Author Topic: Obamacare Master thread  (Read 199466 times)

Offline ChaimMoskowitz

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Re: Obamacare Master thread
« Reply #500 on: April 09, 2018, 12:13:05 AM »
Sounds like you feel your public union retirement coverage is the real world.
No my neighbor paying 300/mo for a family of three on OC is the real world. A buddy with a small business that OC saved is the real world. I can go on and on but that wouldn't matter.
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Offline aygart

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Re: Obamacare Master thread
« Reply #501 on: April 09, 2018, 12:17:39 AM »
No my neighbor paying 300/mo for a family of three on OC is the real world. A buddy with a small business that OC saved is the real world. I can go on and on but that wouldn't matter.
If you don't then others do have cases of people with less access to quality healthcare. Yes I am sure there are those who benefited, especially those who get government subsidies. That doesn't mean it is the case with nearly everyone. I know of people who were very seriously hurt by obamacare and have not yet recovered. There was never any claim that no people gained from it. Just bringing examples of some who did is merely anecdotal and cherry picked.
Feelings don't care about your facts

Offline ChaimMoskowitz

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Re: Obamacare Master thread
« Reply #502 on: April 09, 2018, 12:19:57 AM »
If you don't then others do have cases of people with less access to quality healthcare. Yes I am sure there are those who benefited, especially those who get government subsidies. That doesn't mean it is the case with nearly everyone. I know of people who were very seriously hurt by obamacare and have not yet recovered. There was never any claim that no people gained from it. Just bringing examples of some who did is merely anecdotal and cherry picked.
You missed the point again. Millions more have coverage. There is a net gain.
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Offline aygart

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Re: Obamacare Master thread
« Reply #503 on: April 09, 2018, 12:25:22 AM »
You missed the point again. Millions more have coverage. There is a net gain.
You keep repeating the same fallacy and you are the one who missed the point. I did not claim that there are not more people covered. (although many of them were in realty covered pending them putting a pen to paper-this is a very high percentage of your "millions") Coverage and access are not the same. Increased coverage can and does mean decreased access. The patients I dealt with needed a very specific sub-specialty which they no longer had access to when their old plan disappeared under Obamacare. The doctors they needed stopped taking any insurance which was available to them since the insurance companies no longer compensated for the specialized practice. They were left with coverage but no access. This is just one example.
Feelings don't care about your facts

Offline ChaimMoskowitz

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Re: Obamacare Master thread
« Reply #504 on: April 09, 2018, 12:33:23 AM »
You keep making the same fallacy. Coverage and access are not the same. Increased coverage can and does mean decreased access. The patients I dealt with needed a very specific sub-specialty which they no longer had access to when their old plan disappeared under Obamacare. The doctors they needed stopped taking any insurance which was available to them since the insurance companies no longer compensated for the specialized practice. They were left with coverage but no access. This is just one example.
I am not disputing what say. That is your experience.

If millions more are covered that means many more will have access. Does that mean there won't be examples like yours, no.

We do you think the R's have not passed anything? It is because they don't have anything better.
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Offline aygart

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Re: Obamacare Master thread
« Reply #505 on: April 09, 2018, 12:43:52 AM »
I am not disputing what say. That is your experience.

If millions more are covered that means many more will have access. Does that mean there won't be examples like yours, no.

We do you think the R's have not passed anything? It is because they don't have anything better.

again. Coverage is not access. Millions got coverage to go to a doctor for there strep throat which they could have gone to clinics for anyhow. Tens of millions lost access to the various speciallized sub-specialties that if they develop various conditions it can cost them their life or leave them wih serious unresolved issues. Not everyone will actually need to use the access that they lost but every single person covered by any HMO lost access in the event that they do need these specialists. Access is not only lost by those who need it but is lost by EVERYONE. You are taking a very simplistic view of something much more complex. Is it a gain to have taken away the access to life saving doctors from everyone to give coverage for a few people's throat cultures (while the rest had their co-pays and deductibles go up so that they end up paying cash for those types of things now evenb with coverage)?

Even disregarding this aspect of the discussion, Obamacare did a lot more than just give subsidies to people to buy insurance. Had it been limited to the subsidies that is a totally different discussion. We could have had that without all of the regulations added which caused the access to be lost. You cannot look at only one metric which is attributable to a small fraction of the bill and then disregard the rest and say the whole thing is good.
Feelings don't care about your facts

Offline aygart

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Re: Obamacare Master thread
« Reply #506 on: April 09, 2018, 12:44:28 AM »
We do you think the R's have not passed anything?

THAT is the question???????
Feelings don't care about your facts

Offline ChaimMoskowitz

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Re: Obamacare Master thread
« Reply #507 on: April 09, 2018, 12:57:42 AM »
again. Coverage is not access.
Take the worse policy out there and I am sure there will be something it can used for that you would normally not go to doctor for because you had no insurance. It might not have access to everything you want but having the coverage gave you access.

Would you rather just see everyone just go to the emergency room for everything?
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Offline aygart

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Re: Obamacare Master thread
« Reply #508 on: April 09, 2018, 01:02:01 AM »
Take the worse policy out there and I am sure there will be something it can used for that you would normally not go to doctor for because you had no insurance. It might not have access to everything you want but having the coverage gave you access.

Would you rather just see everyone just go to the emergency room for everything?
Of course those who now have coverage are better off than they had been without it (if there was more between them and coverage than a signature). That has ZERO bearing on anything I wrote. If it took away a much more importnt access then it came a big price.

There are many other answers to that. Many hospitals have opened clinics right next to their emergency rooms for such patients.
Feelings don't care about your facts

Offline ChaimMoskowitz

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Re: Obamacare Master thread
« Reply #509 on: April 09, 2018, 01:06:02 AM »
That has ZERO bearing on anything I wrote.
Then we are not understanding each other so I will leave it at that.
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Offline ExGingi

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Re: Obamacare Master thread
« Reply #510 on: April 09, 2018, 02:40:48 AM »
Made you need to get out in the real world more?

Speaking of the article. Cry me a river!!!
When she looked for coverage last fall, the cheapest plan Whitman could find was $1,734 per month, with a deductible of $10,500 for the family. She splits her time between mental health counseling and mediating legal disputes, such as divorces. She made about $110,000 before taxes in 2016.
The Whitman family.
Source: Whitney M. Whitman
But student loans, mortgages on a home and a rental property, car payments and credit cards squeeze their budget — and health insurance is what got squeezed out.
Based on her source of income, I would say there's a high probability that her earnings are subject to self-employment tax, so I would estimate her income related tax burden to be around 30,000. Let's assume she qualified for an Obama HAMP, so her housing expense can be another 31% of her income. Add to that almost $21,000 just for premiums, before co-pays and deductibles, and another $10,500 just for a medical expense emergency fund, and all you have left for food, clothing, college and retirement savings (let's assume she does a Roth IRA), debt service and other miscellaneous expenses and there's not much, if anything left!

But here's the problem:
Quote
Whitney Whitman waited until her 7-year-old daughter had been sick for almost two weeks before taking her to the pediatrician for a visit that ended up costing $275.

I am certain that an insurance EOB would have shown total Dr compensation for the visit (including co-pays) of less than 40% of that amount (and I'm probably being generous).

If she would be allowed to purchase a catastrophic plan, that might have cost a much more palatable $600-$800 a month, and that Dr visit would have been billed at the negotiated rate of around $125 or less. 

If BHO would have used his tactics (employed in passing the (u)ACA) to make it illegal to have such disparity in billing/reimbursement based on how the patient pays, and allowing everyone to purchase (only) catastrophic plans (and add an FSA component in there, possibly with government matching or funding for low income individuals), then we might be talking about increased coverage and access to better Healthcare.
I've been waiting over 5 years with bated breath for someone to say that!
-- Dan

Offline ExGingi

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Re: Obamacare Master thread
« Reply #511 on: April 09, 2018, 01:30:06 PM »
Take the worse policy out there and I am sure there will be something it can used for that you would normally not go to doctor for because you had no insurance. It might not have access to everything you want but having the coverage gave you access.

Would you rather just see everyone just go to the emergency room for everything?

So here's something I'm sure you would really LOVE about Obamacare:

Prior to the (u)ACA there could have been various income/asset tests in order to qualify for Medicaid. The (u)ACA changed that and made only one uniform test for Medicaid qualification, which is a MAGI (Modified AGI) test. So thanks to Obamacare, people can have millions in assets, and possibly even a high income but low enough MAGI (for example if they have real-estate related income, which is offset by depreciation) and qualify for Medicaid. I am sure there might be some DDF members that can confirm this here. I have answered that question (along with proof from State websites to back my assertion) for quite a few people on DDF as well as outside the DDF community.

So prior to the (u)ACA many of these people might have CHOSEN to go without insurance, as they might have been young and didn't feel the urgent need given the costs. They might have had insurance only for their children (through SCHIP) and possibly their wives. Obamacare made all of these previously uninsured individuals, currently insured by Medicaid. Are those the people you are so happy that you are happy that Obamacare helped? (I am very happy for those people, and am happy to be able to provide help and answers to anyone needing health insurance in NY).
I've been waiting over 5 years with bated breath for someone to say that!
-- Dan

Offline ChaimMoskowitz

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Re: Obamacare Master thread
« Reply #512 on: April 09, 2018, 01:50:45 PM »
So here's something I'm sure you would really LOVE about Obamacare:
Preexisting conditions and children covered on parents policies until 26, of course.
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Offline ExGingi

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Re: Obamacare Master thread
« Reply #513 on: April 09, 2018, 01:52:31 PM »
Preexisting conditions and children covered on parents policies until 26, of course.
Which are the main causes for annual double digit percentage increases in premiums (along with rising deductibles and co-pays), and insurers dropping out of markets. That's a lot to love.  ::)
I've been waiting over 5 years with bated breath for someone to say that!
-- Dan

Offline ChaimMoskowitz

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Re: Obamacare Master thread
« Reply #514 on: April 09, 2018, 02:12:17 PM »
Which are the main causes for annual double digit percentage increases in premiums (along with rising deductibles and co-pays), and insurers dropping out of markets. That's a lot to love.  ::)
Lets not worry about lives that have been saved.
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Offline aygart

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Re: Obamacare Master thread
« Reply #515 on: April 09, 2018, 02:17:45 PM »
Lets not worry about lives that have been saved.
You are the one not worrying about the lives saved but being blinded by the less relevant number of people covered. There have been numerous studies discussing how the number which really counts which is outcomes has gotten worse. They have coverage for strep cultures but those who have had insurance all along and had access to quality care specializing in specific serious medical conditions have lost that life saving access so people can get their throat cultures for $5 less after their high copays.
Feelings don't care about your facts

Offline ExGingi

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Re: Obamacare Master thread
« Reply #516 on: April 09, 2018, 02:30:59 PM »
Lets not worry about lives that have been saved.
Wow. How many lives are saved daily in the UK with their national health system? Or for that matter in Canada?

Can you back up the "lives that have been saved" claim with facts? Or is this just another case of symbolism (more people enrolled - let's get the language correct) over substance (better healthcare, and dare I say - financial, outcomes)?
I've been waiting over 5 years with bated breath for someone to say that!
-- Dan

Offline ChaimMoskowitz

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Re: Obamacare Master thread
« Reply #517 on: April 09, 2018, 02:33:29 PM »
You are the one not worrying about the lives saved but being blinded by the less relevant number of people covered. There have been numerous studies discussing how the number which really counts which is outcomes has gotten worse. They have coverage for strep cultures but those who have had insurance all along and had access to quality care specializing in specific serious medical conditions have lost that life saving access so people can get their throat cultures for $5 less after their high copays.
If the ACA is bad as you say it is I guess their are protests going on to get rid of it? I guess the polls say it is the most unpopular program? Maybe with all its flaws it still helps more than it hurts?
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Offline ChaimMoskowitz

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Re: Obamacare Master thread
« Reply #518 on: April 09, 2018, 02:37:36 PM »
Can you back up the "lives that have been saved" claim with facts? Or is this just another case of symbolism (more people enrolled - let's get the language correct) over substance (better healthcare, and dare I say - financial, outcomes)?
No I can't back it up because all the numbers are all over the place. Any article I post for or against can be countered with another article.

Just trying to get basic numbers on how many more are covered is impossible. I seen one article about the number of policies that were canceled. What they didn't tell you is that x amount was canceled and y of those were replaced with no loss in coverage.
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Offline ExGingi

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Re: Obamacare Master thread
« Reply #519 on: April 09, 2018, 02:58:15 PM »
No I can't back it up because all the numbers are all over the place. Any article I post for or against can be countered with another article.

Just trying to get basic numbers on how many more are covered is impossible.

Here you go again with the meaningless symbolism over substance!

As @aygart rightfully and eloquently pointed out, many of those newly "covered" were previously covered, but not enrolled. As I pointed out above, some of those newly covered/enrolled might have become eligible for Medicaid due to the elimination of all asset tests for Medicaid qualification. Let's at least get the terminology right and irrefutable. Let's just refer to people ENROLLED.

There are probably many additional millions currently enrolled, which might have not previously been. But what is the real effect of that on healthcare or access to healthcare? On the other hand, there have been drastic changes to plans and reduced accessibility to many that previously had decent access to quality healthcare.

Quote
I seen one article about the number of policies that were canceled. What they didn't tell you is that x amount was canceled and y of those were replaced with no loss in coverage.
You might have seen one article or possibly more, but I work in the real world, with real people who search for alternatives when their plans are canceled, when insurers change (and create new, more limited) provider networks, and they have to find alternatives so that they can see the same doctors they previously saw.

You might have individual plans that offer out of network benefits in IL, but in NY (at least in the lower Hudson counties - haven't checked other counties) no individual plan has any out of network benefits. Furthermore, insurers created different networks for their individual plans, so even the insurers that have excellent networks, might not make those available to people with individual (non-employer based) coverage. Prior to Obamacare, there were easier workarounds, people set up their own businesses and got "employer" coverage. Obamacare made it impossible, unless you have a non-spouse employee who is actually enrolling, to use that workaround.

I've been waiting over 5 years with bated breath for someone to say that!
-- Dan