Obamacare Enrollment Estimates Less Than 50,000

londonfog

londonfog

Well-Known Member
ginwilly said:
My answers and suggestion are anti-central planning and community based so you won't consider them real ideas and have been rehashed for the years I've been on here. I believe less government intervention and bureaucracy is part of the solution as well as educating people on healthy choices. Our FDA works against our interest. I can't buy a Canadian drug that does the same as ours for a fraction of the cost because we can't trust third world countries like Canada, we can only use good ole US meds (made in Malaysia).

I already pay for my health care voluntarily so please drop that strawman you are assigning to me.

While it's true that I and others don't want to be forced to pay for things against our will, that's not the argument, that's the point. You can't make them under the present law. You can require it by mandate, but if someone really doesn't want to pay, you won't make them under the ACA, get it? If you can grasp that simple concept, that a shit load of people are economically incentivized to NOT pay, and the only incentive TO pay is "it's the right thing to do for the greater good", yet still can't grasp that our ER abuse was not addressed I'm wasting my time.

More cons

Adds yet another layer of bureaucracy that requires increased manpower to fill out properly causing costs to rise.
Decreases the incentive to businesses expand over 50 full time employees
Decreases the incentive of the individual to take ownership of their health.
Decreases the amount of full time jobs and makes the 29hr job the new rage.
Adds financial burden to states who can't print their way out.
More doctors are refusing to take medicaid leaving an increased number of people without a doc, since medicaid is far and away the most popular choice of expansion.
Expensive medical equipment that is a staple of US manufacturing just became more expensive with shiny new taxes, the incentive now being to move those jobs overseas, or pass the costs onto the patients, another cost increase.
It does NOTHING to address ER abuse
The entire premise of the bill relies on young healthy people who don't feel the need to pay for health care insurance to suddenly pay because it's the right thing for everyone else.


Decrease does not mean eliminate before you construct that strawman too.
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dude you failing...
Let me address the ER in laymen terms

Ms. Sally Ginwilly had to go to ER for her heavy menstrual bleeding. She had no health insurance or primary doctor so this problem continued with every heavy menstrual cycle racking up unpaid cost on our emergecy room, being this was the only way for Ms. Ginwilly to receive treatment. She was able to get AHCA which gave her a primary doctor and regular treatments ( birth control pills )to stop her heavy flow. No more did she have to rush to the emergency room just to get treated for her heavy menstrual cycle. Do you think her not going to ER help cost or hurt cost ?
 
Doer

Doer

Well-Known Member
abandonconflict said:
Yes, yes it does.
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But, in the light of History, that one man was correct. And he tried to round up homos as well. So he blew his cred.

His methods only, though legal, were over the top. He was held responsible for a suicide and censored and then died young, an alcoholic.

It was recognized, that we do not want to make the Communist party illegal and thus drive it under ground, so it is not true.

It has never been illegal, just UN-desireable. And Hollywood was infiltrated as we plainly see today.
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With the highly publicized Army–McCarthy hearings of 1954, and following the death of Senator Lester Hunt of Wyoming by suicide that same year,[SUP][8][/SUP] McCarthy's support and popularity faded. And, on December 2, 1954, the Senate voted to censure Senator McCarthy by a vote of 67 to 22, making him one of the few senators ever to be disciplined in this fashion. McCarthy died in Bethesda Naval Hospital on May 2, 1957, at the age of 48. The official cause of death was acute hepatitis; it is widely accepted that this was caused, or at least exacerbated, by alcoholism.[SUP][9][/SUP]
 
ginwilly

ginwilly

Well-Known Member
londonfog said:
dude you failing...
Let me address the ER in laymen terms

Ms. Sally Ginwilly had to go to ER for her heavy menstrual bleeding. She had no health insurance or primary doctor so this problem continued with every heavy menstrual cycle racking up unpaid cost on our emergecy room, being this was the only way for Ms. Ginwilly to receive treatment. She was able to get AHCA which gave her a primary doctor and regular treatments ( birth control pills )to stop her heavy flow. No more did she have to rush to the emergency room just to get treated for her heavy menstrual cycle. Do you think her not going to ER help cost or hurt cost ?
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If Sally was too poor to afford insurance before she could have gotten on medicaid. If she was too poor to pay the 10 co-pay for BC pills she could have gotten them free at any planned-parenthood clinic. If a lack of BC pills was the true cause of her problem, it would have been solved with her first heavy bleeding visit to the ER. You seem to think doctors are idiots. Poor analogy, try another.

If Sally was too poor to afford insurance, but not poor enough to qualify for medicaid, she is now on O'care with a 6k deductible. That 6k must be met before her ER visits are covered even though she was poor and needed subsidies to afford the insurance, let alone the care. If she goes to the doctor, the doctor has the right to refuse treatment without payment up front but she has a 6k deductible. Her best financial incentive is to abuse the ER until her deductible is met before seeing that doctor.

The drug seeker is the biggest abuser of ERs presently. How does the ACA address this? What if those abusers are the type of people who would refuse to pay? (shocking conclusion isn't it) but EMTALA still won't allow us to not see this person.

Because it just will still isn't a good answer.
 
londonfog

londonfog

Well-Known Member
ginwilly said:
If Sally was too poor to afford insurance before she could have gotten on medicaid. If she was too poor to pay the 10 co-pay for BC pills she could have gotten them free at any planned-parenthood clinic. If a lack of BC pills was the true cause of her problem, it would have been solved with her first heavy bleeding visit to the ER. You seem to think doctors are idiots. Poor analogy, try another.

If Sally was too poor to afford insurance, but not poor enough to qualify for medicaid, she is now on O'care with a 6k deductible. That 6k must be met before her ER visits are covered even though she was poor and needed subsidies to afford the insurance, let alone the care. If she goes to the doctor, the doctor has the right to refuse treatment without payment up front but she has a 6k deductible. Her best financial incentive is to abuse the ER until her deductible is met before seeing that doctor.

The drug seeker is the biggest abuser of ERs presently. How does the ACA address this? What if those abusers are the type of people who would refuse to pay? (shocking conclusion isn't it) but EMTALA still won't allow us to not see this person.

Because it just will still isn't a good answer.
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I see positive things in AHCA..you don't

It is now the law of the land..good luck..I'm good
 
Doer

Doer

Well-Known Member
ginwilly said:
I see positive things too, you are doing it again....

Do you understand yet how ER abuse was not addressed?
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It isn't? How so?

It seems to me after all the flotsom and jetsom is cleared, after high water confusion subsides, you may have close to 100% coverage of those that used the ER as first and last resort.

Therefore, the ER is a changed beast, it has new options of triage, funds recovery, etc. The existing ERs can morph to the needs and send people home to get a Dr. visit scheduled for that cold. (which will be over by then and you cannot have antibiotics, just because)

I see this as allowing the ERs to be that.

And, btw, drug resistant strains is an actual, real problem. ER abuse never was.
 
ginwilly

ginwilly

Well-Known Member
Doer said:
It isn't? How so?

It seems to me after all the flotsom and jetsom is cleared, after high water confusion subsides, you may have close to 100% coverage of those that used the ER as first and last resort.

Therefore, the ER is a changed beast, it has new options of triage, funds recovery, etc. The existing ERs can morph to the needs and send people home to get a Dr. visit scheduled for that cold. (which will be over by then and you cannot have antibiotics, just because)

I see this as allowing the ERs to be that.

And, btw, drug resistant strains is an actual, real problem. ER abuse never was.
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Just at my hospital alone there were 28 people with over 100 visits to the ER in a year and 114 with more than 50, more "emergencies" than most families see in a life time. You are dead wrong that ER abuse is not a real problem.

There is a 6500 deductible. Not one person has explained how just having insurance changes this fact. Are they going to magically pay that ER bill now?

EMTALA is still the law Doer, we can't send people home to see their doc anymore since the bill than we could before. The bill does nothing to address this.
 
C

ChesusRice

Well-Known Member
ginwilly said:
Just at my hospital alone there were 28 people with over 100 visits to the ER in a year and 114 with more than 50, more "emergencies" than most families see in a life time. You are dead wrong that ER abuse is not a real problem.

There is a 6500 deductible. Not one person has explained how just having insurance changes this fact. Are they going to magically pay that ER bill now?

EMTALA is still the law Doer, we can't send people home to see their doc anymore since the bill than we could before. The bill does nothing to address this.
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A single ER bill can easily be 6500 so for the other 49 I guess the hospital gets paid
 
ginwilly

ginwilly

Well-Known Member
ChesusRice said:
A single ER bill can easily be 6500 so for the other 49 I guess the hospital gets paid
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If your single bill is over 6K then you were most likely there with an emergency. This is not the abuse/drug seeking ER abuse that people are talking about.

To your point, if insurance now pays those other 49 visits instead of the hospital writing off the costs, how does insurance get cheaper?
 
C

ChesusRice

Well-Known Member
ginwilly said:
If your single bill is over 6K then you were most likely there with an emergency. This is not the abuse/drug seeking ER abuse that people are talking about.

To your point, if insurance now pays those other 49 visits instead of the hospital writing off the costs, how does insurance get cheaper?
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Because the risk is spread to a larger pool of insured people
Hospitals get paid and they lower prices
which in turn lowers the payouts the insurance companys have to pay the hospitals
rinse and repeat

A downward pressure on health care prices occur
 
ginwilly

ginwilly

Well-Known Member
ChesusRice said:
Because the risk is spread to a larger pool of insured people
Hospitals get paid and they lower prices
which in turn lowers the payouts the insurance companys have to pay the hospitals
rinse and repeat

A downward pressure on health care prices occur
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In theory...

How it works in actuality is those ER visits are written off the profit margin and the hospitals pay less taxes as a result. If those are paid now, hospitals increase profits, the demand for health care workers expand and our salaries go up, while insurance companies margins are decreased so they raise their prices. It's a rigged game that needs real reform, not what we did.
 
C

ChesusRice

Well-Known Member
ginwilly said:
In theory...

How it works in actuality is those ER visits are written off the profit margin and the hospitals pay less taxes as a result. If those are paid now, hospitals increase profits, the demand for health care workers expand and our salaries go up, while insurance companies margins are decreased so they raise their prices. It's a rigged game that needs real reform, not what we did.
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Part of the ACA
Hospitals get paid for results not readmissions
And doctors are liking that alot
 
ginwilly

ginwilly

Well-Known Member
ChesusRice said:
Part of the ACA
Hospitals get paid for results not readmissions
And doctors are liking that alot
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you'll have to provide proof that the majority are liking results oriented reimbursement. If you meant CEOs were liking it, then you'd be right.

Let's think through any unintended consequences. Would certain patients take precedent over others? How and which ones? Is it wise to treat to core measures instead of treating the individual? Has standardized one-sized fits all testing improved our education system? How will it work in this case? Are government studies up to date?

A real life anecdotal example of government in healthcare. You come to me with bad heel spurs. I know through studies and experience that acetic acid has about a 50% success rate when used with iontophoresis. Your private insurance companies will let me try ionto a few treatments in the hopes they avoid orthotics, surgery or other much more costly methods. Medicare/caid says the core measures don't meet standards so ionto with acetic acid is not reimbursed. We have to go directly to the more expensive methods we were hoping to avoid.

Another would be you come to me a year past your stroke because you still can't walk. Government studies say that brain cells don't regenerate and you will gain all you can in that first year with the majority coming in the first 6 months. Those studies were outdated 25 years ago when I went to school. We now know there is no time limit but core measures say otherwise. Here's a neat little kicker, government calls this pre-existing condition as chronic and denies your rehab coverage.
 
C

ChesusRice

Well-Known Member
ginwilly said:
you'll have to provide proof that the majority are liking results oriented reimbursement. If you meant CEOs were liking it, then you'd be right.

Let's think through any unintended consequences. Would certain patients take precedent over others? How and which ones? Is it wise to treat to core measures instead of treating the individual? Has standardized one-sized fits all testing improved our education system? How will it work in this case? Are government studies up to date?

A real life anecdotal example of government in healthcare. You come to me with bad heel spurs. I know through studies and experience that acetic acid has about a 50% success rate when used with iontophoresis. Your private insurance companies will let me try ionto a few treatments in the hopes they avoid orthotics, surgery or other much more costly methods. Medicare/caid says the core measures don't meet standards so ionto with acetic acid is not reimbursed. We have to go directly to the more expensive methods we were hoping to avoid.

Another would be you come to me a year past your stroke because you still can't walk. Government studies say that brain cells don't regenerate and you will gain all you can in that first year with the majority coming in the first 6 months. Those studies were outdated 25 years ago when I went to school. We now know there is no time limit but core measures say otherwise. Here's a neat little kicker, government calls this pre-existing condition as chronic and denies your rehab coverage.
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Since the Affordable Care Act was signed three years ago, more than 370 innovative medical practices, called accountable care organizations, have sprung up across the country, with 150 more in the works. At these centers, Medicare or private insurers reward doctors financially when their patients require fewer hospital stays, emergency room visits and surgeries — exactly the opposite of what doctors have traditionally been paid to do. The more money the organization saves, the more money its participating providers share. And the best way to save costs (which is, happily, also the best way to keep patients alive) is to catch problems before they explode into emergencies.
http://www.nytimes.com/2013/10/14/opinion/keller-obamacare-the-rest-of-the-story.html?_r=0
 
ginwilly

ginwilly

Well-Known Member
ChesusRice said:
Since the Affordable Care Act was signed three years ago, more than 370 innovative medical practices, called accountable care organizations, have sprung up across the country, with 150 more in the works. At these centers, Medicare or private insurers reward doctors financially when their patients require fewer hospital stays, emergency room visits and surgeries — exactly the opposite of what doctors have traditionally been paid to do. The more money the organization saves, the more money its participating providers share. And the best way to save costs (which is, happily, also the best way to keep patients alive) is to catch problems before they explode into emergencies.
http://www.nytimes.com/2013/10/14/opinion/keller-obamacare-the-rest-of-the-story.html?_r=0
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Again, in theory.

Let's try to think about unintended consequences again. A chronically sick patient would hurt a doctor's metrics so the incentive would be to drop those "problem" patients. Elderly and disabled need not apply.

The metrics based pay sounds good in theory but the incentives it creates are perverse. It's a typical first level thinking policy.
 
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