1. Welcome! Please take a few seconds to create your free account to post threads, make some friends, remove a few ads while surfing and much more. ClutchFans has been bringing fans together to talk Houston Sports since 1996. Join us!

The Bomb Buried In Obamacare Explodes Today-Hallelujah!

Discussion in 'BBS Hangout: Debate & Discussion' started by gifford1967, Dec 3, 2011.

Tags:
Page 1 of 5
  1. gifford1967

    gifford1967 Member
    Supporting Member

    Joined:
    Feb 4, 2003
    Messages:
    8,308
    Likes Received:
    4,654
    Really interesting take on what could be the most significant component of the Affordable Care Act.


    The Bomb Buried In Obamacare Explodes Today-Hallelujah!

    Rick Ungar
    Forbes.com

    I have long argued that the impact of the Affordable Care Act is not nearly as big of a deal as opponents would have you believe. At the end of the day, the law is – in the main – little more than a successful effort to put an end to some of the more egregious health insurer abuses while creating an environment that should bring more Americans into programs that will give them at least some of the health care coverage they need.

    There is, however, one notable exception – and it’s one that should have a long lasting and powerful impact on the future of health care in our country.

    That would be the provision of the law, called the medical loss ratio, that requires health insurance companies to spend 80% of the consumers’ premium dollars they collect—85% for large group insurers—on actual medical care rather than overhead, marketing expenses and profit. Failure on the part of insurers to meet this requirement will result in the insurers having to send their customers a rebate check representing the amount in which they underspend on actual medical care.

    This is the true ‘bomb’ contained in Obamacare and the one item that will have more impact on the future of how medical care is paid for in this country than anything we’ve seen in quite some time. Indeed, it is this aspect of the law that represents the true ‘death panel’ found in Obamacare—but not one that is going to lead to the death of American consumers. Rather, the medical loss ration will, ultimately, lead to the death of large parts of the private, for-profit health insurance industry.

    Why? Because there is absolutely no way for-profit health insurers are going to be able to learn how to get by and still make a profit while being forced to spend at least 80 percent of their receipts providing their customers with the coverage for which they paid. If they could, we likely would never have seen the extraordinary efforts made by these companies to avoid paying benefits to their customers at the very moment they need it the most.

    Today, that bomb goes off.

    Today, the Department of Health & Human Services issues the rules of what insurer expenditures will—and will not—qualify as a medical expense for purposes of meeting the requirement.

    As it turns out, HHS isn’t screwing around. They actually mean to see to it that the insurance companies spend what they should taking care of their customers.

    Here’s an example: For months, health insurance brokers and salespeople have been lobbying to have the commissions they earn for selling an insurer’s program to consumers be included as a ‘medical expense’ for purposes of the rules. HHS has, today, given them the official thumbs down, as well they should have. Selling me a health insurance policy is simply not the same as providing me with the medical care I am entitled to under the policy. Sales is clearly an overhead cost in any business and had HHS included this as a medical cost, it would have signaled that they are not at all serious about enforcing the concept of the medical loss ratio.

    So, can private health insurance companies manage to make a profit when they actually have to spend premium receipts taking care of their customers’ health needs as promised?

    Not a chance-and they know it. Indeed, we are already seeing the parent companies who own these insurance operations fleeing into other types of investments. They know what we should all know – we are now on an inescapable path to a single-payer system for most Americans and thank goodness for it.

    Whether you are a believer in the benefits of single-payer health coverage or an opponent, mark this day down on your calendar because this is the day seismic shifts in our health care system finally get under way.

    If you thought that the Obama Administration chickened out on pushing the nation in the direction of universal health care for everyone, today is the day you begin to understand that the reality is quite the contrary.

    If you believe that the end of private, for-profit health insurance is some type of nefarious step towards a socialist society, then you might want to attend church this Sunday to mourn the loss of health insurers being able to worm out of covering the bills of a cancer patient because she forgot to write down on her application that she had skin acne for three months when she was a teenager.

    Of course, those of you who fear the inevitable arrival of universal health care really shouldn’t be too fretful. There will always be a for-profit health insurance industry for those who want to pay for it. The only difference will be that those who cannot afford private coverage will also have an opportunity to get their families the medical care that they need

    Everyone wins-except the for-profit health insurers.

    I can live with that.

    http://www.forbes.com/sites/rickung...ried-in-obamacare-explodes-today-halleluja/2/
     
    #1 gifford1967, Dec 3, 2011
  2. Commodore

    Commodore Member

    Joined:
    Dec 15, 2007
    Messages:
    33,578
    Likes Received:
    17,551
    "If you like your plan, you can keep your plan" - Barack Obama
     
    #2 Commodore, Dec 3, 2011
  3. Rockets1616

    Rockets1616 Member

    Joined:
    Sep 30, 2007
    Messages:
    1,263
    Likes Received:
    10
    sounds good to me
     
    #3 Rockets1616, Dec 3, 2011
  4. robbie380

    robbie380 ლ(▀̿Ĺ̯▀̿ ̿ლ)
    Supporting Member

    Joined:
    Aug 16, 2002
    Messages:
    23,994
    Likes Received:
    11,171
    Let me know when the root problem of exploding health care costs is fixed.
     
    #4 robbie380, Dec 3, 2011
  5. madmonkey37

    madmonkey37 Member

    Joined:
    Jun 20, 2003
    Messages:
    2,499
    Likes Received:
    52
    The medical loss ratio was over 90% in the 1990's. I wonder what made it go down ....

    [​IMG]
     
    #5 madmonkey37, Dec 3, 2011
    1 person likes this.
  6. Raven

    Raven Member

    Joined:
    Jul 24, 2002
    Messages:
    14,984
    Likes Received:
    1,025
    Healthcare is a fundamental right. It might take another generation to fully implement universal coverage, but we will get there.

    :)
     
    #6 Raven, Dec 3, 2011
  7. thadeus

    thadeus Member

    Joined:
    Sep 14, 2003
    Messages:
    8,313
    Likes Received:
    726
    This really should have been the aim of all the healthcare debates.
     
    #7 thadeus, Dec 3, 2011
  8. Invisible Fan

    Invisible Fan Member

    Joined:
    Dec 5, 2001
    Messages:
    45,954
    Likes Received:
    28,050
    By culling the old or weak, and turning them into sweet delicious Soylent Green?


    No nation has yet figured out how to consistently contain healthcare costs. It's a work in progress as people live longer and demand costlier treatments...
     
    #8 Invisible Fan, Dec 3, 2011
  9. Gutter Snipe

    Gutter Snipe Member

    Joined:
    Jul 30, 2001
    Messages:
    2,987
    Likes Received:
    65
    Most other countries have reasonable health care costs compared to the US.

    We need to address the fundamental issues:

    1. No open pricing leads to a lack of competition on price and corruption. If I saw that MH will do prostrate cancer surgery for $100,000 and my share is $20,000, but DH does it for $50,000 and my share is $10,000, then I can go to DH and exert pressure on MH to bring their price down.

    Right now all the prices are in the dark - with negotiations and kickbacks galore.

    2. Reform the prescription drug system. Patents last too long and poor Americans can't afford drugs that are available for pennies in India. Much of the cost for drug companies is in bribing the gatekeepers (physicians).

    America is a poor country - I'd like to see us spend less money on big bang theory research and global warming research and more on medical research.

    3. Too many freeloaders and not enough payers. This is just one more area where we give free care to non-citizens. Once again, we can't afford it.
     
    #9 Gutter Snipe, Dec 3, 2011
  10. Dubious

    Dubious Member

    Joined:
    Jun 18, 2001
    Messages:
    18,318
    Likes Received:
    5,090
    I argue this with my buddy, the head of one of the largest hospital systems in Texas all the time. Basic health care has to be a national right, we already do it anyway since not even Ron Pail will let the indigent die in the streets. It has to be rationed by reasonable rational value choices, death panels is you have to call it that, we all ready do it anyway, by who has insurance that will or won't pay for certain procedures and boards that decide who will or won't get organs for transplants.

    The system is already sort of there but we just won't formalize it because of the kneejerk reactions to defining and limiting the extent of what we call basic universal healthcare .... who we will strive to cure and who we will let die, but there has to be decisions made. Should taxpayers spend $100,000 to extend the life of a 75 year old man? A political hot potato no one will touch so we get left without a single payer mandate, with private, for profits making the ethical decisions and a publicly funded spaghetti bowl of regulations and institutions dealing with the uninsured.

    Make me King and I'll fix it.
     
    #10 Dubious, Dec 3, 2011
  11. DonnyMost

    DonnyMost Member
    Supporting Member

    Joined:
    May 18, 2003
    Messages:
    48,993
    Likes Received:
    19,938
    This is not a perfect solution, but it given the constraints of the system, its about as good as we could hope for right now. Hopefully this gets the ball rolling toward single payer.
     
    #11 DonnyMost, Dec 3, 2011
  12. Commodore

    Commodore Member

    Joined:
    Dec 15, 2007
    Messages:
    33,578
    Likes Received:
    17,551
    You mean healthcare is fundamental entitlement.
     
    #12 Commodore, Dec 3, 2011
    1 person likes this.
  13. thadeus

    thadeus Member

    Joined:
    Sep 14, 2003
    Messages:
    8,313
    Likes Received:
    726
    This should be also be done with homeowner's insurance and auto insurance.

    Yeah, and I hope this is just a necessary step to a single-payer system.
     
    #13 thadeus, Dec 3, 2011
  14. mc mark

    mc mark Member

    Joined:
    Aug 31, 1999
    Messages:
    26,195
    Likes Received:
    471
    No, I'm sure Raven meant what he said.

    Excellent news!
     
    #14 mc mark, Dec 3, 2011
  15. Commodore

    Commodore Member

    Joined:
    Dec 15, 2007
    Messages:
    33,578
    Likes Received:
    17,551
    Healthcare is already a right, there is nothing stopping you from purchasing it.

    What you want is healthcare as an entitlement.
     
    #15 Commodore, Dec 3, 2011
  16. mc mark

    mc mark Member

    Joined:
    Aug 31, 1999
    Messages:
    26,195
    Likes Received:
    471
    Sort of like gays can get married already, just to someone of the opposite sex.

    right?
     
    #16 mc mark, Dec 3, 2011
  17. Commodore

    Commodore Member

    Joined:
    Dec 15, 2007
    Messages:
    33,578
    Likes Received:
    17,551
    Nope, more like you have a right to bear arms, but not a right to have someone buy you a gun. That would be an entitlement.
     
    #17 Commodore, Dec 3, 2011
  18. mc mark

    mc mark Member

    Joined:
    Aug 31, 1999
    Messages:
    26,195
    Likes Received:
    471
    Guess we'll just have to agree to disagree this fine morning.
     
    #18 mc mark, Dec 3, 2011
  19. Carl Herrera

    Carl Herrera Member

    Joined:
    Feb 16, 2007
    Messages:
    45,153
    Likes Received:
    21,575
    Bottomline: we already ain't gonna let the indigent die when they come to ERs. So, there is your Entitlement right there.

    So, the question is how best to efficiently not just let people die.
     
    #19 Carl Herrera, Dec 3, 2011
  20. Major

    Major Member

    Joined:
    Jun 28, 1999
    Messages:
    41,687
    Likes Received:
    16,216
    This gets to the heart of the problem. No one actually knows how to cut costs. But the best and most important part of this bill is that it authorizes experimenting with basically every idea that health care economists have come up with to see what works and what doesn't. Unfortunately, these tests may take several years - but they will give us much more powerful data on what really will cut costs, instead of political talking points. I have no idea why Democrats focused their talking points on the increased coverage as opposed to lowering cost.
     
    #20 Major, Dec 3, 2011
(You must log in or sign up to post here.)
Page 1 of 5

Share This Page