An explanation for Oerdin's magical Obamacare premium drop

[Asher]

Yes, I suppose you have a point in there somewhere?



Not in British Columbia. Which, last I checked is still part of Canada.

Part of != Is.

BC is all kinds of ****ed up. Don't conflate it with all of Canada. Even then your facts are wrong. The insurance for BASIC only (liability) is through a government insurance company, but can be acquired through many different brokers. If you get anything other than basic, you go through private companies.

The plight of British Columbians must be terrible to suffer such injustices. It's certainly comparable to people being bankrupted by obscene and absurd medical bills in the US.

[Wezil]

Of course he's a ****** (and wrong) Asher.

Goes without saying doesn't it?

[Sava]

The entire false premise of Obamacare can be summed up in a few concepts.

1) The goal of Obamacare was to expand the amount of people receiving health care thus total demand for helath care services is expected to increase as a result.

2) The result of Obamacare is that the providers of the services will be forced to supply services at lower reimbursement rates than they currently do.

3) The inevitable conclusion is that suppliers will exit the market and new suppliers will decide the exorbitant entry costs (read tuition costs, malpracitc epremiums etc.) will dissuade new potential doctors from entering the field. Some shifting toward nurse pracitioners etc will occur but that results in a likely lower quality of health services.

4) Thus Obamacare makes what rationing situations exists an even worse situation by mandating an increase in demand in one instance while perversely incenting supply to diminish both in terms of availability and quality of service.

Well. Sort of.

With regards to #3 specifically... new doctors won't be summarily dissuaded from entering the market. That's silly. Health care is a massive business. The result is/will be that rural areas will be under-served.

But most of the downsides of Obamacare were already present. As much as Republicans want to rag on it, it really didn't change a whole lot. The opposition to Obamacare was purely partisan opportunism. Both sides want it because the big companies want it. Republicans were just playing their part in the political theater. They gave their base a boogeyman. Obama paid lip service to the liberals saying it was a step in the right direction. The only substantive changes, as far as we're concerned as consumers of health care, had to deal with shutting down some of the more abusive practices.

It's not like doing so solved any serious problems. Companies are still driven (by the almighty profit motive) to squeeze as much as they can out of hospitals, doctors, and patients. Some entities, like rural hospitals and practices, will be hurt more.

But the conservatives here don't want to dismantle the private insurance racket. Most are content with pretending like Obamacare is the problem. Which is fine. You guys need a bad guy. At least it's not women, gays, mexicans or muslims. That's progress

[Ogie Oglethorpe]

Well. Sort of.

With regards to #3 specifically... new doctors won't be summarily dissuaded from entering the market. That's silly. Health care is a massive business. The result is/will be that rural areas will be under-served.

Every doctor I have had discussions with has had the same general comment. "Once Obamcare is fully implemented I will have to re-evaluate my practice and make a decision as to whether I continue."

As for rural America being under-served, why is this a preferable outcome?

But most of the downsides of Obamacare were already present. As much as Republicans want to rag on it, it really didn't change a whole lot. The opposition to Obamacare was purely partisan opportunism. Both sides want it because the big companies want it. Republicans were just playing their part in the political theater. They gave their base a boogeyman. Obama paid lip service to the liberals saying it was a step in the right direction. The only substantive changes, as far as we're concerned as consumers of health care, had to deal with shutting down some of the more abusive practices.

Yes most of the downsides were present and Obamacare intensifies them.

It's not like doing so solved any serious problems. Companies are still driven (by the almighty profit motive) to squeeze as much as they can out of hospitals, doctors, and patients. Some entities, like rural hospitals and practices, will be hurt more.

And the only way to make that situation better is to provide competitive alternatives rather then limit them. One such idea now prevented is going without insurance (i.e. self insuring) and paying in cash if you need the services.

But the conservatives here don't want to dismantle the private insurance racket. Most are content with pretending like Obamacare is the problem.

Seems Obamacare has made sure the insurance market became the focus rather than the costs of health care. In doing so, it is Obamacare that has ensured that the insurers get first serving at the trough.

[Krill]

Yeah, #3 is an overly simplified point that is basically wrong. The main reason that more doctors aren't trained comes down to a variety of factors including colleges not wanting to train any more, it being exorbitant to train as one in the first place (just as Guy), and that there is always a limited talent pool: the more talented people you draw into one area the less there are to go around, unless you can actually improve the size of the talent pool through education and other sociological means...by which improving health of the population is one such means.

[Ogie Oglethorpe]

Its rather simple you have huge entry costs which are increasing annually at a rate greater than CPI. You have increased operating and overhead costs. You can achieve less revenue per hour than you could before. More costs and less revenue means one thing and one thing only. Less supply. Isn't rocket science.

[Sava]

Every doctor I have had discussions with has had the same general comment. "Once Obamcare is fully implemented I will have to re-evaluate my practice and make a decision as to whether I continue."

As for rural America being under-served, why is this a preferable outcome?

I never said it was. It's preferable for the insurance companies. They love it. Rural communities aren't as profitable.

And the only way to make that situation better is to provide competitive alternatives rather then limit them. One such idea now prevented is going without insurance (i.e. self insuring) and paying in cash if you need the services.

Obamacare is neutral on the notion of competition, which is absolutely stupid and silly with regards to healthcare. Nobody "shops" for health care. It's not like we're talking about selling widgets here.

Seems Obamacare has made sure the insurance market became the focus rather than the costs of health care. In doing so, it is Obamacare that has ensured that the insurers get first serving at the trough.

The cost of health care is high BECAUSE of the insurance market. But again, very few people want to address the real problem. And you seem part of the crowd that just wants to play political theater with the issue instead of shooting the elephant in the room. Which is fine. I'm sure it feels good to shout "Obamacare! Obamacare!" and pretend like that's the problem. I imagine it's quite cathartic.

[Sava]

Its rather simple you have huge entry costs which are increasing annually at a rate greater than CPI. You have increased operating and overhead costs. You can achieve less revenue per hour than you could before. More costs and less revenue means one thing and one thing only. Less supply. Isn't rocket science.

The costs are high because insurance companies are squeezing doctors and hospitals. They withhold reimbursements like it's going out of style. Hospitals and doctors need armies of administrative people in order to deal with all the red tape. That costs money. They need armies of marketing people to try and compete for business. That costs money. "Competition" doesn't save patients money. It costs everyone more. It's a huge amount of labor costs that doesn't bring in enough revenue to justify its existence. Nobody goes to the doctor because they want to... because some slick marketing campaign made them.

You're right. This isn't rocket science. The problem with health care in America is the insurance companies. They exist solely to make money. They don't contribute anything. They don't facilitate. They don't provide a service. They stand in between patients and the healthcare providers. They are useless middlemen. They are like mobsters skimming off the top. They offer "protection" in the form of "saving" us from the high cost of paying for individual services. But those costs are high because insurance companies exist!

It's basically a criminal enterprise... only, it's not illegal.

[Ogie Oglethorpe]

Obamacare is neutral on the notion of competition, which is absolutely stupid and silly with regards to healthcare. Nobody "shops" for health care. It's not like we're talking about selling widgets here.

No. Obamacare specifically prevents people from having the flexibility to shop for the insurance option that best meets their needs. As one example, my prefered choice was an HSA with a minimum catastrophic coverage. Now no longer a qualified plan.

Whether Obamcare was intended as nuetral or not the unintended consequence is the number of Insurance providers has dropped in most markets as well as have their offerings.

[Ogie Oglethorpe]

You're right. This isn't rocket science. The problem with health care in America is the insurance companies. They exist solely to make money. They don't contribute anything. They don't facilitate. They don't provide a service. They stand in between patients and the healthcare providers. They are useless middlemen. They are like mobsters skimming off the top. They offer "protection" in the form of "saving" us from the high cost of paying for individual services. But those costs are high because insurance companies exist!

I disagree with this premise. The entirety of the problem is the cost of health care as a whole. Which for the record Obamacare fails to address miserably and truly never really was intended to be addressed. Focussing exclusively on the insurance component is one of the fundamental problems with Obamcare.

However, if insurance truly is the problem then more competition not less seems the appropriate response.

[Sava]

Facepalm.

So you want more competition to lower the cost of an entirely unnecessary industry?

Conservatives like to talk about entitlement... as if it's so horrible that people are "entitled" to food, water and shelter in order to survive. But yet, when that same feeling of entitlement is applied to a group of people who want to make money by doing nothing (in the case of the insurance business), they seem to want to defend that "right" like it was their own child.

It's mind boggling... and more proof that ideology of any kind rots your brain.

[Ogie Oglethorpe]

Facepalm.

So you want more competition to lower the cost of an entirely unnecessary industry?

I believe I have already given you an alternative to that. Self insuring. A form of competition.

Further along the spectra of risk acceptance - high deductible catastophic plans etc.

[Sava]

Insurance companies have made sure that costs are so high that such a thing isn't a viable option.

Again, you seem determined to come up with piss-poor solutions to an artificial problem.

And if you love competition so much, why not go to a single-payer system? That way, the government (basically our sugar daddy who would pay the bills) deals directly with legitimate healthcare businesses who compete for healthcare dollars in a marketplace without the inflated costs generated by the insurance industry.

I know the thought of people getting something "for free" is horrible. Even though "for free" means our collective tax dollars... and not actually "for free".

Do you just enjoy paying more for something? I don't get it.

Do you know how insurance works? It's basically socialism, only we don't get the benefits of lower costs via collective investment (tax dollars). It's socialism with a middleman... and without the accountability of representative democracy. If all the revenue of insurance companies was going to some elected official, you'd think it was corruption. But because it's mostly a bunch of rich white guys, it's okay. I mean, they aren't the government.

I'm trying very hard not to call you retarded. But you are.

[Imran Siddiqui]

Focussing exclusively on the insurance component is one of the fundamental problems with Obamcare.

It was the only way to get increased coverage. I'm sure some in the administration would have loved to go to single payer, but there is absolutely no chance in Hell that gets through Congress.

[DinoDoc]

In that case it is healthy folks who have to subsidize sicker folks, so that sicker folks don't have to pay ridiculously high premiums. Also I'd imagine that poor young folks are generally sicker than the rich young folk, as a general rule. And yes, that's ok.

Out of curiosity, what's the incentive for these healthy young folks to get insurance in the post-Obamacare era since there's a ban on excluding people from coverage due to pre-existing conditions? Why not just get a policy when you get sick?