Certainly health care efficiency will have a negative effect on costs. But by
itself can it fix insurance companies canceling insurance when maximums are
reached? But itself can improved efficiency insure those uninsurable under the
current system? The answer is clearly no on both counts.
Re: Mike Richards "Making health insurance exempt from Interstate Commerce
laws would allow free competition nation-wide." OK, but the insurance
commissions in virtually all of the states do not want this - they want to
control the selling of insurance locally. Why? It could be because they wish
to protect local monopolies, or (more likely) they don't trust insurers
generally and believe a national insurance market would only compound the
problems they have making health insurance honest. So, Mike, which is it?
Re:MarkAMany states have tort reform."The Affordable Care
Act contains many provisions intended to drive the health care system toward
providing greater value.These ideas include accountable care
organizations, patient-centered medical homes, value-based purchasing in
Medicare, incentives for hospitals to provider better, safer and more efficient
care, an excise tax on "Cadillac" health plans, and better information
about treatment effectiveness to help patients and providers make informed
decisions.The value-based purchasing program, for example, will
change the way Medicare pays hospitals for inpatient care. Instead of paying
hospitals for the amount of care they provide, Medicare payments will now also
depend on the quality of care provided. The idea is that by following best
practices, hospitals will forgo unnecessary care, help patients recover faster
and spend less."(Obamacare will drive down health costs CNN 2012)
"Not so fast. There are other reasons some folks are being told they'll
have to change health plans next year. Many of them are having to switch plans
not because of Obamacare but because their insurance companies want to move them
into policies with higher profit margins.Insurance companies have
been sending similar notices to their customers for years. My son Alex -- and
thousands of other customers of a Blue Cross plan in Pennsylvania -- got such a
notice four years ago, months before Congress passed the health reform law.Why? The insurer wanted to move those policyholders out of a plan with a
reasonable $500 annual deductible and into one with a deductible ten times that
amount. To accomplish that, Blue Cross notified its policyholders that their
health plan would not be available in 2010. Their options were to switch to the
high-deductible policy, which would still cost them a couple of dollars more
each month, or to another plan with that reasonable $500 deductible. If they
chose the latter, their monthly premiums would increase 65%....And that
strategy will continue until every last one of us is in a high-deductible
plan."(Wendell Potter former C
Amen to Mike Richards. Excellent comment.
I think, if they had second thoughts about passing gas for the health care plan
they wouldn't be sitting in the mess they are in.
"Making health insurance exempt from Interstate Commerce laws would allow
free competition nation-wide."We constantly hear that. So,
which states have the cheap insurance that the rest of us want?
Well Dave I do agree that this economy is suffering from a lack of demand but
I'd challenge the idea that sagging demand is because of too few people.
Especially since the demand dropped off the cliff in '09. Also
I don't think there's any question which comes first industries/jobs.
Sey's law of you build and they will come was disproved soundly in the
'30's. Lastly new industries will be highly efficient and
will need far fewer workers. As a matter of fact most of the high tech world
today is going begging for qualified applicants and that's with a 7+
unemployment rate. People's not the problem skills is the problem.
@JoeBlow - Actually, the way health insurance works is that health plans have to
be filed with the state several months and sometimes years in advance.
So...since Obamacare mandated certain changes when it was first passed,
insurance carriers had to file changes (or build new plans) within EVERY state
in which they operate. That type of work costs extra money in operation costs.
They also have costs associated with informing insureds and clients about how
plan changes affect them. I know firsthand about this as I worked for a health
insurance company when Obamacre was passed, and it immediately increased
workload, almost company-wide. And it's not limited to just
insurance companies. Healthcare providers are also looking at an increase in
patients since previously uninsured people will be seeking care, so they have to
be prepared to handle that influx and the increased operational costs associated
with it. So, you can't assert that the door swings both ways in
relation to cost since the ACA placed requirements on insurers that had to be in
place by its effective date, and they weren't turn-key changes. Health
insurance was already a mess, the ACA just made it messier...
EW.You cannot prove that the fraud in Medicare is any greater than
the fraud in the private world. Have you ever heard of ID theft, lies in
advertising, taxpayer scams, unnecessary health and dental recommendations?Anybody.The object of having insurance is to spread the cost
over as large a number of people as possible so that each person pays an
equitable costs that may be more than he needs but less than catastrophic.Buying insurance is making a small bet that the event will happen
costing a great deal of money. If the event doesn’t happen you are out
the money of your bet. If the event does happen and the insurance agent pays
off, you are still just out the money of your bet. Based on the
notion that government people are no more dishonest than ordinary people; since
they are usually the same people, the best option would be single payer
I am continually appalled by the lack of dialogue regarding tort reform. This
should be front and center of ANY serious discussion regarding health care
costs.Physicians feel obligated to order costly studies for the
small (but legally costly) chance they could be missing something bigger. Best
patient practice would dictate that such studies only be ordered after certain
inclusion criteria are met or symptoms persist despite treatment for a presumed
(more common) diagnosis. This is obviously a generalization of the problem, but
the message is clear - so called "defensive medicine" has taken a
stranglehold on our nation. Why is this being ignored? Does the
legal profession have too strong of a foothold in Washington to admit to
it's own problems?
pragmatistferlife said-- "Well Diligent Dave higher birth rates will also
destroy advanced economies unless those economies develop industries and jobs
that will support those children in a life sustaining fashion."'pragmatist', which comes first, the chicken or the egg? Same
question could be asked, Which comes first, a higher birth rate, or a better
economy to support more children?The situation we're in, you
will never develop industries or jobs without a higher birth rate.It
was, in fact, the so-called 'baby boom' (1946 to 1964) that got and
kept us out (for a number of decades) The Great Depression. Sure, WWII increased
temporarily much higher employment. But the death and carnage and debt from WWII
would have worsened the situation without increased demand.The
problem in the economy today is too little demand. This has come about because
of sub-replacement birth rates. An increase in birth rates is a pre-requisite to
a better economy. Birth rates alone won't do it. But, without them, nothing
can do it!
Florida is ground zero for Medicare fraud. "ObamaCare allows
the HHS to step away from its “pay and chase” model — where
Medicare and Medicaid routinely paid every bill that comes in and only goes
after someone if it’s blatantly obvious that something was wrong …
like 991 dental procedures in one day.HHS is beginning to embrace
what private sector health insurers have done for years: pre-claims
adjudication. As HHS Secretary Kathleen Sebelius stated, “Now,
we’re analyzing patterns and trends and claims data, instead of just going
claim by claim.."(Forbes)
You know my stand on it, Bob. Get insurance companies, with their shareholders,
buildings, tv ads, and everything else out of the picture entirely. None of that
goes to deliver health care, but it all costs money. Health care is a commodity
like no other, and it costs a lot to deliver it. But it is also an honourable
service we can and should provide one another as part of our responsibility to
our society, and in doing so we can save money.
Independent of health care costs is the premiums individuals pay. There is no
question with Obamacare premiums are going to continue to go way UP and that is
the killer cost that makes Obamacare unworkable. Already individuals are seeing
premium costs 2-3 times higher with the exchange and projections show that only
getting worse. There may be some slow down in cost but Obamacare makes that
irrelevant with what it does with premiums all due to wealth redistribution.
Making health insurance exempt from Interstate Commerce laws would allow free
competition nation-wide. As it stands, only ObamaCare is "pseudo"
nation-wide. When the government, instead of the customer, dictates what a
policy must cover, many small companies cannot compete. The government
"monopoly" crushes competition.Getting government out of our
personal welfare would be a giant step in the right direction. If people had
the sense to buy major medical insurance ONLY, prices for customary services
would fall because the patient would pay all of those costs out-of-pocket.
Health-care providers would only be able to charge what the free-enterprise
market would bear. Nothing about Obama will reduce health care
costs. Forcing those who are past child bearing years to buy maternity
insurance. Forcing employers to pay for contraception is an affront to the 1st
Amendment, i.e., government is dictating religious doctrine which is
prohibited.Only the power hungry and those who want someone else to
pay for their personal welfare could ever believe in ObamaCare. Giving up
liberty for government "mush" shows that some Americans have no
When the author says that the cost of health care have slowed down, I think he
means that the increase in the cost of health care have slowed down. In any case he is probably wrong. Private health care costs to the patient
are not governed by costs but by the market. And the market is controlled by
@Roland Kayser:For the last 10 years most Ins. Companies have
covered preventive care at no cost to the insured. So I don't see that
making a big difference anymore other than for the 10% that the ACA is supposed
to give coverage to now.
Well Diligent Dave higher birth rates will also destroy advanced economies
unless those economies develop industries and jobs that will support those
children in a life sustaining fashion. What we have now with a
finance centric economy that simply pumps out wealth to a few will be crushed
with a higher birth rate so I hope you also propose societal investments in new
industries and education.
Preventive care certainly increases quality of care, and should be encouraged.
The best overall solution for reducing healthcare costs per capita,
interestingly, is to increase birth rates. Of course, a person of any age can
have healthcare problems. But, the biggest driver of healthcare costs in this
nation has been the overall aging of the population. Naturally, the longer you
live, the more you age. But, also, the fewer babies that are born, the faster
overall a population ages.Aging is by itself the greatest increasing
factor in disease and healthcare costs. Not too many young people need hips or
knees replaced. Dementia is strongly associated with old age. And, while a
number of factors could help with diabetes, aging is a major contributing factor
to the great increase in Type 2 diabetes (adult on-set diabetes).Most people in this nation are unaware that the U.S. and all nations (with one
minor exception) in the world with advanced economies have had sub-replacement
birth rates for some time. Economically AND healthwise, this one factor is
destroying and will further destroy civilization worldwide.
"However, since it still hasn’t gone into effect — its official
starting date is Jan. 1, 2014 — it’s a stretch to give it credit for
events that preceded its inaugural."True Mr Bennett. However,
the same logic could be applied on the other side. Many have blamed rising
costs on the ACA. In your words "It's a stretch to give it
"blame" for events that preceded its inaugural"
Yet fraud is rampant in Medicare in comparison to the private sector, who
can't afford to lose their money unlike government who seems to think they
can leach more out of taxpayers whenever they run out. That carelessness will
drive costs back up while simultaneously driving quality of health care down if
we allow government to stay involved in healthcare. It will drive the insurance
companies out of business in a relatively short time period and at that point it
will be either Obamacare (think Medicaid type quality) or cash only for those
who can afford it. The government will have ruined another private industry.
The same logic applies to the ACA requirement that preventive care be available
at no cost to the patient. We spend a little more up front, but that will be
repaid by dramatically lower costs in the future.