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Author Topic: ACA  (Read 8926 times)

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Offline mia h

Re: ACA
« Reply #50 on: November 04, 2013, 02:03:27 PM »
Having said that as well I often see in these threads an almost sense of "they are evil since they make profit" and I would like to point out there is nothing inherently wrong with turning a profit.

Profit might not be inherently wrong, but how moral is it to make a profit out of someone elses illness?
And I'm not talking about the doctors, nurses etc, but shareholders and directors of insurance companies etc, who make money from people being ill but don't contribute one iota to curing one person.

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Re: ACA
« Reply #51 on: November 04, 2013, 02:13:59 PM »
edit:  Not positive on windstorm coverage - will need to look the specifics, it may be mandated by my state.  But I remember there was a couple of them that didn't apply to my region, can't remember right now, but my point is that people pick and choose insurance coverage based on their need.

See, the problem is that that's not all they pick and choose on.  They also pick and choose on price and...I can't think of the word - "known-aboutness".  I mean that they don't pick an affordable plan that meets all their needs that they've never heard of.

I suspect the logic - and Obama didn't consult with me on it (he often goes entire days without running decisions by me) - behind parts was to raise a minimum bar that, agreed, will not be needed by all people but that also allows people to pick and choose options on top of that minimum.  So Act of God damage, as we call it over here, might well be something people in Tornado Alley add on but Minnesota gives less of a fuck about.  However, Third Party, Fire and Theft remain as a baseline, and a higher baseline than was previously available.

Offline Valthazar

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Re: ACA
« Reply #52 on: November 04, 2013, 02:24:58 PM »
I suspect the logic - and Obama didn't consult with me on it (he often goes entire days without running decisions by me) - behind parts was to raise a minimum bar that, agreed, will not be needed by all people but that also allows people to pick and choose options on top of that minimum.  So Act of God damage, as we call it over here, might well be something people in Tornado Alley add on but Minnesota gives less of a fuck about.  However, Third Party, Fire and Theft remain as a baseline, and a higher baseline than was previously available.

So how exactly does mandating a "minimum bar" for all people miraculously make it affordable?  Because that's not what is going to happen, as I said from the beginning, this does very little to reduce the market price of private insurance-based healthcare.  It's giving the illusion of slight price drops, with the government stepping in and artificially reducing prices on certain plans - but it is does very little in developing a sustainable solution.

Think about this far-fetched analogy for a second:  If you're a shop-keeper, and the government tells you that you are pricing your white bread too high (since they claim it is a basic necessity for the poor) and that you should reduce it a certain amount.  You comply, but because your profits will take a hit, you decide to raise prices on other types of bread and/or decrease your supply of other types of bread.

Because that's exactly what is happening with healthcare.  It's an imperfect analogy though, because the government is footing a part of the bill with regard to people on welfare, etc.  This raises an entirely different ethical question, that would be an entirely tangential discussion.

Honestly, I was part of the 82% or whatever of Americans that had optimism in Obama's 2008 election.  I didn't vote for him, but I still felt that his policies were sensible at least.  But he has wavered so much on his 2008 campaign promises, it's ridiculous.
« Last Edit: November 04, 2013, 02:35:10 PM by ValthazarElite »

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Re: ACA
« Reply #53 on: November 04, 2013, 02:30:52 PM »
Profit might not be inherently wrong, but how moral is it to make a profit out of someone elses illness?
And I'm not talking about the doctors, nurses etc, but shareholders and directors of insurance companies etc, who make money from people being ill but don't contribute one iota to curing one person.

Often that has been a knock on insurance in general and I will be the first to admit insurance companies piss me off more often than not. But call me skeptical but I do not see shareholders of companies lining up to provide coverage without some promise of profit and personally I do not have the extra funds to cover my neighbor in case of catastrophe. So who is going to provide this service if not a profit driven company? And if you respond the government then how is this service to be paid for? Because it is going to cost since doctors, nurses ect expect a pay check.

Offline Zakharra

Re: ACA
« Reply #54 on: November 04, 2013, 02:39:39 PM »
 I've been following this discussion, it's been interesting, but I have some questions to bring up too. I'm not sure if these are true, so I'd like to know from people who have studied it.
From what I have heard, some groups of people will be getting subsidies from the government in order to be able to afford the ACA coverage. How does that make it affordable when the subsidy comes from the government in the first place? And what's the upper line for being able to get this subsidy?  One of the cases I heard of that is getting this subsidy was staffers of the US Congressmen, who (I could be wrong) can make over $75-100,000 a year. If it is affordable for everyone, why can't the government itself use it?

 I have also heard that the unions have an exemption written in for them. Their plans are grandfathered in like everyone elses, but if their plan changes (as required by the ACA), the price of said plan cannot change. If that's true, that seems to be sticking it to the non union people in a big way. Those peoples plans have to be changed (and lose the grandfather status when they are changed) and cost more, while union people get to keep their lower costing plans even when they change.
 
 Another one I have heard is many doctors opting out of the ACA because they don't like the payment schedule or plans. If it's true, what will the people who have the insurance do if the doctors won't accept patients with the plans (and payment coverage)?

 I've heard these from several different places, but I don't know is any of these are accurate.

Offline gaggedLouise

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Re: ACA
« Reply #55 on: November 04, 2013, 04:51:50 PM »
Here's an analogy:

According to your logic, I am being parsimonious and stupid by not opting into windstorm coverage insurance on my home, even though I live in an area that has a historically negligible incidence of large-scale tornado damage.  On the other hand, floods are very common where I live, and thus, flood and water damage insurance is critical.

If someone is living in the midwest, it would be the exact opposite of my scenario.

According to what you are saying, as an analogy, all of us should pay more for all of these insurances, even though statistically, our needs are different.

edit:  Not positive on windstorm coverage - will need to look the specifics, it may be mandated by my state.  But I remember there was a couple of them that didn't apply to my region, can't remember right now, but my point is that people pick and choose insurance coverage based on their need.

Realizing that you need to protect your house against tornadoes and extreme weather damage  if you live in the southern Midwest, or against snow if you live around here - and sometimes to choose a house that's built solidly enough, down to the foundations, to stand up to most kinds of weather, even if there are more pretty-looking and affordable homes around - that's nowhere near rocket science. Those issues are fairly easy to understand and put into practice. But mastering a whole range of diseases and possible dysfunctions, from throat infections and allergies to AIDS, respiratory ailments, blood diseases and brain tumour, knowing what kind of damage they might incur, how easy or hard they are to diagnose with certainty, what you have to ask for in an insurance and how to make sure they're included, that really is expert knowledge.

Some people would probably be ready to sign away coverage of treatment for "loosely related side effects of venereal ailments that are not part of such ailment proper" only to find they had dropped just about any coverage of AIDS from their insurance. They wouldn't know until the day they or someone in the family is showing definite signs of the syndrome. How many people know on the spot what "venereal disease" is? How many are aware that HIV in itself is just the door-opener for most of the really serious diseases that are part of a full-blown AIDS journey? - lung ailments, all sorts of cancer and general weakness are not directly caused by the HIV virus, but by other diseases. And how many would be able to spot that this kind of language implied AIDS at all?

Anyway, most people do not expect to ever get hit by such a disease and if they notice what such a phrase was about, they could easily convince themselves that "only gays, junkies and hookers catch that one - I'm safe". If you're in your twenties or thirties and a bit of tight on money, and you're in a situation where the pricing of your insurance provider means you have to chip some off your insuirance cover, that would probably be one that many people wouyld be ready to sign away. Knowing about these things and much more, and being able to weigh them across the board, that's expert knowledge. It's not something you can expect most people to have at the point they shop for health insurances, especially not young adult people, or even to acquire. But the state will have it if it stands as the ┤backer and the heavyweight negotiating partner for health care.
'
Call me clueless if you like, but I don't think it's reasonable or fair that people should be left standing without coverage when they, or their child, are hit by AIDS, some difficult-to-diagnose breathing ailment or an unusual kind of cancer that very rarely happens in that age segment. "You signed these papers yourself and they do not cover that disease" is a really nasty answer when the prospect they face is a painful death and nothing like the proper health care. The answer to that kind of issue isn't to make people beg at local charities or try to sell their story to the newspapers to arouse pity, but to make sure that the baseline level of what's included in people's health insurance is high enough to cover these things, and that no part of it can be signed away by the individual holder of the insurance.


Quote from: Zakharra
I've been following this discussion, it's been interesting, but I have some questions to bring up too. I'm not sure if these are true, so I'd like to know from people who have studied it.
From what I have heard, some groups of people will be getting subsidies from the government in order to be able to afford the ACA coverage

I haven't been following the discussion on pricing and government subsidies in the general news media in detail, but I've heard a couple times that under the ACA, some large groups of people who would not be able to pay for their health insurance deals - and some of whom might not be able to pay *any* kind of insurance at the present time, whether on their house or on their car or on their basic health - those people would have most or all of their premiums paid through government subsidies. Maybe that intention has been trimmed a bit from when the law package was first drafted back in 2009/10, but it would still be the option today for many millions of people who used not to be able to afford proper health insurance. I think that makes it a major step forward.

But I can see the counter-argument coming that "we can't afford it as a nation".




« Last Edit: November 04, 2013, 05:10:56 PM by gaggedLouise »

Offline mia h

Re: ACA
« Reply #56 on: November 04, 2013, 05:24:06 PM »
Often that has been a knock on insurance in general and I will be the first to admit insurance companies piss me off more often than not. But call me skeptical but I do not see shareholders of companies lining up to provide coverage without some promise of profit and personally I do not have the extra funds to cover my neighbor in case of catastrophe. So who is going to provide this service if not a profit driven company? And if you respond the government then how is this service to be paid for? Because it is going to cost since doctors, nurses ect expect a pay check.

Forgetting the government for a second, lets assume that 10% of your premiums go straight out the door as share holder dividends. If the company was made to operate as a non-profit organization then your insurance premium just dropped by 10%.
But if it was run by the government then it would have to be paid for by taxes, so your taxes would go up but you wouldn't have an insurance premium to pay. If the system could be set up to run efficiently then overall you'd be better off, I did read somewhere that insurance companies admin costs run to about 25% of the premium where medicare's admin costs are about 5%. If you are getting good healthcare and it costs you less than it does now, do you really care if you are paying a private company or the government?

Offline Kythia

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Re: ACA
« Reply #57 on: November 04, 2013, 05:31:38 PM »
So how exactly does mandating a "minimum bar" for all people miraculously make it affordable?  Because that's not what is going to happen, as I said from the beginning, this does very little to reduce the market price of private insurance-based healthcare.  It's giving the illusion of slight price drops, with the government stepping in and artificially reducing prices on certain plans - but it is does very little in developing a sustainable solution.

Think about this far-fetched analogy for a second:  If you're a shop-keeper, and the government tells you that you are pricing your white bread too high (since they claim it is a basic necessity for the poor) and that you should reduce it a certain amount.  You comply, but because your profits will take a hit, you decide to raise prices on other types of bread and/or decrease your supply of other types of bread.

Because that's exactly what is happening with healthcare.  It's an imperfect analogy though, because the government is footing a part of the bill with regard to people on welfare, etc.  This raises an entirely different ethical question, that would be an entirely tangential discussion.

Honestly, I was part of the 82% or whatever of Americans that had optimism in Obama's 2008 election.  I didn't vote for him, but I still felt that his policies were sensible at least.  But he has wavered so much on his 2008 campaign promises, it's ridiculous.

Well, I'd be an idiot then (in the white bread analogy).  Why not simply make less of a profit on selling white bread safe in the knowledge that people will continue to shop at my store as all my other prices are lower.  Its not like they're going to go to one shop for their bread, another for their butter and a third for their cheese.  People want to pick up an entire cheese sandwich in one place.

Offline Valthazar

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Re: ACA
« Reply #58 on: November 04, 2013, 07:26:28 PM »
Well, I'd be an idiot then (in the white bread analogy).  Why not simply make less of a profit on selling white bread safe in the knowledge that people will continue to shop at my store as all my other prices are lower.  Its not like they're going to go to one shop for their bread, another for their butter and a third for their cheese.  People want to pick up an entire cheese sandwich in one place.

I was using that analogy intentionally to represent an industry that sells a single commodity (bread), with multiple varieties (similar to the healthcare industry - which sells healthcare, but of multiple varieties).

I am not sure if you are familiar with how (well-run) businesses price their products.  There's a curve for every business which represents the peak potential price for the commodity, given all expenses and wages that need to be paid out.  All businesses, if they aspire to run at maximal efficiency, seek to determine and achieve this optimal price point.  However, like we have been saying, this market-determined price point may not always be affordable for the net sum of all consumers (especially with regard to an industry like healthcare). 

When you artificially alter this equilibrium pricing point for a business (whether it is advantageous for mass consumers or not), it immediately sends shocks waves through the pricing for other product varieties the company sells.  If you want me to elaborate on this further, I can - but essentially, if a company is operating at the peak price point (which most corporations have the labor/time required to achieve), then suddenly reducing the price for one commodity type will make it extremely difficult to maintain prices for other products, without running at a loss.  This is because, whether or not they are reaping gigantic profits, their business plans are so delicately crafted in the short-term, that it would most certainly introduce risk into the business/industry.  For example, a company could be running a $5,000,000 profit/year.  But if expense reports, dividends, and income contracts are already clearly defined for how this profit will be distributed, the company is in great jeopardy if the "anticipated" revenue stream is suddenly altered.  The company's credit line may be affected, their leveraged debt may not be paid on time, etc.  So you can understand why artificial fluctuations in price can drastically affect a healthcare company - thus leading to many existing plans being dropped.

I don't want to turn this into a pure economics discussion though, so probably best to leave this for another thread
« Last Edit: November 04, 2013, 07:29:06 PM by ValthazarElite »

Offline Valthazar

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Re: ACA
« Reply #59 on: November 04, 2013, 07:46:44 PM »
I've been following this discussion, it's been interesting, but I have some questions to bring up too. I'm not sure if these are true, so I'd like to know from people who have studied it.
From what I have heard, some groups of people will be getting subsidies from the government in order to be able to afford the ACA coverage. How does that make it affordable when the subsidy comes from the government in the first place? And what's the upper line for being able to get this subsidy?  One of the cases I heard of that is getting this subsidy was staffers of the US Congressmen, who (I could be wrong) can make over $75-100,000 a year. If it is affordable for everyone, why can't the government itself use it?

First and foremost, it is important to differentiate between Medicaid and ACA.  The ACA is intended to provide some "free" and low-cost premium healthcare plans for those whose income is "higher" than the threshold currently for Medicaid.  Generally, the ACA offers Gold, Silver, and Bronze healthcare plans, with Gold being the top-tier plan, and Bronze being the low-tier plan.  The few free ACA plans are all Bronze level, and vary considerably based on which private insurance company is offering it.  But generally, bronze plans generally cover about 60 percent of a person's medical costs in addition to standard benefits such as prescription drugs, maternity care and mental health treatment.  The very important fact here is that there are significant out of pocket costs that still exist.  However, there are limits on this out of pocket costs - $6,350 for individuals and $12,700 for families.  Far from 'affordable' if you ask me, and a simple heart attack can still ruin a family's finances.  Again, usually monthly premiums will work out to about $20-30 for even Bronze plans, but it is certainly possible that some will get free Bronze coverage through ACA.  For example, I just looked it up and the average premium works out to zero after the tax subsidy for a family of four earning $50,000 a year on the lowest-cost bronze plan in Fairfax County, Virg., Jackson, Miss., and Anchorage, Ala.  Basically they will qualify for enough tax subsidies to cover the entire cost of the plan.

Basically, a LOT of people get subsidies, but only some get enough subsidies to cover the entire cost of healthcare under ACA.
« Last Edit: November 04, 2013, 07:50:55 PM by ValthazarElite »

Offline gaggedLouise

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Re: ACA
« Reply #60 on: November 04, 2013, 08:18:54 PM »
I was using that analogy intentionally to represent an industry that sells a single commodity (bread), with multiple varieties (similar to the healthcare industry - which sells healthcare, but of multiple varieties).

I am not sure if you are familiar with how (well-run) businesses price their products.  There's a curve for every business which represents the peak potential price for the commodity, given all expenses and wages that need to be paid out.  All businesses, if they aspire to run at maximal efficiency, seek to determine and achieve this optimal price point.  However, like we have been saying, this market-determined price point may not always be affordable for the net sum of all consumers (especially with regard to an industry like healthcare). 

When you artificially alter this equilibrium pricing point for a business (whether it is advantageous for mass consumers or not), it immediately sends shocks waves through the pricing for other product varieties the company sells.  If you want me to elaborate on this further, I can - but essentially, if a company is operating at the peak price point (which most corporations have the labor/time required to achieve), then suddenly reducing the price for one commodity type will make it extremely difficult to maintain prices for other products, without running at a loss.  This is because, whether or not they are reaping gigantic profits, their business plans are so delicately crafted in the short-term, that it would most certainly introduce risk into the business/industry.  For example, a company could be running a $5,000,000 profit/year.  But if expense reports, dividends, and income contracts are already clearly defined for how this profit will be distributed, the company is in great jeopardy if the "anticipated" revenue stream is suddenly altered.  The company's credit line may be affected, their leveraged debt may not be paid on time, etc.  So you can understand why artificial fluctuations in price can drastically affect a healthcare company - thus leading to many existing plans being dropped.

I don't want to turn this into a pure economics discussion though, so probably best to leave this for another thread

Hmmm. It's a good description of how it works in the theory of many an economics textbook - but less solid if one wants to describe real markets. Whether it's the market of consumer goods, real estate or services.

Many companies selling services (such as health insurance) or any kind of tech gadgets are much more interested in cornering a market share, and doing it fast, than in finding a perfect price. Look at the mobile phones and tablets market.- for many years, those kinds of goods, and especially mobile phones and smartphones, have been sold at prices that look like a shoestring. You pay one dollar, or ten dollars - in places that have a lower-value basic coin than the dollar prices can get even more ridiculous; I bought my current phone for one Swedish crown which equals something like 15 cents, quite common here -  and you get a spanking new modern phone with nice design and lots of the modern extra goodies. 99% of the actual price is baked into the monthly fees over the time that the phone will remain locked to a subscription with the operator it's sold in tandem with, and presumably the operator/ISP will pay much of that money back to the shop that sold the phone, maybe some to Apple or Samsung as well. The over-the-counter prices you'll get have nothing to do with what the phone really cost to make and market, sometimes even the full price of the phone (including let's say 24 monthly fees of 20 dollars each) probbly don't have very much to do with the real value...anyway, the value of a certain model of a smartphone is quite subjective, it depends on what you like and what kind of design you're after. Those price settings are all about shoring up a part of the market and doing it fast. Once the customer has signed to a subscription, they won't be able to change the deal without paying all the still outstanding money up front. The price trade-off in selling phones, magazine trial subscriptions and so on that way shows it to be very underpriced, sellers and producers are counting on taking a big loss in the short term to get a good market niche.

I don't think there's any reason why health insurance companies should be putting up the "perfect price" that creates an equilibrium. More likely they'll ask for, or try to grab, what they think they can get from the buyer/s.

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Re: ACA
« Reply #61 on: November 04, 2013, 08:29:20 PM »
I don't think there's any reason why health insurance companies should be putting up the "perfect price" that creates an equilibrium. More likely they'll ask for, or try to grab, what they think they can get from the buyer/s.

I know, that is exactly what I am saying.  The optimal price is the maximum they can charge for a product, before seeing drops in demand that significantly affect their bottom line.  That is the equilibrium I am referring to.

Offline gaggedLouise

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Re: ACA
« Reply #62 on: November 04, 2013, 08:39:53 PM »
I know, that is exactly what I am saying.  The optimal price is the maximum they can charge for a product, before seeing drops in demand that significantly affect their bottom line.  That is the equilibrium I am referring to.


Well,  what I'm arguing is that the current state of the US health insurance market sounds heavily tipped in favour of insurance companies. So if there is an equilibrium at this point in time, or an optimal pricing line for various kinds of insurance packages, it may have landed too high - because there is no powerful competition from the public sector.


Also, if current pricing depends a lot on what companies feel they are able to get by hyping up their services through publicity (rather than facts...) and on what they can see other companies are asking and getting for their solutions, then it doesn't really hold up that cutting the prices on a few key items would create chaos ripping through the entire range of services and deals the company is offering. I think that was a key assertion in your reasoning here:

Quote from: ValthazarElite
Essentially, if a company is operating at the peak price point (which most corporations have the labor/time required to achieve), then suddenly reducing the price for one commodity type will make it extremely difficult to maintain prices for other products, without running at a loss.  This is because, whether or not they are reaping gigantic profits, their business plans are so delicately crafted in the short-term, that it would most certainly introduce risk into the business/industry.  For example, a company could be running a $5,000,000 profit/year.  But if expense reports, dividends, and income contracts are already clearly defined for how this profit will be distributed, the company is in great jeopardy if the "anticipated" revenue stream is suddenly altered.  The company's credit line may be affected, their leveraged debt may not be paid on time, etc.  So you can understand why artificial fluctuations in price can drastically affect a healthcare company - thus leading to many existing plans being dropped.

« Last Edit: November 04, 2013, 08:48:01 PM by gaggedLouise »

Offline Valthazar

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Re: ACA
« Reply #63 on: November 04, 2013, 08:47:08 PM »
I agree with you, and that's the reason I at least understood and respected Obama's plan at first because it would have at least decreased that price point through competition.  But I am not understanding how the ACA hopes to reduce the costs.  The Republicans lambasted the ACA for all the wrong reasons, and transformed it into something very different.  But at the same time, I am not sure why Obama backs this current law, since it is remarkably different than his original one.

Also, if current pricing depends a lot on what companies feel they are able to get by hyping up their services through publicity (rather than facts...) and on what they can see other companies are asking and getting for their solutions, then it doesn't really hold up that cutting the prices on a few key items would create chaos ripping through the entire range of services and deals the company is offering. I think that was a key assertion in your reasoning here:

I did not want to turn this into an economics thread, but I can explain this.

This is not about hyping anything up - it is about supply and demand, and companies capitalizing on limitless demand to make insane profits.  For example, in a monopoly industry, with only 1 manufacturer, the company can price its product at a ridiculous amount, and make enormous profits.  You are suggesting that because of these enormous profits, they would not feel any chaos.  Let me explain.

When they draft the next year's budget, they are basing it on the income stream/profit estimates from the previous year.  Assume the monopolist is predicting $500,000,000 in profits the next year.  They would have allocated this money in advance - such as for building new facilities with this profit, or committed to salary increases for their executives, and numerous other budgetary allocations.  In other words, a sudden artificial interjection in their pricing model would throw these budgetary estimates in sway.

This has an extremely deleterious effect on the way the business' fundamentals are viewed by rating agencies and creditors.  Many businesses respond to this type of financial risk by going into preservation mode, minimizing as much uncertainty as they can.
« Last Edit: November 04, 2013, 08:57:44 PM by ValthazarElite »

Offline gaggedLouise

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Re: ACA
« Reply #64 on: November 04, 2013, 09:12:27 PM »
I agree with you, and that's the reason I at least understood and respected Obama's plan at first because it would have at least decreased that price point through competition.  But I am not understanding how the ACA hopes to reduce the costs.  The Republicans lambasted the ACA for all the wrong reasons, and transformed it into something very different.  But at the same time, I am not sure why Obama backs this current law, since it is remarkably different than his original one.


How about, because this issue was the single most important promise he had made during the 2008 election campaign, both he and his voters had invested a lot of hope in it, and had got it through into law, despite a huge amount of resistance and anger from the Republicans and the Tea Party. When that level of investment has been made, it's not on the table to say "we couldn't get the best option, the one you really deserved and the one I was campaigning for, so I'm dropping the whole thing. The GOP succeeded in outwitting us and sinking the whole project through their obstruction. Goodbye." (remember, the Senate republicans swung around and dropped their support for key features of the original law).

No leading political man in power can afford to finish his own flagship proposal that way.

Then again, I don't agree that the whole thing has become diluted to the point that it is only a shadow of what was promised in 2008/9. It's been trimmed down some, certain groups will land outside, but it's still a major push forward.

Offline consortium11

Re: ACA
« Reply #65 on: November 04, 2013, 09:39:48 PM »
Well, I'd be an idiot then (in the white bread analogy).  Why not simply make less of a profit on selling white bread safe in the knowledge that people will continue to shop at my store as all my other prices are lower.  Its not like they're going to go to one shop for their bread, another for their butter and a third for their cheese.  People want to pick up an entire cheese sandwich in one place.

Off topic:

You'd be surprised.

Since the economic crisis hit one of the more interesting bits of consumer research to come out was that people were doing exactly that (in the UK at least), turning their weekly shop at one supermarket into a weekly shop at three or four. They'd go to ASDA for the special offer on bread (where they can freeze the excess), TESCO for the price reduction on cheese and Sainsbury's for the buy one, get one free on butter... and then hit LIDL for the half-price weekend offers which they'd buy in bulk and cheap eggs.

It's one of the reasons the budget supermarkets like LIDL and ALDI have expanded their ranges and started to offer more "luxury" options. People had started to buy the basics (bread, milk, eggs etc) from there because of a lower base price but were then going to other supermarkets for the other products (notably meat but also ready meals and the like). Realising that they were getting people through the doors with the basics but not enticing them to do their whole shop there they started to change their product lines and presentation to do exactly that.

Offline RetributionTopic starter

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Re: ACA
« Reply #66 on: November 04, 2013, 11:06:22 PM »
Forgetting the government for a second, lets assume that 10% of your premiums go straight out the door as share holder dividends. If the company was made to operate as a non-profit organization then your insurance premium just dropped by 10%.
But if it was run by the government then it would have to be paid for by taxes, so your taxes would go up but you wouldn't have an insurance premium to pay. If the system could be set up to run efficiently then overall you'd be better off, I did read somewhere that insurance companies admin costs run to about 25% of the premium where medicare's admin costs are about 5%. If you are getting good healthcare and it costs you less than it does now, do you really care if you are paying a private company or the government?

I honestly have no issue with a system as you laid out. I just have little faith in the government to be able to do that efficiently. Which is what ends up being the real rub for me. Or a non-profit organization doing a similar thing would be nice, but again I am not real sure how implementation could be made to work. Of course that also then leads to the question of employment. For example around here a large insurance company is a major employer.

Offline Phaia

Re: ACA
« Reply #67 on: November 05, 2013, 01:38:34 AM »
http://www.washingtonpost.com/blogs/fact-checker/wp/2013/10/30/obamas-pledge-that-no-one-will-take-away-your-health-plan/?tid=pm_politics_pop

I found this little gem and was amazed at some of things I did not KNOW about ACA...like I now have to pay to treat those i substance abuse programs....so if i understand this...i could break the law and get  caught with using drugs...get insurance [they cannot deny me] and let others help pay for my drug problem....wow what the heck am i waiting for...i think getting a kilo of crack nis great place to start

I am sure I will hear howling about this but honestly i find it disgusting that I now have to help pay for someone that breaks the law [you have to normally to need substance abuse help]...I have donated in the pass to variuos grops that help those in that kind of need but to force me to pay is a different matter...

My husband is very AMUSED that he must carry maturnity coverage....i am all for equal pay between men and women...but do we really have to get the guys...all of them to pay for maturity?

the estamates i am seeing is already 2 million have lost thier insurance...i think it will be very funny if the 16-20 million that werent insuranced get replaced by 10-15 million that had been insured but now cant afford it!

phaia

Offline Chris Brady

Re: ACA
« Reply #68 on: November 05, 2013, 02:56:58 AM »
My Canadian Province's system is somewhat similar in that, it has all the benefits spread out equally, no matter what the age or gender of the individual who has it.  Yes, I do have maternity benefits, that I'm pretty sure I won't need.  Pretty sure.  And frankly, I'd rather be covered for something legitimate on the off chance it does happen, and not need it, than not have it, and maybe end up needing it.

Is money more important than your, or your loved one's health?

Offline mia h

Re: ACA
« Reply #69 on: November 05, 2013, 04:56:42 AM »
I just have little faith in the government to be able to do that efficiently.
Of course that also then leads to the question of employment. For example around here a large insurance company is a major employer.

So if the government is inefficent that's bad because it wastes your taxes.
But if a private company is inefficent that's fine because it keeps people in work?!

Offline Valthazar

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Re: ACA
« Reply #70 on: November 05, 2013, 07:24:19 AM »
So if the government is inefficent that's bad because it wastes your taxes.
But if a private company is inefficent that's fine because it keeps people in work?!

A consistently inefficient company that is under-performing in meeting earnings targets, and running losses, will eventually lead to bankruptcy, since they are under competitive pressure from other companies and new entrants.  When an inefficient company eventually has to file for bankruptcy and leave the industry, it naturally leaves a "gap" - offering more competitive products or prices for consumers.  This means that shareholders and principal owners of businesses are the ones hurt during bankruptcy.

The reason why Retribution and I are saying there is a tendency for government to be inefficient, is because there is no competitive pressure for efficient workflow (since no one is competing with the government).  For example, Social Security is pretty much drained, and the reason they are still chugging along with this inefficient system, is because there is no direct competition for social security.  We're all required to pay into it.

So when government is inefficient, is it the shareholders and principal owners (as a comparison) who are hurt?  Absolutely, and those of us who are tax-paying citizens are technically shareholders of government, and because we lack choice, are basically going down when the government goes down (assuming a hypothetical scenario where a significant amount of our services were channeled through the government).  But this has nothing to do with this healthcare / ACA discussion.
« Last Edit: November 05, 2013, 08:33:03 AM by ValthazarElite »

Offline mia h

Re: ACA
« Reply #71 on: November 05, 2013, 08:37:07 AM »
Except that's only turn in markets that operate under perfect competition and no insurance market does, the barriers to entry are huge and even if you did get into the market the existing players in the market have the ability to crush new enterants like a bug.

And there are competitive pressure for governments to be efficient, they're called elections.

Social Security is a mess not because it's inefficient but demographics and life spans have change significantly since it's inception, and those things would have changed regardless of everyone being required to pay in. That and succesive governments keep writing the trust fund IOU's instead of putting money in there. Does Social Security need reform? Yes. Does that have anything to do with it being funded through taxation? No.

Offline Valthazar

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Re: ACA
« Reply #72 on: November 05, 2013, 08:48:07 AM »
mia h, I'm willing to discuss that issue with you, if you'd like to start another thread.

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Re: ACA
« Reply #73 on: November 05, 2013, 08:54:24 AM »
No matter how we assess the ACA, any one of us, I have a feeling this thread is currently trailing into a debate about the legitimacy of taxes and on markets vs state action - which is kind of beside the point...

*nods aře to a thread of its own on taxation, governments and service markets*

Offline RetributionTopic starter

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Re: ACA
« Reply #74 on: November 05, 2013, 09:01:38 AM »
Not to be too skeptical but get back to me when Social Security is fixed. As you pointed out there were built in flaws in the system and they are not getting fixed. I have paid into said system for *thinks* 33 years and do not expect to see any return on that money.

But you and I are not going to agree on this. I would love, love, to see a well run state sponsored health care program. Maybe something along the lines of Medicare I am just really, really, skeptical about that ever being pulled off. Hell, I work for the government in the President's home state. I have paid into our retirement for 24 years and it looks like I may get a big fat nothing for that investment http://www.huffingtonpost.com/tag/illinois-pension-crisis
So keeping in mind the above listed examples I think I would be pretty gullible to expect differing results from government programs when they keep failing.

I know many here are big on "pull your weight" and help the little guy but I just looked at my last pay stub. Deductions including retirement, insurance, 401 k, state tax, fed tax, social security over $1K in deductions I kinda think I am pulling my weight and every time I turn around someone is wanting to increase that number. This does not include sales tax, property tax, license fees, you get the idea. We all need to pay our share for things we all use roads, military, and yes even health care for those less fortunate, but there is a point where the well runs dry and I am starting to feel tapped out.