The last time I looked hospital costs were going up fastest in large urban areas where the competition was most intense. One of my friends who used to be CofS at a big hospital here explained it to me once, in terms I thought made sense. To compete for the patients available hospitals constantly add new wings, new services, new expensive treatment modalities and so forth, and consequently operate at 65% of capacity, jacking up prices on the patients they have to try to make ends meet.
Can we finally put the Obamacare fight to rest?
- Thread starter zeke4ahs
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The last time I looked hospital costs were going up fastest in large urban areas where the competition was most intense. One of my friends who used to be CofS at a big hospital here explained it to me once, in terms I thought made sense. To compete for the patients available hospitals constantly add new wings, new services, new expensive treatment modalities and so forth, and consequently operate at 65% of capacity, jacking up prices on the patients they have to try to make ends meet.
Seniors do live longer, but not by as much as it might appear. We are living longer on the front end as well. A child born today has a far greater chance of getting out of childhood than 50 years ago, and any child dying has a tremendous impact on life expectancy. Here is a chart that shows life expectancy by year/by age. A 60 year old white male in 1929 was expected to liver another 14.72 years. In 2011 that was 21.5 years. So we've gained 7 years since 1929. At ago 70 it was 9.20 years in 1929, and 14.3 in 2011. So 5 additional years for a 70 year old today. At age 80, the change is 3 years.
I will admit that other than statutory construction and separation of powers ( Court's should not rewrite laws passed by Congress to meet a social goals) which has it basis in the Constiution there are no other Contstitutional issues.
I'm in favor of universal coverage. One system for all. However, I also favor a plan that penalizes those who smoke, eat fast food, drink, don't exercise, etc. There must be an incentive to encourage healthy behavior.
For both you and Rockfish...
http://www.nytimes.com/2015/01/06/u...ow-roil-its-faculty.html?smid=tw-nytimes&_r=1
This is what companies are "claiming" at least.
"In Harvard’s health care enrollment guide for 2015, the university said it “must respond to the national trend of rising health care costs, including some driven by health care reform,” in the form of the Affordable Care Act. The guide said that Harvard faced “added costs” because of provisions in the health care law that extend coverage for children up to age 26, offer free preventive services like mammograms and colonoscopies and, starting in 2018, add a tax on high-cost insurance, known as the Cadillac tax."
Well I'm not an expert on the issue, but I'll take your word on it. I'll take issue with Romania however where you may wait 20 minutes for an ambulance to arrive. Also, ask the Roma about the medical care they receive.
We've actually lost quite a bit of life expectancy. Noah lived to be 950.
Hospitals are opening up clinics across the street from other hospitals in an effort to van them to their hospital. Incredibly dirty business.
Wrong, wrong, wrong. Here are two examples.
I had a good plan at the job I left at the end of 2014. 80/20 plan with a $1,000 deductible. Costs to me were going to go up 22% to keep the same plan with the same deductible. My employer was to pay an equal share of the increase. The company has 15,000 employees
I took a new job at a small firm and began paying their 2014 rate. They told me before I started that their insurance was going up, but didn't have the exact number. They also split the increase, but were paying 40% of the increase. My rates every 2 weeks went from $155 to $271 or 75% for their same plan. I have a $0 deductible for hospitalization, emergency services, and a 20 copay for office visits and a $10 copay for medication. A very good plan, but expensive. It was more reasonable before this year. It has already paid off with my wife needing $12,000 in care that cost me less than $100.
The rich aren't going to be affected by increases. The poor will not care what the increases are. The subsidies will have cover them. The middle class are the ones being squeezed. A family that was able to save a little by cutting back on vacations, eating out, or skipping the replacement of an aging car, now have to come up with another round of cuts to break even. They aren't getting any help from Obama. He has no idea what the middle class is like today.
All we had to do was offer the choice of a bare bones plan or a better plan to those without insurance and wanted it and left everyone else alone. The plan would follow you wherever you lived. Young adults and people that can self-insure would have the option to skip coverage or buy it on their own. People that already had plans would not have been affected. Subsidize those that needed it by a new tax on alcohol and tobacco products and a small tax increase on everyone else. Instead, Democrats took control and created a bureaucratic mess that is falsely called the Affordable Healthcare Act. People will make themselves dizzy trying to spin opinion that costs are lower. I would expect a very low percentage of people have seen a reduction. I would expect reduced costs were the result of taking on a higher deductible and out of pocket expense. I have been told to wait until 2016. The fun really starts then.
What evidence is that? I already linked several sources that indicate dramatic premium increases are impending for those on public exchanges living in states like NY, IL and NE. Anyone that I know with private insurance has seen substantial changes to their policy over the past few years (increased costs and reduced benefits).
Not exactly Buzz
There are a number of dots to be connected and one of those dots is the ACA. The significant increase in part time employment is tied to Obamacare employer mandates and the pathetic recovery.
dave, you claim to be a lawyer, yet yours are among the least lawyerly posts on the board. If you have nothing substantive to say, please feel free to just shut up.
Facts? Basis? Links? Once again, all you've got is The World According to CO. Hoosier.
I have, and I've talked to an American expat who did some time in Romania. The reports were positive, which is part of the basis for the statement I made.
We are twice as fat as France, as was indicated last week in the obesity thread. Surely you understand that fat people, and by extension, a fat country, will have worse outcomes.
Yes, i've read various employers and insurance companies make such claims. But they never identify the specific provisions of the Affordable Care Act they blame for the increased employee payments under large employer plans -- that Obamacare assiduously attempted to leave alone.
Remember that large employer plans already provided coverage that was at least on par with the standards that now prevail in the individual market, where the Affordable Care Act really did make big changes. There's no particular reason to take large employers seriously when they blame Obamacare for the higher costs they're imposing on their employees.
Well, I haven't soaked in every word, yet, but I've breezed through the opinion and the dissent. A couple of thoughts:
1. The vote was exactly what I thought it would be, but not the reasoning. Rock mentioned this, but I want to highlight that SCOTUS didn't just decide this thing with Chevron step 1. It excepted the case from Chevron altogether, labeling it as one of those rare situations where Congress would never have left the interpretation to an administrative agency, and so what appears to be ambiguous must not be. This is a new one on me (it's not exactly the same as the analysis that's been cleverly called "Chevron step zero"), and I think it is yet another chink in the armor that is and has been Chevron.
2. Related to #1, the two ACA decisions have shown Roberts' evolution as a jurist. My first thought when reading his reasoning was, "This is very un-Roberts-like." But then I realized that was my thought with NFIB, as well.
3. Scalia has become a caricature of himself. His entire dissent is essentially an argument that anyone reading the law objectively must have concluded that it was the intent of Congress that the law not work. There was a time when Scalia would have made a reasoned argument for leaving statutory interpretation up to agencies, but, of course, he couldn't do that here, as it still wouldn't give him the result he wants, so instead he simply repeats the tortured interpretation of the ACA crafted by the law's opponents.
1. The vote was exactly what I thought it would be, but not the reasoning. Rock mentioned this, but I want to highlight that SCOTUS didn't just decide this thing with Chevron step 1. It excepted the case from Chevron altogether, labeling it as one of those rare situations where Congress would never have left the interpretation to an administrative agency, and so what appears to be ambiguous must not be. This is a new one on me (it's not exactly the same as the analysis that's been cleverly called "Chevron step zero"), and I think it is yet another chink in the armor that is and has been Chevron.
2. Related to #1, the two ACA decisions have shown Roberts' evolution as a jurist. My first thought when reading his reasoning was, "This is very un-Roberts-like." But then I realized that was my thought with NFIB, as well.
3. Scalia has become a caricature of himself. His entire dissent is essentially an argument that anyone reading the law objectively must have concluded that it was the intent of Congress that the law not work. There was a time when Scalia would have made a reasoned argument for leaving statutory interpretation up to agencies, but, of course, he couldn't do that here, as it still wouldn't give him the result he wants, so instead he simply repeats the tortured interpretation of the ACA crafted by the law's opponents.
And once again, people in other developed countries drink and smoke a lot more than we do. Surely you understand that boozing and smoking will produce worse outcomes.
I challenge you to find a study showing that we pay twice as much as other developed countries because Americans are, as a whole, unhealthier than those who live in other developed countries. After you do that, I challenge you to explain how this has anything to do with the effect of the Affordable Care Act on large employer group health plans.
Any evidence connecting those dots? Here's some of mine:
http://www.amazon.com/gp/product/B007BP3GXA?redirect=true&ref_=kinw_myk_ro_title
http://www.amazon.com/gp/product/B003LSTK8G?redirect=true&ref_=kinw_myk_ro_title
http://www.amazon.com/gp/product/B003LSTK8G?redirect=true&ref_=kinw_myk_ro_title
Far as I can tell, the only dots that really matter are the real-estate bubble and the global financial services meltdown, both brought to us courtesy of the GOP playbook and free-market capitalism. As you can see, I have some support for my POV.
Once again, your idea of a Patriot is the person that believes as you. 6-3 isn't really close, and some of the reliable conservatives voted against it. Scalia is probably the most political of the entire group, sadly.
Of course I do, though I think twice as fat as France is a bit off, but the studies I've seen adjust for that, and deal with matters as to which fatness isn't all that pertinent, and the results don't change: our health care system isn't distinguishable from that of any other developed nation, on the data I've seen, except w/r/t cost.
Scalia went Full Moops in his dissent, arguing both that "The card says 'Moops'" and that it really was the Moops -- and not the Moors -- who invaded Spain: He insists that (1) the law can only be read in a way that literally no one actually read it; and (2) Congress really did intend to destroy the health insurance markets in states that didn't establish their own exchanges -- even though there is literally no evidence for any such intention. It's ridiculous.
Well, I guess we can't put it to rest. Sadly, every single one of the Republican candidates have already talked about their intention to repeal. Here's my question: every single person has to admit there are things in it that are not perfect, things that need amended. Why, oh why, can't the GOP work on making it a better bill, rather than just getting rid of the whole thing? If they are indeed, the Patriots they like to think they are? The only reason I can come up with is that they don't want something they sneeringly called " Obamacare" to work. It's a loss for them when it does. The hell with the American public. And that's just sad.
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You know the answer to that, z; you just stated it: the GOP is into partisanship and pandering, and nothing else: admitting that ACA is here to stay but might need fine-tuning give the Prez a political victory they'd all die rather than concede, and will anger the knuckle-draggers who are all that's left of their constituency, other than the Koch brothers and a bunch of corporations.
You can't say it has nothing to do with it. After all Obamacare required companies to provide insurance for employees' dependents until they are 26 if certain conditions are met. That provision worked to my benefit.
That data has to be out there. Insurance companies certainly know how many people in this group they are insuring and what the cost is. But I have not seen that data. It leads me to believe it does not help the insurance companies to release it. That makes me suspect that yes, this makes an impact but at the same time the companies have used ACA as an excuse to raise rates.
How often are you at the doctor's office? You could put a dime a day away for 3/4 of a year to save your extra $10. Sheesh! I don't think an extra $250 deductible is "killing the middle class". Hyperbole much?
Well, you can interpret this graph as you wish.
The difference in obesity between the U.S. and other developed countries is vast. In the previous thread, there was a source indicating obesity is responsible for 21% of our health care cost, Rock thought it was closer to 15% . Either way, that is somewhere around 300-400 billion dollars a year in health care costs.
69% of our country is overweight, 30+% is obese. Just 9% of France is obese. What is more troubling is that our country is becoming more and more obese.
Rock...yea countries eat, drink and smoke differently. Fortunately, smoking in the US is decreasing. Obesity is not.
Do you know what would happen if we magically cut off 21% of our health expenditures? We'd drop all the way from first down to.... first.Well, you can interpret this graph as you wish.
The difference in obesity between the U.S. and other developed countries is vast. In the previous thread, there was a source indicating obesity is responsible for 21% of our health care cost, Rock thought it was closer to 15% . Either way, that is somewhere around 300-400 billion dollars a year in health care costs.
69% of our country is overweight, 30+% is obese. Just 9% of France is obese. What is more troubling is that our country is becoming more and more obese.
Rock...yea countries eat, drink and smoke differently. Fortunately, smoking in the US is decreasing. Obesity is not.
Even if we had no obesity-related health problems at all - as in ZERO - we'd still spend more per capita than any other country.
The point of this discussion before was, and continues to be, that, fat as we are, our obesity doesn't account for how much money we are spending compared to other developed countries.
Great, let's all get fat. Let's not take any personal pride in ourselves nor our families. Heck, it only 20% of 2 trillion dollars per year. Who needs that?
Do you have Pizza Hut's number?
I already told you how I interpret it, IUJ (and I've been aware of this data for a long time): as one data point, which has been adjusted for in the numerous studies of the efficacy of the world's health care systems. One might almost think you made your mind up before doing whatever research you did.Well, you can interpret this graph as you wish.
The difference in obesity between the U.S. and other developed countries is vast. In the previous thread, there was a source indicating obesity is responsible for 21% of our health care cost, Rock thought it was closer to 15% . Either way, that is somewhere around 300-400 billion dollars a year in health care costs.
69% of our country is overweight, 30+% is obese. Just 9% of France is obese. What is more troubling is that our country is becoming more and more obese.
Rock...yea countries eat, drink and smoke differently. Fortunately, smoking in the US is decreasing. Obesity is not.
I'm in favor of single care for all... but I also believe there must be provision that penalizes those who drink, smoke, eat pigs like pigs. On the same token, there must be an incentive for those who take care of themselves. I also believe that the young should not be subsidizing those who have had many more years to save $!
That's ridiculously stupid. Are you going to respond to my actual point, or just stick your fingers in your ears and spout nonsense like this?
I've already stipulated that (1) obesity is a substantially larger problem here than it is in other countries; and (2) obesity increases costs. You keep proving points that aren't in dispute.Well, you can interpret this graph as you wish.
The difference in obesity between the U.S. and other developed countries is vast. In the previous thread, there was a source indicating obesity is responsible for 21% of our health care cost, Rock thought it was closer to 15% . Either way, that is somewhere around 300-400 billion dollars a year in health care costs.
69% of our country is overweight, 30+% is obese. Just 9% of France is obese. What is more troubling is that our country is becoming more and more obese.
Rock...yea countries eat, drink and smoke differently. Fortunately, smoking in the US is decreasing. Obesity is not.
But for the eleventieth time, you've done absolutely nothing to establish that our per capita costs are twice as high as those of other countries because disproportionately more Americans are obese. You're using obesity as a proxy for a population's overall health without establishing that this is a good proxy. I keep pointing out that people in other countries smoke and drink a lot more than we do precisely to illustrate that many different things affect a population's health. You can't fixate on just one factor -- as you persistently keep doing.
Again, find me a good study that actually supports your point. I won't say that there is no such study, but I will say that I've looked at this quite a lot, and I haven't found one.
Meanwhile, I have established that our unit prices are vastly higher than everyone else's, and in other posts in other threads I've established that our utilization rates are actually lower than those in other developed countries. And that our costs are higher even though American consumers have more "skin in the game". None of these conclusions are remotely controversial among people who study this stuff.
But conservatives don't want to look for the problem where the data says it is for the same reason that they reject climate science -- they can't abide the policy prescriptions that obviously flow from the data. So they blame third-party payer. Or fat people. Or poor people. But never the corporate health care providers to whom we're massively redistributing our income and our wealth. That's a sap's game for suckers and the unscrupulous.
Btw, one of the worst features of Obama Care is the amount of paperwork and administrative bureaucracy it causes for medical offices. The same of medicare. There is significant waste and unnecessary expenditure there. I don't know the exact specifics, but this is something i've been told by multiple doctors. I guess government in general=bureaucracy and paperwork.
Also, what i've observed... doctors spend more time writing notes and plugging crap into software than spending time with the patients due to liability and/or medicare reasons.
I'd like to see your basis for this. By the way, single-payer is the way to go for administrative simplicity.
I'll get back to you. Just txted a doctor.
In the meantime... I've never seen such a bloviation as this by Republicans. In the grand scheme this is a not a major issue in the sense that this doesn't endanger lives or significantly hurt individuals in any clear way.
Where is the focus on ISIS and other more pressing issues?
I deeply respect your willingness to pay more, but I don't think that's where we need to go. Instead we need to focus on reducing health care costs for the entire population, which is all that drives the increasing costs of Medicare (which is an exceptionally efficient system by American standards). Before we take money from the elderly or the poor or the sick, I think we should take it back from the very corporate health care providers that are now taking it from all of us. The last thing we need to do is pit generations against generations.
I think that's almost certainly not true, t: most of the pros I know complain about the costs of private-sector admin. The hospitals and doctors complain about the different requirements of each insurer, and the insurers complain about the different requirements of each hospital.
I also know that when the private insurers carved out a piece of Medicare in the form of Medicare Advantage they did it in part by promising that they could deliver Medicare benefits more efficiently than CMS. As it turned out they couldn't; CMS was much more efficient.
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