryan and Tom Coburn seriously. They've got great ideas that I think a lot of Americans could get behind to make cuts where they could. And I wish the GOP would stop slavishly following Grover Norquist because the spending-revenue gap is too large to close without new revenue. As much as Norquist loves to talk about mortgaging America's childrens' future, he needs to man up and support doing what is necessary to pay that mortgage down now. Fix it, don't exacerbate the problem.

Publius2k • 8 years ago

"A third of the country's getting government benefits."

And that statistic doesn't set off any alarm bells?

SemperCogitens • 8 years ago

I didn't quote my usual 3:1 cuts to tax increase thing here. Having a third of the country getting benefits is of course a problem. The question is what to make of it.

Do you argue that this is the result of a weak economy caused by a crash caused by bankers who should be in jail for the blatantly stupid risks they took with other people's money? Yes, that has something to do with it. Weak economy, few jobs, 70%+ jobs that are being created are part time. Bloated service industry. The most common jobs (service and retail) don't pay enough to keep full-time people off of the dole. Yes, people are going to need government services at a time like that.

But it also a problem of the social safety net being too generous? Absolutely. We as Americans like to be generous. We want to help others, if for no other reason than to tell ourselves we're good people. So we vote for these things, but we can't pay for them. They're promises we can't keep without borrowing from the Bank of China, but we make them because the choice between borrowing money and putting food on the table is a no-brainer. You put the food on the table and worry about the bill later.

The question is how to fix it. My short answer is: new management.

Publius2k • 8 years ago

"Do you argue that this is the result of a weak economy caused by a crash caused by bankers who should be in jail for the blatantly stupid risks they took with other people's money?"
Actually, in my opinion, the crash was caused by stupid people taking out 0% APR or interest only mortgages for homes they never intended to keep (or even occupy, in some case). Bankers didn't shove the loans down their throats, but based on human nature most who screw up that badly will immediately plead deceptive practices despite the loans complying with the Federal Truth in Lending Laws. I question whether banks even were permitted to disallow loans to those who didn't qualify for them. Similarly, no one forced homeowners to use the increasingly inflated equity in their homes as ATMs to buy the latest big screen TV, iGadget, or SUV. But as always happens stupidity came home to roost and took down a lot of others with it.

I do agree that this country's economy is far too heavily weighted towards services (including retail) than production and have believed that for over thirty years. Being the world's industrial engine after the devastation of WWII when no one else could manufacture much of anything went a long way towards making the US a superpower. But that's no longer an option. Americans are too concerned about the price tag on the latest toy to consider investing in large-scale manufacturing infrastructure and any domestic product will be undersold by or outsource to China, Korea, or Singapore once it becomes a commodity.

As to the social safety net, my opinion is that is something better left to the private sector. Americans do like to be generous, but being strong-armed into it by government legislation is a compensation, not a solution to the social problems. Worse, people will become dependent upon it and more and more come to expect it. A classic study of seagulls in the 70s showed that some seagulls had never learned to fish because through several generations they had subsisted on the refuse dumped from boats shrimping in the area. When the fleets moved elsewhere, the seagulls began to starve because, despite the availability of fish, none of them knew how to fish. And quite frankly I believe that seagulls (and most other animals) are smarter than people. Assistance through the government too quickly becomes a crutch rather than a support. And the problem with putting food on the table now and worrying about the bill later is that the trend shows that no one is thinking about "later".

My opinion on how to fix it? About the same as for fixing a broken leg - realize that it will be painful, admit that it will take time to work through, and start doing what must be done rather than pumping in more painkiller, forgetting that there's a problem because the pain has been numbed and procrastinating, and having an even worse problem developg. But no one dares to tell the voters that.

Yahweh • 8 years ago

You can always count on human nature and its greed. That will never, ever change.

The government's role is to implement policies that make the best use of that human nature and to not implement policies that interfere with the invisible hand of free markets.

Government backstopping of mortgages, deregulation of bank's investments, and Federal Reserve easy money policies of the 2000s are the three factors SOLELY responsible for the crash.

Blaming people for jumping into a super hot housing market is like blaming a swarm of seagulls rather than the guy that's throwing handfuls of food to them.

Publius2k • 8 years ago

A major omission in your reasoning is that it is the individual's duty and no one else's for him or her to develop a sense of self-control and responsibility. Anger, hatred, and similar emotions are just as innate as greed and yet society expects (or once expected) people not to give in to them. The liberal government does all it can to prevent individual's from developing that sense of accountability and responsibility with policies that do all they can to protect individual's from the consequences of their actions that should act as natural deterrents to bad choices.

alfie0077 • 8 years ago

Yea no Rs are getting anything, however every illegal alien Catholic invader does. .. And every one is a D. There are now over 50 Million illegal alien Catholic invaders in the USA.

KansasGirl • 8 years ago

I wouldn't know what party these 7 million young, healthy suckers are affiliated with, but it doesn't change the fact that they are needed to make Obamacare work.

MnFatts • 8 years ago

Let's see, supposedly 48 million uninsured, 9 million that buy their own insurance, 500,000 a month enrolling, this should only take 9 years or so.
Genius plan!

looncraz • 8 years ago

It will never hit full-compliance. 30 million will remain uninsured... most of the newly insured are the 17 million on medicare. The exchanges and all that are just about forcing people to buy expensive insurance plans to offset the costs of the quiet medicare expansion - with the feel-good bonus of insuring those with pre-existing conditions.

Guest • 8 years ago
looncraz • 8 years ago

No, the only real fix for that is universal insurance in one form or another - the ACA does not accomplish that.

Guest • 8 years ago
looncraz • 8 years ago

Nope, no proper attempt to insure everyone has been made. You can't do it with straight-up socialist health care - that would completely undermine the U.S. healthcare system.

You can't do it by having the government pay for care directly - that would undermine freedom of choice and result in drastic fraud.

You do it by purchasing fall-back plans for every single U.S. citizen. The plan must be minimal, offering little more than vaccines, a fixed number of doctors visits a year, certain routine care, critical medicines, 50% cost-sharing for emergency services, and bankruptcy protection (via maximum-out-of-pocket per year, by income level). It is a plan no one should have a desire to rest upon, but enough to protect those with no alternative and result in a healthier population.

From there, all other insurance plans are secondary insurances to the default plan which insurers bid on for pools of citizens (equally divided across age groups). Insurers can know nothing about those they are insuring - bills go through the social security system, claims are then made to the insurers, then the insurers pay the claims. Insurers will be allowed a set profit figure, similar to how the ACA operates, and any additional amounts are refunded to the social security administration.

Medicaid/medicare/etc... will become simple databases of people who receive augmented coverages for free. No one will need to carry an insurance card unless they have supplemental insurance or qualify for augmented coverage.

All supplemental coverages include excise taxes to help cover the costs of the default ("free") policy. Employers will offer whatever they please, but will likely cover more as a result of the lower prices.

Not only is that a simpler system legally, and logistically, it is cheaper per capita and gives 100% coverage without punishing a single person.

SemperCogitens • 8 years ago

This is one of the most intelligent comments I've seen on Discus ever, across any site that has it. It actually addresses the problem, puts forth logical and feasible solutions and doesn't troll in the process. While I'm not sure I agree 100%, this is a darn good addition to the conversation we should be having on healthcare - how to fix it.

Additional props for suggesting that the fallback plan cover basic preventative care that medical evidence has shown for years to be the most cost-effective way to improve health. Vaccines, contraception, annual checkups need to be universally available. This helps address many chronic diseases before they start and gets people funneled out of the ER and into the doctor's office where they should be for basic services.

Guest • 8 years ago
SemperCogitens • 8 years ago

The way I understand it, the majority of hospitals are supplied by wholesale distributors like Cardinal Health. When I was involved in negotiations like these hospitals I used to work for, there was definitely a competitive bidding process. Those distributors had to prove that not only were their products good (and we tested them in patient care settings to verify they worked and met doctors' and nurses' needs), but that they could beat the other guys' prices. Not only that, but we knew full well what our competitor hospitals were getting from their contracts. It's an insular community and people talk.

Hospitals used to buy from individual suppliers. It's too expensive. You can't afford to do it for anything but a handful of specialty supplies, and you only do that when the doctor demonstrates the supply or device is necessary for proper patient care. For anything you use in any kind of quantity from bedpans, to syringes, to sterile operating drapes, you go through a distributor who'll sell a contract to supply you with what they have. Usually they want exclusive contracts. Occasionally, they'll negotiate piecemeal contracts for certain supplies, but again, these aren't no-bid contracts. At one hospital, we got a good deal on most everything we liked, but our surgeons hated their contract suture because it broke too easily, so we bought that alone from another company.

The current system for these things is quite competitive and works well.

The real issue is big-ticket items which have much more price variability. A surgical saw for example might cost $12K, unless you had an exclusivity contract and maintenance agreement and they'd drop it to $4K because they knew they'd make it back on batteries, saw blades, and repair after warranty. Big difference. Implanted surgical devices are similar, with widely varying costs. That's where the money is being made by companies like J&J, Stryker, Medtronic, and others. There's where a larger bidding system might be helpful. One of my hospitals was small and not able to get great deals. Another was part of a large network of major metropolitan hospitals all on the same contract, and they got great prices. This is a situation where consolidation and large health organizations actually do benefit the patient.

Yahweh • 8 years ago

You have my vote.

I mean that literally. Run for office. We need people like you that can think.

Ralph Siegler • 8 years ago

why shouldn't our healthcare system be "undermined", it is three or more times the cost of other country's just to line fat cat's pockets.

Put a 1% tax on every Wall Street transaction, no matter how large or small, there would be then no need for income tax, national debt would disappear and we could fund anything

looncraz • 8 years ago

I agree, wholeheartedly, with the 1% transaction fees! I believe that idea (or one similar) was originally fronted by Ron Paul to fully fund the government while eliminating income taxes entirely (how sweet that would be!).

However, contrary to popular belief, the quality of our medical care in the U.S. has no equal - the problem is getting access to that care. Competition, profit-seeking, and the litigious nature of the population have resulted in a "silently" efficient system - an efficiency that is hidden under the the costs displayed to the consumer as a result of ill-conceived government regulations, non-paying patients, excessive labor costs, medical device prices, and many other monetary problems...

In Canada, if you need cancer treatment, you're better off heading to the U.S. and paying out of pocket. Meanwhile, many Americans are trying to get to Canada for the free routine care. That shows where the strengths and weaknesses reside in each approach. We need an approach similar to Canada's for free outcome-based routine care, but we need to increase access to our unparalleled emergency and 'exotic' health care.

SemperCogitens • 8 years ago

So how do you fix it?

[edit: looncraz answers this succinctly in a comment below, so you don't really need to read the rest of what I wrote]

ACA already makes it a punishable offense not to purchase health insurance, punishable by a large fine, and administered by the IRS. This allows people who wish to do so to choose not to buy health insurance, but at a cost. It's a gamble, but we do live in a free society where people should be able to choose to pay the doctor's bill how they want to.

Would you suggest stiffer penalties, a de facto move to strip that freedom to spend one's money how one chooses?

Would you suggest wage garnishment, similar to income tax withholding as a way to compel compliance?

Would you suggest nationalizing the whole thing?

Simple math indicates that the cheapest way to reduce the individual cost of healthcare is by having everyone insured in one big pool. The big pool allows for the greatest sink from which to fund the expensive outliers (the catastrophically sick), but there are downsides.

The government (until John Robert's twisted logic) couldn't force you to buy a product or service like health insurance.

Theoretically, free market competition would help keep prices low, so you need multiple insurers in the game to be fighting for customers. A monopoly would not be in the consumer's best interest.

Actually reducing cost to provide care at the doctor's office would better address the problem of rising costs than a cost-shifting mechanism like an insurance plan.

If you want to know how to really fix the problem, you have to look at the root causes. Reducing the cost of care at the doctor's office, clinic, and hospital is what needs to be done here.

SemperCogitens • 8 years ago

This is incorrect. The exchange plans are by and large cheap and offer poor coverage. They're not expensive by the standards of private insurance now, though they are more expensive than they should be because ACA regulations require they cover things not currently covered which drives the prices up, even for the catastrophic coverage plans with the bank-breaking deductibles and copays.

Yes, it is a Medicaid expansion and a big one - 33%, but it should be noted that this 33% is basically cash given directly to the states to help run their exchanges and subsidize the costs of their plans. It's not really a 33% expansion of the federal program as it currently exists. The risk for those states is if that funding is ever removed, they'll individually be on the hook for those costs without the federal support which is why red states rejected the money and went with the federal exchange, which they don't have to fund or subsidize - a smart move if you advocate shrinking the entitlement portion of our budget in order to address the $17T debt.

As for "feel good bonuses", if you've ever had to try and get insurance with such a condition, you'd understand clearly why it was an abuse that needed to go, just like lifetime caps. These were both expensive to insurance companies, and they cut costs to their consumers (us) by refusing to cover them, the downside being that the sick people got hosed. ACA does a handful of good things, and these two are on the list. Polls over the last few years have consistently shown support for these measures, and they should be kept. What I disagree with is the fact that ACA doesn't offset those costs with other cuts. It shifts those costs onto others, specifically: large employers and the federal government. It doesn't reduce cost, it raises cost, then changes who gets the bill, and that is broken and needs to be fixed.

looncraz • 8 years ago

"The exchange plans are by and large cheap and offer poor coverage."

That depends entirely on your starting point. If you are the kind of person that has been without insurance and is now forced to buy insurance through an exchange - the plans include too much of the wrong things are way overpriced (in general & ignoring subsidies). $160/mo would buy a catastrophic coverage a year ago with 80% cost-sharing and $2500 deductible. It didn't cover anything other than emergency care, but it it was sufficient to keep people afloat if the worst happened (broken arm, car accidents, non-elective surgery, etc...).

"As for "feel good bonuses", if you've ever had to try and get insurance with such a condition, you'd understand clearly why it was an abuse that needed to go, just like lifetime caps."

Actually, I am intimately aware of the situation - from personal experience. My insurance rose $120/mo with the next renewal period because of a medical condition - pricing me right out of insurance. The ACA would have prevented that, for sure, which is, as you say, one of the good things it brings to the table.

I wholeheartedly agree with your assessment that the ACA doesn't reduce costs in any way shape or form - that is one of the fundamental issues I have with the ACA. That and the tens of millions which will remain uninsured and forced to pay fines... the negative effects on businesses, etc...

Mike • 8 years ago

Not cheap, based upon the spreadsheet examples site offers, since I'm one of many who can't get passed the glitches, for man 12 years younger than me, his cost is more than 217% more than my current coverage, and it's worst than what I got now, but of course I get to lose what I have.

Yahweh • 8 years ago

Wait until they see the Loss Ratio resulting from the adverse selection of the people that signed up.

Who do you think is clamoring to sign up for insurance, the young healthy person who doesn't need it and just wants another monthly bill or the elderly and chronically sick that fully intend to use every bit of their new benefits?

Adverse selection death spiral. It's already started. Watch what happens to those premiums after one or two renewals.

tuesdaysgone • 8 years ago

" about 476,000 health insurance applications have been filed through federal and state exchanges"..................................... Sad.. but yet, not expected.

ROB • 8 years ago

it is not about care. it is a scam & rip off. just ask those 90% of americans who already have and now are in risk of losing their private insurance. Even if you want to sign up for this, unless you make $2k a year or you have cancer or something, the cost is 500% higher than private health insurance and deductible is much higher too. don't forget what obama said to the low information voters , it is cheaper, you get to keep what you have and much lower deductible. we know this is just another big gov leftist program. this is about spreading misery to all and equally

Librarian53 • 8 years ago

You are spreading false information. I can only guess what your motivation is... paid for these comments, work for the insurance industry?

The cost of insurance through the ACA is not higher than private health insurance, it is much lower than buying the policy on your own, as the ACA state exchanges give people the buying power of a group.

Sectionhand • 8 years ago

Documentation please .

Boatdrink • 8 years ago

Front page- Charlotte Observer- Today- BlueCross and Blue Shield rates increase up to 250% due to obamacare.

Librarian53 • 8 years ago

Of what? That an individual will pay a higher premium than someone applying in a group?? That is the way the insurance industry works.

Guest • 8 years ago
Librarian53 • 8 years ago

You have some false info. Medicare is only for seniors. Maybe you meant Medicaid?

Each state has a different cutoff to be eligible for Medicaid. In Texas, for example, you have to be making $5,000 or less a year!

(That explains why so many poor working Texans didn't have health insurance!) Quite a few red states have the same ridiculous limits.

As far as the $5,000 deductible you referred to, which state is that, as each one has different offers from the insurance companies participating?

What matters to me with insurance is the maximum out of pocket amount I would have to spend in a year, as huge medical bills are what puts so many Americans in bankruptcy each year. (almost half of all bankruptcies are from unpaid medical bills after a catastrophic illness or injury, even though many of those folks had health insurance, as before the ACA, too many policies were deficient in this regard.)

Guest • 8 years ago

Do you mean in theory or in reality? Because I have yet to see anyone state that they are getting a better rate from an exchange. Maybe I'm wrong, I've only scoured the Internet for weeks looking.

Cuban Pete 1976 • 8 years ago

You can "only guess" ? Explains your post.

Librarian53 • 8 years ago

Yes, I only guess at people's motivations unlike some far right commenters who frequently claim to know what a liberal is thinking. Anyone who claims to know what someone else is thinking is delusional.

David • 8 years ago

Can you say aristocracy? The law of the land doesn't apply to them. What's next...taking your bride?

Guest • 8 years ago
RR CC • 8 years ago

Exactly! There are those of us who want no part of this, at all, and prefer never to seek health care. We don't expect others to understand our reasons but we have them. As it is now many people I know sign waivers through their employers' health plans and in the event of an emergency won't be taken to the hospital. No penalty will make us buy health insurance so why can't we just sign a waiver?

Cuban Pete 1976 • 8 years ago

How about a more efficient socialist solution? Say, concentration camps or reeducation centers?