No...it is about access to affordable health care by creating access to insurance. The actual costs of providing care weren't the goal. Previously, without access to the more affordable employer sponsored health care, or if one couldn't pay for that even if offered, there were no alternatives if one didn't qualify for government healthcare programs.

And that is the major problem with it and the one thing that desperately needs to be addressed.

And that is the major problem with it and the one thing that desperately needs to be addressed.

 

But you'd be screaming just as loud if the government stepped in to regulate the costs of providing services.

And that is the major problem with it and the one thing that desperately needs to be addressed.

So you would want the powers that be to put a cap on what Doctors and Hospitals can charge patients ??

Insurance reform is what we needed. Not health care reform, and like usual, the government waits until things are so lopsided that they put a bandaid on a broken arm, and in this case, the wrong damn arm. We needed insurance reform 15 years ago, and had that even been the goal with Obamacare a much more approachable, and soon achievable goal would have been the result. But, lobby and politics won't let that happen. Now you get this package laced with all the goodies that only a dozen humans on the planet have read in its entirety. The government could screw up a cheese sandwich. Ask Hammertime what he thinks of the changes from Obamacare considering his angle with open enrollment, etc.

Insurance reform is what we needed. Not health care reform' date=' and like usual, the government waits until things are so lopsided that they put a bandaid on a broken arm, and in this case, the wrong damn arm. We needed insurance reform 15 years ago, and had that even been the goal with Obamacare a much more approachable, and soon achievable goal would have been the result. But, lobby and politics won't let that happen. Now you get this package laced with all the goodies that only a dozen humans on the planet have read in its entirety. The government could screw up a cheese sandwich. Ask Hammertime what he thinks of the changes from Obamacare considering his angle with open enrollment, etc.[/quote']

 

How would you reform insurance?

How would you reform insurance?

 

Here's the thing, the insurance companies negotiate their UCRs (usual and customary fees) per zip code. A chest xray in Whitesburg is less expensive than one in Chicago. Those negotiations have zero oversight. There's step one. Step two, when PPOs, HMOs and capitation plans became the norm, you pigeon holed healthcare to huge facilities, basically forcing the hands of providers to participate in those plans or lose business. On the surface, that looks pretty good doesn't it? Well, what's happened, it's watered down health care because docs are afraid to practice on a fee for service basis, fearing that they'll see 1/3 of the patients that they see with those managed care plans. Now, you are finding that those rates that were thought at one time to make it competitive and reasonable for companies, those UCRs are out the roof and now the insurance companies have taken the hit because everyone is herded like cattle into (insert giant group healthcare facility here) and run thru the mill, so to speak. So, trickle down effect makes the premiums outrageous and the average middle to lower income folks out of luck if they're employer didn't provide insurance for them because it's cost prohibitive. Often the care now is watered down simply because providers lack the time to treat patients in a manner that they should be treated because of the bottom line forced over their heads by ( X facility) to meet a daily goal. What that's done is force good ole Doc Smith on the corner who saw a reasonable amount of patients a day, treated them fairly at a reasonable cost, out of business because he's no longer in the network of providers.

 

I could go on and on, but I won't for fear of this turning into a B-Ball-Fan length diatribe.

^ - I would love to hear (or read) more about how it 'really works'.

 

It sounds like your describing a failure of the 'free market' to do what 'free markets' are supposed to do. Instead it sounds like the classic problems with monopolies or oligopolies. But not necessarily because the providers and facilities set out to do it but because the different models - networks, HMOs, etc. forced them into these moves. Is that close to accurate?

 

It seems clear something is amiss when you read a bill and it shows the rack rate on a service and then it shows the pre-negotiated 'network discount' that is the range of 50%. It says that the pricing, discounting and charges are all fictitious. No one knows what anything really costs or what they should really charge for it and they try to make people think its a great thing to be part of some mega-plan because they can show this super discounts.

 

But discounts should be 5 maybe 10% - not 50% for 'group rates'. At 50%, it just shows the system is very messed up.

 

Unfortunately ACHA seems to fix none of this.

 

Here's the thing, the insurance companies negotiate their UCRs (usual and customary fees) per zip code. A chest xray in Whitesburg is less expensive than one in Chicago. Those negotiations have zero oversight. There's step one. Step two, when PPOs, HMOs and capitation plans became the norm, you pigeon holed healthcare to huge facilities, basically forcing the hands of providers to participate in those plans or lose business. On the surface, that looks pretty good doesn't it? Well, what's happened, it's watered down health care because docs are afraid to practice on a fee for service basis, fearing that they'll see 1/3 of the patients that they see with those managed care plans. Now, you are finding that those rates that were thought at one time to make it competitive and reasonable for companies, those UCRs are out the roof and now the insurance companies have taken the hit because everyone is herded like cattle into (insert giant group healthcare facility here) and run thru the mill, so to speak. So, trickle down effect makes the premiums outrageous and the average middle to lower income folks out of luck if they're employer didn't provide insurance for them because it's cost prohibitive. Often the care now is watered down simply because providers lack the time to treat patients in a manner that they should be treated because of the bottom line forced over their heads by ( X facility) to meet a daily goal. What that's done is force good ole Doc Smith on the corner who saw a reasonable amount of patients a day, treated them fairly at a reasonable cost, out of business because he's no longer in the network of providers.

 

I could go on and on, but I won't for fear of this turning into a B-Ball-Fan length diatribe.

 

There's a lot here....all excellent for discussion.

 

One area I really want to explore is quality of care. According to my source (who I trust with my life) one area you mention, volume versus outcome, is being addressed in the AHCA. I also feel strongly about preventative care being the fundamental way to prevent life threatening disease by preventing, or detecting early, those diseases. The new requirements by the AHCA on expanded required coverage is a positive to affect that, wouldn't you agree? Wouldn't you also agree that the credits for those who qualify, to offset the cost of insurance is a positive? How do you feel about the requirement to provide coverage for those with preexisting conditions? And the end of lifetime maximums? Personally, I have family, low income family, that will benefit from those.

 

I do feel that the AHCA at least begins to address some of what you outline. Again, there are ways to improve it. Bit if it is completely scrapped, the every one of your concerns are still in existence.

So, two people on here think insurance costs are just fine the way they are. Good to know.

So' date=' two people on here think insurance costs are just fine the way they are. Good to know.[/quote']

 

That's quite an over simplification.

I'll chime in more in the next few weeks, we have open enrollment coming up.

From UPI story about a week ago:

"Annual premiums for employer-sponsored family health insurance coverage rose by 4 percent from last year, the 15th annual Kaiser/HRET survey indicates. ... Since 2003, premiums have increased 80 percent, nearly three times as fast as wages, which increased 31 percent and inflation, which increase by 27 percent. In the 2000s annually rate increases were often in double digits."

 

The key numbers are "since 2003" and "80 percent."

To make it simpler for you, I will put it in the "King's English" for you to understand. My premium will increase 93% in 2014. The key numbers are 93% between now and Jan 1!

To make it simpler for you, I will put it in the "King's English" for you to understand. My premium will increase 93% in 2014. The key numbers are 93% between now and Jan 1!

A lot of companies will use the implementation of the Affordable Care Act as an excuse to drive up rates and then assign all the blame on the president. Similar occurred in '08 when companies took advantage of the financial meltdown to jettison jobs or move even more to distant lands.

A lot of companies will use the implementation of the Affordable Care Act as an excuse to drive up rates and then assign all the blame on the president. Similar occurred in '08 when companies took advantage of the financial meltdown to jettison jobs or move even more to distant lands.

I don't think you get it. The ACA was designed to put insurance companies out of business, except for the country's largest insurer, the US Federal Govt. Your ignorance on economics and common sense is staggering.

I don't think you get it. The ACA was designed to put insurance companies out of business, except for the country's largest insurer, the US Federal Govt. Your ignorance on economics and common sense is staggering.

What kind of a plan you got? Typical high-deductible? Single or family? What did you pay in '13 and what will you pay in '14? Is your company plan self-funded? You work in a non-union shop?