TBT: Jim Douglas/Universal Healthcare (Really? You ask. Yes.)

[mirjo]

http://content.healthaffairs.org/content/26/6/w697.full

Due to our short term memory loss on all things that didn't happen 5 minutes ago, I thought I would post this journal article from about 2007 for those who may think all this healthcare crap is new. It's not. Just a new sheriff in town directing traffic. What is new are the federal mandates. And since most people are on the "throw it all in the obamacare pot" train blaming everything from a toe fungus they had 8 years ago to dinner burning last night on Obamacare.(I am neither for nor against the affordable care act at this point, I am just humored by the blame it receives for all things)

I want to ask a serious, genuine question:  For those of you who feel your insurance coverage is now worse because of Obamacare (the affordable care act), what was so good about it before that was destroyed by this law? Has it really been affected or do you just think it has been? This law only was in effect this year, so if your insurance coverage hasn't changed much in several years, ACA can't be blamed.

I'm just trying to get people to think about things a little. I have heard the most ridiculous comments from people everywhere that  indicates few really has a clue or even want one. There are plenty of issues with this thing that could be fixed, however unless people know what they're talking about they can't even have a discussion.
As for the non-affordable, "affordable" premiums being offered: I have concluded that  what we're seeing is the full amount that we never see since employers usually pick up a large percentage of the premium cost. They also likely get discounts--it's unknown/unclear if these are discounted rates. I think if you compare the coverage etc to your own employer backed policies, you will find they're all just as crappy--except maybe for the the most expensive (if you have a choice of policies)

Can the average person afford a high deductible policy that isn't subsidized by an employer or the government? Clearly not. But is it the cause of everything bad happening? Not likely. If a republican gov could work with a democrat legislature to work out a reform in state health care they could all live with, then it seems like the yahoos in Washington should be able to do the same thing, in reverse order. What we had before the feds got involved, worked for those it needed to work for. It may not have been perfect or agreeable to some, but it was a compromise.

[nhibbard]

Well from a care standpoint, no one really knows what changed yet until you go to use the care. The costs are out of control though. Government was not meant to make websites, but when they do, it's a blank check. Look at how much was spent on websites and administration. We could have used that for care. Or better yet, the Feds could have made one website for everyone.

Then we talk about cost savings, but as far as I can tell, when you only have 1 or two companies competing for everyone, there isn't really competition to drive down prices. So now all we have is the gas station model of how much can we go up without going up too much.

There are also so many ways out that no one knows who is in. I'm not because our company was big enough. Most states don't force you in, that further confuses things and skews the savings because the base isn't as large as it could be. Vermont is the last place I'd ever look to scale any program because there aren't enough people. One big city has more potential to test a new healthcare model than this entire state and that is where all of this should have been flushed out.

[mirjo]

Agreed, it's a circle jerk. And those getting short shrift are (as always) the monkies in the middle. Healthcare reform does need to happen, but perhaps on a smaller, better thought out scale, a piece at a time. Ramming large contested legislation down the collective American throat is a disaster as we have witnessed. Only the US gov would think: GO BIG, OR NOT AT ALL!  Even FB built up to it's billions of worldwide users over time.

There is more wrong with healthcare than just insurance. It's all broken from the out of control cost of procedures/drugs/clinicians/supplies in this country, to the poor reimbursment for Medicare & Medicaid which is causing a crisis all on its own-esp with the population aging due to the babyboomers reaching age 65 starting about 3 years ago (mandatory Medicare age).

I don't feel any of this has been executed well, unfortunately--even if the initial thought was in the right place. Sadly, our politicians chose to fight over ideology for four years while this thing sat there with all its many problems when there was ample time and opportunity to figure out a few things--such as a little more control of the ins co, etc. Meanwhile, the robber barons in the pharmaceutical & insurance industries saw ways to keep themselves fat & happy by adding to the confusion and making matters worse than need be. I think it's complete crap what took place in CA in  at the hand of the ins. co. not necessary for them to say they're going to only allow certain clinicss etc, whatever in the exchange. It's a way for them to manipulate the system for their own benefit. a loopholeee nott seen in advance, because no one wass looking at that    and trying to roll out with a bum website?? Good Grief. Amateur hour at its finest!!

[mirjo]

Pardon the sticky keys! Spelling is not as bad as it appears. On an old computer causing me problems!

[mkr]

I am blessed to not have had to deal with Obama Care and VT Single Payer.  I DO have several friends that the cost went up for them so much, they cannot afford to have insurance.

[mirjo]

I think the high cost is due to the fact that employer-offered insurance premiums are subsidized by the employer and we as employees never know the real cost, just the amount we have to pay. It seems that someone will realize eventually that it's not affordable for the average person and the whole intention will fail. THEN maybe someone will clue-up and fix the damn thing, as it should have been, just sitting in limbo for 4 years, instead of waiting until it rolls out to discover it's too expensive among other things.

[mkr]

Agreed.....