Debate Now An Unhappy Birthday for Obamacare?

[Foxfyre]

I support the ACA for selfish reasons, the wife makes lots of money making sure health providers (hospitals) are in compliance.......

Heh.. you and Liz Fowler.

If you've got a piece of the action, it's not a bad gig.

She actually fell into it by accident, she worked medical records before she went into government contracting so she knows medical coding, admin and Gov-speak, perfect for what hospitals need to meet Meaningful Use requirements but no, she's not making the type of money Fowler is making. Alas......

Well I am one who thinks that you don't bite the hand that feeds you. And I don't fault anybody for taking opportunity that is there and somebody is going to do anyway so long as it is honest and ethical work. So a discussion like this would not be advisable for you or her.

But I sure would like to be a fly on the wall to hear what she knows in private.

 

[Ringel05]

I support the ACA for selfish reasons, the wife makes lots of money making sure health providers (hospitals) are in compliance.......

Heh.. you and Liz Fowler.

If you've got a piece of the action, it's not a bad gig.

She actually fell into it by accident, she worked medical records before she went into government contracting so she knows medical coding, admin and Gov-speak, perfect for what hospitals need to meet Meaningful Use requirements but no, she's not making the type of money Fowler is making. Alas......

Well I am one who thinks that you don't bite the hand that feeds you. And I don't fault anybody for taking opportunity that is there and somebody is going to do anyway so long as it is honest and ethical work. So a discussion like this would not be advisable for you or her.

But I sure would like to be a fly on the wall to hear what she knows in private.

She's not on the inside so to speak, all she does is make sure everyone understands the regs in plain English and makes sure the new reporting programs (and some old) have the correct data input fields, first what is required and second what each department needs on top of the mandate.
She organizes the assets and oversees much of the implementation mostly from a IT perspective which is kinda funny because while she knows the medical coding and medical coding software she's pretty much clueless when it comes to technology. She's a manager who gets the job done and unlike the similar job in Podunk where the hospital is constantly mismanaging money she's now working for a large, growing healthcare system.

 

[Sun Devil 92]

Just taking one point from your post, I say FOUL on the focus on keeping people healthy. If that was the case they would have been looking for ways to increase the healthcare that is actually AVAILABLE to the people. They would have promoted policies that make routine health maintenance affordable instead of a lot of authoritarian rules, regulations, and mandates that have diminished the access to healthcare for many as well as greatly increase the cost for many.

What do you think has been happening?

Evidence-based preventive care is carved out of cost-sharing (even catastrophic, i.e. sub-bronze, plans have to offer primary care visits outside the plan's deductible). One of the new features they rolled out on healthcare.gov last open enrollment period was the ability to sort plan offerings by the medical management programs they offer (e.g., heart disease, diabetes, asthma, high blood pressure, etc) to better connect people to plans that meet their needs.

New primary care models that increase capacity and improve delivery are being rolled out. We just had a record residency Match Day and most of the growth was due to new money being put into training additional primary care doctors.

Meanwhile, just last week you had another announcement of new funding for community health services:

Health and Human Services Secretary Sylvia M. Burwell announced today approximately $101 million in Affordable Care Act funding to 164 new health center sites in 33 states and two U.S. Territories for the delivery of comprehensive primary health care services in communities that need them most. These new health centers are projected to increase access to health care services for nearly 650,000 patients.

That's not an isolated event, it's emblematic of the ongoing funding being poured into primary care. The PricewaterhouseCoopers brief on the ACA at 5 years that I've already referenced tallies some of the investments the ACA is making in expanding access to primary care:

Not to mention that ACOs are now being paid to keep people healthy, hospitals are being paid to keep healthy (which is why most of them have or are rolling out population health management strategies).

Keeping people healthy is the name of the game now.

Where is that 31 billion coming from ?

 

[Sun Devil 92]

I am asking where the savings came from. That was the question I asked...pure and simple.

I know I don't always ask clearly.

So I'll keep trying.

Their cost sharing has dropped....does that mean things cost less or someone else is picking up the tab.

Don't try to read anything into it. It is just a question.

A critical thing to understand here (and in all things) is that health care in America doesn't cost $3 trillion because health care in America costs $3 trillion. It costs $3 trillion because those who fork over that money can be convinced or coerced to do so. "Cost" is used synonymously with "price" at times but price is just what people can be made willing to pay, and actual underlying cost tends to creep up as incentives for efficiency and wise use of resources disappear.

As for Medicare Part D, what HHS (and I guess by extension me) is talking about is a benefit change that saves millions of Americans on direct costs because it covers more of their prescription drug costs. Has the cost they used to pay but are now free of descended upon the taxpayer (as opposed to coming out of the puffed up "costs" that drug manufacturers pass on to payers)? Maybe, I don't really know--Medicare Part D isn't really my thing. But if it has the impact for the taxpayer has been minimal, since total per beneficiary Medicare spending is actually declining, which is not something that happens for Medicare. Even as the donut hole has been closing.

My scrip prices, and other costs, have gone down with ACA but for those who are not aware of it, Medicare is insurance for which you pay a premium.

Medicare started out much as ACA has - some problems that needed to be addressed. The difference was that congress wanted to fix what was wrong in order to benefit all Americans. As we all know, ACA has been passed more times than any other law and I've read the Repubs plan to waste even more tax payer's money in their insane campaign to take affordable health care insurance away from us.

For those who have not seen the documentary or read the book, Money Driven Medicine is a real eye opener.

Yes, well I can't get a plan for $70 like I had before for one of my adult children. It's now going to cost $300 or so.

That isn't affordable health care for us.

And spare me the "junk plan" B.S.

 

[Ravi]

I support the ACA for selfish reasons, the wife makes lots of money making sure health providers (hospitals) are in compliance.......

Heh.. you and Liz Fowler.

If you've got a piece of the action, it's not a bad gig.

She actually fell into it by accident, she worked medical records before she went into government contracting so she knows medical coding, admin and Gov-speak, perfect for what hospitals need to meet Meaningful Use requirements but no, she's not making the type of money Fowler is making. Alas......

Well I am one who thinks that you don't bite the hand that feeds you. And I don't fault anybody for taking opportunity that is there and somebody is going to do anyway so long as it is honest and ethical work. So a discussion like this would not be advisable for you or her.

But I sure would like to be a fly on the wall to hear what she knows in private.

She's not on the inside so to speak, all she does is make sure everyone understands the regs in plain English and makes sure the new reporting programs (and some old) have the correct data input fields, first what is required and second what each department needs on top of the mandate.
She organizes the assets and oversees much of the implementation mostly from a IT perspective which is kinda funny because while she knows the medical coding and medical coding software she's pretty much clueless when it comes to technology. She's a manager who gets the job done and unlike the similar job in Podunk where the hospital is constantly mismanaging money she's now working for a large, growing healthcare system.

Fascinating. So not only has the ACA made it possible for millions to have access to healthcare, it has also created jobs.

 

[dblack]

I support the ACA for selfish reasons, the wife makes lots of money making sure health providers (hospitals) are in compliance.......

Heh.. you and Liz Fowler.

If you've got a piece of the action, it's not a bad gig.

She actually fell into it by accident, she worked medical records before she went into government contracting so she knows medical coding, admin and Gov-speak, perfect for what hospitals need to meet Meaningful Use requirements but no, she's not making the type of money Fowler is making. Alas...... [emoji38]

Well I am one who thinks that you don't bite the hand that feeds you. And I don't fault anybody for taking opportunity that is there and somebody is going to do anyway so long as it is honest and ethical work. So a discussion like this would not be advisable for you or her.

But I sure would like to be a fly on the wall to hear what she knows in private.

She's not on the inside so to speak, all she does is make sure everyone understands the regs in plain English and makes sure the new reporting programs (and some old) have the correct data input fields, first what is required and second what each department needs on top of the mandate.
She organizes the assets and oversees much of the implementation mostly from a IT perspective which is kinda funny because while she knows the medical coding and medical coding software she's pretty much clueless when it comes to technology. She's a manager who gets the job done and unlike the similar job in Podunk where the hospital is constantly mismanaging money she's now working for a large, growing healthcare system.

Fascinating. So not only has the ACA made it possible for millions to have access to healthcare, it has also created jobs.

Gobs of 'em. Hundreds of thousands of people, who might otherwise be doing useful work, will be shuffling papers in the name of insurance industry profits. Makes you proud to be an American, eh?

 

[Ringel05]

I support the ACA for selfish reasons, the wife makes lots of money making sure health providers (hospitals) are in compliance.......

Heh.. you and Liz Fowler.

If you've got a piece of the action, it's not a bad gig.

She actually fell into it by accident, she worked medical records before she went into government contracting so she knows medical coding, admin and Gov-speak, perfect for what hospitals need to meet Meaningful Use requirements but no, she's not making the type of money Fowler is making. Alas......

Well I am one who thinks that you don't bite the hand that feeds you. And I don't fault anybody for taking opportunity that is there and somebody is going to do anyway so long as it is honest and ethical work. So a discussion like this would not be advisable for you or her.

But I sure would like to be a fly on the wall to hear what she knows in private.

She's not on the inside so to speak, all she does is make sure everyone understands the regs in plain English and makes sure the new reporting programs (and some old) have the correct data input fields, first what is required and second what each department needs on top of the mandate.
She organizes the assets and oversees much of the implementation mostly from a IT perspective which is kinda funny because while she knows the medical coding and medical coding software she's pretty much clueless when it comes to technology. She's a manager who gets the job done and unlike the similar job in Podunk where the hospital is constantly mismanaging money she's now working for a large, growing healthcare system.

Fascinating. So not only has the ACA made it possible for millions to have access to healthcare, it has also created jobs.

Yup, and that money to pay these people has to come from somewhere, right now hospitals and other healthcare facilities are forking out hundreds of thousands of dollars to meet compliance or face a minimum $50k Federal fine, just the first fine. Eventually those costs will get passed on to the "consumer".

 

[Greenbeard]

She's not on the inside so to speak, all she does is make sure everyone understands the regs in plain English and makes sure the new reporting programs (and some old) have the correct data input fields, first what is required and second what each department needs on top of the mandate.
She organizes the assets and oversees much of the implementation mostly from a IT perspective which is kinda funny because while she knows the medical coding and medical coding software she's pretty much clueless when it comes to technology. She's a manager who gets the job done and unlike the similar job in Podunk where the hospital is constantly mismanaging money she's now working for a large, growing healthcare system.

Nothing wrong with making sure a hospital system does its job well. That's important work.

Where is that 31 billion coming from ?

If you mean why is creating all those new primary care providers deficit neutral, that would be Title IX of the ACA: Revenue Offset Provisions.

Gobs of 'em. Hundreds of thousands of people, who might otherwise be doing useful work, will be shuffling papers in the name of insurance industry profits. Makes you proud to be an American, eh?

She works for a hospital system not an insurer, genius.

 

[dblack]

She's not on the inside so to speak, all she does is make sure everyone understands the regs in plain English and makes sure the new reporting programs (and some old) have the correct data input fields, first what is required and second what each department needs on top of the mandate.
She organizes the assets and oversees much of the implementation mostly from a IT perspective which is kinda funny because while she knows the medical coding and medical coding software she's pretty much clueless when it comes to technology. She's a manager who gets the job done and unlike the similar job in Podunk where the hospital is constantly mismanaging money she's now working for a large, growing healthcare system.

Nothing wrong with making sure a hospital system does its job well. That's important work.

Where is that 31 billion coming from ?

If you mean why is creating all those new primary care providers deficit neutral, that would be Title IX of the ACA: Revenue Offset Provisions.

Gobs of 'em. Hundreds of thousands of people, who might otherwise be doing useful work, will be shuffling papers in the name of insurance industry profits. Makes you proud to be an American, eh?

She works for a hospital system not an insurer, genius.

Let's ask Ringel05 : Are the increased compliance requirements based on the insurance mandates from ACA?

The point being, the law that your sponsors have foisted on us is rent-seeking corporatism of the worst kind. I creates layers upon layers of useless bureaucracy with the primary goal of keeping your precious insurance companies in tall cotton.

 

[Greenbeard]

Are the increased compliance requirements based on the insurance mandates from ACA?

The point being, the law that your sponsors have foisted on us is rent-seeking corporatism of the worst kind. I creates layers upon layers of useless bureaucracy with the primary goal of keeping your precious insurance companies in tall cotton.

I hate to be the bearer of obvious news, but hospitals don't comply with insurance regulations. I know you can't tell the difference between insurers and providers, which is why it continues to amuse me that you think I work for an insurer. But let's face facts, dude: you don't know shit about shit.

You've got a made-up libertarian view of reality that you've never bothered to check against, you know, reality and so you just say things. And assume they're correct. Good luck with that!

 

[dblack]

Are the increased compliance requirements based on the insurance mandates from ACA?

The point being, the law that your sponsors have foisted on us is rent-seeking corporatism of the worst kind. I creates layers upon layers of useless bureaucracy with the primary goal of keeping your precious insurance companies in tall cotton.

I hate to be the bearer of obvious news, but hospitals don't comply with insurance regulations. I know you can't tell the difference between insurers and providers, which is why it continues to amuse me that you think I work for an insurer. But let's face facts, dude: you don't know shit about shit.

I know shit when I smell it. And your propaganda reeks to high-heaven.

 

[Greenbeard]

I know shit when I smell it.

Honestly, that would be surprising. Tell me more about how I work for Wellpoint! And how hospitals have to live up to insurance regulations!

Christ.

 

[dblack]

I know shit when I smell it.

Honestly, that would be surprising. Tell me more about how I work for Wellpoint!

I don't care you who you work for - or who would bother to pay you for posting such drivel - but it's clearly a concerted, consistent effort to pump out the PR published by the corporations and government agencies with a vested interests in herding health care consumers.

 

[Greenbeard]

I don't care you who you work for - or who would bother to pay you for posting such drivel - but it's clearly a concerted, consistent effort to pump out the PR published by the corporations and government agencies with a vested interests in herding health care consumers.

Clearly you're very interested in who I work for. You bring it up every chance you get. Non sequitur after non sequitur.

And though I don't think it's been particularly opaque (although obviously this is all very confusing to you), you've guessed wrong time and again. So I'm going to throw you a bone. I work for a provider system that's working very hard to improve care in a changing environment. Insurers are my nemesis, not yours. Get a grip.

 

[dblack]

I don't care you who you work for - or who would bother to pay you for posting such drivel - but it's clearly a concerted, consistent effort to pump out the PR published by the corporations and government agencies with a vested interests in herding health care consumers.

Clearly you're very interested in who I work for. You bring it up every chance you get. Non sequitur after non sequitur.

And though I don't think it's been particularly opaque (although obviously this is all very confusing to you), you've guessed wrong time and again. So I'm going to throw you a bone. I work for a provider system that's working very hard to improve care in a changing environment. Insurers are my nemesis, not yours. Get a grip.

- it's about time you fessed up. It's been very clear your interests are in selling us a 'system'. A system that will benefit your claimed 'nemesis' every bit as much as it benefits providers. Consumer and citizens are simply dupes to be 'managed' and milked.

 

[Greenbeard]

- it's about time you fessed up. It's been very clear your interests are in selling us a 'system'. A system that will benefit your claimed 'nemesis' every bit as much as it benefits providers. Consumer and citizens are simply dupes to be 'managed' and milked.

Indeed, my job is to make sure insurers don't screw anybody out of their money. Kinda the opposite of your implication, huh? Thanks for the apology, asshole.

 

[Sun Devil 92]

Where is that 31 billion coming from ?

If you mean why is creating all those new primary care providers deficit neutral, that would be Title IX of the ACA: Revenue Offset Provisions.

If I read the first page or two correctly, that would be through taxes. Somebody else is funding that 31 billion.

Did I read that correctly ?

BTW: I am not reading a 233 page document. Next time, why not just say what it says so I'll know what you are pointing at.

 

[dblack]

- it's about time you fessed up. It's been very clear your interests are in selling us a 'system'. A system that will benefit your claimed 'nemesis' every bit as much as it benefits providers. Consumer and citizens are simply dupes to be 'managed' and milked.

Indeed, my job is to make sure insurers don't screw anybody out of their money. Kinda the opposite of your implication, huh? Thanks for the apology, asshole.

I don't buy that. You might have a genuine desire to protect the interests of the provider system you work for, but you're willing to sacrifice consumers to the insurance industry in the process, as mandated customers, as pawns in a backroom deal between the 'major players' of the health care industry and the federal government.

 

[Sun Devil 92]

There is a lot of internet news on how Hawaii's exchange is going to shut down.

They are looking for more cash and don't seem to be able to raise it.

What gives ?

Well, that is certainly not a happy birthday for Obamacare (if it is true).

 

[Sun Devil 92]

- it's about time you fessed up. It's been very clear your interests are in selling us a 'system'. A system that will benefit your claimed 'nemesis' every bit as much as it benefits providers. Consumer and citizens are simply dupes to be 'managed' and milked.

Indeed, my job is to make sure insurers don't screw anybody out of their money. Kinda the opposite of your implication, huh? Thanks for the apology, asshole.

I don't buy that. You might have a genuine desire to protect the interests of the provider system you work for, but you're willing to sacrifice consumers to the insurance industry in the process, as mandated customers, as pawns in a backroom deal between the 'major players' of the health care industry and the federal government.

Even a lemon of a car can look great and drive off the lot well.

Social Security is a prime example.

I am afaid Obamacare looks to go the same direction.

Still dblack....I'd like to know what metrics you would put in place to track it's progress.

The one I recall hearing all the time was the 16% we spend on healthcare (which really is to much...but not for the reasons the left claims). Have you seen anything on reductions in those costs ? If they are still at 16% in two years, I'd say we are not making any progress (all the tripe about ER's and the like will have not come to pass).