Can Obamacare be Fixed?

[PMZ]

When the basis of your argument is something you can't prove (I'm a FOX addict) you start to look kind of silly. The truth I don't watch much of any of the them. There's your conservative news outlets like FOX and there's your liberal ones like MSNBC and CNN. The big difference though is at least FOX is honest about who they are. For the most part they admit they're conservatives while you have MSNBC who doesn't seem to have the pride to admit their liberal bias and are trying to pass themselves off as objective journalists.

As a liberal kool aide drinker you believe government is getting 'better'. Better at what I have no clue. Anyone with a level of objectivity can see otherwise when we have a President who has so brazenly ignored the limitations of his office and lied repeatedly.

Fox addicts are easy to spot. They are all misinformed in exactly the same ways.

Perhaps the point that you're trying to make is that government better than Bush's is a pretty low bar. He was the worst we've ever had. So we've gone from the worst to the modern Lincoln. And that's why Fox addicts are so easy to spot.

So we've gone from the worst to the modern Lincoln.

Wow! That's funny.

Another Fox fan. Tell us more about what they've said about our president.

 

[Bern80]

To put it in context, with the rate of inflation at 2.5%, then nominal prices increase at 2.5%. Unless wages are increasing at better than the rate of inflation, every real dollar increase in health care spending comes out of something else. It comes out of gasoline, food, clothing, transportation, Christmas or whatever.

And, in fact, at the very least we know minimum wage has not kept up with inflation.

http://www.fas.org/sgp/crs/misc/R42973.pdf

So, a deceleration of health care costs is significant.

Sure it is, but there are better ways to do it and ways that would not just deccelerate the increase, but actually make them go down. Government red tape is a huge expense for providers and Obamacare just adds to it, not to mention the extra expenses in taxes to them. Then there's the insurance side of the equation and it's difficult to see with how various parts of Obamacare effect them how prices would come down there either.

The big picture is this. We were told this would be good for everyone. We'd get to keep our health care plans and our doctors. No exceptions. The cost of premiums would go down. None of that is happening. It's getting to the point where even democrats are starting to say we need to pull the individual mandate. And the big problem I have with it is all of these market reactions to Obamacare were pretty easily predictable. It's not difficult to predict what will happen to the premiums of healthy 20 - 30 year olds would look at community rating and pre-existing conditions mandates. Ironically the system working at all is heavily dependent on this age group buying insurance to offset all the new costs of actually paying for sick people. Except the system totally disincentivizes them from doing so. It's just a giant clusterfuck, with a few winners in the form of sick people and mostly losers, everyone else.

 

[Bern80]

I don't know anyone here who doesn't believe that capitalism is a great tool. Like a hammer. What would we do without hammers. Of course quite marginalized on screws.

I believe in accountability. Demonstrated success that can be rewarded with more responsibility. That’s why I love democracy. The ultimate in political accountability.

Business at the moment is failing the country. By the only measure that really counts, growth. But instead of accountability, what do we hear? Pitiful whining by the professional mourners recruited by Fox propaganda for their business partners, the Republican Party.

Even worse, we are rewarding failed and failing business leaders lavishly. Like royalty. For screwing customers and employees for the one group that adds zero value. Shareholders.

Business is broken. Government was, but has been recovering.

Of course as a Fox addict, you have no idea of what's going on. You hear the opposite of what's going on 24/7/365. Why? That makes you useful to the people who are failing, so that they can avoid accountability.

In today's competitive world, America can't afford failure. The path away from it involves massive accountability changes.

That's what informed people in America are working on.

When the basis of your argument is something you can't prove (I'm a FOX addict) you start to look kind of silly. The truth I don't watch much of any of the them. There's your conservative news outlets like FOX and there's your liberal ones like MSNBC and CNN. The big difference though is at least FOX is honest about who they are. For the most part they admit they're conservatives while you have MSNBC who doesn't seem to have the pride to admit their liberal bias and are trying to pass themselves off as objective journalists.

As a liberal kool aide drinker you believe government is getting 'better'. Better at what I have no clue. Anyone with a level of objectivity can see otherwise when we have a President who has so brazenly ignored the limitations of his office and lied repeatedly.

Fox addicts are easy to spot. They are all misinformed in exactly the same ways.

Perhaps the point that you're trying to make is that government better than Bush's is a pretty low bar. He was the worst we've ever had. So we've gone from the worst to the modern Lincoln. And that's why Fox addicts are so easy to spot.

This is referred to as a strawman argument. Just label your oponent as something and argue against that whether it's actually true or not (which it isn't). I'm objective enough to know that Bush wasn't the greatest President in the world, but as far as abuse of the office of President goes, it is undeniable that Obama takes the cake. Understanaly since you have no objectivity, you won't see that.

 

[PMZ]

Bern continues to report Republican propaganda he was issued on Fox, and continues to believe that it's news.

 

[Bern80]

Bern continues to report Republican propaganda he was issued on Fox, and continues to believe that it's news.

And PMZ continues to give immature responses he has no real evidence for.

 

[PMZ]

Bern continues to report Republican propaganda he was issued on Fox, and continues to believe that it's news.

And PMZ continues to give immature responses he has no real evidence for.

There is ample evidence for what I claim but, for some reason, it hasn't been reported on Fox.

 

[itfitzme]

To put it in context, with the rate of inflation at 2.5%, then nominal prices increase at 2.5%. Unless wages are increasing at better than the rate of inflation, every real dollar increase in health care spending comes out of something else. It comes out of gasoline, food, clothing, transportation, Christmas or whatever.

And, in fact, at the very least we know minimum wage has not kept up with inflation.

http://www.fas.org/sgp/crs/misc/R42973.pdf

So, a deceleration of health care costs is significant.

Sure it is, but there are better ways to do it and ways that would not just deccelerate the increase, but actually make them go down. Government red tape is a huge expense for providers and Obamacare just adds to it, not to mention the extra expenses in taxes to them. Then there's the insurance side of the equation and it's difficult to see with how various parts of Obamacare effect them how prices would come down there either.

The big picture is this. We were told this would be good for everyone. We'd get to keep our health care plans and our doctors. No exceptions. The cost of premiums would go down. None of that is happening. It's getting to the point where even democrats are starting to say we need to pull the individual mandate. And the big problem I have with it is all of these market reactions to Obamacare were pretty easily predictable. It's not difficult to predict what will happen to the premiums of healthy 20 - 30 year olds would look at community rating and pre-existing conditions mandates. Ironically the system working at all is heavily dependent on this age group buying insurance to offset all the new costs of actually paying for sick people. Except the system totally disincentivizes them from doing so. It's just a giant clusterfuck, with a few winners in the form of sick people and mostly losers, everyone else.

Man, I don't know what to tell you except that like so many you are obviously and incredibly biased, obstinantly misinformed, and have a flawed model of economics that is in error at its very basic principles.

 

[itfitzme]

These look interesting;


www.census.gov: the Census Bureau released revised figures on health insurance coverage from the 2000 to 2010 Current Population Survey Annual Social and Economic Supplements (CPS ASEC), reflecting enhancements to the editing process. Because the data after the enhancements is not consistent with earlier data, the Census Bureau introduced a new historical series (HIB-1 to HIB-8) and discontinued the HIA- series.
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www.ncsl.org: Health Insurance Premiums: This report summarizes the health plan choices and premiums that will be available in the Health Insurance Marketplace.
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Data | HealthData.gov : The National Health Expenditure Accounts (NHEA) are the official estimates of total health care spending in the United States.
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www.aetna.com The Facts About Rising Health Care Premiums Underlying Health Costs Drive Growth April 2010
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bea.gov: Measuring health care costs of individuals with employer-sponsored health insurance in the U.S.: A comparison of survey and claims data
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bea.gov: Changing Mix of Medical Care Services: Stylized Facts and Implications for Price Indexes
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bea.gov: BEA compares healthcare data sets
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Search in BEA on Healthcare providing numerous PCE health care data sets.


bea.gov: healthcare - U.S. Bureau of Economic Analysis Search Results


stlouisfed.org: bea, health, pce, price index - Economic Data Series - FRED - St. Louis Fed
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Some care must be made in determining what the data actually is and what to use.

There is the real dollar price for healthcare given a constant basket of healthcare goods.

There is the actual quantity and real dollar supplied healthcare per individual.

There is the quantity of individuals that are actually purchasing health care.

These are all significant in that they mean different things and misinterpreting the data will lead to a completely erroneous conclusion. An increase in percentage of GDP, even real GDP, isn't necessarily informative. The single factor that $ pays for is labor added value.

If there is an increase in the employment to pop ratio where that employment goes to the healthcare markets, percentage RGDP can increase with a commensurate increase in standard of living, not a decline in other products. That is what we really want. And, we would also like to see efficiency increases as well.

Simple increase in expenditures, even real dollars per cap can be misleading.

 

[itfitzme]

Oh, this is annoying:

May 6, 2013 - A new report finds that individual health insurance premiums will drop in ... on health history, the institution of a health insurance mandate helps

Obamacare: Lower Health Insurance Premiums in New York, and Higher Premiums Most Everywhere Else - Hit & Run : Reason.com

Mar 22, 2013 - Big health insurance companies are predicting huge premium increases

Health Insurance Premium Increases Vowed By Companies For 2014

2013 Employer Health Benefits Survey | The Henry J. Kaiser Family Foundation
Aug 20, 2013 2013 Employer Health Benefits Survey , The key findings from the survey, conducted from January through May 2013, include modest increases in premiums for both single coverage (5%) and family coverage (4%).


SEP 25, 2013 - Until today's report, little information was available about insurance...Average Obamacare Premiums Will Be Lower Than Projected

Average Obamacare Premiums Will Be Lower Than Projected - Kaiser Health News

 

[Spoonman]

the only way to fix obamcare is with a republican president and republican control in both the house and senate

 

[dblack]

the only way to fix obamcare is with a republican president and republican control in both the house and senate

LOL... it's always good to start out the weekend with a belly laugh. Thanks, Spoonman.

 

[PMZ]

the only way to fix obamcare is with a republican president and republican control in both the house and senate

No chance of that until they dump the dixiecrats and the propaganda machine.

 

[dblack]

Voting for Republicans to get rid of PPACA makes about as much sense as voting for Democrats to repeal the PATRIOT Act.

 

[itfitzme]

the only way to fix obamcare is with a republican president and republican control in both the house and senate

And what is "broken"?

These are the real dollar rate changes from 2008 to 2009 to 2010.

State '10-9 '09-8
US.....4.1.....6.8
AK -25.6.....14.7
AL 28.8.....12.7
AR 31.2.....-4.9
AZ -5.7.....3.8
CA 2.2 8.6
CO -0.3 6.6
CT 6.3 3.9
DC 9.4 4.3
DE 12.1 5.1
FL 12.2 -0.3
GA 0.4 13.2
HI 2.6 7.8
IA -0.5 7.8
ID 17.4 3.9
IL 4.4 2.1
IN -9.9 8.3
KS 9.4 1.3
KY 6.3 8.5
LA 7.5 20.3
MA 3.7 9.3
MD -3 12.1
ME 4 4.6
MI -5.7 12.4
MN 6.2 4.2
MO 5.1 6.9
MS 1.3 8.8
MT 4.4 4.8
NC 5 5.2
ND 13.7 8.1
NE 17.8 -1.5
NH -3 0
NJ -3.9 2.5
NM 13.2 11.7
NV 5.9 18.2
NY -9.3 10.8
OH 7.8 4.6
OK 8 4.6
OR 9 7.1
PA 2.7 5.9
RI 8.1 3
SC 5.6 0.9
SD 9.3 1
TN 2.8 6.8
TX 8.3 7.4
UT 4 1.8
VA 10.8 9.6
VT -2.4 2.4
WA -0.5 12.2
WI -5.4 7.8
WV 12.7 -3.6
WY 8.9 2.1

they vary from state to state, with an average of 4.1% for 2009 to 2010 and 6.8% for 2008 to 2009. The standard deviations are 9.121505724 5.079998456 respectively.

So, given these baselines, you can present evidence of something "broken". The disparity between states is huge.

 

[itfitzme]

Here is an interesting article from

State Trends in Premiums and Deductibles, 2003?2011: Eroding Protection and Rising Costs Underscore Need for Action - The Commonwealth Fund

December 12, 2012

State Trends in Premiums and Deductibles, 2003–2011: Eroding Protection and Rising Costs Underscore Need for Action

Rapidly rising health insurance premiums and higher cost-sharing continue to strain the budgets of U.S. working families and employers. Analysis of state trends in private employer-based health insurance from 2003 to 2011 reveals that premiums for family coverage increased 62 percent across states—rising far faster than income for middle- and low-income families. At the same time, deductibles more than doubled in large and small firms. Workers are thus paying more but getting less-protective benefits. If trends continue at their historical rate, the average premium for family coverage will reach nearly $25,000 by 2020. The Affordable Care Act’s reforms should begin to moderate costs while improving coverage. But with private insurance costs projected to increase faster than incomes over the next decade, further efforts are needed. If annual premium growth slowed by one percentage point, by 2020 employers and families would save $2,029 annually for family coverage.

 

[itfitzme]

The Supply and Demand model of micro economics is based on the perfect market, perfect information, perfect competition, etc.

In fact, real markets have imperfections such as barriers to entry and economies of scale that yield oligopolies and monopolies. Ideal markets are such that any price above cost is profit and attracts new suppliers until prices drive down to costs. Excess supply causes prices to fall below cost and demand increases to consume all excess, eventually driving quantities to equilibrium or driving competitors out of the market.

The typical supply and demand model, with supplier favored market imperfections, is



The equilibrium point is above the cost of supply. Due to barriers to entry, such as capital equipment start up costs, the equilibrium price is in the profit region. This was the condition of health insurance premiums prior to implementation of the PPACA. With a 20% cap of earnings, price was nearer to the cost line. This is established fact.

A point arose as to how the demand would react to an increase in customers. The simple fact of the demand curve is that it is for all of the population, not just those purchasing. If the price were free, everyone would happily take an infinite quantity. If the price were infinite, no one would take any. Everyone that is purchasing will happily take their quantity at less than the equilibrium price.



So the demand curve sets the boundary above which product will not move given the price.

Now, given that the demand curve account for the entire population, the remaining point is what it means that the demand curve shifts.



It means that the population of consumers has more real income available for purchase of a larger quantity. Exactly how much more and what the price break on increase quantity is depends on the price elasticities.

The question is, then, what is the supply curve for a monopoly or oligopoly dominant market and how will the equilibrium point shift?

(This is all based on the assumption of identical pricing. More typically, like movie tickets, there are price differentials. How do we account for price differentials?)

 

[itfitzme]

This is the supply and demand for the condition of oligopoly or monopoly markets with efficiency of scale. The supply curve falls in price as quantity increases because the fixed cost of production is divided out over more quantity.



The demand curve is actually unconstrained by what would otherwise be increasing prices to quantity. It can actually shift without increased real income available because no increased income is required.

 

[dblack]

Man, those sure are some charts and stuff.

 

[itfitzme]

The health care market does not consist simply of insurance carriers. There are a host of markets along vertical chains. The structure is more like a tree.

Some categories are

Financial System:
.....Student Loans:
Education:
.....Faculty:
.....Publishers:
Trained Labor:
.....Doctors:
.....Nurses:
.....Medical Technicians
Capital Equipment and Facilities:
.....Hospitals:
.....MRI Equipment:
Products:
.....Drugs:
.....Medical Devices:
.....Supplies:
.....Lab tests:
Health Insurance:

Health insurance is simply the end point of price payment for the majority of demand. Each of these markets have their own particular supply and demand curves. Some, like insurance, have efficiencies of scale, others, not so much. Student loans have efficiencies of scale. Drug manufacturing as well. Some tests do, not so much for others.

MRI equipment has to be fully utilized otherwise cost per test goes up as the equipment cost spreads out over fewer individuals. Still, at some point, they are fully utilized.

Medical Technicians are a labor efficiency of scale as tasks previously performed by nurses are given to techs. Larger cities, high technician employment per nurse/doctor. Rural areas, kinda depends on when demand reaches the critical point that technicians become viable.

And there is a point, rural vs metropolitan areas have their own particulars.

And then the whole issue of price differentiation.

 

[itfitzme]

Man, those sure are some charts and stuff.

A picture is worth a thousand words......