Obamacare

Obamacare Gives Insurers Money To Cover Unexpected Costs. Is That a Bailout? Does It Matter?

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Whitehouse.gov

In recent weeks, health insurers have sounded less than enthusiastic about Obamacare. At a health industry investor's conference last week, the head of Cigna warned that his company might take a loss on plans sold in Obamacare exchanges. In an SEC filing, Humana said that the demographic mix in the company's exchange plans was "more adverse" than expected. The CEO of Aetna told CNBC this week that so far, the exchange plans his company has offered in the exchanges have not successfully attracted the previously uninsured—setting up the possibility that Aetna might eventually pull out of the exchanges. And on Wednesday, credit rating agency Moody's downgraded health insurers, projecting that earnings would be less than expected in 2014 as a result of the "ongoing unstable and evolving environment" surrounding the rollout of the health law.

Insurers may be down on the law. But they're not quite ready to bail. For one thing, they've spent years reorganizing segments of their businesses around its requirements. And for another, the law provides a backstop to cushion the blow. If costs are significantly higher than insurer targets, the federal government will share the financial pain by reimbursing them for a percentage of their losses.

In other words, taxpayers will be on the hook for unexpected insurer costs—and the greater those unplanned insurer costs are, the bigger the taxpayer share of the tab will be.

Insurers will be reimbursed for high expenses through Obamacare's risk corridors, one of several provisions in the law intended to mitigate the risk to health plans participating in the exchanges. The way that the risk corridors work is that for any insurer spending between 3 and 8 percent above an insurer's target level, the Department of Health and Human Services will reimburse them for 50 percent of the losses. For any spending that goes over the 8 percent threshold, the federal government pays 80 percent. This illustration from the American Academy of Actuaries provides a helpful way of visualizing how the program, which is active from 2014 to 2016, works:

American Academy of Actuaries

As the graphic shows, the backstop is symmetrical. Just as insurers are covered in the case of greater than expected spending, they are also required to pay out if spending is significantly below target. But given the gloomy financial outlook for insurers offering plans on the exchanges, the widespread expectation is that the federal government will do all the paying out this year—and insurers will not pay into the system at all.

That's not what was advertised. As Wake Forest Law professor Mark Hall noted in a 2010 Health Affairs paper on Obamacare's risk provisions, the law was written under the assumption that payments to and from the government would balance out. Some insurers would spend more than expected; others would spend less. The program would be revenue neutral, or close enough.

At this point, we can be pretty sure that won't be the case. What we don't know, however, is how the government's share of insurer costs will be funded. As Hall noted, and as influential health law professor Timothy Jost also pointed out in a separate Health Affairs piece, the law makes no mention of what to do if the cost to the government is more than the amount paid in. Given that estimates suggest the payout to insurers could be worth several billion dollars this year, and that the potential costs are not capped at all, that's not a small matter.

That liability makes for a pretty big political target.

Sen. Marco Rubio (R-Fl.) has already dubbed the risk corridors an insurer bailout, and proposed legislation ending the program. This sparked a debate about whether the program is or is not a bailout, with some vocal opponents of the law objecting to the description.

Their argument, broadly speaking, is that it's not really a bailout because it wasn't tacked on after the fact to cover irresponsible corporate behavior. This strikes me as a semantic quibble, especially since the provision was essentially repurposed long after it was passed—transformed from the revenue-neutral risk sharing program that was originally envisioned into a mechanism for the federal government to pay off insurers who are taking a financial hit by participating in the administration's signature law. And it's a mechanism that the administration has proposed expanding in response to the messy rollout of that law, potentially putting taxpayers on the hook for even greater costs.

Does it really matter what word is used to describe it? Call it a bailout, call it corporate welfare, call it a federal insurance company subsidy made necessary by the administration's poorly designed and implemented law—what matters is that it's a provision from an unpopular law that puts taxpayers on the hook for the health insurance industry's bottom line. No matter what you call it, it's an ugly giveaway to insurers that wasn't initially sold as such.

It's also a provision that the administration believes is necessary for the survival of the law, and the health insurance industry it regulates. In its justification for awarding a rapid no-bid contract to Accenture, the tech firm brought in to work on the federal exchange system after last year's disastrous launch, the federal government explained that it needs the financial management system that's supposed to make the risk corridor payments to be completed by mid-March of 2014. Without that system in place, the administration might end up inaccurately forecasting risk corridor payments, "potentially putting the entire health insurance industry at risk." That risk, the administration said, put the "entire healthcare reform program" in jeopardy.

Bailout or no, then, at this point the debate remains somewhat academic: The financial backend for making the risk corridor payments, a system the administration claims to believe is absolutely necessary to the law's success, hasn't even been built yet—and the administration just switched tech contractors in a panic after the last one utterly failed to deliver. That's the level of competence that's gone into implementing this law so far. Will the late-game lineup change put the system on better footing? If not, this bailout may need a bailout.

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  1. That word you’re searching for, I believe it is something like this:

    FYTW

    1. It’s pronounced fatwa.

  2. Money flows from me to others, to the sole benefit of others, against my will.

    1. “We’re saying that for America to get back on track, we’re probably going to cut that short and not give it to you. We’re going to take things away from you on behalf of the common good.”

    2. Come on, ProL. They all tell me taxation isn’t theft. Just because you’re having money stolen from you against your will…

      1. It’s my money. I don’t authorize anyone to take it, yet there it goes. Shouldn’t I get some return on my “investment?”

        1. It’s not your money, ProL. It’s the government’s. Just be happy they let you keep any of it.

        2. You signed that social contract when you drove on the public roads, glibertarian.

          1. I could buy a helicopter with the money they’ve taken from me.

            1. Then you would be flying in FAA airspace!

              /derp

              1. Your country grows tiresome.

            2. You expect to ride on the public airwaves for free?

            3. You know your safe little area used to be a pirate haven before the government came and cleaned it up for you. And then started sponsoring Gasparilla to keep you drunk and complacent.

              1. Oh, I rather doubt it’s clean. Cops like tits, too, you know. I used to be in a krewe, so I know. Oh, yes, I know.

                1. No one likes it when you about your tits, ProL.

                  1. Fortunately, we’re talking about the female variety. I saw more cops partaking of that phenomenon than doing, you know, cop work.

  3. Why it’s going bend the curve! Reduce the deficit! Bring Healthcare to the uninsured!

    and thanks to the team – and protect Obama – mentality, the Dems are going to hold on to the damn thing, no matter how painful or patently awful it is.

    1. Good. Let them sink to the bottom with it.

      1. The soundtrack for sinking to the bottom:

      2. The problem is they won’t sink to the bottom. Because FREE SHIT, FREE SHIT, WHY DO YOU TEATHUGLIKOCHIKKKANZ HATEZ TEH POOR!!!!111!!!!!

  4. “In other words, taxpayers will be on the hook for unexpected insurer costs?and the greater those unplanned insurer costs are, the bigger the taxpayer share of the tab will be.”

    Only sorta. The taxpayers are tapped-out; the gov’t is going to have to borrow this money, going a long way, I’m sure, to ‘reducing the deficit’ as promised…as promised… as promised…as promised…as promised…as promised…as promised…as promised…
    HEY! The record’s stuck!

  5. Does it really matter what word is used to describe it?

    That’s the only thing that matters. “Bailout” poll tests poorly, and Rubio thinks he’s running for vice president.

    The entitlement mentality of insurers during this whole process has been breathtaking in its scope. Expanding access to healthcare has practically been secondary to making sure poor wittle insurers aren’t out a single dime from the effort. IMO allowing companies to profit from inflated costs for attending to basic human needs is a big fat giveaway all by itself.

    1. Shorter Tony:

      Profit is evil and doctors should be slaves.

      1. Try more sauce.

        1. Did I upset our wittle fascist?

        2. Tony|1.24.14 @ 12:55PM|#
          “Try more sauce.”

          The truth doesn’t taste so good?

          1. This could be construed as Tony attacking mercantilism.

            Forcing citizens into commerce artificially increases demand.

            That must be what he means by ‘inflated prices’. Voluntary agreements for services rendered destroys the whole concept of inflated.

    2. Tony|1.24.14 @ 12:48PM|#|?|filternamelinkcustom
      IMO

      I think we have identified the problem with your argument.

    3. IMO allowing companies to profit from inflated costs for attending to basic human needs is a big fat giveaway all by itself.

      “IMO allowing you to run a business without breaking your kneecaps is a big fat giveaway all by itself”

      /Tony Soprano

      Expanding access to healthcare has practically been secondary to making sure poor wittle insurers aren’t out a single dime from the effort.

      So why are you still on the internet? Is expanding access to healthcare secondary to having an internet connection for you?

      1. Just ignore the fact that the entire program Tony loves is depriving millions of people of healthcare. Tony is all about increasing access. He told me so.

        1. Regurgitating talking points is so easy you’d think you could manage to keep current on them.

          This month it’s about insurance company bailouts.

          1. Tony|1.24.14 @ 1:09PM|#
            “Regurgitating talking points is so easy you’d think you could manage to keep current on them.”

            Yes, projection, along with lying, pretty much makes up your schtick.

          2. The numbers don’t lie. Millions of people who had health insurance before don’t have it and can’t afford to get new now. And millions who still have insurance have seen their access to doctors and care drastically reduced.

            Obamacare has done more to deny access to health care than any government action in US history. Those are the facts Tony. You and your ilk own them and all of the accompanying human misery. It is what people like you do; make things worse and make humans suffer in the name of your lunatic beliefs.

            1. You act like I don’t know where this bullshit comes from.

              This talking point stems from redefining “losing health insurance” as “any change whatsoever happening to your health insurance.” It is simply a lie straight from the pit of hell that millions of people are losing health insurance. And there’s a reason Republicans have moved on from it.

              1. You act like I don’t know where this bullshit comes from.

                I don’t write the numbers, I just read them. And pretending that people are not losing their insurance and others not losing their doctors is a lie straight from hell. It is unsurprising that someone caught up in an ideology from hell would claim the truth, not the lies comes from hell.

                What do you have to say the cancer patient who lost their doctor thanks to Obamacare and then was audited by the IRS because they had the nerve to say something about it? You own that person’s misery. You at least owe them an explanation.

                1. I linked to a reputable news source, you are pulling shit from newsmax. Your talking point is false. Your masters have moved on. Now it’s all about bailouts.

                  1. Oh so what you have to say Tony “is fuck you, you are lying anyway and probably deserved it if you are not”

                    That doesn’t surprise me. You love the People, you just hate every individual person.

                  2. Did you even read your own link?

                    The report starts with an assumption that 4.7 million will receive cancellation notices about their 2013 plan. (Notably it doesn’t endorse that figure, just takes it on for the sake of argument.) But of those, who will get a new plan?

                    According to the report, half of the 4.7 million will have the option to renew their 2013 plans, thanks to an administrative fix this year.

                    Of the remaining 2.35 million individuals, 1.4 million should be eligible for tax credits through the marketplaces or Medicaid, according to the report.

                    Of the remaining 950,000 individuals, fewer than 10,000 people in 18 counties will lack access to an affordable catastrophic plan.

                    So half of them might be allowed to keep their current plan for a year, after which they are screwed. And that of course has not materialized, since most states and insurance companies aren’t bothering to reinstate those plans.

                    And then, even with tax credits, the exchange plans are still too expensive for many people. This report is nothing but bullshit.

                    1. lots of “shoulds” in there.

                  3. You linked to an op-ed by a leftist hack.

                    1. But it confirms his desires, therefore it must be the truth.

                  4. You wouldn’t know a reputable news source from a box of rocks. The law guarantees that the current “death spiral” could not happen, else there would be no insurers on the exchanges. Stupid law, but it is the law, and the current risk is based precisely on that law.

                    This is like stumbling into a convention of Birthers!

      2. You can’t deny the simple arithmetic in my argument: profit is an additional cost to consumers they wouldn’t have to pay if the system were socialized. It’s part of the reason our system costs more than anyone else’s. There’s a middleman, and government doesn’t impose any cost controls. This is especially the case when it comes to pharmaceuticals.

        1. and Obamacare just made it worse… good master and lord you have there.

        2. profit is an additional cost to consumers they wouldn’t have to pay if the system were socialized.

          Because if you take away the ability to make a profit everyone will want to provide the service out of their sense of public duty or something.

          Tony if socializing things worked, communism would have worked. Instead it resulted in the poverty and misery and murder of hundreds of millions of people. The reason it did is that you can’t get people to do things out of their social duty. People build things and do things because they can make a profit doing so.

          You can call it socialism or whatever. But it is all just communism implemented in smaller scales instead of over the entire society. But the scale doesn’t change the reality of human nature. If the Soviets can’t make a proper toaster or car, which they couldn’t, no government run medical system is going to result in anything but monstrous results. And indeed, we have the Canadian and UK systems that tell us as much, as if the Soviet and Cuban examples were not enough.

          You are sick and monstrously evil Tony. You don’t realize it but you are.

          1. I can see why you’d feel that way considering your ridiculous strawmen appear genuine.

            Lots of services are socialized or subsidized in this country. We achieved universal education without the need for a for-profit education industry. We achieve universal national defense without anyone seeing a ROI on aircraft carriers. Sometimes if you want something, you just need to throw money at it. Humans are capable of doing things without the profit fairy guiding their every move. That doesn’t mean I believe profit is evil or has no utility when it comes to innovation, etc. I just think it constitutes an unnecessary cost when it comes to services we consider universal basic needs.

            1. Tony|1.24.14 @ 1:18PM|#
              “Lots of services are socialized or subsidized in this country.”

              Yes, they are and they are uniformly the ones that people would rather avoid if they can.

            2. We achieved universal education without the need for a for-profit education industry.

              Thank you for making John’s point for him, Tony.

              1. A bunch of functionally illiterate graduates from Detroit public schools would disagree with Tony, but they can’t read is ridiculous posts.

            3. Lots of services are socialized or subsidized in this country. We achieved universal education without the need for a for-profit education industry.

              Subsidizing is not socializing. Stop moving the goal posts. And education costs us trillions of dollars and produces very little in return. If public schools are the examples of what you want our hospitals to be, you have already lost the argument.

              Humans are capable of doing things without the profit fairy guiding their every move.

              Sure they are. They just won’t do them in large groups or do them well at the macro scale. They never created the new Soviet Man Tony. They tired and murdered hundreds of millions of non hackers in the attempt. But in the end, people chose to work for themselves or not at all than work for the collective. No matter how much you wish it were not true and paradise were possible, it isn’t going to change. Again, you live in complete denial of how the world actually works and believe in monstrously evil things as a result.

              The devil doesn’t come in cloven hooves and horns. He comes with good intentions telling you how unfair the world is and how we should want to fix it. My God are a living breathing example of that.

              1. You are being hysterical John. Are you denying that this country has a mixed economy, with some products subsidized or socialized? Or are you merely hand-waving away every single last bit of the socialized part of our economy in some sort of porch-sitting curmudgeon’s generality? Yes we’d be so much better off without public education. An agrarian society is pretty charming.

                Furthermore, every country worth living in on this planet has a mixed economy. If me arguing for socializing healthcare as a basic human need is the same thing as me calling for communism, then surely that must mean you advocate pure laissez-faire capitalism. And I mean pure. No publicly funded armed forces, nothing. Otherwise you’re a communist.

                1. Yes we’d be so much better off without public education. An agrarian society is pretty charming.

                  We left an agrarian society before achieving anything close to universal education.

                2. Are you denying that this country has a mixed economy, with some products subsidized or socialized?<?I

                  Sure. And to the extent it is subsidized, it ends in disaster. Subsidizing education sounds great until you realize it now costs $30K a year to go to college and we tax poor people to pay for school administrators to make six figure salaries and retire after 20 years. Everywhere it is subsidized it either doesn’t work at all or produces pathetic results in comparison to the resources put into it.

                  Yes, you and your ilk have managed to leech a lot of wealth from the private economy to subsidize your lunatic ideology. But that doesn’t make your argument.

                3. then surely that must mean you advocate pure laissez-faire capitalism. And I mean pure. No publicly funded armed forces, nothing. Otherwise you’re a communist.

                  You don’t even know what capitalism means. It’s an economic system, not a political system.

                  1. You don’t even know what capitalism means. It’s an economic system, not a political system.

                    Hell, you could even consider it the lack of a political system.

                  2. It sure seems like a political system in this country. Or a religion. If it’s merely a set of economic levers, why are its outcomes sacrosanct?

                4. An agrarian society is pretty charming.

                  Ironically, the only people who obsess about the virtue of agrarianism are hardcore Marxists who also believe in fully socialized education at every level.

            4. We achieved universal education

              Is there a “Mission Accomplished” banner hanging somewhere behind you?

            5. You’re using the education system, of which home school students average about 30 percintile points higher in every subject, as an example that socialism works?

              Give us some more nuggets of why socialism is so much more efficient Tony. I mean, we have the USSR, DPRK, PRC, Venezuela, Detroit and hundreds of other failed examples in the last century to show what a cluster fuck Leftist economic ideology is, so we need some good counter examples here.

              1. Come on Procrasinatus, what is a better functioning institution, The Mayo Clinic or the Detroit Public Schools? Tony just wants to bring the efficiency of the Trabant factories and performance of the Detroit Public Schools to American health care. He just wants the best for America.

                1. I went to a fantastic public school. It was fantastic because it was in a wealthy area and had money out its ass. Therefore, all public schools are fantastic, ipso facto QED.

                  1. So without public education, the rich would have good schools and the poor would have shitty schools…kind of like what a happens with public education.

                    Do you even read what you write?

                    1. The rich would have good schools, and the middle class and poor would probably have no schools. That’s why we subsidize them.

                  2. Tony|1.24.14 @ 1:32PM|#
                    “I went to a fantastic public school….”
                    If you are representative of what that school issued, it SUCKS!

            6. Tony:

              We achieve universal national defense without anyone seeing a ROI on aircraft carriers.

              So, no one made any profit building aircraft carriers?

              1. Hey wait a minute Brian. You mean there really is no defense industrial complex getting rich off of America’s wars? But Tony spent the entire Bush Administration telling me about Haliburton. I am shocked.

              2. Obviously contractors make money, but that’s evading the point. Government bureaucrats make perfectly informed decisions about providing the public service called “national defense,” and they mange to do it without profit motive (for the government) entering into it, because that’s not the goal. The end of every human endeavor is not profit. That’s the end of just some human endeavors. In this context, the end should be universal access to healthcare. If anything, profit motive just gets in the way.

                1. Government bureaucrats make perfectly informed decisions about providing the public service called “national defense,”

                  So, was the occupation of the Philippines perfectly informed? The Iraq War? The Vietnam War? Drone bombing wedding parties?

                2. I never thought I would see the day that Tony was defending the Military wing of our government, but here he is.

                3. Government bureaucrats make perfectly informed decisions

                  After all, God himself appointed them!

                  about providing the public service called “national defense,”

                  Well, that’s the label on the package, so that’s what’s inside, folks!

                  and they mange to do it without profit motive (for the government) entering into it, because that’s not the goal.

                  God’s own Angels with their perfect decision making abilities are being snookered by the Devil and his evil profitses and his lies and his treachery!

                  Oh gee, I guess they’re not perfect after all.

                  1. Government bureaucrats make perfectly informed decisions

                    That is why government owned manufacturing has been such a success. Like I said below, the Progs have dropped the mask and gone full commie.

                  2. After all, God himself appointed them!

                    The Divine Right of Bureaucrats.

                4. Tony:

                  Government bureaucrats make perfectly informed decisions about providing the public service called “national defense,” and they mange to do it without profit motive (for the government) entering into it, because that’s not the goal.

                  So, now you’re down with the military-industrial complex? It’s now an example of government working? You’re completely OK with the military budget?

                  What a fascinating reversal.

                  1. I think it should now be abundantly clear to anyone paying attention that you just reflexively say whatever you think sounds good at any given moment for whatever point your trying to make, and whether or not it conforms to reality, much less avoids contradicting anything else you’ve repeatedly said, it a secondary concern.

                    If you want to keep arguing like that, then go ahead. You’re saying more about yourself than anyone else here, and it makes your constant whining about libertarians, their “religious ideology”, and their apparent contradictions, all the more silly.

                    I mean, for christ sakes, you were just telling us a while ago about how you wanted to seriously gut the military budget, and now it’s “government bureaucrats making perfectly informed decisions.”

                5. Tony:

                  Obviously contractors make money, but that’s evading the point.

                  Since your point was that profits are additional costs that consumers have to pay, and they “get in the way”, and you’re holding up the military-industrial complex as a profitless venture, I’d say I’m addressing the point extremely directly: that companies make profits in these government affairs all the time.

                  And now, you’re evading the point by trying to pretend that profits don’t exist in places they clearly do.

                  1. I thought for sure you’d come back by pointing out the vast amount of waste in defense spending… but that kind of makes my point now doesn’t it?

                    1. Tony:

                      I thought for sure you’d come back by pointing out the vast amount of waste in defense spending… but that kind of makes my point now doesn’t it?

                      So, here’s your argument: “Profit is bad, and leads to waste. Look how efficient the military is! Oh, it’s not efficient, and there is profit. Look how bad profit is!”

                      So, now the military-industrial complex is purely profit driven?

                      You’re not really good at this thinking business, are you?

                6. Government bureaucrats make perfectly informed decisions about providing the public service called “national defense,” and they mange to do it without profit motive (for the government) entering into it,

                  Wow.

                  Once again Tony showing that he’s brave enough to tear off a chunk of his singularity dense ball of bus-causing-pregnancy stupid and hurl it at the world.

                7. Ever heard of the revolving door?

                8. Government bureaucrats make perfectly informed decisions about providing the public service called “national defense,” and they mange to do it without profit motive (for the government) entering into it

                  Right, that’s why I here about weapons platforms that the military doesn’t even want or need but that are built by order of Congress. They are making an informed decision, all right, and the motive is power. But go ahead, regale us with stories about how awesome the Joint Strike Fighter has been.

            7. That doesn’t mean I believe profit is evil or has no utility when it comes to innovation, etc. I just think it constitutes an unnecessary cost when it comes to services we consider universal basic needs.

              So you don’t think there’s a need for innovation when it comes to basic human needs.

              1. Food is a basic need. Should we go to Soviet Style public farms?

                73 years of famine here we come! Forward!

              2. I don’t think profit is the only incentive behind innovation. I think innovation ought to be heavily incentivized in healthcare, especially where market forces incentivize not innovating.

                1. I don’t think profit is the only incentive behind innovation. I think innovation ought to be heavily incentivized in healthcare, especially where market forces incentivize not innovating.

                  How are market forced incentivizing NOT innovating? And can you actually name another incentive to innovate beside profit?

                  People just doing it for fun maybe?

                  In any case, it’s obvious there will be less innovation if you take profits out of the system.

                  Besides that, without profits and price signals, aside from innovation the distribution of resource will necessarily be less efficient. It will be hard to tell WHAT to spend money on, even choosing amoung established technologies.

            8. Universal education, Tony? Public schooling does not mean everyone gets an education.

              At one of CUNY’s four-year colleges, 90% of 200 students tested couldn’t solve a simple algebra problem. That is not universal education.

              Try again.

            9. “Sometimes if you want something, you just need to throw money at it.”

              Right Tony, because the people you are throwing money at certainly are not in it for the money…Also, this money that you are throwing is an absolute gamble that mostly fails and must first be confiscated from someone who is productive. That is all.

        3. Tony|1.24.14 @ 1:05PM|#
          “You can’t deny the simple arithmetic in my argument: profit is an additional cost to consumers they wouldn’t have to pay if the system were socialized”

          Your arithmetic is fine; it’s your ignorance of causes that’s your problem.
          Absent those profits, there wouldn’t be any medical care to pay for.
          So profits are not “additional” costs. They are part of the costs necessary to deliver the goods.

          1. Those profits are price signals that tell investors what to invest capital in producing more of.

            The profit is the cost of organizing information so we know what we need more of and what we need less of.

            1. Yeah, but we don’t need price signals, because central planners have perfect information. See Tony above, re: military acquisitions. The information problem is solved!

              1. Lol. Nobody thinks the military procurement system is remotely efficient.

        4. profit is an additional cost to consumers they wouldn’t have to pay if the system were socialized

          It is quite easy to deny your assertion.

          Enlighten us Tony, if you will, on how much savings would be realized to the consumer if all upper management salaries and “profits” were disappeared and given back to the customers?

          After that, realize that the bureaucracy and regulatory nightmare the federal government brings to any problem will far outweigh the salaries of upper management and the profit made by a private insurance company.

        5. So now we have not only health insurance administrators as the middlemen, but government administrators as the middlemen,too, Fucking brilliant.

        6. You can’t deny the simple arithmetic in my argument: profit is an additional cost to consumers they wouldn’t have to pay if the system were socialized.

          You can’t substitute accounting for economics, that’s like substituting arithmetic for physics.

          Money is fungible, but the things it is spent on are not. You cannot shift money from one thing to another without consequence.

          1. Sure. I want to shift money from the offshore accounts of insurance company CEOs into the pockets of healthcare consumers.

            1. You can always pay for your own health care. Oh right, the tax code punishes doing that, just like it punishes keeping money in the country.

              There’s something about incentives buried in there, but I’m sure you can ignore that lesson and just do more stealing to solve the problems of the stealing you’ve done in the past.

            2. Get back to us once you’ve figured out how much money an individual healthcare consumer would get if we confiscated all the money in all the offshore accounts of all the insurance company CEOs in the country. I’m willing to bet it would be less than $100.

              Oh, and while your at it, you may want to start coming up with a plan to deal with the complete collapse of the insurance industry.

        7. Just to use an example close to me:

          I help represent a small pharma company. There are a lot of them out there.

          This small company has licensed a drug. This drug is already in use in many other countries around the globe, including the EU. However, it is not yet licensed in the US.

          The company will end up spending upwards of $50 million to do the testing necessary to license this drug. The drug itself, however, is relatively inexpensive to produce. The disease this drug is intended to treat is relatively rare, with US-based sufferers in the 4 digits.

          Given the above parameters, do you think that the company should only be able to charge based on production cost, or should they be able to charge enough to recoup their testing costs?

          1. Excellent point. But I thought it was the evil free market causing inflated healthcare costs.

          2. I’m sure his wise government solons with perfect information can tell you. As a bonus, these incorruptible, omniscient beings aren’t burdened with petty human concerns like profit.

        8. You’re not really this stupid Tony.
          I’m sure you understand the price mechanism.

          Or has the failure of ObamaCare led you to go full Socialist retard? This new aversion to “profits” sounds suspiciously like “surplus value”.

          1. He is really that stupid. The Progs have gone full commie. I think they sense that the repo man is getting close and they just don’t care anymore. They have stopped even pretending to be reasonable.

        9. Jesus christ you are a fucking idiot. Without profit, no industry would contract with the gov to provide “free health care”, aircraft carriers, etc.

          Also the gov doesn’t control costs, it controls prices.

        10. You can’t deny the simple arithmetic in my argument

          If you could do simple arithmetic, that argument would have substance.

        11. “You can’t deny the simple arithmetic in my argument: profit is an additional cost to consumers they wouldn’t have to pay if the system were socialized.”

          Yes we can.

          Socialized healthcare needs capital too, and one way or another someone have to pay for it (opportunity cost for example). There is no such thing as free lunch.

        12. It is false to suggest that the impact of the profit goes away if the system is socialized.

        13. There is always profit. People only act with incentives. The incentives in a capitalist system are sums of money. The incentive in a socialist system is power over others. Those that wish to act completely altruistically can do so under either system. But, those people are few and far between. Personally, I want people to be incentivized with money, not power. I want them to have to provide me with something I want before they get something out of me, rather than just working politics until they get control over what they want.

          1. Well put!

        14. You can’t deny the simple arithmetic in my argument: profit is an additional cost to consumers they wouldn’t have to pay if the system were socialized. It’s part of the reason our system costs more than anyone else’s. There’s a middleman, and government doesn’t impose any cost controls. This is especially the case when it comes to pharmaceuticals.

          This whole statement…just, wow. Wow. The pursuit of profit spurs innovation and lowers costs for consumers through competition. But why am I telling you that? It won’t matter.

    4. Tony:

      IMO allowing companies to profit from inflated costs for attending to basic human needs is a big fat giveaway all by itself.

      Health insurance != basic human need.

      1. I was referring to healthcare.

        1. Tony|1.24.14 @ 1:09PM|#
          “I was referring to healthcare.”
          The kind you get from the barber?

        2. Tony:

          I was referring to healthcare.

          Health insurance != healthcare.

          1. I would even add that;

            healthcare != basic human need.

            Considering the notion of healthcare didn’t exist until the 1960-70s, I find it hard to believe that the human race and western world developed to say… the 1920s, while completely or nearly entirely lacking a basic need. It’s like saying bees are a basic necessity to plant life.

            1. Societies evolve. We didn’t used to imagine a need for public education either. We also used to predict the future by reading entrails.

              1. Tony:

                Societies evolve. We didn’t used to imagine a need for public education either.

                Now basic human needs = whatever we decide to imagine they are?

                That’s completely arbitrary. It kinda takes all the strength out of the “we need the government to take care of everyone’s basic human needs!” argument, when you admit that you define basic human needs to be anything you really, really like doing. It just devolves into a truism: “We need the government to take care of everything we deem necessary to be taken care of!”

                Great argument.

                1. Yes, it’s somewhat arbitrary (but not really). I think it’s best when people can make their own minds up about it (democratically) and not have a tiny segment of libertarian jackasses with control issues dictate it for them.

                  1. Tony|1.24.14 @ 5:49PM|#
                    “Yes, it’s somewhat arbitrary (but not really).”
                    It’s totally arbitrary.

                    “I think it’s best when people can make their own minds up about it (democratically)”
                    Fine. In which case, they can pay for it themselves.

                  2. Tony:

                    I think it’s best when people can make their own minds up about it (democratically) and not have a tiny segment of libertarian jackasses with control issues dictate it for them.

                    You win the award for the most ass-backwards comment today.

                    Democracy != people making their own minds up about it.
                    Individual freedom means people making their own minds up about it. That’s libertarianism.

                    A tiny segment of jackasses with control issues dictating everything for everyone = democratically elected congress.

                    Regardless, you only like democracy when it’s producing outcomes you enjoy. You dump it the minute people want to ban gay marriage, abortion, etc. Suddenly, then, we can’t make up our own minds about it (if that’s the language abuse you want to commit in describing it that way).

                    1. You’re not describing my approach to democracy accurately. I am aware that democracies can make bad choices. I’m just not aware of an alternative that tends to make better choices.

                      You are engaging in quintessential libertarian semantic bullshit. What does it mean, exactly, to leave people alone to make their own minds up about stuff? Apparently it means forbidding them (and I mean actively) from deciding they want to certain collective decisions in a democratic way (which most of them find perfectly fair).

                      Yes you have control issues. You guys are the walking embodiment of the paranoia of not being in charge. You look at goddamn roads with suspicion. Despite the content of your rhetoric, you’d clearly be among the least capable of wielding power judiciously. You’re sitting here admitting that democracy is too messy for you.

                    2. Tony|1.24.14 @ 7:17PM|#
                      “You’re not describing my approach to democracy accurately. I am aware that democracies can make bad choices. I’m just not aware of an alternative that tends to make better choices.”

                      You’re dissembling again.
                      It’s not ‘bad choices’ that are at issue; it’s using democracy to legitimatize theft, asshole.

                    3. Apparently it means forbidding them (and I mean actively) from deciding they want to certain collective decisions in a democratic way (which most of them find perfectly fair).

                      Incorrect. No libertarian has ever suggested forcibly preventing people from forming collectives and making decisions democratically. It’s actually the opposite: libertarians oppose conscripting people into a collective and forcing them to comply with decisions made democratically by the very people who conscripted them. In libertopia you’d be perfectly free to indulge your Marxian wet dreams to your heart’s desire, so long as you don’t put a gun to someone else’s head and force them to participate. But that would strip your ideology of its entire meaning.

                    4. So how do you deal with the fact that new people are born, often into societies that are already set up?

                      Libertarianism is a crock of shit, especially as you’re describing it.

                    5. No one is objecting to people collectively doing what they want. Corporations are just that. A group of people all contribute to a pool to create a large enough pool to do something none of them individually could have done.

                      Obamacare is not that. It is forcing everyone into doing something collectively, and to do it the way a committee decided was best for them.

                    6. What does it mean, exactly, to leave people alone to make their own minds up about stuff? Apparently it means forbidding them (and I mean actively) from deciding they want to certain collective decisions in a democratic way (which most of them find perfectly fair)

                      No, it means not forcing people to join their collective.

                      Despite the content of your rhetoric, you’d clearly be among the least capable of wielding power judiciously.

                      Which is why libertarians don’t want power over others.

                  3. So the people who want to be left alone and leave others alone have control issues.

                    Say it out loud and you might grasp how stupid you sound. But, maybe not.

                  4. I think it’s best when people can make their own other people’s minds up about it (democratically)

                    FTFY

                  5. It’s the progressives who want to control others. I am happy ‘when people can make their own minds up’…..they can do whatever they want so long as they pay for it and don’t harm me. Why should I have to pay for your ‘basic human need’ for 200 channels of HD cable if I don’t share in that assessment of its value?

                    1. It’s the progressives who want to control others.

                      That’s really the thing. We’re not trying to control them, they are trying to control us. And they can’t understand why we don’t like it. How can we be against doing good stuff for people?

                      Progressives would learn a good lesson if someone actually tried to force thme to live according to someone else’s beliefs for once. They get a free ride by living in a society filled with people who just want to leave everyone else alone. They never have to experience being the ones who someone else is trying to force their will upon.

          2. Tony…I guess what I don’t understand, and I’m not trying to be argumentative, it appears you are refusing to say ‘Wow, this is a royal screw up (I’m Canadian, we say ‘royal’ this, ‘royal’ that). I want socialized medicine, but Obama messed up badly. We need to start over.’ Why would you not say that? Do you actually think things are good with this?

            If you can’t say that you aren’t defending people, you are defending government. Which is what we believe is typical of North American lefties. Almost as if they really believe, ‘I don’t like people. I like government. I like government because it protects me from people, whom I don’t trust. It is the system I represent and wish to maintain, not those the system ostensibly serves.’

            1. CANADA?

              Where your Supreme Court ruled your “Medicare” to be an unconstitutional threat to human life, citing all the Canadians who die on waiting lists of a year or more? “Access to a waiting list is not access to health care.”

              Where your federal government is now spending our GDP equivalent of a half-trillion dollars to reduce those barbaric waiting lists? To increase your massive shortage of diagnostic testing for things like cancer?

              My father was among the first to be diagnosed and cured of colon cancer. That was the 1950s. Canada STILL doesn’t test for colorectal cancer.

              1. Mike….I probably wasn’t clear. My post was asking Tony why he couldn’t admit that despite wanting socialized medicine, Obamacare is not it, and is not working.

                I was not giving any props to Canadian medical care. It is a mess. Hugely. And, the average person is going to be hurt it by it soon. As the boomers age and get sick the resources just aren’t there. The wait times are getting longer, and will get longer.

                My best friend was suspected of having tongue cancer. It took him two months to be diagnosed, despite his MD being really sure it was cancer right away. But, then it took 5 months to get any treatment! In the time he waited it went from a Stage One to a Stage Three. He was given the maximum amount of chemo and radiation allowed. It is in remission now, but if it comes back, he dies. Because they can’t give him any more treatment.

                If you get breast cancer, you’re treated in a few days. Because breast cancer is political. Prostate cancer – not so much.

                I’ve had friends die from not getting treatment, with treatable diseases.

                1. Thanks pulseguy,

                  it’s a good point that even under socialized single-payer, resources are finite.

                  People have this idea in their heads that single-payer means free unlimited treatment for everyone. But it just means a different distribution of the same resources. Instead of spending it on prostate cancer it gets spent on breast cancer. It is determined by politics instead of wealth. Even if you have the money and are willing to pay for your own prostate cancer treatment, you can’t because it’s illegal. You have to go to another country.

                2. Thanks for clarifying, Pulseguy. My employer sent me to Canada for a few years in the 1970s.

                  Your comment on “political” is more dangerous than you think. It fact, I now call it political (not government) healthcare. Think about it. We entrust our very lives to politicians assuming that — if they face a choice between increasing our taxes and cutting our benefits — they’ll choose our health over taxes. Can pigs fly?

                  Your national Medicare began large cutbacks during tight money in the mid-90s.

                  Down here our Medicaid is a free government health program for the poor. But 1/4 our uninsured, 12 million Americans, are eligible (pre-Obamacare) but never enrolled.

                  So, the uninsured percentage is HIGHER along Medicaid eligible s (18.8%) than in the private insurance market (16.3%). Cost is NOT the problem. We can’t give it away!

                  Back to the point, Medicaid pays doctors less than our Medicare (for seniors), and doctors cannot provide treatment for as little $17 per visit. Politics — here against an entire class of people.

                  So we severely underfund Medicaid but severely over-promise Medicare ($50 trillion unfunded liabilities). How can that be? Seniors vote. Poor people do not. Political healthcare in BOTH our countries.

                  Here’s all the proof on our uninsured rates.

                  http://bit.ly/1bJg8ue

                  COPYRIGHT 2012-2014 BY MICHAEL J HIHN

    5. IMO allowing companies to profit from inflated costs for attending to basic human needs is a big fat giveaway all by itself.

      Some day, when this great system of yours comes crashing down, you will learn the lesson that you should have learned in the first place: there is only one power great enough to allow or disallow things truly, and her name is nature, and she does not suffer fools.

      Your “basic” human “needs” are not free. They are positive things, which must be provided using someone’s time, effort, and materials. Those things are not free, and no matter how much you try to manipulate money and prices, those costs will always be paid, one way or another.

      1. I didn’t say they were free. I said they are cheaper when we pay for them socially than when we pay for them through the for-profit system.

        1. Prices are not costs, and debt-inflated fiat currency is not real money.

          The cost of the same procedure performed by a doctor of equal skill to the same standards is the same everywhere.

          So, if it costs $100 in India, $500 in Mexico, $5000 in Europe, and $10000 in the United States, then there must be another explanation for the difference in price!

        2. Only if you believe that the government can perfectly know how to allocate resources.
          With no price mechanism, how does the government know whether it needs more oncologists or more gynecologists?

          Or, more accurately, with no price signals, what incentive is there for people to choose to become one rather than the other?

          1. Tony doesn’t care about issues like that, second order effects, etc.

            Once you can label your system “universal”, it’s mission accomplished time, regardless of what it looks like.

            1. Brian|1.24.14 @ 1:54PM|#
              “Tony doesn’t care about issues like that, second order effects, etc.”

              Tony is entirely too stupid to even have a clue as to what you’re posting about.

              1. If your goals are noble, results are irrelevant.

          2. Why don’t you ask one of the entire rest of the civilized countries how they manage it?

            Healthcare is a special market in which price signals don’t and probably cannot play the role you want them to. Apart from the fact that US consumers are buffered from price signals through insurance, the nature of healthcare doesn’t lend itself to robust market competition (e.g., in an emergency, you go to the hospital closest to you when you need to not when you want to). In short, the US healthcare economy is a giant market failure. Controlling costs by fiat like all other civilized countries do will not satisfy the market gods, but it’s better than the quasi-consumer-based system we have, because it’s cheaper and not any worse on quality.

            It must be terribly inconvenient never being able to believe in facts that don’t support your preconceived utopian worldview. I suggest not having one.

            1. Tony:

              Apart from the fact that US consumers are buffered from price signals through insurance

              Which has everything to do with government, and nothing to do with markets.

              the nature of healthcare doesn’t lend itself to robust market competition (e.g., in an emergency, you go to the hospital closest to you when you need to not when you want to)

              That might make sense if all of healthcare was an ambulance ride to the hospital. But it’s not. It’s been debunked over and over again, but you guys love saying it, because it’s so consistent with your ideology. So, you never let it die. I’ve had way too many family members go doctor/procedure shopping to call BS on “no market competition, all ambulance rides.”

              Controlling costs by fiat like all other civilized countries do…

              This statement is false. See Singapore.

              It must be terribly inconvenient never being able to believe in facts that don’t support your preconceived utopian worldview. I suggest not having one.

              I would take that seriously, if your argument contained a true statement.

              1. Even in the case of emergency procedures, there’s market competition.

                I was with a family member who had a medical emergency. We drove them to the hospital. There are two hospitals available.

                By your beliefs, faced with this decision, I’d have to immediately drive to the closest one. Is that what you would have done?

                Instead, we decided that we preferred one over the other. They were both about as far away, while one had a reputation for being nicer and providing better, faster treatment. Since we had insurance, price difference wasn’t an issue, so we went to the nice one.

                Wow. These two hospitals competed for our business, and one got it.

                Now, you propose that, if we add the price of care to the equation, suddenly it’s an insolvable problem? We couldn’t easily factor in price, if we wanted? Or, the price would have to be sky-high at both because we don’t have any choices, even though we clearly do?

                The whole “can’t have markets in healthcare” argument is just BS. That’s why the argument is always anecdotal: “Imagine a ride in the hospital, with a harpoon through your head! Understand that practically all of medicine is just like that!”

                Sorry, but that’s completely contradicted by reality and probably everyone’s own self-experience (if you like anecdotes). The data doesn’t support it. But socialist democrats go for it every time. I think the phrase you use is “religious ideology.”

            2. Tony|1.24.14 @ 3:38PM|#
              “Why don’t you ask one of the entire rest of the civilized countries how they manage it?”

              Don’t have to ask; they keep ’em in line until they die.

            3. Healthcare is a special market in which price signals don’t and probably cannot play the role you want them to.

              This is like saying “healthcare exists in a special universe where the is no gravity and where 2+2 does not equal 4”.

              Granted that the healthcare market is screwed up because of the employer-based system, but to say that price signals don’t work is just wrong. They do work, they just are pointing at the wrong things because of how we’ve intervened. Right now, consumers get the price signal that no matter what they spend, it’s going to cost them same to them, so they might as well spend more. Right now, doctors get the price signal from the Medicare reimbursement rates as to what procedures they should perform more and less, if they want to make more money.

              Price signals would work just fine if we actually let insurance act like insurance instead of subsidizing it through employers and regulating it so that consumers never see it’s true cost.

        3. Is “pay for them socially” a technical term you learned while getting your Univ. of Chicago econ degree?

          Almost every commodity known to mankind has become cheaper over the last 500 years, via market pricing and productivity gains achieved by pricing signals, in terms of hours worked required to acquire. This did not happen because some fool set an artificial price floor/ceiling. Most non-covered medical services have become cheaper and better as compared to the covered variety.

          Moron.

        4. 73 years of famine in the Soviet Union says they aren’t cheaper. The cost in human misery and human life isn’t figured into your government mandated cost of wheat.

        5. Which is why there are numerous examples of how the government provides such great service at a good price.

          It is for-profit services that bring the price of things down. Constant pressure on providing better and better service at a cheaper and cheaper price.

          I used to own a day to day business. I had 65 employees. I was a thrifty businessman, constantly working all year at getting my costs down. Every January, when things were slow I would go over everything I purchase and shop around between suppliers getting prices down even further – because I had some time in January. Despite my constant grinding in January I would end up dropping my monthly expenses by between $5,000 and $10,000. Roughly an $80,000 or $90,000 annual improvement to my bottom line.

          I have friends who are high up in the local provincial government. I asked does anyone ever do that in any department of the government. Nope, they said. Never. They put stuff out for tender, sometimes, and just accept the simplest, easiest bid.

          There is not a chance in the world I could not shave 20-35% off any government budget anywhere in a few months of digging.

          Profit is usually in the 3-5% range.

          You’re just plain wrong, Tony.

    6. Expanding access to healthcare has practically been secondary to making sure poor wittle insurers aren’t out a single dime from the effort.

      If I want to expand access to healthcare, is it just to impose the cost of doing so on a small group of people, instead of spreading it evenly throughout society?

      IMO allowing companies to profit from inflated costs for attending to basic human needs is a big fat giveaway all by itself.

      Those profits are what drives companies to “expand access” to healthcare by providing more of it, and of the right kind. Without prices and profits there is no way of knowing which tests and treatments are more in demand and no way of directing resources towards producing more of them.

      1. You don’t understand Hazel. The key to getting more people and resources into providing healthcare is to make sure no one makes a profit doing so.

        Yeah, Tony and a lot of other people actually believe this.

        1. Tony does the standard leftie thinking thing. ‘What do I want?’ Cheaper healthcare. Then, take the first and supposedly easiest way of achieving that, in this case take out the profit line item, and say ‘there I solved the problem.’

          What do we want? A society in which nobody shoots anyone else. Sounds good to me. How do we get it? Take away guns from law abiding people. It is an easy and simple fix. What could go wrong?

    7. Expanding access to healthcare has practically been secondary to making sure poor wittle insurers aren’t out a single dime from the effort.

      Poor Tony suddenly catches up to the page that most libertarians have been on since before Obamacare was passed. Compelling citizens to give money to insurers unwillingly might be a bad idea.

      Tony, many of us knew from day one that this wasn’t about reducing the cost of healthcare or expanding access. We voted against it. Feel free to join us next time.

  6. The problem with Obamacare is that it’s not complicated enough. A well crafted law is so complicated that no one can tell what it actually costs or where the money actually went.

    1. The good thing about Obamacare is that unlike most government programs there is an immediate cost due and payable by individuals. In this case by the average person having to pay higher premiums and having higher deductibles.

      Most gov programs have a cost, which we all pay, but no one is billed directly for it. So, no one really notices the overall costs. This is the first government program I’ve seen, other than sales taxes, that people can see what it is costing them.

      Do you like the War on Drugs? Yes! Good. Your share of the cost is $125 for each and every one in your family. Please send a check to the government for $500 to cover you and your wife and your two kids. How many would still approve of it? Probably nobody.

      I wish wars were fought on this basis. Everyone gets billed each month for the cost directly. We’d never go to war again, unless it was absolutely necessary.

  7. ‘The only ones that aren’t going to like it [PPACA], are the insurance companies.’

    The POTUS figured that out even though presumably the insurance company lobbyists, I am guessing, saw it as a free gift of 40 million new policies. Obama truly understands the power of government to make his points perfectly clear.
    [the rest of us still like it, because if we don’t it’s because we are trying to deny the first black POTUS of his legacy.]
    [I love how that legacy word gets thrown in.]

  8. I’m curious as to how risk corridors are supposed to interact with the rebates and MLRs.
    If the plan has lower than expect medical expenses, does it pay the excess back to consumers via rebates, or does it pay the government via risk corridors?

    Also, note how this diminishes the incentives that insurers have to sign up the young and healthy.
    If they have a “bad” mix, the government reimburses the loss. If they have a good mix, they lose most of the gains.

    The net effect is that any deviation from the 80% MLR requirement will automatically be adjusted back towards it, meaning the insurer is guarenteed a 20% overhead with which to pay for administrative costs. So the insurer really has no reason to care about what risks it is undertaking. Its profits are going to be roughtly the same either way. It’s just a game of trying to ride the edge of the risk corridor so you can maximize that 20%.

    1. A loss is still a loss. I would expect Insurance companies to much prefer to be in the black.

      1. Ahh, but the MLR stays that you must spend 80% of your income on medical care. You get to keep 20% for administration and profit. But 20% of $100,000 is bigger than 20% of $10,000. So who do you want as your consumer? The person who is going to spend less, or the person who is going to spend more?

        Note that the compensation is not based on your *profits* it’s based on whether the aggregate spending was more or less than expected. There’s probably a sweet spot in there where you maximize revenue to your 20% chunk comes out as large as possible after getting your compensation.

  9. Obama’s Health Care Reform Speech to Congress
    Finally, let me discuss an issue that is a great concern to me, to members of this chamber, and to the public ? and that is how we pay for this plan.

    Here’s what you need to know. First, I will not sign a plan that adds one dime to our deficits ? either now or in the future. Period. And to prove that I’m serious, there will be a provision in this plan that requires us to come forward with more spending cuts if the savings we promised don’t materialize.

    Fuck you mister president.

  10. No less than half the population will be eligible for medicaid. If you’re 60 or something, you’ll be eligible for medicare in a few years and you’ll find ways to not buy healthcare. Some might pay the penalty.

    If you’re illegal, then nothing changes. If the free clinics and local healthcare programs are transitioned to medicaid, then you might be in trouble.

    A “mandate” doesn’t work if you give people options to weasel out of it. And if it doesn’t work, that means less customers for the insurance companies. How could they not see it?

    They can’t turn to Republicans or conservatives to help “enforce the law” or the penaltax. There’s a whole lot of power those people are looking forward to returning to.

    1. Except that I doubt “we plan to strictly enforce the mandate” is exactly the kind of platform that will get the Republicans back in power, though I wouldn’t be shocked if the stupid party tried it.

  11. I have pointed this out to Tony before, but here it is again:

    Private Insurer Profits? $13 Billion. Medicare Fraud? $48 Billion.

    In fact, health insurance is one of the least profitable industries in America. 2010 profit margins for publicly-traded health insurers averaged a measly 4 percent. By comparison, cigarette manufacturers have margins of 20%; railroads 15%; long-distance carriers 14%; and soft drink manufacturers 13%. If health insurers are profit-hoarding devils, so is the rest of the private economy.

    1. And I’ve repeatedly pointed out that the biggest cost drivers are in underlying medical care costs. Sector-wide, healthcare’s margins are higher than 20%.

      Obamacare is about expanding access to health insurance. The more complex task will be controlling healthcare costs. I’m sure you guys have much to contribute to that project.

      1. Tony:

        Obamacare is about expanding access to health insurance. The more complex task will be controlling healthcare costs.

        I guess all those people who believed that Obamacare was all about controlling healthcare costs feel really silly now, huh?

        1. Well it does have provisions for doing that, most significantly in changing the way Medicaid pays providers. And costs have actually been going down for the first time in recorded history. It’s debatable how much of that is due to the ACA, of course.

          I’m not claiming the ACA is the final solution for healthcare. Never have.

          1. There’s always noise in the data, but healthcare costs vs. GDP have been going up in every civilized country for the last 30 years.

            If you think the ACA has suddenly produced magic, be my guest. But, I wouldn’t go around claiming that those who disagree are blinded by ideology and disconnected from reality. It could just be that they’re aware of the data.

          2. Tony|1.24.14 @ 5:40PM|#
            “Well it does have provisions for doing that, most significantly in changing the way Medicaid pays providers.”

            Oh, there’s a winning strategy; pay your suppliers nothing! That’ll cut costs to zero, along with cutting services the same amount.

            1. What is your healthcare reform policy idea, dipshit?

              1. The same idea that provides us with food, clothing, computers, and a million other things: the free market.

                1. Ah, so unicorns. I thought so.

              2. Tony|1.24.14 @ 7:01PM|#
                “What is your healthcare reform policy idea, dipshit?”

                Pay for what you use, slimy turd.

              3. 1. Change in tort law. Too much of doctors salaries go to malpractice insurance.

                2. No one should see a doctor with 12 years of education until they have seen a nurse with half that. Most MD stuff, I’d estimate over 90% can be handled by a competent health practitioner.

                3. Anyone on the government dole, including all pensioned government workers, anyone on Medicaid, etc. gets bare-bones medicine. If they want to top it up themselves with after market add-ons, then fine. But, only the basics are covered by the public purse.

                4. Stop funding pharmaceuticals. Take them off the insurance plans. The cost of them will drop significantly, and they will be used less. They don’t produce good health benefits. What does produce health benefits is people living healthier.

                5. Different insurance rates for anyone on the government programs depending upon lifestyle. If you smoke you pay something to get insurance, even if you’re on the government dole. Your outcomes are worse, you should pay more.

                6. A massive public service announcement program to encourage healthy living. Over time PSAs work. Look what they’ve done for drinking driving, and smoking. At least 50% of diseases are self-inflicted through bad living.

          3. I’m not claiming the ACA is the final solution for healthcare.

            Well, if I were to consult anyone on final solutions, you’d be the man.

      2. Yeah, Obamacare will “control healthcare costs” by taxing medical devices and health insurance plans. Brilliant.

      3. Tony|1.24.14 @ 4:12PM|#
        “And I’ve repeatedly pointed out that the biggest cost drivers are in underlying medical care costs. Sector-wide, healthcare’s margins are higher than 20%.”

        You are full of shit. No ‘healthcare’ company shy of some snake-oil outfit shows average margins greater than 7%.
        I don’t know where you get your load of bullshit, but you need to grow up.

        1. Major drug manufacturers and device makers are well above that.

          1. Tony|1.24.14 @ 5:38PM|#
            “Major drug manufacturers and device makers are well above that.”

            They are nothing of the sort. If they were, the money going to investments in them would be a flood.
            They, like every competed company make an average of 7% when times are good.
            You’re either an ignoramus or a lying POS; which is it?

            1. Tony is wrong. What a surprise.

              The Average Profit Margin of Pharmaceuticals

              According to Yahoo! Finance’s industry summary, the average profit margin for generic drug companies as of April 2013 is 5.4 percent. The largest average profit margin is for major drug manufacturers at 18.4 percent. This group includes Pfizer, AstraZeneca and Bristol-Myers Squibb. For the “other drug manufacturers” category, which includes Teva Pharmaceutical Industries and Allergan, the average margin drops to 12.2 percent. These segments of the pharmaceutical industry have high barriers to entry due to high research and development costs tied to U.S. Food and Drug Administration compliance; these costs can exceed hundreds of millions of dollars.

              The average profit margin for publicly traded drug wholesalers, including Cardinal Health and McKesson Corporation, is the lowest in the pharmaceutical industry at 1.30 percent. The profit margin for drug-related product producers, which includes Herbalife and USANA Health Sciences, is 11.7 percent. The latter category is sometimes referred to as nutraceuticals. More small businesses operate in these segments.

              1. Tony is wrong. What a surprise.

                Sky: blue. Water: wet. All’s right with the world.

      4. Margins are not profits, Tony.

        Can you do a little work before you pontificate?

  12. If you die your holdings will be sold to cover the medical costs, this is written in the healthcare law. Do you honestly think that this will not be padded to the hilt?

    1. Are you on drugs or merely insane?

  13. No, it is not a bailout and Suderman misrepresents it — like his hysteria about Congress having a “special exemption” in the exchanges.

    It’s technically not about “costs” either. It’s about risk. The law guarantees that the potential death spiral will not happen, else no insurer would be on the exchanges. Dumb, but it is the law so cut the bullshit.

    When we hear that enrollment by the young and healthy was estimated at 40% … that ratio was legally guaranteed.

    But the dumbass wing of libertarianism wants to blame insurance companies instead of Obamacare itself. Strategy? Tactics? What are they?

    1. “But the dumbass wing of libertarianism wants to blame insurance companies instead of Obamacare itself. Strategy? Tactics? What are they?”

      Pretty sure that’s a dumbass presumption on your part; got a cite?

      1. (snicker) It’s in the law, Sluggo. That’s why it may have to be paid. Are you saying Obama invented it out of thin air? Or that Suderman’s delusion is true, that it was “repurposed” after passage?

        This is the best explanation I could find for you.

        http://www.nationaljournal.com…..s-20131110

        And, ummmm, what is the purpose of that $63 tax on all insured Americans? Learn about it here.

        http://www.politico.com/story/…..01810.html

        The “bailout” is paid from a dedicated tax on … INSURANCE COMPANIES!!!! Good grief.

        1. Hey moron, a tax on insurance companies just might, just might actually be a tax on consumers that buy insurance policies since the price of the policy will rise by the amount of the tax. You sure are up on economics. Simpletons of your ilk should just STFU or jump off a bridge into your nearest river. It will help alleviate global warming because we’ll be closer to the goal if your aren’t emitting CO2. Idiot.

          1. Hey dipshit, where did I defend the tax???

            I simply told you what the tax is paying for. You ass-ume I defended the tax??? (lol)

        2. Michael Hihn|1.24.14 @ 11:50PM|#
          “(snicker) It’s in the law, Sluggo.”

          You might do better (maybe) if you learned to read. I asked you for a cite to prove this claim:
          “But the dumbass wing of libertarianism wants to blame insurance companies instead of Obamacare itself.”
          Now, idjit, got any cites or are you as stupid as you seem to be?

          1. Michael Hihn”(snicker) It’s in the law, Sluggo.”

            You might do better (maybe) if you learned to read.

            What part of “it’s in the law” confused you, Sluggo.

            I asked you for a cite to prove this claim:
            “But the dumbass wing of libertarianism wants to blame insurance companies instead of Obamacare itself.”
            Now, idjit, got any cites or are you as stupid as you seem to be?

            Stop drooling.
            1) Obamacare uses the same guarantee that Medicare Part D had, balancing risk

            2) Shame on me for assuming you had read the post that we are commenting on.

            Follow the link to Kaiser. Two risk measures both transfer dollars between nsurance companies — from the ones who get the lowest risks to the ones who wind up with the highest risks. Reason: nobody knows which plans will wind up with the highest-cost patients. The ones with the highest risks mean the others will have lower risks. It balances the risk entirely with transfers between insurance companies …. not taxpayers.

            If the so-called death spiral appears, as seems likely, then the administration has said the RATIO would change, on the transfers between insurance companies — still breakeven. (not taxpayers)

            or are you as stupid as you seem to be?

            (snicker) Stop drooling!

    2. Luke , the stupid is strong with this one.

      1. montanamike, you’re the dipwad who accused me of defending a tax, because I explained what it’s supposed to pay for?

        Ummm, if I say the federal income tax pays most discretionary spending, would you claim I was defending the income tax?

        It seems that you target your raging trashmouth to people who know what they’re talking about. (lol) Are you done stalking me?

    3. “But the dumbass wing of libertarianism wants to blame insurance companies instead of Obamacare itself. Strategy? Tactics? What are they?”

      Really? Since when have libertarians been blaming insurance companies instead of Obamacare? I haven’t heard that.

      And….”Strategy? Tactics? What are they?”. What in the world does that mean?

      1. And….”Strategy? Tactics? What are they?”. What in the world does that mean?

        You don’t see any either!

  14. I’m generally “pro business” but in this case, I have no sympathy. In the first place, I have never in my entire life had an insurance company pay a claim in full according to the terms of the policy, so for that reason alone, they can all burn in hell.

    In the second place, they all got in bed with Obama voluntarily. If that turns out to have been a bad business decision, then they can damned well eat the loss.

    You lie down with dogs, you get up with fleas.

    1. Good points, OldOllie, but it’s Obama that crawled into business with the insurance industry.

      The individual mandate came from the health insurers. In December of 2009, Obama had been elected, but not yet taken office. The industry trade association announced that they would ignore pre-existing conditions only if there was the mandate.

      It’s not generally known these days, even among self-proclaimed libertarians, but the health insurers were created by FDR! It was the only way to provide coverage to a group of employees in the same company. Before that, coverage was provided through voluntary organizations — then more common fraternal and ethnic lodges.

  15. Clearly the goal is to collapse the system.
    What part of “The Cloward – Piven Strategy” is not readily apparent?
    Both 0bama and Clinton are admittedly life-long disciples.

  16. what Jimmy said I am taken by surprise that a student able to profit $4756 in 1 month on the internet. browse around this website W? o? r? k? s? 7? 7? .? ?? ?? ??

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