jj3044 wrote: thegreekdog wrote: jj3044 wrote: thegreekdog wrote:
jj3044 wrote:Is it better than letting healthcare become 33% of our GDP by the time my kids are in college? Yes, I think so.
How do you know that it's better? If you don't know that it's better (and it seems like you don't), why would you spend $1.1 trillion?
jj3044 wrote:The funny part is that I hear a lot of complaints that the bill is going to cost 1.1T. But it has the potential to save a far greater sum of money to our country than that.
It has the potential? What, in our history, leads you to believe that something the government does will save money? You are putting a lot of faith in a government that has, among other things, waived the requirements of the ACA for going on 300 different (and large) companies and that, among other things, has helped to nearly bankrupt social security, and that, among other things, has helped to make sure Medicare and Medicaid are ineffective at best.
That is correct, I don't know that it will be better. All I know is that the current system is unsustainable and WOULD have bankrupted our country. I'm pretty sure we are all in agreement there. So, I'm willing to try it. I think that there are a lot of good provisions in the bill that will help reduce the cost of healthcare in the long run. Hopefully our government made a good decision.
Which good provisions in the bill will help reduce the cost of healthcare in the long run?
Are you concerned about the assignment of waivers to various large employers?
Are you concerned that the individual mandate will require that people purchase health insurance with generous benefits and virtually no cost-sharing?
What provisions of the ACA require that premiums and costs of insurance remain static? In other words, what's to prevent all health insurance from doubling their prices?
I'm not sure if you read my older posts, but I illustrated many provisions that should reduce costs and improve outcomes. Instead of re-hashing the same post, feel free to search for them... I don't post too often so it shouldn't be hard.
As for waivers, my understanding is that those waivers are for a limited time only. I know that one company that I work with has a waiver, but that waiver expires in 2014 when they are forced to change their benefit design. That being the case, I am not worried as everyone will be on the same playing field. See, the waiver was needed for groups that wouldn't be able to afford coverage if they immediately got rid of their old designs (with lifetime limits, etc) that helped keep the cost lower for those groups. If their weren't any waivers, those groups would have been forced to drop coverage way before the healthcare exchanges were set up. The waiver allowed those companies to keep coverage until the exchanges were ready in 2014. At least, that is my understanding.
I'm not sure what you consider "generous benefits". Can you elaborate? The policies must have a minimum amount of coverage in order to be approved, but I'm not sure if that is what you are talking about here?
The ACA actually does have provisions to eliminate arbitrary rate increases. Insurers are now forced to spend at least $0.85 from every dollar on paying claims, so their overhead is limited to 15% or less. Also, I believe the ACA sets up regulators that will approve rate increase filings. They look at the financials and decide if the filing is appropriate. I happen to live in a state that their has been a health insurance commissioner for some time doing just that, so I have seen how it works. He often denies or reduces the proposed rate increases.
I did a search and there are actually too many to read. I trust that you've indicated the perceived benefits of the ACA.
(1) Waivers - You do not seem concerned. After a few minutes of searching, I cannot find anything tangible that indicates the waivers are temporary. I went on two supportive websites (Mother Jones and the SEIU website) and did not find anything there either. That's not to say I don't believe you, but the administrators of the ACA are not making it very clear that these are temporary, and that seems like a rather easy way to debunk conservative critiques. Kathleen Sebelius noted that "without the waivers, many employers would have increased premiums, and some would have dropped coverage altogether." A lobbyist for the AFL-CIO noted (in defense of his organization's waiver), that "some union health plans had a legitimate need for waivers because they had annual coverage limits lower than $750,000. If they had to increase coverage to that level they would incur significant new costs." These two statements seem to indicate that the ACA should not be implemented for all employees; just those employees of organizations which could afford the increased limits. That seems rather counterintuitive.
(2) Generous benefits - A simple example might be appropriate. Prior to the ACA, a health insurance plan cost $100 and provided potentially $200 of benefits. Subsequent to the ACA, a health insurance plan cost $120 and provided potential $500 of benefits. Does it concern you that the increase in benefits is not offset by an increase in cost?
(3) Rate increases - The law does not prevent rate increases. From the "healthcare.gov" website:
"For the first time ever in every State, insurance companies must publicly justify any rate increase of 10% or more. And the law gives States new resources to review and block these premium hikes."
I'm not sure how "public justification" of a rate increase helps. There can be a request or demand for public justification without a law. I make a demand for justification for price increases when I choose to purchase a cheaper pair of shoes. The market tends to take care of these things. Nevermind that the threshhold is 10% or more. This also seems like burden shifting by the government. Instead of the federal government assuming the burden of blocking premium hikes, it puts the onus on state governments. And, although some may call me paranoid, I'm not convinced that insurance companies don't have the wherewithal or political capital to block and attempts at blocking premium increases... especially at a state level.
I'm not suggesting that the ACA is a bad law. I don't know the answer. There are things about it that concern me (in addition to those listed above). To be honest, I would have preferred a state-run healthcare program than the ACA (although my most preferred plan would be to remove health insurance regulations completely and provide for increased competition). To be fair, as well, the ACA is essentially the Republican plan from the late 1990s and was implemented by a Republican governor in Massachusetts. Ultimately my concern is that this is a corporate boondoggle for health insurance companies that will merely pass more costs on to taxpayers. There is nothing that has happened between then and today that has convinced me otherwise.