I used to be disgusted, and now I try to be amused.

[sebastian_dangerfield]

Originally Posted by Greedy,Greedy,Greedy

Look, you can actually do the research, but there's pretty clear consensus that the cost curve has been bent and ACA has something to do with that. Here, we had the lowest increase in premium this year of any time in memory. If you are in the ACA individual market place, you probably have options you didn't have before: the individual market place was pretty thin before ACA. Anyone here have any experience with it, other than in a COBRA context?

Note also, first reaction to the failed Republican bill: Republican states looking to opt in to Medicare expansion. Something's working...

But it's pointless talking to you, of course. TM, stop me.

I do. I paid for my family's policy out of pocket for a period of time, pre-ACA.

It was impossibly complex and expensive. There were options, but none that gave you even 75% of the coverage you wanted. This was the moment I concluded actual health insurance would be preferable to this TPA thing we instead have acquired.

But that's a third rail argument. No direct purchase system can even be discussed as an option.

[Tyrone Slothrop]

Originally Posted by sebastian_dangerfield

There's no debate over the fact that many insurers have left, limiting plan choices, and that premiums are going up 25% this year.

There's a different exchange for each state. Some are in better shape than others. And the word "exploding" suggests a problem that can't be solved, a triumph of hyperbole over reality.

[Tyrone Slothrop]

Originally Posted by sebastian_dangerfield

I'm still skeptical. We've an aging population. Subsidies can only do so much.

Of what are you skeptical? You seem to be suggesting that it's just too expensive to provide health care because lots of people are old.

[sebastian_dangerfield]

Originally Posted by Tyrone Slothrop

Of what are you skeptical? You seem to be suggesting that it's just too expensive to provide health care because lots of people are old.

What's the main driver of insurer exits? The pools are sicker than anticipated, translating to losses.

What happens to people more as they get older? Medicare doesn't kick in until one is 65. The Diabetes Belt alone could render that 25% increase a yearly thing.

[Replaced_Texan]

Originally Posted by sebastian_dangerfield

What's the main driver of insurer exits? The pools are sicker than anticipated, translating to losses.

Well, for Aetna it was wanting to merge with Humana. http://ktla.com/2017/01/24/federal-j...-of-obamacare/

[Adder]

Originally Posted by sebastian_dangerfield

It was impossibly complex and expensive. There were options, but none that gave you even 75% of the coverage you wanted. This was the moment I concluded actual health insurance would be preferable to this TPA thing we instead have acquired.

You know what's (relatively) simple and covers pretty much everything you want? Medicare.

But we can't have that for everyone because it would mean no profits for insurance companies and providers get paid less...

[ThurgreedMarshall]

http://talkingpointsmemo.com/edblog/...-strong-part-2

TM

[Greedy,Greedy,Greedy]

Originally Posted by ThurgreedMarshall

http://talkingpointsmemo.com/edblog/...-strong-part-2

TM

I loved John Dean's rant, when you said, pretty much "People! I've seen what a cover-up looks like. I was in the middle of it! This is it!"

[ThurgreedMarshall]

Seems like if Obamacare fails it will be because this administration refuses to enforce the mandate.

http://www.politifact.com/punditfact...-death-spiral/

TM

[Greedy,Greedy,Greedy]

Originally Posted by ThurgreedMarshall

Seems like if Obamacare fails it will be because this administration refuses to enforce the mandate.

http://www.politifact.com/punditfact...-death-spiral/

TM

You liberals with your facts.

[sebastian_dangerfield]

Originally Posted by Adder

You know what's (relatively) simple and covers pretty much everything you want? Medicare.

But we can't have that for everyone because it would mean no profits for insurance companies and providers get paid less...

You know what's even cheaper than that, and gets insurers entirely out of the loop in terms of preventative and elective care decisions, while driving the costs down for those services? Actual insurance.

"Wait, that's crazy talk," you say. Well, yes -- yes it is. But as we currently live in a Bizarro Universe in which health care is tied to employment and our "insurers" are actually horribly run TPAs, this might just be the "lunacy" we're looking for. Really, considering what we have, any proposal judged absurd is probably far more fundamentally sound than fixes preserving anything close to the status quo.

But you're right. Our perceptions and expectations are so warped, and the systems in place to handle health care so fucked up, no normal fix could ever be implemented. Instead, the best suggestion is Medicare for all. (And seriously, that probably is the best suggestion.) How lazy, stupid, and fucked are we?

[sebastian_dangerfield]

Originally Posted by Greedy,Greedy,Greedy

You liberals with your facts.

Let's see what the 2018 and 2019 cost increases will be. If that 25% 2017 increase drops, you may have a case to be smug. If it remains static or climbs, well, "You liberals with your lack of math..."

[sebastian_dangerfield]

Originally Posted by ThurgreedMarshall

Seems like if Obamacare fails it will be because this administration refuses to enforce the mandate.

http://www.politifact.com/punditfact...-death-spiral/

TM

Actually, given 80% of plans are subsidized, if the premium increases significantly outstrip the new taxes used to cover the subsidies, and the GOP refuses to increase those taxes to adjust for those increases, doesn't that also put pressure on the program?

[Adder]

Originally Posted by ThurgreedMarshall

Seems like if Obamacare fails it will be because this administration refuses to enforce the mandate.

http://www.politifact.com/punditfact...-death-spiral/

TM

Which will mean that enrollees are sicker than expected??

[Adder]

Originally Posted by sebastian_dangerfield

You know what's even cheaper than that, and gets insurers entirely out of the loop in terms of preventative and elective care decisions, while driving the costs down for those services? Actual insurance.

There is no such thing for health care. There's preventable death for people who can't afford to pay for the care they need or there's cost sharing - what we call health insurance.

It should be obvious that the best way to share costs is universally, with the lowest possible administrative costs - Medicare - but it's not because we prefer to pretend that markets are always best.

Instead, the best suggestion is Medicare for all. (And seriously, that probably is the best suggestion.) How lazy, stupid, and fucked are we?

I don't think there's anything fucked up about it.