Why Obamacare is a Failure

I don't know, man, but I've come to the realization that in the effing US of A, I have to get a part-time job to pay for my healthcare.

Thanks, Obama.

Oh no! How can I possibly do so?

I laughed. And I am proud. Thank you.

Average salaries for American MDs, practicing primary care is in the ball park of about $220,000/year ( depending upon where you get the stats). For the UK, MDs practicing primary care medicine, under the single payer Gov regulated program, the salary is of the order of $170,000.

This is one reason why American MDs are against the Gov-single payer system and it's also why many, many MDs will not take insurance, medicare ,or medicaid payments ( These payments are too low).

OK Maporsche.

I was clearly wrong. This shows the rate of increase of premiums has slowed since Obamacare was implemented.

Thanks.

The fact that rising cost has slowed, in a system already costing way too much means that it is still rising, not that it is under control.

If the cost to operate a system has risen and accelerated exponentially every year since inception, and someone inserts a hack that doesn't eliminate the rising, but slows the rate of rising, why is that not a good thing? Because the hack didn't eliminate the rising, is that a reason to curse the hack, or find a way to build on it?

It just something for them to use, they are pulling everything out about Obama as much as they can from conservative sources. If Obama's numbers go back down, it is better for Trump. I guess they want it better for Trump because it is not going to affect Sanders in the slightest since he ain't going to be the nominee.

That's what it surely appears like, but some like Finn say I'm nuts to point out the resemblance between Lash and edgar's latest, and the currently popular right wing talking points.

It's as if you think Obama, a politician, is above criticism.
It is dangerous to see politicians as icons of virtue who can do no wrong. He's made several bad judgments. They'll let you down every time.

I see the irony coming from a worshiper of Saint Bernie, but you can't put me in a box that easily. I've openly criticized Obama's speeches at HBCUs, his over-eagerness to compromise his strengths away and other things I don't like. I won't go search for the posts, because you've frankly proven not worth the effort.

It'd be a waste of everyone's time. You "criticized" his speech? Seems a lot like poorly camouflaged hero-worship.

LOL. Yeah, this is some relevant **** you're stirring here. Go on. I'm intrigued.

Here is another's take on it.


Dan Karr
Founder and CEO, ValChoice
Political discussion aside, The Affordable Care Act (ACA) will fail for business reasons. Whether the ultimate result is the law getting repealed or modified, change is necessary to have a viable and vibrant health insurance industry that drives cost reduction and improved customer service.

The fundamental reason the ACA will fail is because it mandates a minimum Medical Loss Ratio (MLR). MLR is the percentage of premiums paid out to cover health care expenses. When this law came into effect, many American’s thought mandating MLR was good because it guaranteed a minimum level insurance companies would pay to cover health care costs. However, the unintended consequences are having the opposite effect.

The problems associated with mandating MLR are two-fold: 1) incentivizing the insurance industry to become less efficient; 2) contributing to the elimination of new insurers entering the market and increasing the level of competition.

Unintended Consequence
Taking these two points one at a time, let’s review why mandating MLR delivers the opposite of the intended consequence. The reason is that mandating MLR reduces the ability of businesses to increase profits by improving profitability (efficiency).

Take for example the need to slow or stop the rapid escalation of fees that medical service providers charge. Under this new system, cost reductions achieved by insurers driving down the cost of medical services will not contribute to the profits they earn, unless the reduction in the cost of services is matched with a reduction in insurance company overhead. While corresponding reductions in the operating cost of insurance companies — or even a slowing in cost increases — sound ideal, it’s not realistic. Therefore, the impact is a reduced incentive to control the prices medical service providers charge since these cost reductions no longer benefit the business or the shareholders.

By setting a fixed ratio of health care expenses paid to premiums earned, this new law makes increasing revenue the primary mechanism for increasing profits. As an example of how the law does not deliver the intended consequences of reduced costs, insurers are now incentivized to allow fees charged by service providers to rise, leading directly to increased revenue, and consequently increased profits. This clearly shows that legislating MLR is more likely to result in rising medical costs rather than declining costs.

Diminishing Competition
Let’s move to the second point about how mandating MLR virtually eliminates new entrants into the market. The unintended consequence of this is reduced competition, also leading to increasing prices.

New entrants break into markets by targeting market segments not already occupied by incumbents. In health insurance, the easiest market segments for new entrants to target are the individual and small group markets. This is because small group markets consist largely of emerging companies where there are no incumbent providers and the individual market experiences a high-level of churn with self-employed and unemployed people that need insurance and aren’t covered by group plans.

Startup companies typically have a younger population and therefore, much lower medical expenses. Insurance pricing laws called “community rating” mandate higher insurance prices for the risk assumed with younger plan participants. Because community rating requires higher pricing, but the risk is lower due to the younger population in startup companies, meeting MLR requirements becomes virtually impossible unless an established risk pool that includes older people already exists. The unintended consequence is that emerging insurance companies are not a viable business and competition is again limited.

Demonstrating this second point that the ACA virtually eliminated new entrants into the health insurance markets are the early results of CO-OPs (Consumer Operated and Oriented Plans) established under the ACA. These plans were established as non-profits, giving an inherent advantage of not paying taxes. Even with the advantages of tax-free operations and receiving $2 billion in government loans, after only two short years, 11 of 23 CO-OPs have already failed. In a move forbidden for private industry, some of the remaining 12 have received permission to reclassify the loans they received from the federal government as assets rather than liabilities in order to give the appearance of meeting solvency requirements imposed by regulators.

Health care costs increasing at more than two times the rate of increase in the Consumer Price Index is a problem the U.S. has suffered for decades. The ACA clearly did not cause this problem, however, the problem will worsen under any law that mandates MLR. The solution lies in pricing and cost transparency, encouraging competition and rewarding efficiency.


Dan is the founder and CEO of ValChoice, an insurance analytics company.
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This from Huffington Post

No, I wrote that it was, at the very least, absurd of you to suggest edgar and Lash are right-wing operatives.

Now you want to assume an "Aw shucks, all I did was point out a resemblance...and some, like Finn, say I'm nuts" facade.

If you didn't mean what you wrote, and you were just charged up, say it, don't try to change what's there for everyone to read.

Guilty! I suggested edgar and Lash are acting like right wing operatives.
This is the exact quote:"They should be right wing operatives, if they're not already."
What is my sentence oh Poobah?

Now let me ask you - is it equally ridiculous in your estimation, to suggest that they are perusing known right wing sources for some of their information?

Your sentence is a course in reading comprehension.

"..if they are not already" suggests they are, not simply that they "are acting like..." yet you still want to dodge what you wrote and make it an issue about me.

Either you meant what your wrote or you didn't. Is it really that hard for you to accept this?

If they don't care, it's no skin off my nose. I just have a hard time with idiotic comments and a harder time with the defense of idiotic comments.

This is why this battle between Democrats/liberals/progressives about Sanders and Clinton is so fascinating and illustrative.

I've made the argument that progressives and conservatives can't share this country for much longer in large part because of the vitriol in the communication between the two sides. Here we see the same absurd vitriol passed back and forth between two supposedly like-minded cliques. Maybe we need three new nations, One for conservatives, one for Clintonistas and one for Berners.

No, it isn't.

Of course that isn't what you wrote, but if you want to edit your original comment to reflect this new angle, I might actually agree with you.

When they can't stand to know the truth, they attack the messenger and ignore the truth.