Obamacare's Looming Premium Hikes

[IndyDave1776]

My out of pocket premium has gone up from $245 to $294 / month. That is a 20% increase. Last night chatting with friends theirs went up 34%.

While I despise the ACA the fact is premiums would be going up with or without the ACA!!! Medical care prices are left unchecked, uncontrolled, and unknown.

Eventually, we are going to need to address the real problem with healthcare costs, those who generate them and NOT those who pay them. Please note that I am NOT suggesting government controls, only that some system needs to be put in place to dissuade the rising cost of healthcare from the large nonprofit(?) hospitals.

Regards and Happy New Year,

Doug

Exactly. Instead of addressing the actual problem, Kenyan & Co. manufactured an additional new problem, or rather set of them, many of which have absolutely nothing to do with health care.

I would argue that the fundamental problem is the existence of insurance as we had come to know it. Health insurance would have remained manageable had it been limited to insurance against catastrophic problems rather than a system of beating feet to the doctor every time the kid sneezes and being completely insulated from the cost of doing so to the point of artificially driving up the costs. At this point, ACA worsens the problem significantly by increasing the artificial demand and artificially increasing the payout to people who otherwise would be uninsurable. Like it or not, insurance is a form of gambling, and the premiums are going to be high when the house is guaranteed heavy payout.

The only sustainable solution is to have those consuming the services required to have some significant skin in the game when paying the bills and to quit artificially increasing demand. Hell, at minimum a strong plurality of doctors have operated their practices for years on people coming in for 'scheduled maintenance' rather than going to the doctor when actually ill.

The laws of supply and demand cannot be outmaneuvered, and when the demand is artificially spiked, so will the prices. Then, you add in all the other government kibitzing, and you have the recipe for the disaster we are now experiencing.

 

[Libertarian01]

Exactly. Instead of addressing the actual problem, Kenyan & Co. manufactured an additional new problem, or rather set of them, many of which have absolutely nothing to do with health care.

I would argue that the fundamental problem is the existence of insurance as we had come to know it. Health insurance would have remained manageable had it been limited to insurance against catastrophic problems rather than a system of beating feet to the doctor every time the kid sneezes and being completely insulated from the cost of doing so to the point of artificially driving up the costs. At this point, ACA worsens the problem significantly by increasing the artificial demand and artificially increasing the payout to people who otherwise would be uninsurable. Like it or not, insurance is a form of gambling, and the premiums are going to be high when the house is guaranteed heavy payout.

The only sustainable solution is to have those consuming the services required to have some significant skin in the game when paying the bills and to quit artificially increasing demand. Hell, at minimum a strong plurality of doctors have operated their practices for years on people coming in for 'scheduled maintenance' rather than going to the doctor when actually ill.

The laws of supply and demand cannot be outmaneuvered, and when the demand is artificially spiked, so will the prices. Then, you add in all the other government kibitzing, and you have the recipe for the disaster we are now experiencing.

I think we mostly agree. Insurance is definitely part of the problem. And skin in the game is fine, but the last two (2) years running I have had to meet a VERY large deductible for my income, and that deductible did not dissuade me from doing something stupid. My stupid was 100% independent of this.

We need to look at free market solutions like the Surgery Center of Oklahoma | Free market-loving, price-displaying, state-of-the-art, AAAHC accredited, doctor owned, multispecialty surgical facility in central OK. that costs MUCH less than the "non-profit" hospitals it competes with.

The ACA had some good ideas that I do agree with, like the more people with coverage WILL spread the cost around, but by forcing such at the point of an economic gun it undermines free will and liberty. Plus the fact that some people really cannot afford insurance, then get slammed by penalties. I have a friend in this boat.

The health insurance companies have never gotten rich on the premiums. The bulk of the profits they have made has been from investments. People do not understand this. So the real cost drivers ARE the medical providers that hire more and more and bill outrageous amounts only to negotiate down and take massive losses from the uninsured. This will eventually need to be addressed in some fashion.

When I speak of "medical providers" I am not talking about the small doctors office in Podunk, USA. I am talking about the major pharmaceutical companies, the large hospital groups, etc. It isn't the little guys that are driving costs, it is the major providers AND the layers of red tape placed upon them from within and without. The without being idiotic government rules and the within being driven by the fear of lawsuits.

We won't fix a damn thing until everyone from provider to insurance company to medical gear manufacturer to patient is PO'd! Only when we have made everyone mad will we have achieved some form of meaningful reform.

Until then, it is just bandaids on bullet holes at too high a price.

Regards,

Doug

 

[bwframe]

Free market competition will fix all of this mess. We have seen the devil, now let's get it out of healthcare. Get the government out of healthcare and insurance. Let companies compete across state lines. Problem solved.

 

[IndyDave1776]

Doug, I would tend to agree for the most part. With the ACA, even things it may accidentally get right are just that, accidents, built on a foundation that is untenable in terms of both the Constitution and general principle. If I were to stop and start digging, one major problem I see is the law regarding insurance fraud. As it has been explained to me, if the provider charges whatever amount, and then agrees to charge the insurance company, say 70% of that, if they charge me personally less than 100% if I pay out of pocket, they have put themselves in legal jeopardy for fraud. Medicare fraud works the same way, only it demands that Medicare get the lowest price that provider charges absolutely anyone. I recall a case a couple of years ago in which a doctor was under threat of losing his license for Medicare fraud for working on an indigent person without charging. That is just wrong on several different levels. I really like the posted flat rate pricing idea from the example you linked. The problem is that ACA will interfere in this by double-dipping most people who are motivated to value shop or find the extortionate penalties/taxes/WTF-ever John Roberts wants them to be this minute less crippling than the extortionate prices for less care than was previously available for less cost.

At the end of the day, aside from protection from fraud, I see government having little or no role in any real solution.

Oh, and heading down this path will likely bring back the private practice which has largely disappeared from the landscape much to teh detriment of most all.

 

[Clarity]

Free market competition will fix all of this mess. We have seen the devil, now let's get it out of healthcare. Get the government out of healthcare and insurance. Let companies compete across state lines. Problem solved.

Unless you mean to completely scrap Medicare and Medicaid, this is nonsense.

 

[bwframe]

Free market competition will fix all of this mess. We have seen the devil, now let's get it out of healthcare. Get the government out of healthcare and insurance. Let companies compete across state lines. Problem solved.

Unless you mean to completely scrap Medicare and Medicaid, this is nonsense.

What two government areas are more prone to corruption, abuse and fraud? Bound to be a way to fix these with some privatization.

Didn't Obamacare shove a huge number of folks into these programs?

 

[cbhausen]

View attachment 43938

 

[paintman]

Just got my new premium last night. Went up t o $1300 per month with a $1000 per person deductable or $2000 for the family. If I go on our company insurance its $1000 per month with a$3000 per person and $6000 for family. At this point I'm think I'm better off to just not have any. If it was nt for my kids I'd drop it.

 

[steveh_131]

My company was kind enough to absorb the premium increase for this year, which was quite large. (Although I am sure that this is in lieu of any raises or yearly bonuses for us)

According to my W2, they are now paying $30,000 per year for a family insurance plan. It's a good plan by today's standards, but still has a $2,000 per person deductible and I think $8,000 max out of pocket.

Now despite the fact that my family operates on a single modest income so that my wife can raise my children, I or my employer or somebody will soon be paying this 'cadillac' tax of $1,000 per year on this health plan.

Very affordable.

 

[K1LLB0XS373N]

Obamacare...No thanks....o wait....they didn't ask....

 

[Doug]

Well, as Hiliary said, "We must stop thinking of the individual and start thinking about what is best for society."

It's OK for you and/or your children to suffer and/or die if society overall is better off. That's the Progressive way.

 

[Libertarian01]

Doug, I would tend to agree for the most part. With the ACA, even things it may accidentally get right are just that, accidents, built on a foundation that is untenable in terms of both the Constitution and general principle. If I were to stop and start digging, one major problem I see is the law regarding insurance fraud. As it has been explained to me, if the provider charges whatever amount, and then agrees to charge the insurance company, say 70% of that, if they charge me personally less than 100% if I pay out of pocket, they have put themselves in legal jeopardy for fraud. Medicare fraud works the same way, only it demands that Medicare get the lowest price that provider charges absolutely anyone. I recall a case a couple of years ago in which a doctor was under threat of losing his license for Medicare fraud for working on an indigent person without charging. That is just wrong on several different levels. I really like the posted flat rate pricing idea from the example you linked. The problem is that ACA will interfere in this by double-dipping most people who are motivated to value shop or find the extortionate penalties/taxes/WTF-ever John Roberts wants them to be this minute less crippling than the extortionate prices for less care than was previously available for less cost.

At the end of the day, aside from protection from fraud, I see government having little or no role in any real solution.

Oh, and heading down this path will likely bring back the private practice which has largely disappeared from the landscape much to teh detriment of most all.

I agree, but I also see that some of the things they "got right" (which can be argued about later) WERE done with intent and logic, and not accidentally.

For example, the tax on the "Cadillac" plans was intended to serve two (2) separate yet important goals, IF you want the ACA to work.

First, it raises money to support the subsidies that are being given to folks. We might not like it or agree with it, but it was intentional.

Second, it was meant to do diminish the number of Cadillac plans available. Many folks like to blame unions for some of the problems, and this IS one of them that can predominantly placed on the union doorstep. By demanding Cadillac plans in their contracts for decades they basically created a consumer/patient mentality whereby they could go to the ER for a hangnail or a minor sniffle and pay basically nothing. This has realistically placed an increased burden on the healthcare system that doesn't need to be there. So the ACA hopes to diminish this drain of time and resources by dis-incentivizing the existence of such plans. THIS WAS INTENTIONAL, and logical.

Whether we disagree with the legal foundation for the ACA is another matter entirely, but there was a reason for it.

In regards to the Oklahoma Surgical Center, there is another one in Pennsylvania: Procedures They copied the OSC website, but that is fine with me, and the Dr who started the OSC as well.

However, I still contend that the free market is only part (albeit a big part) of the solution, as medical care is NOT entirely a "free market" institution. Just look at Martin Shkreli, raising the price of a life saving drug from $13.50 to $750, which costs about $1 to produce. He was already making a 1,300% profit, but I guess that when people will DIE without the drug and you are the only manufacturer of it, well... Ethics be damned! What can the consumer do - not buy it? If that is the case they die! Not exactly a fair choice there.

I am sorry but that is NOT free market! The same goes for chemotherapy and other treatments that are the difference between life and death. It also goes for implant companies in Warsaw, IN not getting into a price war. Why should they when they are all making a killing and don't want to lose profits? There is no free market here as well. With massive governmental barriers to entry they are virtually guaranteed inflated profits for years to come.

I am not saying the ACA is anywhere near the solution, but I will also contend that when your life or the life of a loved one is on the line and the choice is either "buy this or DIE" the free market goes out the window, at least to a point.

The story about the doctor and the indigent guy is horrible! I guess the simple solution is to charge the guy $X and then simply never collect it, and write it off as a bad debt. Seems a stupid hoop to have to jump through, but if that is what it takes...

I don't think the ACA, medicare, or medicaid can touch the OSC (yet) because they simply do not take ANY insurance of any kind. They operate solely on a "you pay up front" the full cost of the procedure, thus avoiding any entanglements of treating anyone differently or negotiating with anyone. I personally believe the insurance companies are idiots for not using them, but the Dr explains in one of the videos why they do not. Now there is a good criticism of the short sighted stupidity of the insurance industry.

Rambled on too much.

Regards,

Doug

 

[IndyDave1776]

I agree, but I also see that some of the things they "got right" (which can be argued about later) WERE done with intent and logic, and not accidentally.

For example, the tax on the "Cadillac" plans was intended to serve two (2) separate yet important goals, IF you want the ACA to work.

First, it raises money to support the subsidies that are being given to folks. We might not like it or agree with it, but it was intentional.

Second, it was meant to do diminish the number of Cadillac plans available. Many folks like to blame unions for some of the problems, and this IS one of them that can predominantly placed on the union doorstep. By demanding Cadillac plans in their contracts for decades they basically created a consumer/patient mentality whereby they could go to the ER for a hangnail or a minor sniffle and pay basically nothing. This has realistically placed an increased burden on the healthcare system that doesn't need to be there. So the ACA hopes to diminish this drain of time and resources by dis-incentivizing the existence of such plans. THIS WAS INTENTIONAL, and logical.

Whether we disagree with the legal foundation for the ACA is another matter entirely, but there was a reason for it.

In regards to the Oklahoma Surgical Center, there is another one in Pennsylvania: Procedures They copied the OSC website, but that is fine with me, and the Dr who started the OSC as well.

However, I still contend that the free market is only part (albeit a big part) of the solution, as medical care is NOT entirely a "free market" institution. Just look at Martin Shkreli, raising the price of a life saving drug from $13.50 to $750, which costs about $1 to produce. He was already making a 1,300% profit, but I guess that when people will DIE without the drug and you are the only manufacturer of it, well... Ethics be damned! What can the consumer do - not buy it? If that is the case they die! Not exactly a fair choice there.

I am sorry but that is NOT free market! The same goes for chemotherapy and other treatments that are the difference between life and death. It also goes for implant companies in Warsaw, IN not getting into a price war. Why should they when they are all making a killing and don't want to lose profits? There is no free market here as well. With massive governmental barriers to entry they are virtually guaranteed inflated profits for years to come.

I am not saying the ACA is anywhere near the solution, but I will also contend that when your life or the life of a loved one is on the line and the choice is either "buy this or DIE" the free market goes out the window, at least to a point.

The story about the doctor and the indigent guy is horrible! I guess the simple solution is to charge the guy $X and then simply never collect it, and write it off as a bad debt. Seems a stupid hoop to have to jump through, but if that is what it takes...

I don't think the ACA, medicare, or medicaid can touch the OSC (yet) because they simply do not take ANY insurance of any kind. They operate solely on a "you pay up front" the full cost of the procedure, thus avoiding any entanglements of treating anyone differently or negotiating with anyone. I personally believe the insurance companies are idiots for not using them, but the Dr explains in one of the videos why they do not. Now there is a good criticism of the short sighted stupidity of the insurance industry.

Rambled on too much.

Regards,

Doug

Doug, you have made a fine argument against the ACA.

1. "Cadillac" plans. These plans in and of themselves are not a problem. They are only a problem when envy sets in. Their adverse effects could easily be rectified by simply not covering doctor visits for hangnails. This does not require higher out of pocket premiums, copays, and deductibles. As for paying for the other guy, I can understand your point that this redistribution is necessary to make ACA function, but it is not justifiable in any way. The effort to reduce the numbers of such plans is nothing but punitive class warfare nonsense.

2. Martin Shkreli? OK, we can adjust the patent law. If manufacturers want to make back their money in a short time through extortionate pricing, shorten the time they have available to do it. Problem solved.

3. You hit the nail on the head. The problem is massive government barriers to entry. Solve the problem rather than trying to counter it with another problem which is equally bad in the other direction. You get to have a free market and satisfactory results both that way.

 

[steveh_131]

However, I still contend that the free market is only part (albeit a big part) of the solution, as medical care is NOT entirely a "free market" institution.

I have never yet come across a true 'failure' in the free market, in any sector. Libertarians shouldn't be making comments like that. I've issued this challenge many times: Show me a free market 'failure' and I'll show you the big government meddling that actually caused it.

I haven't lost that challenge yet.

Just look at Martin Shkreli, raising the price of a life saving drug from $13.50 to $750, which costs about $1 to produce. He was already making a 1,300% profit, but I guess that when people will DIE without the drug and you are the only manufacturer of it, well... Ethics be damned! What can the consumer do - not buy it? If that is the case they die! Not exactly a fair choice there.

You're right, this is not a free market. This is a result of two things, patent law and the FDA. Both are anti-free-market government constructs. Place the blame at their feet, not at the feet of capitalism.

The specific difficulty is that, by government regulation, you need to have on hand a fairly large quantity of the original drug in order to test it against your generic. This a-hole was able to squeeze supply so much that no competing companies could get enough of it to perform the government's overblown testing methods.

In a free market, somebody could have synthesized and sold that drug quickly, easily and cheaply.

I am not saying the ACA is anywhere near the solution, but I will also contend that when your life or the life of a loved one is on the line and the choice is either "buy this or DIE" the free market goes out the window, at least to a point.

This has nothing to do with the free market. All sorts of life-supporting goods and services are provided via the free market. Buy food or die. Buy shelter or die. You can't just jettison your libertarian principles because something is 'too important' to leave in the hands of free individuals.

 

[GodFearinGunTotin]

I have never yet come across a true 'failure' in the free market, in any sector. Libertarians shouldn't be making comments like that. I've issued this challenge many times: Show me a free market 'failure' and I'll show you the big government meddling that actually caused it.

I haven't lost that challenge yet.

[/SIZE][/FONT]

[/SIZE][/FONT]You're right, this is not a free market. This is a result of two things, patent law and the FDA. Both are anti-free-market government constructs. Place the blame at their feet, not at the feet of capitalism.

The specific difficulty is that, by government regulation, you need to have on hand a fairly large quantity of the original drug in order to test it against your generic. This a-hole was able to squeeze supply so much that no competing companies could get enough of it to perform the government's overblown testing methods.

In a free market, somebody could have synthesized and sold that drug quickly, easily and cheaply.

[/FONT]

This has nothing to do with the free market. All sorts of life-supporting goods and services are provided via the free market. Buy food or die. Buy shelter or die. You can't just jettison your libertarian principles because something is 'too important' to leave in the hands of free individuals.

You're not seriously asserting that people shouldn't be able to protect their intellectual property via patents, are you? If memory servers, patents were one of the original powers delegated to the Feds in the Constitution. Protecting your investment and capital in coming up with marketable products is important in promoting trade, commerce, and markets.

 

[steveh_131]

You're not seriously asserting that people shouldn't be able to protect their intellectual property via patents, are you? If memory servers, patents were one of the original powers delegated to the Feds in the Constitution. Protecting your investment and capital in coming up with marketable products is important in promoting trade, commerce, and markets.

With that statement I was speaking specifically to the minutiae of patent law surrounding generic pharmaceuticals and the entangled safety regulations that allowed that idiot to get away with jacking up his prices. Those regulations are to blame - not the free market.

But to answer your question more completely, yes I do think that intellectual property is an unnecessary government construct that stifles innovation and hampers the free market. And yes, I am aware that it was enumerated in the constitution. I happen to disagree with it. That's a larger topic beyond the scope of this thread.

 

[GodFearinGunTotin]

With that statement I was speaking specifically to the minutiae of patent law surrounding generic pharmaceuticals and the entangled safety regulations that allowed that idiot to get away with jacking up his prices. Those regulations are to blame - not the free market.

But to answer your question more completely, yes I do think that intellectual property is an unnecessary government construct that stifles innovation and hampers the free market. And yes, I am aware that it was enumerated in the constitution. I happen to disagree with it. That's a larger topic beyond the scope of this thread.

So, you're saying it's not a libertarian ideal to be able to protect my intellectual property? Isn't that the sort of things you guys rail on as the absolute necessary function of government -- to protect property? If I were ever inspired sufficiently to come up with some highly marketable idea, I would absolutely want it protected so that I could profit from it. I certainly wouldn't want some dude to take a look at it, copy it, and profit from my work. I agree with the founders that the protection of intellectual property is a key for promoting innovation and absolutely necessary. To not support that strikes me as kind of supporting the socialization of intellectual property---if it's not mine and something I own and can protect, it's everybody's.

Another reason I'll never be confused as a libertarian, I guess.

 

[IndyDave1776]

So, you're saying it's not a libertarian ideal to be able to protect my intellectual property? Isn't that the sort of things you guys rail on as the absolute necessary function of government -- to protect property? If I were ever inspired sufficiently to come up with some highly marketable idea, I would absolutely want it protected so that I could profit from it. I certainly wouldn't want some dude to take a look at it, copy it, and profit from my work. I agree with the founders that the protection of intellectual property is a key for promoting innovation and absolutely necessary. To not support that strikes me as kind of supporting the socialization of intellectual property---if it's not mine and something I own and can protect, it's everybody's.

Another reason I'll never be confused as a libertarian, I guess.

We spilled billions of pixels worth of text on this one before. The libertarian argument is that intellectual property right is a right to a fictitious substance, a barrier to entry, and an infringement of anyone else producing a product with his own hand, and your head start from having invented it and catching them flatfooted should be adequate, which, of course, is why we never have patent infringement actions before the product even hits the shelf. Copyright infringements, likewise, could be a full production in seconds.

 

[steveh_131]

So, you're saying it's not a libertarian ideal to be able to protect my intellectual property? Isn't that the sort of things you guys rail on as the absolute necessary function of government -- to protect property?

This is not necessarily a libertarian ideal. Many libertarians would disagree with me on this. The question is not whether property should or should not be protected. The question is whether or not an idea is morally equivalent to physical property once you've shared it with someone else.

Supporting the free market, free of regulation is a libertarian ideal. My beef with Doug was his conclusion that a negative outcome was caused by not enough government.

If I were ever inspired sufficiently to come up with some highly marketable idea, I would absolutely want it protected so that I could profit from it. I certainly wouldn't want some dude to take a look at it, copy it, and profit from my work. I agree with the founders that the protection of intellectual property is a key for promoting innovation and absolutely necessary. To not support that strikes me as kind of supporting the socialization of intellectual property---if it's not mine and something I own and can protect, it's everybody's.

Please prove the bolded statement, because I strongly disagree. Mankind has been thinking, creating, innovating and inventing since our very creation. Imaginary property laws are relatively recent.

We spilled billions of pixels worth of text on this one before.

Yes we certainly have, and nobody ever made a convincing argument that intellectual property is morally equivalent to physical property. I poked a billion holes in it. It never has and never will be treated like physical property.

The libertarian argument is that intellectual property right is a right to a fictitious substance, a barrier to entry, and an infringement of anyone else producing a product with his own hand, and your head start from having invented it and catching them flatfooted should be adequate, which, of course, is why we never have patent infringement actions before the product even hits the shelf. Copyright infringements, likewise, could be a full production in seconds.

First of all, that is not a 'libertarian' argument.

Secondly, if you can't keep your patent from being infringed before your product hits the shelf then you're doing something wrong. Physical property rights and contract law still apply. Use them to keep your inventions secret until you produce the item. If someone violates your physical property rights or violates a contractual obligation to duplicate your idea then they can and should be prosectued.

 

[GodFearinGunTotin]

This is not necessarily a libertarian ideal. Many libertarians would disagree with me on this. The question is not whether property should or should not be protected. The question is whether or not an idea is morally equivalent to physical property once you've shared it with someone else.

Supporting the free market, free of regulation is a libertarian ideal. My beef with Doug was his conclusion that a negative outcome was caused by not enough government.




Please prove the bolded statement, because I strongly disagree. Mankind has been thinking, creating, innovating and inventing since our very creation. Imaginary property laws are relatively recent.



Yes we certainly have, and nobody ever made a convincing argument that intellectual property is morally equivalent to physical property. I poked a billion holes in it. It never has and never will be treated like physical property.



First of all, that is not a 'libertarian' argument.

Secondly, if you can't keep your patent from being infringed before your product hits the shelf then you're doing something wrong. Physical property rights and contract law still apply. Use them to keep your inventions secret until you produce the item. If someone violates your physical property rights or violates a contractual obligation to duplicate your idea then they can and should be prosectued.

Miles apart are we on this. I support the idea of the government protecting my rights to fruits of my labor -- whether that's building something physical, monetarily, or something intellectual.