Im curious why you correctly think that the sick will flood the Individual market but the healthy will hold out, that it would help insurance companies thrive?

The law only allows age banding at a max of 3:1, while currently most have a max of 6:1. So if you are young... your rates are going to skyrocket because of just that factor, even ignoring guaranteed issue and the new required benefits that aren't in plans.

As for regulating payments that makes sense on the surface (i.e the medicare fallacy), but it comes with unintended consequences. The most obvious and dangerous being that if there isn't money to be made in medicine you'll lose a lot of talented future doctors to other careers. There will already be shortages in primary care because it's less lucrative than specialties. Dentistry already has seen a shift to cosmetic because it's more profitable than general.

I know it started 15 minutes ago, but we are providing the Video Streaming for the event the Blue Cross Blue Shield of WNY is running right now.

This is a symposium of HealthCare professionals, lawyers and names within the WNY and NY area talking about the ruling.

If interested, you can watch it here...

http://www.wgrz.com/life/advertorial...w/default.aspx

Mainly a barrier-to-entry argument. The money in health insurance is with the contracts with large supplies of younger, healthier employees. And, as you said, the change in rates for the young means those customers will be more profitable. Which means much lower rates.

So, how do you set up a new health insurance company without getting those clients? With the added difficulty of not being able to compete across state lines.

Like much legislation, it's tailored to support existing big business. I know it sounds like tin-foil-hat conspiracy crap, but it does seem that both the Democrats and the Republicans are beholden to the large groups that finance their re-election campaigns.

Meanwhile, we desperately need health care reform. As you said, a huge risk lies in the scenario where there's little incentive to become a doctor. There are already shortages in many fields, including general practice. When it comes to big pharma, we have a system where there's huge incentive to develop new drugs that give you erections, but very little incentive in attacking the problem with increasingly antibiotic-resistant infections.

We're lucky to live in such a wealthy, thriving country. We spend an enormous amount on health care. We could do so much better if only our politicians were honest people.

Unfortunately, I can't think of a good solution. I'm pro-freedom, so a complete ban on political advertising is anathema. McCain-Feingold was a nice try at starting to address the problem, but I agree that we can't just suspend the Constitution because of good intentions.

I didn't say anything about people getting fired. I just said I'm going to have to play games with where people are staffed amongst the three LLC's currently in my business. It's called tax avoidance and it's perfectly legal. I'd also note that the level of games that will be played to avoid this tax are going to be a huge part of the coming years (assuming it survives).

Hopefully at some point they will address this (although I think we have different concepts of what "address this" will mean, and I'll just leave it at that).

The new rules are going to drive the rates up for the young and healthy, not lower them.
I think the reality is going to be that the young profitable members are going to have to bail on the product and only purchase when necessary. The tax/penalty isn't high enough to compel people to stay in the market if their rates quadruple.

So without the young subsidizing the old and rate review in effect... The barrier to entry really becomes that the premium cant keep up with the claims as the population spins into a death spiral.

Low penalty + tighter age banding + rate review + mandated benefits + no individual underwriting/rate ups = dead product. One man's opinion - companies will be attempting to turn in their licences in states in the ind market - and states will be forcing companies to pay to play - to have a group licence you'll have to offer an ind product, which companies will make as unattractive as possible to keep membership low and losses to a minimum.

I don't disagree that corps influence legislation to their benefit - but because the penalty is so low, the admin to implement is high, the new taxes will drive groups to move to less profitable self insured plans... It's not the insurance cos who are benefiting in the corporate sector. I don't know enough about Medicaid to know if it helps the industry or not.

There's no addressing about it. There are TONS of loopholes built into these laws to provide options for tax avoidance for businesses. If you aren't playing the game as a business owner, you're throwing money away.

Listen, I've been very consistent in my support of a flat tax rate without any loopholes, deductions, etc. I'd much prefer a system without them because it would make my job a whole lot easier. But that's not my fault nor any of the business owners in this country.

I didn't word it very well, but that's what I was trying to say. When pricing, an existing large insurance company will be able to offer a big business with lots of young profitable members a rate closer to actual cost.

For the younger individuals (like me) outside of the system, rates will skyrocket and the products we would ordinarily choose will no longer be available. The tax/penalty is going to be a fact of life, it seems.


Which is pretty much what we have today anyway, only there's no forcing insurance companies to play. My rates have gone up 50% in the last year alone.


There's still good profit in the big insurance companies - especially when you consider that it's a completely artificial and unnecessary mechanism in a state-run health-care world. It's regulated profit, but it's protected and easy.

I think health-care reform requires entirely removing employers from the equation. But I worry that the entire system is unsustainable without that influx of money. Since people view health care as an entitlement, they aren't willing to spend money when they need health care.

I read this and I have to ask, "Do those women have the slightest clue what they're talking about?"

The law does nothing but save rights for women when it comes to medical care. What on earth would they have to get upset about? Single or married for that matter?

Obviously there is a difference in opinion on how the law will effect everything long term, and I admit that only time will really tell the truth of that. Anyone claiming to know for certain one way or the other is simply spouting their party line.

Beyond that however, I really fail to understand the vitriol. Change is hard. people like their status quo, but change is also inevitable. Why piss into teh wind? All it does is get you wet?

This is an issue far bigger than medical care for a great deal of people. And tbh, you should know that without asking.

Ah you are conflating the individual and group markets. Yes, group insurance will stay more stable as the members are subsidized by their employers generally. Group rates may become a bit more unstable with ACA because now large group is also guaranteed issue regardless of participation or emplyer contributions. Generally today large groups require a certain level of employer contributions to get competitive quotes - otherwise you end up with only the sick utilizers enrolled. Starting 1/1/14 - carriers can't refuse group coverage on contibs or participation - which may make the large group market less stable if employer's start to scale back contibutions even further. Without getting into a very technical discussion on how it's priced it will have a different effect on groups 50-150, 150-500 and 500+.

I am not familiar with Michigan's individual market - but if the rates went up 50% over two years I would imagine the claims have gone up a similar amount. Michigan of course is dominated by one carrier who has toyed with the state legislature over the past decade - I have worked on Michigan at times in the large group space and it's one of the least competitive states I've experienced.

Personally I don't think you can solve cost issue with legislation. The only think that will make the system sustainable in the long term is a major shift in the behavior of the people it serves. How America convinces it's citizens to live healthier lives and treat end of life care differently I have no idea. When your system supports expensive treatments long past a terminal diagnosis to merely extend life for a short period at a low quality... How can you even discuss the issue when every conversation turns into a tonedeaf discussion of death panels.

Edit: There are states today that force insurers to offer individual products in order to participate in their group market. That won't become a new issue, just more widespread.

What exactly are you looking to avoid? The penalty/tax for not covering employees? It's a silly thing not to offer since it passes through to your employees. If you don't offer it, you have to make up for it with a higher salary anyways. It's not like health insurance is an added expense to your books.

Romney raises an astonishing $4.6 million in 24 hours. Could this be a case of Obama winning the battle but ultimately losing the war?

Romney campaign donations hit $4.6 million following health care decision

Evidently the Obama campaign didn't do too badly either.

Obama, Romney Duel Over Post-SCOTUS Fundraising | TPM2012

Best quote from that article. Emphasis mine.

Maybe George Clooney, Bill Maher, Sarah Jessica Parker and Steven Spielberg each donated $1 mill? ;)

Obamacare sucks. *Funds campaign of guy who put it in practice first*

LOL

Wait, so the Romney statements were cold-hearted or something, and the Obama ones were about compassion? As opposed to you know, both being about campaigning? I guess we're back to normal!!

Mitt has more large donors than Obama Vic...that's a discussion you're doomed to lose.

Do you not understand the difference or do you just think its irrelevant somehow?

From a Forbes column:

The majority of the citizens of Massachusetts wanted “Romneycare.”

The majority of American citizens did NOT want“Obamacare.”

“Romneycare” was developed by a coalition of Labor, Management, Republicans and Democrats, who collaborated on its makeup, its contents, and represented the people of the state of Massachusetts—at that time in history. That is how a representative democracy works. If Romney disagreed with parts of the Massachusetts law, that was overcome by the 85% Democratic legislature’s power.

Obamacare was “crammed down our throats” by Barack Obama, Nancy Pelosi and Harry Reid and the Democratic majorities in the House and Senate, in spite of the fact that almost 2/3 of Americans neither favored the law nor wanted it! And almost that many still do not like it, and still do not want it. Pelosi’s now famous statement, “We have to pass the bill so that you can find out what is in it…away from the fog of the controversy…” is indicative of the disregard for the wishes of American citizens.

{shrug} Worthless sumbitch won't do anything useful about anything, what's the f'n point?

The objections conservatives have with Obamacare are all a part of Romneycare. They are eerily similar even in principle. Particularly the individual mandate.

Except the constitutional objection. And the "1 size fits all" objection. And the distrust of federal bureaucracy objection. And the national debt objection.

I'm sure there's people who hate all mandates, there's people that hate all government-supported healthcare. But it's not everyone, not even close. Not everyone who has any issues with Obamacare is a crazy conservative. (I know the strategy is to paint all opposition as extreme, but it's just not reality.)

This is not even close to true. It wasn't crammed down anybody's throat anymore than any other law (and in fact a great deal less than others). And polls have consistently shown throughout the process that people overwhelmingly WANT the provisions within the bill, they're just buying into the negative-messaging around the bill as a whole put out by political opposition.

And finally...I don't get how Pelosi's statement is indicative of the disregard for the wishes of American citizens. That's just stupid editorializing by Forbes. Was it the smartest thing she's ever said? No. But it doesn't in any way even remotely relate to disregarding anybody's wishes. That just makes NO SENSE.

Quoting a propaganda piece doesn't really point out differences. Both were put in place by democratically elected officials. If the people don't like it, they can vote out those who put it in place and replace them with those who will repeal it. I could care less either way as it doesn't affect me much at all.

Both sides whine too much about politicians putting in place things they don't like. Everyone has the power to vote those people out.

With the exception of the mandate, the individual pieces of the ACA poll well among the general public. It isn't as simple as saying people hate it.

And the ACA could have also been put together by a coalition, but the GOP refused to participate. Instead a majority of House members andd a supermajority of Senate members voted for it. That's how a representative democracy works.

I don't see any polling that supports your assertion:

RealClearPolitics - Election Other - Obama and Democrats' Health Care Plan

Oh the ït's different because it's Federal" bit. Except for the part when this was the plan Republicans had back in the 90's when Clinton was trying to pass his health care plan.

The plans are practically identical, one was put in place by a Democrat and the other by a Republican. That's the difference.

Or doesn't work, as the case may be.

Try a real pollster instead of a partisan one. RCP is regarded by any objective measure as a POS.

So if you take the positive things out and opinion-test only those things, people are in favor of them? I bet we could do that with the Patriot Act too.

It appears that you don't know what you're talking about. The RCP chart is an average of all of the available polls, and has correctly called the past three presidential elections within one percentage point.

You could do it with the Patriot Act. It's not just the positive things either. It's that political issues are more complex than a yes/no vote. Ask people if they want to cut spending and most will say yes. Ask them if they want to cut Social Security, Medicare, Defense, and Veteran Benefits and they say no. Well you can't really cut spending without cutting those.

There was and is a lot of misinformation thrown around about the bill. A lot of people are basing their opinions off of that. Thus why it polls well on the individual parts of the bill but not on the bill as a whole. Just like the Patriot Act and spending debates.

I'm not even sure who you're criticizing. Is it anyone that opposes Obamacare? Anyone that has concerns about it? Anyone that gave Romney money in the last 24 hours? Anyone who believes states constitutionally have more freedom to enact certain types of legislation than the federal government? Or just some other fixed group with boundaries set by you?

My bad - I must have been confusing them with someone else.

Anyways - all this is just from the first page of Google results.

Try this from your favorite magazine (Forbes):
Ignore the Obamacare Polls - Forbes making the point that "Obamacare exists in the minds of most people not as what it is: a government program with various impacts on the availability of health care, insurance markets, and the economy. Instead, it is a hazy abstraction. It’s a proxy for Obama himself, and his presidency "

There's also this discussion of a CBS/NYT poll from earlier this year:


Or this discussion of a Kaiser Family Foundation survey

Ya, I was thinking about those spending/tax polls and I think that's just human nature that can be explained in a psychology 101 class. It doesn't expose an inherent correctness about one particular political philosophy over another. When I hear people use polls that have that kind of phenomenon to justify that their side is right, I hear, "see, they're in favor of it, they're just not smart enough to know it", and I find that pretty annoying/insulting. Sure, some aren't smart enough, but there's dumb liberals too. There's also really smart people on both sides.

I was criticizing people who rushed out to support a candidate who was a big supporter of the policy a couple years ago. Figure he'd be the last guy you'd want to support if you were against Obamacare.

I'm not justifying it's right, ultimately people who go to the polls will decide. Just that issues are far more complex than "cut spending". If you actually cut spending without raising taxes, you'd be voted out of office immediately for cutting SS/Medicare benefits and our defense budget.

The Patriot Act is a good comparison because it's something that likely has support on the individual parts of it, but not as much when put together. When you muddle it together you can throw in garbage and people get fed shit like "OMG THEY ARE LISTENING TO ME TALK TO MY WIFE ABOUT THE SEX WE HAD LAST NIGHT". Just like Obamacare somehow had death camps latched on to it.

"Specific provisions of the law enjoy widespread popularity. Tax credits to small businesses, the requirement for easy-to-understand plan summaries, the ability to appeal health plan decisions and the prohibition on cost-sharing for preventive services have the support of 69 percent to 80 percent of Americans."

Ya, this kind of stuff. If you ask someone, "are you in favor of the requirement of easy-to-understand plan summaries or are you against them?", I'm guessing most people are going to say yes. Not sure that's a huge validation of popular opinions. Same with "tax credits for small businesses." or "the ability to appeal health plan decisions" Or in those famous tax/spending polls, it's like asking someone, "do you want to cut funding for hospitals?" Without context, no is the easy answer there. But bills and economies don't exist in those vacuums. Sometimes funding might need to be cut for something, but the the impetus for that isn't usually the cut alone. It's not "we hate hospitals". It's, "shit, where can we save some money here - how much harm will occur if we have to cut this, and maybe fund something else instead."

It's people wanting something for nothing, which isn't going to happen.

Well that and people buying into the BS political-theater/death-panel shit like RainMaker was pointing out.

And the unfavorable numbers may also be more complicated.



Looking at a single favorable/unfavorable line doesn't come close to giving a complete picture on public opinion.

I think it's kind of amusing that at least 20% of Americans are apparently against "easy-to-understand plan summaries." I'm sure those are just people who voted they're against everything when they figured out that's what the poll was about. And maybe that group is the only people you guys are really talking about. I just think it's a little disingenuous to rely on that group to make your points, when there's a much larger group of moderates who are more important to this stuff.

:confused:

Fair confused face, I think I was thinking about another old pet peeve that really hasn't been here recently but just tied in a little into the "people are really for Obamacare they're just brainwashed to think they're not" thing. So nevermind.

The 27% of the people who answered keep the ACA and remove mandate.... I don't even know what to think about them.

One random thing that most people don't know. Barring further legislation the dollars paid by your employer to cover dependents until age 26 or higher depending on the state - will become taxible income if those kids aren't dependents on your tax return.

They just don't understand why the mandate is necessary.

My take is....

If the mandate makes or breaks the whole thing, that shows the weakness of the act. If one peg is taken out and the whole thing collapses, then there is something fundamentally wrong with the structure of this law.

At least that's my guess on why they polled that way.