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Pipe dream? Obamacare
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isobars



Joined: 12 Dec 1999
Posts: 14484

PostPosted: Wed Dec 04, 2013 8:39 pm    Post subject: Reply with quote

The Ocare website contractor informed Reuters yesterday that the government has agreed to a solution to the fact that there is no way to transfer Ocare signup payments to the insurance companies. It's simple and foolproof: the federal government gives each insurance a blank check and trusts them to give back what they don't deserve after reconciliation sometime next year.

Makes you feel a LOT better, doesn't it?

W couldn't have said it better: "You can fool the Left ANYTIME, with ANYTHING."

http://tinyurl.com/l5rhbt6
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techno900



Joined: 28 Mar 2001
Posts: 1518

PostPosted: Thu Dec 05, 2013 3:50 pm    Post subject: Reply with quote

From the above link iso pasted:

Quote:
Health plans will estimate how much they are owed, and submit that estimate to the government. Once the system is built, the government and insurers can reconcile the payments made with the plan data to "true up" payments, he said.


Sound business practice - NOT! Some people just live by blind faith.
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pueno



Joined: 03 Mar 2007
Posts: 2743

PostPosted: Thu Dec 05, 2013 4:56 pm    Post subject: Reply with quote

Mr. Fick-shun wrote:
...the federal government gives each insurance a blank check and trusts them to give back what they don't deserve after reconciliation sometime next year.

Oh.

You mean the same way that Cheney gave no-bid, cost-plus contracts to Halliburton and KBR?
.
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mac



Joined: 07 Mar 1999
Posts: 5477

PostPosted: Sun Dec 08, 2013 6:07 pm    Post subject: Reply with quote

By James Surowieki. You will never hear these kinds of things in a Murdoch paper.

Quote:
When it comes to health care, all anyone can talk about these days is Obamacare. And, while that may be understandable, the political furor over the program has obscured a quieter but arguably more consequential development: health-care costs in this country may finally be coming under control. As a new report from the Council of Economic Advisers details, after half a century in which medical spending has well outpaced G.D.P. growth, something has changed. From 2007 to 2010, per-capita health-care spending rose just 1.8 per cent annually. Since then, the annual increase has been a paltry 1.3 per cent.

The slowdown in spending is due in part to the recession and the tepid recovery—but not as much as you’d think. A recent paper by the Harvard economists David Cutler and Nikhil Sahni estimated that the recession explained scarcely more than a third of the spending slowdown. Oddly enough, the public debate over Obamacare has also played a role. Bob Kocher, who was a special assistant for health care in the White House in 2009 and 2010, did a report for Lawrence Summers on the past sixty years of health-care legislation, and found that when Congress seriously considered enacting health-care reform the rate of health-care spending often slowed for a year or two. Just talking about medical costs, it seems, limits medical costs. Kocher, a physician turned venture capitalist (and currently a guest scholar at the Brookings Institution), dubs this “the health-care-policy placebo effect.” As he told me, “When you’ve got politicians going around the country making speeches about how out-of-control health-care spending is killing the economy, health-care providers come to feel that it might make sense to be less aggressive in setting prices.”

Both those effects are bound to be temporary. But there’s good reason to think that the moderation of health-care spending will persist, because, according to Jason Yeung, an investor at Morgan Stanley’s Growth Team, we’re beginning to see deeper structural changes in the health-care system. Historically, costs have been hard to contain because most of the players in the system have had no incentive to do so. Hospitals and doctors have typically been paid on a fee-for-service basis: the more things they do, the more money they get. Insured patients have paid only a small fraction of the cost of their care, and insurers have just passed costs along to their customers. Employers and the government, meanwhile, have been left to foot the bill. “What we’re moving toward instead is a world in which everybody in the system is sharing financial risk,” Yeung told me. “And therefore everybody has an incentive to control costs.”

For consumers, this means higher deductibles and co-pays, and having to think more about prices. A peculiar feature of the American health-care system is the enormous variation in prices that hospitals charge for a procedure, which often are not correlated with quality. So in 2011 California adopted a system of “reference-based pricing” for state workers and retirees. If you needed hip-replacement surgery, say, the state would cover you for the amount charged (minus a deductible) at forty-one “value” hospitals in the state. If you went for a costlier option, you had to make up the difference. Most people chose one of the value hospitals, and their outcomes were similar to those of people who chose the more expensive hospitals. The state saved money, and the threat of losing customers, in turn, led the more expensive hospitals to cut prices; one study found that the price of joint-replacement surgery fell by about a third.

The success of the experiment has inspired other players—like the insurer WellPoint—to follow suit. Meanwhile, a McKinsey study of almost a thousand plans on the A.C.A.’s health-care exchanges found that nearly half had narrower networks of hospitals and doctors than most plans currently offer. Narrower networks let insurers push their customers toward cheaper hospitals, and also give them more leverage in bargaining down prices.

The Affordable Care Act is also helping hold down costs by changing incentives for hospitals and doctors. For instance, it penalizes hospitals when Medicare patients with certain conditions are readmitted within thirty days, on the assumption that this will encourage hospitals to offer better care initially, and to be diligent in following up. And the penalties are having an effect—since the A.C.A. passed, readmission rates have fallen. “Once hospitals feel that gut reaction of not getting paid when the patient has to be readmitted on the twenty-fifth day,” Yeung says, “that reverberates through the whole system.”

What all these initiatives have in common is the idea that health-care providers are going to be paid based on the value they deliver, rather than on the services they perform. We’re in the early stages of that process: Kocher points out that fee-for-service likely still accounts for more than ninety per cent of health-care spending. And changing the system is going to be politically challenging. In theory, after all, reining in health-care spending sounds great. But in practice things like narrower networks limit patients’ ability to see the doctors they want, while less money spent on health care means lower incomes for many doctors and hospitals. So some blowback is inevitable. Still, the changes we’ve seen in the past few years are going to be difficult to stop, because just about everyone now recognizes that when it comes to health care we spend far too much for the results we get. “No one knows when things are really going to change,” Yeung said. “But, even if you’re in a room with no clocks, you can know that when it strikes midnight the world will be different.” ♦
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nw30



Joined: 21 Dec 2008
Posts: 1860
Location: The eye of the universe, Cen. Cal. coast

PostPosted: Sun Dec 08, 2013 7:52 pm    Post subject: Reply with quote

mac wrote:
By James Surowieki. You will never hear these kinds of things in a Murdoch paper.


So what liberal paper or blog did this come from?
BajaDean needs to know, pronto!

Anyway, I read it, and one thing is still true, and this article reaffirms it, this whole thing, just like BHO's campaign is relying on one thing, HOPE.
I've never thought HOPE was a sound policy.
HOPE that the young can be persuaded to sign up, otherwise, all this analysis, based on HOPE, can go down the drain.

_________________
I don't drink the 'cool' aid, I drink tequila, it's more honest.
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mac



Joined: 07 Mar 1999
Posts: 5477

PostPosted: Sun Dec 08, 2013 8:30 pm    Post subject: Reply with quote

My god Martha, it has numbers in it. It must be liberal, and its probably communist! Call Joe McCarthy, quick!
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keycocker



Joined: 10 Jul 2005
Posts: 3525

PostPosted: Sun Dec 08, 2013 8:32 pm    Post subject: Reply with quote

I am a big fan of hope.
Without it we have no ......
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stevenbard



Joined: 11 Nov 1993
Posts: 4313

PostPosted: Mon Dec 09, 2013 12:11 am    Post subject: Reply with quote

http://www.ft.com/intl/cms/s/0/994951f8-5e71-11e3-8621-00144feabdc0.html#axzz2mx244e86


For you believers in Obamacare, let's hope he changes or you'll be dying with bedsores if you're middle class.

“We need some recognition that we’re doing a service to the community. But we can’t do it for free. And we can’t do it at a loss. No other business would do that,” exclaims the president of the California Medical Association, as The Washington Examiner reports, independent insurance brokers estimate 70% of California's 104,000 licensed doctors are boycotting the exchange. “The Covered California board says we have plenty of doctors, and they allege they have 85 percent of doctors participating, but they’ve shown no numbers," and if a large number of doctors either balk at participating in the exchange or retire, the state’s medical system could be overwhelmed. “Enrollment doesn’t mean access, because there aren’t enough doctors to take the low rates of Medicaid,” warns one health director. “There aren’t enough primary care physicians, period.”
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isobars



Joined: 12 Dec 1999
Posts: 14484

PostPosted: Mon Dec 09, 2013 2:34 pm    Post subject: Reply with quote

stevenbard wrote:
70% of California's 104,000 licensed doctors are boycotting the exchange...

and 44% nationwide, according to polls. Lessee ... so far costs -- premiums and deductibles -- are going up farther and faster than even talk radio expected, far more have lost their insurance than have bought any, most premiere hospitals have been excluded from the exchanges, many critical drugs costing 5 figures per year will not be covered, people of ordinary means needing premiere care will thus just have to die, the vast majority of new enrollments are for the free stuff (Medicaid), even THAT isn't free yet it STILL threatens many states' solvency, Ocare architect Ezekial Emanuel admits under pressure that Ocare was never intended to reduce consumer health care costs, some states have only ONE participating insurance provider and thus no competition, we STILL can't buy insurance across state lines and thus must often pay exorbitant prices, 5M have already lost their insurance, 70M-90M more will lose theirs in 2014, only 20% of the youth who voted this clown into office plan to even consider buying Ocare, that money shortfall will force Obama to raise taxes and fees to pay for it, that will in turn stifle the economy even more and LOWER federal revenues, Obama is STILL openly and shamelessly lying about it from the podium, even the most extreme leftward media and demagogues are catching on and raising hell about it all, and your kids will pay for all this with money and shitty healthcare.

How's that working out for any of you?


Last edited by isobars on Mon Dec 09, 2013 9:09 pm; edited 3 times in total
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swchandler



Joined: 08 Nov 1993
Posts: 5969

PostPosted: Mon Dec 09, 2013 3:10 pm    Post subject: Reply with quote

Bard, why do you link us to a bogus worthless website? I have repeatedly tried to view the article that you linked, and the Financial Times trips it up a sign up screen to pay for their crap. You try to close it and move beyond it, and it repeatedly comes up over and over. What a bunch of crap!
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