Here's what happened to people without health insurance since Obamacare

Is Obamacare failing?

I don't think I can go so far as to call it a failure. I think it's helped a lot of people even though some of us got screwed over by it. I know that people who were uninsured and being treated in emergency rooms were mostly paid for by everyone who was insured through higher prices for services. But now the self insured are paying even higher prices. The whole thing gives me a headache.

Watching what is happening with prescription drug prices and wondering how it all fits in with this has me scratching my head though. The news today of Epi pen makers releasing a generic version of their own drug has me really confused.

From what I read on Vox, the main problem is not enough healthy people are enrolling in the exchanges or getting insurance at all so it is not working the way it was meant to. Should have been more like Germany who also have private insurance companies and had hard and fast rules and enforcements. However, Obama does like the compromise, I guess he figured, half a loaf is better than none and he maybe thought like many of us, is a first step. Maybe it can be. I know prescription drug cost are going through the roof. I don't have to pay but my husband has to pay some and I know a lot of people who do.

Insurers Can Make Obamacare Work, But They Need Help From Congress

Clearly there is implied criticism of the other executives, and it's based on Mullaney's underlying premise that Obamacare can't be allowed to fail and that insurers are somehow obligated to do whatever it takes to try and make it work, including changing their business model.

I don't know what Mullaney's credentials are beyond being an "Economics Writer" but if he is going to write about business, I would expect him to know that changing a business model is not like changing one's underwear. A company's business model should be reflected in and drive every aspect of its operations. Changing the business model is a very big deal and is done more out of significant need or desperation than some perceived clever marketing shift. Investors usually don't take kindly to transformed business models unless it is necessary to keep the company afloat.

In any case, Oscar hasn't changed its business model it's changed its product offering in specific markets. Mullaney acknowledges that Oscar isn't employing this new business model company wide, and, in fact, it's right there with the foolish, inflexible CEOs of the other companies in withdrawing from ACA in New Jersey and Dallas. Why doesn't this new business model work in those markets? If Schlosser is so cleverly nimble, why isn't he willing to give up complaining about New Jersey and Dallas and help fix things in those markets?

What's actually changed for Oscar's consumers in New York is that they no longer have access to a wide array of health providers, AKA They don't get to keep their doctor; they don't get to keep their program.

Instead they get a "narrow network" which is a commercial euphemism for "limited and leveraged providers." Oscar can sell their policies for less because they can better control the costs by funneling business into select health provider groups. The group(s) gets a reliable, steady flow of business, but, unless they are a start-up of professionals right out of school that isn't going to be enough of an incentive to reduce their fees to the level required to justify Oscar's reduction in premium. Unless they are also a bunch of altruistic healers too, they are not going to reduce their earning levels to that of the average white collar worker so Oscar can offer more affordable coverage with no reduction in services rendered.

What will happen is what has already happened when health insurance companies buy or partner with medical networks: More patients seen daily, less time spent with patients, and fewer expensive tests and procedures recommended. All of the things that so many patients and doctors, across the country, are already complaining about. I would be willing to wager a large sum of money that Oscar's customers may be happy about the reduced premiums but they will not be happy about the reduced service.

It may be that this hybrid of insurer and provider is the only way for the private health insurance model to be sustainable (I don't happen to agree with that BTW), but it's a bit disingenuous of Mullaney and other liberals to praise Oscar for a business model they've been complaining about for years.

It's also important to note who Mullaney expects to fix the problem and how.

Obviously he points a finger at the insurance companies, and while there is no doubt a fair amount of money wasted by large corporations, it is nothing compared to the staggering amounts thrown away by the government, and most liberals have come to accept government waste as the cost of doing business: providing social programs. If I were a stockholder in any of these companies, I would demand they do more to cut waste, just as a stockholder in this country I demand the government do so as well. Apologists for either side are wrong. There is a lot more they can do, however for some reason I think there's a much better chance of seeing waste cut in corporate America than in the government of America. In any case, the insurance companies are not required (yet) to participate in Obamacare; the government is. If I don't own stock in these insurance companies I have no right to demand they cut waste and that includes executive salaries (whether or not that money is rightfully considered waste). As a citizen and taxpayer, I have every right to demand my government cut waste.

He also points the finger at government, but interestingly enough, only actually cites, specifically, one branch: Congress. The Executive Branch which, at least politically, has the greatest stake in affecting a fix is referred to as generic Regulators. A minor point perhaps, but telling, I think.

These Regulators are charged with addressing one of the most controversial aspects of the legislation, the "individual mandate." What exactly does "more aggressively" entail? Are young people who don't buy insurance not paying their fines (or are they taxes?) . Are they even being sent notices that they must pay? How does the government find them?

Or does Mullaney mean the fines/taxes need to be raised and penalties for failing to pay them stiffened? And what about all those poor college kids who can't make their tuition loan payments, and whom liberals are all desperate to help? Do we want to burden these already heavily burdened young people with another financial obligation? Or is it the kids who don't go to college who need to pay more of their fair share or else?

To a lesser and more subtle degree, he points a finger as well at the Middle Class who need to stop expecting the benefits of broader choice because it's not helping to make the program work for the poor. And who does he think is going to pay for the increased subsidies he calls for Congress to invest in the program? He explains the this increase in funding is needed to further subsidize premiums for the Middle Class so I guess it's only right that the Middle Class should pay. Oh wait a minute, he probably means that the Rich will pay for this additional funding by Congress, that and all of the other thousands of new things liberals want the government to buy. You know who they are, the very CEOs who make so much more than our heroes Mario Schlosser and John Molina, and all fly around the world in corporate jets rather than paying for first class tickets on commercial flights.

So, what it all boils down to is that Obamacare can be fixed if:

1) Insurers move to the hardly new or innovative "narrow network" approach and reduce choice and quality of service in favor of lower premiums
2) Insurers stop paying their executives multi-million dollar salaries and using corporate jets
3) Congress spends more taxpayer money on the program
4) Regulators get tougher on young, healthy scofflaws
5) The Middle Class reduces it's expectations for quality of health care service and pays more in taxes.

That's pretty simple.

I don't see it happening but maybe Mullaney and his fellow liberals can demand that the government make participation by private insurers mandatory. If left on their own, the greedy bastards will all just pull out and leave the mess to the Non-Standard Health Insurers who provide a crappy product for a low cost. That's what happened with the Auto Insurance industry. Poor people can find the coverage the government mandates, but it's insufficient, in many cases structured to encourage fraud, and involves a business model in which there is no defined customer.

Better off putting your efforts into socialized medicine Tim.

No, we just rain the money down straight on them out of our wallets.

It is not a matter of making sure "Obamacare" doesn't fail but making sure all those presently using "Obamacare" won't suddenly lose their insurance this year and making sure future enrollees have insurance. I am going to look up to see if there are any polls to see if people want to do away with "Obamacare" all together and go back to the way it was before which would be a very different question than a simple poll conducted on Obamacare. I would be very surprised if a majority did.

So far what I have found is most would favor replacing Obamacare with Sander's idea of health insurance for all, a lower percentage favor keeping as it is and only 22% favor repealing it and not replacing it with a federal funded system. Kind of what I though and I agree. Right now, it would be easier to fix than to scrap it all together, but maybe I am wrong, in which case, that would be good, then we could say, to heck with insurance companies.

Majority in U.S. Support Idea of Fed-Funded Healthcare System

This sounds good to me.

The evidence to date strongly suggests the main faults of Obamacare are serious defects in the design of a system which assumes people will follow its procedurtes blindly, without error and behave exactly as the system designers imagined they would - a rather basic error.

That, plus typical accounting failures on the part of government agencies have brought the system to collapse. More of the same poision isn't likely to improve the situation. Estimates of criminal overbilling on Medicaid and Medicare exceed 10% of the total.

Under Obamacare the insurance companies are merely the government's scapegoats. That problem is being quickly solved as the insurance companies leave the system.

At least you are an honest conservative with a conservative outlook on all problems and/or issues.

I am not sure but it isn't a strawman for you to say people are scapegoating the companies but it would be nice to cut them out all together and go with a fully funded fed insurance plan for the country.

Some of the problems have been conservative governors who have refused to participate in the program and some of the problem is healthy people thinking they are going to live charmed lives and so don't want to spend money on insurance which means the insurance companies have less money for not healthy people such as myself. (I am talking about who don't have insurance through their employers but don't receive government health care, small business owners and the like) We really need an enforced federal mandate and congress needs to pass some kind of a law to get us one or else a universal health care. Poll after poll have shown most people think Obamacare didn't go far enough rather than thinking it went too far, so people want a federal funded health care system and conservatives needs to face it and try help make it more efficient and cost effective rather than trying to sabotage it. If the problem is because it came under Obama, then change it and name it something else. If the problem is a deep rooted disliking of government programs, then get over it, people want it just like they want Medicare and other such programs.

I didn't say the people are scapegoating the insurance companies. I said the government is scapegoating them for the many follies, contradictions and errors in an il-conceived, far-reaching law that included penalties disguised as taxes and which creaded truly absurd incentives to consolidate and combine hospitals and medical service operations, even as it sought to expand demand for their output. The reult has been an increase in the cost of health care for everyone. Only a mindless government bureaucracy could come up with something so nonsensical. A business doing so would be quickly wiped out by such folly. Unfortunately, governments thrive on correcting previous stupidities with nore stupidity.

since it's actually Romney-care, maybe just call it that?

Most people didn't understand what Sanders plan would entail, just like they didn't know what the ACA would entail. Tax increases would be through the roof to cover govt insurance for 350 million people. When govt fails,there is nothing better than govt doubling down on a failure. Just give them more control over the system and they can fix everything.

"Romneycare" as the lie goes was never meant to be implemented for the entire country, it was meant for his state and his state only.

Rather than trotting out your conservative talking points, why don't you read why Obamcare is struggling right now? In every article I have read, most insurance companies point to healthy people shying away from buying insurance as the main problem. It simply leaves less revenue and it is not hard to see how that would happen. However, I think they are raising the penalty for not buying insurance and that might help the struggling insurance companies in the exchanges if people see that paying for insurance might be better than trying to buck the system.

What, me buy insurance?

That's true of heath insurance. Unless the healthy buys insurance, the system isn't going to work. The risk needs to be spread within the general population for any insurance product to work.
That is also true, because the poor uses the emergency rooms at much higher cost. Since they don't pay for prevention, they end up at the emergency rooms of hospitals that everybody else pays for.
There should be a sliding fee scale for health insurance, and make it mandatory like income tax.

http://www.theatlantic.com/international/archive/2012/06/heres-a-map-of-the-countries-that-provide-universal-health-care-americas-still-not-on-it/259153/

This was talked about before the ACA went into effect but those who did the warning were ignored out of convenience for the law. Now that it is failing you want to double down on a bad policy? Why, because we need to give socialism a chance?

Health care and education should always remain socialist. Most, if not all, developed economies provides universal health insurance. There's good reason for that; the examples are world-wide.

Most if not all of the developed economies in the world do not have the population size of the US. What works for a nation of 5-15 million people does not mean it will work for a population of 350 million. Even the UK at only 65 million doesn't compare to a nation of 350 million.