WSJ article on how screwed up our health care system is

[Junior]

Obamacare is trying to fix some of this but nobody seems to understand that

Trying perhaps but it was rushed through too quickly and relied too much on "who wouldn't want that" and "it's the right thing to do" that it wasn't done right and well-thought out.

And people also don't understand that Obamacare is an ongoing systemic change, not a one-time policy that is complete; it's nowhere near being a finished revamped system

But things should be a pretty much finished product before they are made law. Not that you can't change laws but they should be more well-thought-out so they at least work as enacted.

 

Perhaps it would help if there wasn't an effort to undercut it at every turn.

http://www.nationaljournal.com/columns/washington-inside-out/the-unprecedented-and-contemptible-attempts-to-sabotage-obamacare-20130724

[tschu]

I wasn't expecting that article to take the hilarious turn of going after Roger Goodell, lol. Maybe focus on other people with actual political power

[Mavric]

Perhaps it would help if there wasn't an effort to undercut it at every turn.

http://www.nationalj...macare-20130724

Pretty sure none of that has anything to do with the law that was passed.

[strigori]

The root of the issue is with healthcare we have the only good or service in existence where the price is not plainly available upfront. Many places will not even give a quote for a procedure.

 

Imagine if other businesses operated like our healthcare did.

 

You walk into a grocery store, get a cart and start loading up the things you want. Only there is no pricing anywhere to be seen, and asking gets you no answer. When you get to the register, at this point you are asked "How are you going to pay today?" How you pay will change your cost, but you can't see the differences upfront. So you sign a legally binding agreement to pay, before you they start ringing up your stuff. Only after you have signed, the items are rung up. You still do not get to see a price, instead the cashier says "We will bill you, expect an itemized bill in a few weeks"

 

there is no way in hell anyone lets a system like that exist on anything else. Why do we let it persist on healthcare? A very simple law requiring price listings for every procedure, medicine, doctor fee and so on, being posted would do absolute wonders in change to the system.

That is true but there are a lot of things about the health care industry that make it different. To use your analogy, you can't go into a grocery store, fill your cart then get to the checkout line and tell them you can't afford the groceries so they let you walk out without paying.

People do that all the time with a credit card, and then default on the card. You're just changing who the debt collector is. Many people end up filing bankruptcy and losing pretty much everything they own, because of the screwed medical costs.

 

And how many people cant afford something because the prices are moved depending on how you are paying? There is no other purchasable good or service where you are flat out denied a price upfront. There was a study done on appendectomies in California not that long ago, and the cost differences for the surgery varied between less than $2000 to in excess of $180,000.

 

I dare anyone to find issue with a law requiring all hospitals/clinics/whatever to post a price list for all offered services.

[Junior]

I wasn't expecting that article to take the hilarious turn of going after Roger Goodell, lol. Maybe focus on other people with actual political power

 

Yea, the Goodell thing was odd, but overall it makes a valid point.

[Mavric]

The root of the issue is with healthcare we have the only good or service in existence where the price is not plainly available upfront. Many places will not even give a quote for a procedure.

 

Imagine if other businesses operated like our healthcare did.

 

You walk into a grocery store, get a cart and start loading up the things you want. Only there is no pricing anywhere to be seen, and asking gets you no answer. When you get to the register, at this point you are asked "How are you going to pay today?" How you pay will change your cost, but you can't see the differences upfront. So you sign a legally binding agreement to pay, before you they start ringing up your stuff. Only after you have signed, the items are rung up. You still do not get to see a price, instead the cashier says "We will bill you, expect an itemized bill in a few weeks"

 

there is no way in hell anyone lets a system like that exist on anything else. Why do we let it persist on healthcare? A very simple law requiring price listings for every procedure, medicine, doctor fee and so on, being posted would do absolute wonders in change to the system.

That is true but there are a lot of things about the health care industry that make it different. To use your analogy, you can't go into a grocery store, fill your cart then get to the checkout line and tell them you can't afford the groceries so they let you walk out without paying.

People do that all the time with a credit card, and then default on the card. You're just changing who the debt collector is. Many people end up filing bankruptcy and losing pretty much everything they own, because of the screwed medical costs.

 

And how many people cant afford something because the prices are moved depending on how you are paying? There is no other purchasable good or service where you are flat out denied a price upfront. There was a study done on appendectomies in California not that long ago, and the cost differences for the surgery varied between less than $2000 to in excess of $180,000.

 

I dare anyone to find issue with a law requiring all hospitals/clinics/whatever to post a price list for all offered services.

The article in the OP states he was actually give two different sets of prices up front.

[topekahusker]

How many of us carry uninsured motorist protection on our auto policies even though most states mandate insurance in order to obtain plates for your cars? A person obtains a policy prior to applying for their tags and then can lapse the policy.

 

The same problem is going to happen with Obamacare. A person obtains a policy so they can certify coverage on their tax return to avoid the penalty for not having health insurance. Then they lapse the coverage and show up in the clinic and/or hospital for treatment only to have the reimbursement denied after the bills are submitted for payment. This is one of the reasons the IRS is in the process of hiring thousands of new employees to 'enforce' this new law.

[sd'sker]

Obamacare is trying to fix some of this but nobody seems to understand that

Trying perhaps but it was rushed through too quickly and relied too much on "who wouldn't want that" and "it's the right thing to do" that it wasn't done right and well-thought out.

is this even true? or is this just a fabricated criticism people say who do not like the law? i need more specifics on why it is believed that it was 'rushed' through and 'not well thought-out'.

 

laws are compromises, as was this. i would like to see an example of a law this big that was 'done right' and 'well-thought out'.

 

i think, given the circumstances, this was as good as we were going to get at reforming healthcare. obviously it is not perfect, but when an entire party would rather see the president's ideas fail rather than work together to pass comprehensive reform, what do you expect to happen?

 

again, given the circumstances, it seems pretty well-thought out.

[Mavric]

Here's one list:

 

1. The CLASS Act: ABANDONED, THEN REPEALED

2. Exchanges: MISSED DEADLINES

3. HHS mandate: DELAYED; UNDER LEGAL CHALLENGE

4. Small business plan choice: DELAYED

5. Child-only plans: UNINTENDED CONSEQUENCES

6. Basic health plan: DELAYED

7. High-risk pools: UNDERPERFORMING; FUNDING LOW

8. Early retiree reinsurance: BROKE

9. Waivers: UNINTENDED CONSEQUENCES

10. Co-ops: DEFUNDED

11. “Employee free choice”: REPEALED

12. Medicaid expansion: REJECTED BY MANY STATES

 

To me the waivers is the biggest example. If the law is so great, why did the same administration that pushed for it almost immediately turn around and tell a bunch of companies they could take a pass? And why only them?

[Foppa]

I live in New Zealand, in case you didn't know already. I'm not sure I completely understand the taxes that come out of my paycheck, but it's pretty comparable to what came out of my checks when I worked in the States for 20 years. The only difference I notice is that I don't have any money going into a similar Social Security type system (which no one will end up seeing anyway). Anyway, here are my health care fees I've racked up here so far:

 

Severe sinus infection: $14 doctor visit, $10 meds

2 knee surgeries (1st for torn meniscus, 2nd for torn ACL): $0 MRI, $0 for both surgeries, $34 for pain meds and anti-inflammatories

Wife giving birth to our son: $30 for 3 different ultrasounds, $46.50 in hospital parking over 3 days.

 

I'm not standing up for privatized insurance or Obamacare...all I know is, this country seems to get it, as do others. I'm hardly complaining.

[HuskerLuke]

Obamacare is trying to fix some of this but nobody seems to understand that

 

ObamaCare is completely broken as a law, will never work without significant overhaul, and frankly there's no use pretending otherwise.

 

The only real example I need is the law's main mechanism for achieving universal coverage. There are actually two facets to the law here: the individual mandate, and the ban on denying people with pre-existing conditions. Because sick people are expensive to insure, insurance companies won't insure them because they're a bad business deal. To offset the insurance companies' losses by insuring sick people, ObamaCare seeks to force those who voluntarily don't have health insurance (almost all young, healthy people) into the system. Additionally, these people will have to pay significantly higher premiums than they normally would because again, the insurance companies have to recoup their losses from the sick people that ObamaCare now forces them to take.

 

The reason this won't work is because young people will not be forced into the healthcare system. According to the Kaiser Institute, someone my age, with my income level could get the lowest level plan (Bronze) for a mere $2,500 a year. Or I could forego coverage and pay a tax penalty of $250 a year. This is the option that I am going to go with, because I have no major problems, and should one appear, guess what? Insurance companies can no longer discriminate based on pre-existing conditions, so if I get diagnosed with cancer, I can enroll anyway, and suddenly, a person like me who is supposed to help bankroll this whole operation, is a huge liability.

 

This law is a total bust. My personal preference would be for full repeal, but I imagine an overhaul is more likely.

[sd'sker]

Obamacare is trying to fix some of this but nobody seems to understand that

 

ObamaCare is completely broken as a law, will never work without significant overhaul, and frankly there's no use pretending otherwise.

 

The only real example I need is the law's main mechanism for achieving universal coverage. There are actually two facets to the law here: the individual mandate, and the ban on denying people with pre-existing conditions. Because sick people are expensive to insure, insurance companies won't insure them because they're a bad business deal. To offset the insurance companies' losses by insuring sick people, ObamaCare seeks to force those who voluntarily don't have health insurance (almost all young, healthy people) into the system. Additionally, these people will have to pay significantly higher premiums than they normally would because again, the insurance companies have to recoup their losses from the sick people that ObamaCare now forces them to take.

 

The reason this won't work is because young people will not be forced into the healthcare system. According to the Kaiser Institute, someone my age, with my income level could get the lowest level plan (Bronze) for a mere $2,500 a year. Or I could forego coverage and pay a tax penalty of $250 a year. This is the option that I am going to go with, because I have no major problems, and should one appear, guess what? Insurance companies can no longer discriminate based on pre-existing conditions, so if I get diagnosed with cancer, I can enroll anyway, and suddenly, a person like me who is supposed to help bankroll this whole operation, is a huge liability.

 

This law is a total bust. My personal preference would be for full repeal, but I imagine an overhaul is more likely.

if there was a full repeal, what would you prefer as the alternative?

[HuskerLuke]

if there was a full repeal, what would you prefer as the alternative?

 

Frankly, what we had before was better than what we have now because it didn't put our entire system on the trajectory to collapse.

 

That said, a few reforms that I could get behind:

 

1. Force hospitals and other medical providers to publicize procedure costs. Competition there would work wonders.

2. Allow insurance companies to compete nationally instead of on a state-by-state basis (do you think BCBS's monopoly in Nebraska is good for affordability?)

3. Tort reform, including loser pays laws, and aggressive caps on medical malpractice lawsuit awards.

4. Use the tax system to encourage high deductible plans over low deductible plans.

5. Some sort of government-run plan for the 10 percent or so who can't get health insurance for one reason or another.

[carlfense]

ObamaCare is completely broken as a law, will never work without significant overhaul, and frankly there's no use pretending otherwise.

 

The only real example I need is the law's main mechanism for achieving universal coverage. There are actually two facets to the law here: the individual mandate, and the ban on denying people with pre-existing conditions. Because sick people are expensive to insure, insurance companies won't insure them because they're a bad business deal. To offset the insurance companies' losses by insuring sick people, ObamaCare seeks to force those who voluntarily don't have health insurance (almost all young, healthy people) into the system. Additionally, these people will have to pay significantly higher premiums than they normally would because again, the insurance companies have to recoup their losses from the sick people that ObamaCare now forces them to take.

 

The reason this won't work is because young people will not be forced into the healthcare system. According to the Kaiser Institute, someone my age, with my income level could get the lowest level plan (Bronze) for a mere $2,500 a year. Or I could forego coverage and pay a tax penalty of $250 a year. This is the option that I am going to go with, because I have no major problems, and should one appear, guess what? Insurance companies can no longer discriminate based on pre-existing conditions, so if I get diagnosed with cancer, I can enroll anyway, and suddenly, a person like me who is supposed to help bankroll this whole operation, is a huge liability.

 

This law is a total bust. My personal preference would be for full repeal, but I imagine an overhaul is more likely.

You might want to read about the open enrollment periods before proceeding with your scheme.

 

Then again . . . you sound pretty sure about it.

[sd'sker]

if there was a full repeal, what would you prefer as the alternative?

 

Frankly, what we had before was better than what we have now because it didn't put our entire system on the trajectory to collapse.

 

That said, a few reforms that I could get behind:

 

1. Force hospitals and other medical providers to publicize procedure costs. Competition there would work wonders.

2. Allow insurance companies to compete nationally instead of on a state-by-state basis (do you think BCBS's monopoly in Nebraska is good for affordability?)

3. Tort reform, including loser pays laws, and aggressive caps on medical malpractice lawsuit awards.

4. Use the tax system to encourage high deductible plans over low deductible plans.

5. Some sort of government-run plan for the 10 percent or so who can't get health insurance for one reason or another.

i think depending on who you asked, many would say the system was already collapsing.

 

i like your recommendations, except tort reform. that is a red herring a certain group of people love to point to because it is an easy target and they hate corporate liability in the first place.