I have some Obamacare Questions

[wesfau2]

Yes, Med Mal is insanely expensive.  I come from a family of doctors and know first hand what they pay.  But, the Med Mal insurance racket is just that, a racket.  In Alabama, for instance, there is one Med Mal conglomerate that insures the vast majority of docs and medical facilities and last time I saw their profit margin....holy shit!!!  They are raping the medical profession over the colds.

Lawyers are the popular target, but insurance companies are the biggest problem in the medical industry.

[WiregrassTiger]

Agree.  We also need to open up competition across state lines and have providers cover over state lines.

I agree and a million dollar verdict is too much for a guy who lost his pinky toe in a botched toe nail operation. Unless, of course, it is my toe. That's one problem with limits. Who sets the limits?

I agree that this would likely be a more effective means of making care more affordable.

[AUTailgatingRules]

The only way to make health care affordable is to make it fee for service.

If you have a cold and need to go to the doctor, you pay the costs

If you need t rehab a knee, you pay the costs

If you need to take meds for a particular ailment, you pay the costs

If you have catastrophic event:  Heart attack, stroke, long hospital stay etc, you have catastrophic insurance to cover the costs.

Could you imagine expecting your auto insurance to cover the cost of an oil change?  or a tire rotation, or new bake pads?  No you have auto insurance to cove the costs of a major wreck.  Health care should be the same.

[AUChizad]

Lawyers Insurance companies are the popular target, but insurance companies the providers (hospitals) and pharmaceutical companies are the biggest problem in the medical industry.

Fixed.

[Vandy Vol]

Why do my insurance premiums and my deductibles have to double in cost to cover these people?  Would have been much cheaper to just pay for insurance for these people or let them onto medicare.

My understanding is that the primary reasons for the cost increase are A.) the new law requires more comprehensive coverage that includes mental care, maternal care, etc.; more coverage = higher price, and B.) the health insurance companies are trying to offset the anticipated costs of covering more types of services for more people, especially those with PECs.

So even if the government simply paid for the insurance for these uninsured individuals, the insurance companies would have still increased their prices due to the fact that they still have to cover more people and more services.  Plus you'd likely have an increased tax rate to pay for the government's footing of the insurance premiums.

After all we are only talking about 4,000,000 so far that have signed up.  How can spending trillions to implement Obamacare possibly be worth getting insurance for less than 5% of the population?

That number may or may not be accurate, but there's a problem in that we can't pinpoint how many people have signed up "for/due to Obamacare."

That number you're quoting represents the people who have gotten insurance through the healthcare exchange.  All the healthcare exchange does is assist you with getting quotes from private health insurance companies, as well as determining whether you are eligible for any credits to offset the cost of those quotes.

This means that people who were previously uninsured may be signing up for healthcare directly with the insurance companies, and not through the exchange.  Even if we could obtain those numbers, there probably still isn't a statistical distinction between those who were previously uninsured, nor is there a statistical distinction between those who were going to get insurance anyways or only got it due to the ACA.

The same thing can be said in regard to the Medicaid expansion.  6 million people have signed up for Medicaid since they could start enrolling in the ACA's expansion of the public program.  But that number includes people who would have been eligible for Medicaid previously, alongside those who are newly eligible, so we don't have real numbers as to exactly how many people this has helped.

[GH2001]

Lawyers are the popular target, but insurance companies are the biggest problem in the medical industry.

So you and Ken Nugent rub dongs eh?

If costs weren't so damn high we wouldn't even need insurance. You know like before 50 years ago. Insurance companies are another symptom of a problem. Keep digging.

[GH2001]

Fixed.

Agree. It gets lost on people that insurance companies should not even be needed for routine medical care. But they are. Why?

[Vandy Vol]

So you and Ken Nugent rub dongs eh?

If costs weren't so damn high we wouldn't even need insurance. You know like before 50 years ago. Insurance companies are another symptom of a problem. Keep digging.

Medical malpractice lawsuits are only part of the equation.

Physicians are paid about 5 times more in the U.S. than in peer countries.  Specialists can be even worse.  Although some of this is simply due to the U.S. market being whacky when it comes to medical costs, there are other problems.  The Center for Medicare and Medicaid Services pays much more for specialist services than peer governments.  Private insurers do a shitty job of negotiating with specialists.  There is unnecessary waste of supplies and medicine in the medical industry.  There are unnecessary treatments being rendered because physicians want to rush patients through by just prescribing a common medicine/treatment to see if it works, and if not, then try another, and if it still doesn't work, then do an actual diagnosis of symptoms and look for an accurate course of action with appropriate testing.  So on and so forth.

The airline industry had similar problems years ago.  Labor costs were absurd, and it caused many airlines to eventually go bankrupt.  Pilots don't make what they did years ago (which was sometimes comparable to physicians now, actually), but once they straightened out their costs and made things more reasonable, the business model was fine...and all without reducing safety issues that they were initially concerned with.

[Townhallsavoy]

Medical malpractice lawsuits are only part of the equation.

Physicians are paid about 5 times more in the U.S. than in peer countries.  Specialists can be even worse.  Although some of this is simply due to the U.S. market being whacky when it comes to medical costs, there are other problems.  The Center for Medicare and Medicaid Services pays much more for specialist services than peer governments.  Private insurers do a shitty job of negotiating with specialists.  There is unnecessary waste of supplies and medicine in the medical industry.  There are unnecessary treatments being rendered because physicians want to rush patients through by just prescribing a common medicine/treatment to see if it works, and if not, then try another, and if it still doesn't work, then do an actual diagnosis of symptoms and look for an accurate course of action with appropriate testing.  So on and so forth.

The airline industry had similar problems years ago.  Labor costs were absurd, and it caused many airlines to eventually go bankrupt.  Pilots don't make what they did years ago (which was sometimes comparable to physicians now, actually), but once they straightened out their costs and made things more reasonable, the business model was fine...and all without reducing safety issues that they were initially concerned with.

You bring up an interesting thought.

Just what exactly are pediatricians and general practitioners so good at that they warrant a minimum of $150k/year salary?  I mean honestly, how many times have you gone to an Urgent Care or other family physician and had them do something that you could not have learned how to do yourself? 

PAs and nurse practitioners could easily take over the "You have the sniffles, here's a Z-Pack" market and cut costs exponentially.

[RWS]

You bring up an interesting thought.

Just what exactly are pediatricians and general practitioners so good at that they warrant a minimum of $150k/year salary?  I mean honestly, how many times have you gone to an Urgent Care or other family physician and had them do something that you could not have learned how to do yourself? 

PAs and nurse practitioners could easily take over the "You have the sniffles, here's a Z-Pack" market and cut costs exponentially.

The city that I work for has gone in with two adjacent cities to contract with a health provider for the employees.  No co-pay, and free generic meds in your hand when you walk out of the door.  They use PAs in the clinics.  A doctor comes by each day to review charts and basically sign off on them.  They don't keep any controlled substances on site, but they can write you a prescription for it. 

This works out for the city, because we are self-insured.  BCBS AL administers the plan and everything, though.  Instead of getting charged whatever your doctor decides to charge them for, whether you received it or not, the city pays a fixed rate.  The provider is using PAs, and the cities pay to setup the facilities, maintain them, etc.  It's a pretty good deal for everybody involved, really.  I've gone 3 times so far for things like stomach bug, sinus infection, etc.  I get the same type of treatment I would have at an Urgent Care, except I have meds in my hand when I walk out of the door.  PAs and LPNs really are the wave of the future in this world of Obamacare.