Obamacare ? Anyone?

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Re: Obamacare ? Anyone?

Post by ruckman101 » Tue Apr 21, 2015 10:10 pm

Obamacare was a cave to the current "providers". Nothing will improve until the concept of profit is eliminated from the equation. Compensation for skills isn't a detriment to lowering costs, and in the bigger picture, we all win.


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Re: Obamacare ? Anyone?

Post by 72Hardtop » Wed Apr 22, 2015 3:56 am

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Re: Obamacare ? Anyone?

Post by Amskeptic » Fri Apr 24, 2015 2:06 pm

ruckman101 wrote:Obamacare was a cave to the current "providers". Nothing will improve until the concept of profit is eliminated from the equation.
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Re: Obamacare ? Anyone?

Post by Amskeptic » Fri Apr 24, 2015 2:13 pm

A couple of NYT reader responses . . .
Left unmentioned in this op-ed is the extent to which Republicans have engaged in a campaign of misinformation concerning the Affordable Care Act. Nearly everything that has been said about it by the Right has been wrong. All the predictions about the disaster that would follow when it was implemented have failed to happen. Sure, when polled by the name of Obamacare, the ACA is unpopular, but if you seperately ask people about the provisions within it they love almost everything about it.
This column has haunted me all day since I read it this a.m. Basically, the country is saying to pollsters that they believe only the rich are entitled to be healthy and have access to quality medical care. The poor and working class of America can basically die or live less than healthy productive lives.

What kind of country believes this?

I think Bernie Sanders and the hero postman who delivered the mail on the lawn of Congress is right -- unless we the people are willing to take on the billionaire class in this country who not only control our elections and government officials but also our major media outlets, it is only going to get worse. At what point do we just say no more?
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Re: Obamacare ? Anyone?

Post by 72Hardtop » Mon May 04, 2015 11:12 pm

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Re: Obamacare ? Anyone?

Post by asiab3 » Tue May 05, 2015 6:41 am

They polled doctors? Come on……

For that article to be based in reality, they would have had to use ACTUAL NUMBERS of ER visits by human beings, before and after the ACA. What they "reported" on was simply doctors recollections of numbers.

Surely the real data is available somewhere?

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Re: Obamacare ? Anyone?

Post by 72Hardtop » Tue May 05, 2015 7:15 am

Our ERs have long been flooded with people who don't need to be coming to the ED. The ACA will only add to those numbers in the end. A caveman would know that.
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Re: Obamacare ? Anyone?

Post by 72Hardtop » Wed May 06, 2015 6:22 pm

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Re: Obamacare ? Anyone?

Post by Amskeptic » Thu May 07, 2015 2:05 pm

72Hardtop wrote:Our ERs have long been flooded with people who don't need to be coming to the ED. The ACA will only add to those numbers in the end. A caveman would know that.
Anecdotal evidence is not good enough.
A caveman might or might not know that.

Statistically, the ACA has done more to rein in healthcare costs than expected. It has legs. It has reduced the increasing costs, and it has as importantly reduced negative outcomes (read: expenses) due to peer review requirements.
It has helped! people!
You will see Republicans pretzel themselves into incoherent idiocy as the campaign season heats up as they try to repeal something that We The People do not want to dismantle now. A truly disturbing sight.
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Re: Obamacare ? Anyone?

Post by 72Hardtop » Thu May 07, 2015 2:13 pm

When one goes from having nothing to having something...sure anyone can agree that's better. But it is still far from ideal. Ultimately our future is going to pay for it deeply in terms of overall cost.

His figures on those without healthcare are still far off from the original estimates. Then there is the issue with homeless individuals and illegal immigrants who continue to bleed the system dry and never pay. A vague threat of a penalty at the end of the year will NOT ensure they pay...they are already not paying.

My answer for that...

When either comes for treatment they must pay a min of $50.00 for treatment (offset cost) prior to any treatment rendered. NO exceptions. As bad as it may sound anyone can save $50.00 these days...even if one is homeless or an illegal immigrant.
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Re: Obamacare ? Anyone?

Post by 72Hardtop » Sun May 31, 2015 1:03 am

A New Contestant in Biggest ObamaCare Lie Contest?


When one thinks what we’ve been told since the law’s passage, it’s hard to identify the biggest ObamaCare lie.

Was it when we were told we could keep our doctors?
Or when we were told we could keep our insurance (here’s the humorous version)?
How about when we were told costs would come down?
And don’t forget the whopper about a new entitlement being good fiscal policy?
In other words, just about everything we were told was a fib. Even the tiny slivers of good news resulting from ObamaCare were based on falsehoods.

So I almost feel like I’m guilty of piling on by writing about another big Obamacare lie.

But Charles Krauthammer has such a strong critique of ObamaCare’s mandate for electronic health records that I can’t resist. He starts by pointing out that doctors are unhappy about this costly new mandate.

…there was an undercurrent of deep disappointment, almost demoralization, with what medical practice had become. The complaint was not financial but vocational — an incessant interference with their work, a deep erosion of their autonomy and authority…topped by an electronic health records (EHR) mandate that produces nothing more than “billing and legal documents” — and degraded medicine.

Not just unhappy. Some of them are quitting and most of them are spending less time practicing actual health care.

Virtually every doctor and doctors’ group I speak to cites the same litany, with particular bitterness about the EHR mandate. As another classmate wrote, “The introduction of the electronic medical record into our office has created so much more need for documentation that I can only see about three-quarters of the patients I could before, and has prompted me to seriously consider leaving for the first time.” …think about the extraordinary loss to society — and maybe to you, one day — of driving away 40 years of irreplaceable clinical experience.

Then Krauthammer exposes the deceptions we were fed when Obamacare was being debated.

The newly elected Barack Obama told the nation in 2009 that “it just won’t save billions of dollars” — $77 billion a year, promised the administration — “and thousands of jobs, it will save lives.” He then threw a cool $27 billion at going paperless by 2015. It’s 2015 and what have we achieved? The $27 billion is gone, of course. The $77 billion in savings became a joke. Indeed, reported the Health and Human Services inspector general in 2014, “EHR technology can make it easier to commit fraud,” as in Medicare fraud, the copy-and-paste function allowing the instant filling of vast data fields, facilitating billing inflation.

A boondoggle on the back of taxpayers. Flushing $27 billion is bad enough, but the indirect costs also are large.

That’s just the beginning of the losses. Consider the myriad small practices that, facing ruinous transition costs in equipment, software, training and time, have closed shop, gone bankrupt or been swallowed by some larger entity. …One study in the American Journal of Emergency Medicine found that emergency-room doctors spend 43 percent of their time entering electronic records information, 28 percent with patients. Another study found that family-practice physicians spend on average 48 minutes a day just entering clinical data.

Here’s the bottom line.

EHR is health care’s Solyndra. Many, no doubt, feasted nicely on the $27 billion, but the rest is waste: money squandered, patients neglected, good physicians demoralized.

Not much ambiguity in that sentence. To put it bluntly, “EHR” is the kind of answer you get when you ask a very silly question.



But on a more serious note, now read what Dr. Jeffrey Singer wrote about electronic health records. Simply stated, this is like Solyndra, but much more expensive. Instead of wasting a few hundred million on cronyist handouts to Obama campaign donors, EHR is harming an entire sector of the economy.

The only thing I’ll add is that neither Krauthammer nor Singer contemplated the possible risks of amassing all the information contained in EHRs given the growing problem of hacking and identity theft.

P.S. On another topic, I’ve written several times about the excessive pay and special privileges of bureaucrats in California.

Now, thanks to Reason, we can read with envy about another elitist benefit for that gilded class.

…a little-known California state program designed to protect police and judges from the public disclosure of their home addresses had expanded into a massive database of 1.5 million public employees and their family members… Because of this Confidential Records Program, “Vehicles with protected license plates can run through dozens of intersections controlled by red light cameras and breeze along the 91 toll lanes with impunity,” according to the Orange County Register report. They evade parking citations and even get out of speeding tickets because police officers realize “the drivers are ‘one of their own’ or related to someone who is.”

You may be thinking that the law surely was changed after it was exposed by the media.

And you would be right. But if you thought the law would be changed to cut back on this elitist privilege, you would be wrong.

…the legislature did worse than nothing. It killed a measure to force these plate holders to provide their work addresses for the purpose of citations — and expanded the categories of government workers who qualify for special protections. This session, the legislature has decided to expand that list again, never mind the consequences on local tax revenues, safety and fairness. …Given the overwhelming support from legislators, expect more categories to be added to the Confidential Records Program — and more public employees and their families being free to ignore some laws the rest of us must follow
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Re: Obamacare ? Anyone?

Post by 72Hardtop » Fri Nov 06, 2015 8:26 pm

ObamaCare has cancer. And if it’s not treated quickly and aggressively, it will die



By Dr. Sreedhar Potarazu
·Published October 30, 2015·



June 25, 2015: Supporters of the Affordable Care Act hold up signs as the opinion for health care is reported outside of the Supreme Court in Washington. (AP)


Cancer is the proliferation and growth of abnormal cells that, over time, can invade tissue and cause severe damage to the body’s organs. It’s often hard to spot in its early stages, but once it’s detected, it can reach a point of no return if it isn’t treated.

That’s where ObamaCare is today. It has cancer. And if it is not treated quickly and aggressively, it will die.

The cancer started to grow soon after the Affordable Care Act went into effect, but the spread was too slow to display visible damage. But now it’s detectable, and it has started to invade much of the U.S. economy and our health care systems. Here are some of the symptoms:

Declining enrollment numbers. ObamaCare was designed to provide quality health insurance to people who couldn’t afford it – and for a few years we saw a significant number of early adopters. But a disproportionate number of them were people who previously couldn’t buy health insurance because it was too expensive or because the insurance companies wouldn’t cover their pre-existing conditions. After the ACA was passed, they jumped at the chance to get insurance – and there was a benefit for them.


The projections of ObamaCare’s success were overestimated. The projections of its cost were underestimated. And we still haven’t found a way to provide health care for everyone at a price that is sustainable and ensures quality care for the long haul.

But look at what’s happening now: The projected number of enrollees for 2016 – 20 million on the federal and state health exchanges – has been cut in half to 10 million, according to Health and Human Resources Secretary Sylvia Burwell. Most of the shortfall is attributed to young, healthier individuals who have decided not to sign up. But their contribution to the system is critical, because it helps cover the losses of the older, less healthy people who participate.

If the government’s marketing efforts are successful and those who are already enrolled don’t drop out, the government predicts that 3 to 4 million people will join the system next year. But the economics that were the basis of financing ObamaCare have already been sliced in half, and there is no plan to compensate for the shortfall that will result.

Rising premiums. In the past few weeks, many state insurance regulators have approved all or most of the premium increases sought by the largest health plans in their states. When ObamaCare went into effect, many of these plans offered low rates, anticipating that they would bring in new customers.

Instead, they dug themselves a very deep hole. The customers they took on were less healthy than they expected, and they cost them much more than they’d anticipated. They priced themselves at an unsustainable rate, and now they can’t dig out because the projected number of new members has been cut in half.

You don’t need a math degree to know what a company facing this kind of loss will do to stay afloat: It will raise its prices. This change in market dynamics also has fueled a consolidation in the insurance industry, which will result in decreasing competition that will face a lot of resistance and could drive costs even higher.

The demise of the co-ops. Health care cooperatives – non-profit alternatives to for-profit insurers – were designed to drive more competition among insurers and provide more choices for consumers, especially in places where those choices are limited.

The government set aside billions of dollars in loans to prop up these co-ops, but many have failed in the last couple of months because they lacked the infrastructure they needed to market their product and they failed to understand the risk pools of the populations they were insuring.

A major flaw in government budgeting across healthcare.gov, the state exchanges and the co-ops has been the inability to forecast accurately what it will take to make new models work and keep them running. We have seen numerous explosions along the way because of this. The co-ops’ failure could indicate what will happen to underfunded state exchanges, as well.

Another key ObamaCare provision whose outcome is still in limbo is the Accountable Care Organizations, which were set up to improve the efficiencies of care.

The jury is still out on whether ACOs will be able to deliver quality care, but it is very clear that they have not received the money they need to share information across key stakeholders and coordinate care that is truly cost effective.

Employer Backlash. While the number of people without health insurance has gone down in five years from 17.5 percent to 10.7 percent, most of that is due to a vast expansion of Medicaid and to subsidies that help lower-income people buy insurance. Most of the coverage gains did not come from workers getting affordable health care from their employers.

For many employees on or near minimum wage, the plan options their employers offer are still not affordable. And in a bizarre twist, the health care law considers a worker able to afford employer-sponsored insurance if it costs 9.5 percent or less of his annual household income. But how do employers know how much the household income is when they don’t employ the entire household?

In an effort to stay afloat and not pay a penalty, some employers have resorted to coaxing their employees to get coverage from private or public exchanges. But when employees choose to go without coverage, they don’t get the care they need, and that becomes a huge problem for employers when they get sick and don’t show up to work.

At the same time, insurers are becoming increasingly reluctant to offer policies to small employers, since the employees who sign up for the insurance tend to be the ones who are less healthy and cost more. As a result, many insurers have started gaming the system – offering policies for the first year, as required by law, and then using a loophole in the law that allows them not to renew.

The projections of ObamaCare’s success were overestimated. The projections of its cost were underestimated. And we still haven’t found a way to provide health care for everyone at a price that is sustainable and ensures quality care for the long haul. There is a consistent theme in all of this: ObamaCare has cancer, and it’s spreading. Its diseased organs are now surfacing.

It’s time to recalibrate the financing of the Affordable Care Act, subject it to a rigorous analysis of what works and what doesn’t and present a new business plan that American taxpayers can live with.



Dr. Sreedhar Potarazu is an acclaimed ophthalmologist and entrepreneur who has been recognized as an international visionary in the business of medicine and health information technology. He is the founder of VitalSpring Technologies Inc., a privately held enterprise software company focused on providing employers with applications to empower them to become more sophisticated purchasers of health care. Dr. Potarazu is the founder and chairman of WellZone, a social platform for driving consumer engagement in health.
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Re: Obamacare ? Anyone?

Post by Amskeptic » Fri Nov 13, 2015 7:05 am

72Hardtop wrote:ObamaCare has cancer. And if it’s not treated quickly and aggressively, it will die
By Dr. Sreedhar Potarazu
Published October 30, 2015·
Dr. Sreedhar Potarazu is an acclaimed ophthalmologist and entrepreneur who has been recognized as an international visionary in the business of medicine and health information technology. He is the founder of VitalSpring Technologies Inc., a privately held enterprise software company focused on providing employers with applications to empower them to become more sophisticated purchasers of health care. Dr. Potarazu is the founder and chairman of WellZone, a social platform for driving consumer engagement in health.
Here is Forbes Magazine's take:
With the second year of subsidized private insurance and expanding state Medicaid coverage adding millions more insured Americans under the Affordable Care Act, health care insurers and medical care providers are already seeing billions of dollars in new revenue.

Two major barometers of health industry profits, insurance giant UnitedHealth Group UNH -1.79% (UNH) and hospital operator HCA Holdings HCA -3.08% (HCA) last week raised their 2015 revenue projections by billions of dollars.

HCA, in its preliminary 2015 first quarter report, said revenue could reach $40 billion, an increase of the hospital chain’s earlier outlook of between $38.5 billion and $39.5 billion. It raised its profit forecast as well. HCA chairman and CEO R. Milton Johnson said the quarter’s performance was “driven by continued favorable volume and payor trends in core operations.”

Meanwhile, UnitedHealth in its first quarter earnings report raised its revenue outlook for 2015 by $2 billion, saying the insurer will now generate $143 billion in revenue.


In UnitedHealth’s case, they entered several new markets and put more products on public exchanges after sitting on the sidelines in all but a few states in 2014. “We knew back in January that the market was responding positively so it’s played out nicely,” UnitedHealth Group CEO Stephen Hemsley.
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Re: Obamacare ? Anyone?

Post by Amskeptic » Fri Nov 13, 2015 12:13 pm

Republicans think America is doing terribly, but it isn’t
Ezra Klein
November 13, 2015
Anyone watching the fourth Republican debate would be excused for thinking America is mired in a deep recession — that the economy is shrinking, foreign competitors are outpacing us, more Americans are uninsured, and innovators can't bring their ideas to market.

"We are a country that is being beaten on every front economically, militarily," sighed Donald Trump. "There is nothing that we do now to win."

"The most important question any of us can have is how do we get the economy growing?" Ted Cruz said. "How do we bring back economic growth?"

"We have to take our government back," said Carly Fiorina, "because innovation and entrepreneurship is crushed by the crushing load of a 73,000 page tax code" and "Obamacare isn’t helping anyone."

"What we are going through in this country is not simply an economic downturn," said Marco Rubio. "We are living through a massive economic transformation."

They would be surprised to find that unemployment is at 5 percent, America's recovery from the financial crisis has outpaced that of other developed nations, the percentage of uninsured Americans has been plummeting even as Obamacare has cost less than expected, and there's so much money flowing into new ideas and firms in the tech industry that observers are worried about a second tech bubble.

This beats even the markers the Republican Party established.

In 2008, for instance, Mitt Romney made headlines when he promised that "after a period of four years, by virtue of the policies we’d put in place, we’d get the unemployment rate down to 6 percent — perhaps a little lower."

We're now quite a bit lower than 6 percent, and in less than four years.

This leaves Republicans with two problems. The first is that the economy simply isn't as bad as they're making it out to be — so the apocalyptic rhetoric may well run into month after month of good jobs numbers during the general election. (Of course, if the economy unexpectedly falls into recession, then Republican rhetoric will look much better.)

The second is that Republicans are increasingly focused on economic problems they don't really know how to solve, and don't have much credibility to say they will solve.

Wage growth has been weak — but that's not something the assembled Republicans had much of an answer for. Donald Trump said he wouldn't raise the minimum wage because "wages [are] too high" already. Ben Carson agreed. "Only 19.8 percent of black teenagers have a job who are looking for one," he said, "and that’s because of those high wages."

Income inequality is also worryingly high, and Rand Paul tried to make that into a partisan cudgel. "The bottom line is, if you want less income inequality, move to a city with a Republican mayor or a state with a Republican governor," he said.

But of the 10 states with the highest inequality (as measured by 2010 Gini coefficients), six of them — Massachusetts, Louisiana, Florida, Alabama, Texas, and Tennessee — currently have a Republican governor.

If you cut the data a different way, by looking at the share of income held by the top 1 percent, Republicans still control six of the top 10. (To be fair, Republican control of Massachusetts is recent enough, and unusual enough, that it's probably fairer to say the split is 50-50 in both cases.)

If you take an international perspective, after-tax inequality is much lower in most European countries than it is in the US.

Paul's implausible attempt to blame governors and mayors for broad inequality trends aside, the simple fact is that the Republican tax plans will sharply increase after-tax inequality, and they will do so in the most obvious and mechanical of fashions: They will hugely cut taxes for the top 1 percent (and, making them yet more regressive, they will probably have to cut spending programs that benefit the poor to pay for those tax cuts).

Republicans also focus on the deficit, though less than they did in 2012. Towards the end of the last Republican debate, Carson observed that "$100 million has been added to our national debt" just during the course of the program.

The problem here, however, is that Republicans have entered into a disastrous arms race of ever more expensive tax plans that they have no way to pay for. The Committee for a Responsible Federal Budget's
Jordan Weissmann, observed at Slate that if Rubio's plan only cost $6 trillion — and some estimates place it nearer to $12 trillion — paying for it would require pretty much eliminating the entire defense budget, or the equivalent elsewhere in the government. And that's just not going to happen.

So Republicans are stuck between a description of the economy that seems increasingly detached from the reality of the recovery and a set of economic plans that actually worsen many of the problems Republicans say they want to solve. It's a pickle.
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Re: Obamacare ? Anyone?

Post by 72Hardtop » Thu Nov 19, 2015 4:43 am

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