Obama: 8 million signed up for health care

Enrollments exceed expectations
Associated Press
Apr 18, 2014

 

Eight million people have signed up for health care through new insurance exchanges and the proportion of younger applicants has increased, President Barack Obama said Thursday. The enrollments exceeded expectations and offered new hope to Democrats who are defending the law ahead of the midterm elections.

An impromptu appearance in the White House briefing room offered the president an opportunity to trumpet the new figures, which beat initial projections by 1 million. With an eye toward November, Obama castigated Republicans for continuing to seek out every opportunity to thwart the Affordable Care Act.

"This thing is working," Obama said of his signature domestic achievement.

Touting modest progress on another front, Obama said 35 percent of enrollees are under 35 years old, suggesting that in the final weeks of enrollment, the administration managed to sign up higher numbers of younger, healthier people who are critical to the law's viability.

The most coveted age group comprises those between 18 and 34 years old. White House officials said that for the 36 states where the federal government is taking the lead, 28 percent are in that age group — a step in the right direction from March, when the administration said just 25 percent were 18 to 34.

In a sharp rebuke to his political opponents, Obama called out states that have refused to embrace an expansion of Medicaid under "Obamacare," arguing that their opposition was rooted in nothing more than sheer ideology and political spite.

"That's wrong. It should stop," he said. "Those folks should be able to get health insurance like everybody else."

Although the first year's open enrollment season for the exchanges closed on March 31, the administration is still tallying the number of total enrollees. States managing their own exchanges have been slower to report data, and some Americans who started applications before the deadline were given extra time to complete their enrollment.

The demographic figures also give Democrats an opportunity to blunt the pessimism of Republicans, some of whom have accused the White House of "cooking the books" by announcing large overall enrollment numbers that tell only part of the story.

"They still can't bring themselves to admit that the Affordable Care Act is working," Obama said. "The longer we see the law benefiting millions of people, the more we see accusations that the law is hurting people being completely debunked."

Democrats have been hoping that better-than-expected results could help their candidates reclaim the political high ground on "Obamacare" before Election Day. Seven months out, Democrats are seeking to turn the page on the law's disastrous debut in October, when HealthCare.gov was virtually unusable. Obama seemed to affirm that strategy last week when he announced that Health and Human Services Secretary Kathleen Sebelius, who became the face of the rollout failure, was stepping down.

Polling shows the law remains unpopular in much of the country, but Democrats plan to argue that by trying to repeal the law, Republicans are actively working to take health care away from 8 million Americans.

Although the new figures provide some clarity about how well the exchanges performed, there are still plenty of unknowns.

Officials haven't released a tally of how many enrollees were previously uninsured and are thus gaining health care thanks to the law. It's also unclear how many enrollees sealed the deal by paying their first month's premium to the insurance companies.

Republicans seized on those uncertainties to argue that Obama is hyping figures that obscure the real damage the law is inflicting — like higher premiums, smaller provider networks and canceled policies, according to Senate Minority Leader Mitch McConnell, R-Ky.

"It's long past time for Washington Democrats to work with us to remedy the mess they created — and that means repealing this law and replacing it with real reforms that actually lower costs," McConnell said.

As Obama's health law begins to look more viable, Democrats have been seeking to change the political debate from one about repeal to one about fixing lingering issues with the law.

Obama said it's "absolutely possible" to make improvements, but that it would require a change of attitude from Republicans. But election-year posturing and the GOP's reluctance to be seen as embracing "Obamacare" make than an unlikely proposition.

The president's upbeat assessment came shortly after he and top aides had separate meetings with leading insurance executives and state insurance commissioners.

"I think that's a pretty good number in terms of trying to make sure we have a healthy pool," Montana's insurance commissioner, Monica Lindeen, said of the surge in younger enrollees.

In other positive news for Obama's health care law, California's state-run insurance exchange reported Thursday that nearly 1.4 million Californians had enrolled by the end of open enrollment, besting original projections by almost 100,000 people.

Comments

Darwin's choice

Hahahaha! Thats a good one obama!

http://www.youtube.com/watch?v=a...

Obamacare....making failure look easy!

MrSandusky

Yes, but how many people are actually going to buy and pay for it? 8 million people can sign up for an Amazon account or an Ebay account, but does that mean that 8 million people are buying items from those sites?

How many just set up a free profile just to take a look?

I was at an event yesterday with about 70 other people. I was shocked at how many people said that they signed up for an account, found out how much purchasing the insurance was going to cost them, and decided to just pay the fine rather than buy the insurance.

looking around

If that is how they feel then provide them with forms right then and there to sign-off on all medical services unless arrangements to finance or pay cash is guaranteed.

The Big Dog's back

Exactly!

The Hero Zone's picture
The Hero Zone

Why do that when we can just outlaw gratis/charity/unpaid healthcare? It's easier to just arrest doctors for "tax fraud" by allowing patients to not pay, isn't it? There's far less doctors and hospitals than individuals in order to enforce this sentiment. Shut down all hospitals that don't collect money up front too while we're at it. It's compassionate care mixed with fiscal responsibility. Criminal doctors will be punished for their nefarious care of everyone regardless of ability to pay.

Sheesh.

The Big Dog's back

Going out to right field again?

Darwin's choice

"Dear Mr. Obama, Senate and Congress:

I'm planning to move my family and extended family into Mexico for my health, and I would like to ask you to assist me.

We're planning to simply walk across the border from the U.S. into Mexico , and we'll need your help to make a few arrangements.

We plan to skip all the legal stuff like visas, passports, immigration quotas and laws.

I'm sure they handle those things the same way you do here. So, would you mind telling your buddy, the President of Mexico , that I'm on my way over?

Please let him know that I will be expecting the following:

1. Free medical care for my entire family. (obamacare)

2. English-speaking Government bureaucrats for all services I might need, whether I use them or not.

3. Please print all Mexican Government forms in English.

4. I want my grandkids to be taught Spanish by English-speaking (bi-lingual) teachers.

5. Tell their schools they need to include classes on American culture and history.

6. I want my grandkids to see the American flag on one of the flag poles at their school.

7. Please plan to feed my grandkids at school for both breakfast and lunch.

8. I will need a local Mexican driver's license so I can get easy access to government services.

9. I do plan to get a car and drive in Mexico, but I don't plan to purchase car insurance, and I probably won't make any special effort to learn local traffic laws.

10. In case one of the Mexican police officers does not get the memo from their president to leave me alone, please be sure that every patrol car has at least one English-speaking officer.

11. I plan to fly the U.S. flag from my housetop, put U.S. flag decals on my car, and have a gigantic celebration on July 4th. �I do not want any complaints or negative comments from the locals.

12. I would also like to have a nice job without paying any taxes, or have any labor or tax laws enforced on any business I may start.

13. Please have the president tell all the Mexican people to be extremely nice and never say critical things about me or my family, or about the strain we might place on their economy.

14. I want to receive free food stamps.

15. Naturally, I'll expect free rent subsidies.

16. I'll need income tax credits so that although I don't pay Mexican taxes, I'll receive money from the government.

17. Please arrange it so that the Mexican Government pays $4,500.00 to help me buy a new car.

18. Oh yes, I almost forgot, please enroll me free into the Mexican Social Security program so that I'll get a monthly income in retirement.

I know this is an easy request because you already do all these things for all of his people who walk over to the U.S. from Mexico . I am sure that the President of Mexico won't mind returning the favor if you ask him nicely.

Do you see how stupid this looks when you put it in writing????"

Whiskey Tango F...

Quite possibly the best comment of the year. The truth usually gets deleted on here.

The Big Dog's back

Leave durwood. Please! Do you need help packing? I'll be right over if you do. Call me. :)

Bottom Line

What's wrong with his post, pooch? Dispute it with facts. You know what those are, right?

Darwin's choice

Dog, you big phony! I call you (something) all the time...you never like what I call you!

anthras

Re:"Leave durwood."

Big Dog his name is Darwin not durwood. Was that just an ignorant mistake by you are was it immaturity?

worddrow811

Put this in the print edition for all the other people to see, will you Matt? This is our country now and we have the government to thank for it! Awesome statement and kudos to Darwin's choice!

Stop It

Great stuff, Darwin's choice. Well said.

Pterocarya frax...

God you haters act like Darwin wrote this nonsense himself. He copied and pasted it from some other hater, because he is incapable of having this original of a thought.

Darwin's choice

No hate from you though........democrats.....! Still failing..!

Nemesis

How is that any different from Big Dog?

What's your point, other than that you have no response to offer to WHAT he posted.

sorryhog

Do you really believe his B.S.?

The Big Dog's back

You believed it when the numbers were low.

rbenn

Yawn, tell a lie enough hoping the sheep will believe it. This comment in no way was meant to be racist towards sheep or any other livestock.

The Big Dog's back

So, were the low numbers a lie?

Nemesis

The numbers are IRRELEVANT. So he could MAKE 8 million people to sign up for something by threatening to punish them if they didn't? How many registered with the Selective Service under Nixon? No difference.

coasterfan

The only thing that looks stupid to me are people who STILL insist that the Affordable Care Act isn't working, when it clearly IS working. Sign-up continues to ramp up day by day, and is now ABOVE expectations. One wonders how many people the law would have to help before conservatives would finally grudgingly admit that it is working.

8.5 million is a huge number of people. It would fill Ohio Stadium 85 times. Count from 1 to 85, and then ponder how it took longer than you thought to count to 85. Remind yourself that each number during your count represents 100,000 people.

The big unanswered question still remains: Why are Republicans fighting so hard to keep uninsured Americans from enjoying the same healthcare benefits they enjoy?

Darwin's choice

If 8.5 million were gallons of sewage, it would take 3.7 million toilets to flush it away....kinda the same thing as obamacare, needs lots of flushing!

deertracker

@coaster
Great post!

doppleganger

Coasterfan, I usually agree with most of your posts, but not this one. It is too soon to tell if it is "working". Just because people sign up doesn't mean a thing. How is America going to pay for this? This country cannot afford to insure everyone. If you want insurance, you need to work for it. It is not a right. My family's health insurance cost $15,000 last year (2 people) between my costs and my employer's. There is no way America can afford to pay that for every family. I don't care if the individual is paying $250/mo. The government can not afford to pick up the rest. I do not know what the solution is, and I feel very lucky to have an employer that offers insurance, but our country can not afford this.

The Big Dog's back

You said it, I have no solution. A person who would agree with coaster would have said Single payer, you know, like the rest of civilized countries have.

coasterfan

Dopple: I share your thoughts. America cannot afford to insure everyone, but the previous system was far worse, because WE ended up paying more out-of-pocket (in the form of higher premiums) to cover the ER visits/healthcare costs for the 40 million uninsured. Hospitals didn't treat those folks for free - they passed the cost on to US.

At least with Obamacare, they are forced to pay for some or all of their own healthcare costs. I would counter that we couldn't afford to continue doing things the way we had been. At least this system will take some of the burden off the rest of us.

I would also point out the obvious: if it's too early to say that it's working, then it's also too early to say that it ISN'T working.

So far, the observable results point to that it IS working: signup is above projections, and it's doing the exact things they expected it to do - especially in those states that WANT the law to work.

Single Payer would be much better. The biggest weaknesses of Obamacare are those things that were added to appease Republicans.

The Hero Zone's picture
The Hero Zone

How were they added to appease Republicans when no Republicans voted for this? If you want single payer I sure wish you would actually join with the rest of us who don't like the flaws of the ACA and push for something else. Instead, despite your very own wishes (and admission that the U.S. can't insure all its citizens which single payer would have to do), it is nothing but praise and defense of the ACA as the best thing ever. That seems pretty self-defeating and hollow.

I'll also point out that there were never "40 million uninsured" and question the eagerness and praise you employ by happily "forcing" people to do things.

Your argument: "We pay more to provide healthcare to those who don't have coverage."

Your solution: "We pay more to provide healthcare to those who don't have coverage."

Let's not forget that the U.S. government is guaranteeing profit via taxation to companies, a practice that you rightfully decry elsewhere. How is this any different?

How is any of this make sense to you, is what YOU actually want, or even what is remotely best for us as a country? I'll happily go back and forth all day long on the merits and appropriateness of single payer if we can agree that what has been passed is inappropriate and doesn't do what it was meant to do in the most efficient way possible.

worddrow811

NEVER, NEVER trust numbers that these people try to use. It is not possible to have exactly eight.five million people who have signed up! it's against all logic and is a made-up guess!

coasterfan

Except when the numbers showed - early on - that Obamacare was off to a poor start, fith?. Back in November, Conservatives believed the stats. As soon as things started to turn in Obamacare's favor, well, then suddenly the statisticians were incorrect.

The Hero Zone's picture
The Hero Zone

I believe that those numbers were also disingenuous and that the point of petty Republican poking at the ACA was that "even if these numbers you report are true, look how low it is." Unfortunately as has been illustrated here in these forums locally and over in D.C. is that facts, logic, and communication boil down to asinine party bickering instead of an investigation of the problem(s) at hand.

Donegan

What is working , Postponing critical parts of the bill so morons will believe its working for the next election or the Bill itself? I would choose the former since it has definitely fooled you.
8.5 is a made up number that even the president has stated was a educated guess at best. Knowing that educated number is coming from Obama worshipers makes everyone skeptical as everyone knows Democrats have a hard time with numbers. Just look at the debt.

anthras

Re:"The only thing that looks stupid to me are people who STILL insist that the Affordable Care Act isn't working,"

Obama alleges 8 million signed up. Blue cross tells us that 15-20% that signed up are not paying the premiums. A few million were placed on medicaid getting free coverage thanks to the tax payers and I would like to ask where is the government getting the money to subsidize many of the people that have signed up? The common figure that seems prevalent is that 6 million persons have been cancelled and most of the new sign ups are just those that were cancelled and now signing up at higher premiums with higher deductibles.

The state of Maryland reported that 60,000 people in that state signed up while 73,000 were cancelled. Also what about the millions of persons that had full time jobs with healthcare and now are working a part time job with no healthcare?

dontknowmuch

8.5 million falls WELL SHORT of the 35-40 million we were told needed insurance. If we're sitting in math class and get only 20 percent of our projection we'd be deemed a failure.

Is it working? That cannot be fairly answered and anyone who believes it is continuiing to drink out of Obama's toilet. If this was as good as el Presidente keeps touting, then why the need to keep delaying certain aspects until after elections. If its good enough after the election, its certainly good enough before.

Stop It

“If you can't dazzle them with brilliance, baffle them with bullshit.” ― W.C. Fields.

Dr. Information

Affordable care act with 2/3 of it being subsidized by tax payer money.

8M signed up means nothing. How many have paid?

looking around

The fact is Dr. if they don't make payment it's like any other insurance....they don't get coverage. If they elect to pay the "fine" they don't get coverage, but the money will help to pay for assistance given to others that participate in the program. If they don't get coverage then You and I and all the others who work hard pay taxes and make sure we and ours are covered pay for them totally along with the few Doctors who are willing to provide their services free of charge, and God bless them.

Dr. Information

You missed the point. Signing up is like going on Amazon and placing items in your shopping cart but not actually buying them. 8 million is not the definitive number. Sure you can sign up, but when the bill comes and you don't pay it, which will happen, then are they truly covered? Obama says yes, this number counts, I say it doesn't.

The government has a way to figure out how many have signed up vs signed up AND paid. They just do not want to release the other number because its really low.

The Hero Zone's picture
The Hero Zone

Looking, what hurts the cause you point out is that there are no "teeth" and hardly any resources in an overburdened IRS to do the collection of the tax imposed on people who don't want to be forced by the government to enter into a private contract as a private citizen with a private company. I somehow doubt that if someone doesn't pay for insurance they'll also pay the penalty meaning now (as the argument goes) "we" pay for this person's care with money that isn't contributed to by what would have been collected from this same person.

There's a great many things that sound amazing on paper. "If only people would...", "If only we can force people to...", but when it is put that way and we look at the entirety of history when have any of these "if only" things come to fruition?

That's why I would much prefer a system that doesn't command free people into forced behavior. Instead I would favor a system that allows the individual true portability, choice, and allows natural market forces to make prices for services known and controlled.

But when I hear those like coasterfan continually use "force" with "government" I get very anxious as I hope you can understand...

FTFOI

coasterfan
I lost my insurance because it has gone too high for me to afford. And I make too much to fall into "affordable".
I was born an American with right to make my own choices. One of which is health insurance. I DO NOT appreciate being told by the government what I MUST purchase. I beleive it is a violation of rights.

The Big Dog's back

Don't get the insurance and pay the fine. There, that was easy.

coasterfan

Ah, yes, the typical half-baked conservative responses. Through the ACA, Americans pay for a portion or all of their own healthcare, depending on their financial wherewithal. Whatever portion they pay, WE don't have to pay. Remember, until now we were covering 100% of their healthcare costs. Would Republicans rather go back to the old system in which they had to pay for ALL of the healthcare costs of 40 million uninsured Americans?

Secondly, people are always griping about us using our federal tax dollars for questionable items, such as funding to other countries...such as giving million dollar subsidies to highly profitable companies such as Exxon, Verizon, etc. The ACA instead helps AMERICANS, and more importantly, Americans who most need the help. And best of all, it puts the onus on them to pay for their own healthcare, if possible. This is a good thing.

As far as how many have paid, I read a month ago that it was between 80-90%. The obvious thing conservatives are missing is: just because they hadn't paid their premium yet, doesn't mean they aren't going to pay it later. And certainly many did just that. I DID read that many who had signed up no longer needed it, because they had gotten jobs, or gotten married.

The thing most noticeable about the conservative comments above is their utter lack of substance. They gripe, they call names, but they have absolutely nothing concrete to show that Obamacare is not working. The reason they don't cite any proof is because there ISN'T any proof.

And they STILL dodge my question; WHY are Republicans trying so hard to deny healthcare coverage to millions of Americans???

The Big Dog's back

Exactly!

Darwin's choice

You two are incredible! Remember, a polished terd is still a terd, but your directions on how to pick it up by the "clean" end are amusing.

obamacare/fail

coasterfan

Yup. Another response, completely lacking in substance.

If you want to actually win a debate, Darwin, you have to offer more than "Obamacare is bad".

Bottom Line

Coasterfan, how dare YOU critique Darwin (or anyone on here with a brain, unlike yourself). You, deertracker and big dog have the debate skills of a slow 3rd grader. You brush provable facts aside constantly with childish little remarks. You're a JOKE.

The Big Dog's back

"Provable facts"? That is the funniest thing I've heard in a long time.

Bottom Line

Thanks for the example further proving my point.

Dr. Information

coaster and big are the same poster. They just log back in and out and agree with themselves. Delusional.

Stop It

I thought everyone knew that.

Donegan

Why is Obama postponing the bill 38 times? He is more of a hinderence to your glorious handout to the insurance companies than the repubs ever thought of. Why aren't you mad at him? You know because he is no doing his job enforcing the bill he signed.

The Hero Zone's picture
The Hero Zone

Where did you read these things? Can you please provide links?

Also I'd like to point out: "...such as giving million dollar subsidies to highly profitable companies such as Medical Mutual, Humana, etc."

As for paying their own costs when possible? Weren't people not paying before because it wasn't possible? As I have said before with the ACA we are paying for people to get healthcare so we don't have to pay for people who get healthcare. Where is there any iota of logic in that? It's "the same thing but different" only it's not the same because now we have middlemen, costs, and all kinds of regulations interfering in an otherwise streamlined system.

If you wanted to put everyone on Medicaid, that would have been a simpler bill than this mess "we had to pass to see what was in it."

As for your loaded question? I can't speak for Republicans but I am willing to wager they aren't denying healthcare for anyone. What is unfortunate is that much like Democrats who are lauding this plan as God's gift they can't see past their own inter-party bickering to sit down and discuss the facts and make sound counter-proposals.

peoplercrazy14

Anybody before this healthcare act had the freedom to get insurance nobody was stopping them. Now there's no freedom to make that choice because now it's mandated and you'll be fined, the government is making the choice for you or you will pay. Kind of sounds like extortion which last I knew was illegal but hey, what do I know the government obeys laws and freedoms of American citizens, right?

The Big Dog's back

Gov, Gov, Gov, Obama, Obama, Obama. I kinda feel sorry for you people of low intel. But, you have the choice to get facts or right wingnut talking points. You made your choice.

looking around

Yes, sort of like automobile insurance used to be before mandatory minimum coverages. You could choose to drive or not to drive, however some felt it overbearing and decided to drive anyway.....so they were arrested and fined and forced to buy insurance if they wanted to continue to drive! Nothing is made mandatory until people that feel they should not be responsible for themselves create a problem that regulations, laws, and acts need be put in place to make them responsible. At least you are being offered assistance in the event that your income limits your ability to provide this for yourself.

anthras

Re:"Yes, sort of like automobile insurance used to be before mandatory minimum coverages."

Auto insurance is not mandatory as many companies choose to self insure and for the individual if he can show he is financially responsible to cover an accident insurance is not required. There are many persons that can afford to provide for their own medical care however with Obamacare insurance would still be mandatory.

looking around

I beeg you pardon auto liability insurance is mandatory I don't care if you buy it or post a bond to self insure, which by the way is a pretty dumb way of doing it as it puts your own assets at risk. However I don't know of many wealthy people who can afford health insurance that choose not to buy policy's for themselves mandatory or not. We are talking about a program that helps others who formerly had no means of purchasing insurance or perhaps no desire to, getting coverage.

Retired2008

Obamacare is working.

Remember how well it has worked for you in November.

The Big Dog's back

Yes, please do. Just like your Medicare is working for you.

anthras

Re:"Yes, please do. Just like your Medicare is working for you."

Medicare will not be working as well as it was because Obama is stealing about 492 billion from medicare to help support Obamacare.

Talked to about 9-10 different doctors and not one of them was enthused about Obamacare.

Called and made an appointment with my Dr. and was advised to arrive very early to fill out the additional paperwork or they did suggest to stop in and get the paperwork to fill out prior to my appointment. I did talk to 1 doctor and he advised me they encouraged them to ask if there were any guns in the household however he is refusing to ask that question.

2cents's picture
2cents

Let's see affordable, Hmmm! Our insurance went to $4000.00 per month for 4 people so we canceled it because the income would not pay for it. Makes sense, I guess we will make 8,000,005 of the public back. How did Margaret say it?

http://www.slobodaiprosperitet.t...

coasterfan

Why not tell the other half of the story? If your insurance went up that much (which I doubt), you quite obviously had a bare-bones, useless policy with little to no coverage.

The good news: if you can't afford good coverage, Obamacare provides subsidies. So, basically, an affordable solution is there for you - one with better coverage that you can afford - if you choose to use it.

I know of several people whose insurance rates went down since the ACA went into effect, and they have the same or better coverage as before. A few anecdotal examples - for either side of the debate - don't mean much, do they?

anthras

Re:"Why not tell the other half of the story? If your insurance went up that much (which I doubt), you quite obviously had a bare-bones, useless policy with little to no coverage.

Poor lady had a disease that has required four brain surgeries and has been dropped by all of her doctors and denied medications due to her Obamacare plan. I don't think it can get much more bare bones than that.

http://www.breitbart.com/Big-Gov...

The Big Dog's back

right wingnut site.

anthras

Re:"right wingnut site."

Are you saying that you never provide information from a loonie left wingnut site?

Although it may be a conservative site can you prove that it is not factual?

dontknowmuch

Shhhhhhhhh..... don't that about the one who slurps up everyone from MSNBC

The Big Dog's back

It's not a Conservative site, it's a right wingnut site.

thinkagain's picture
thinkagain

Nice pic of Alfred E Obama, the clueless liar in chief, with that stupid grin on his face.

DBDBDB

Let's see, 40 million people without insurance before Obamacare. 10 million lost their coverage (I am one of those), 8 million signed up, this is success? Only to IDIOTS!

coasterfan

If you lost your coverage, I'm sorry to hear that. If your employer dropped your coverage, your beef should be with him, for not valuing his employees enough to offer them the coverage he should offer. If your policy was dropped because it didn't meet even the base bottom level standards that Obamacare required, then you were wasting your money on a useless policy to begin with.

Little Giant

If Obamacare is so bad...... why doesn't anybody on the right have a better solution?

Donegan

They do. Tort reform and cross state line purchasing would create more of a market and lower prices. But then again this is a handout to his campaign donors so it is a moot point.

coasterfan

Zing! Republicans had the chance to enact healthcare reform during the 8-year Bush presidency. They did not. They had their chance.

The Hero Zone's picture
The Hero Zone

1. Allow insurance companies to compete across state lines.
2. Tort reform (while minor) can contribute to lowering costs.
3. Focus insurance to personal/family Health Savings Accounts combined with a high-deductible plan to promote competition, price awareness, and allow policyholders to purchase emergency or even over-the-counter items (such as bandages and seeing eye dog food) at a tax advantage.
4. If/as necessary offer funds to the HSAs to ensure care can be received.
5. Encourage stronger doctor-patient relations through "concierge care" where a doctor (usually a primary physician) offers his services to a clientele for a flat yearly fee. This completely cuts out insurance companies, compels the doctor to provide quality care at lower cost, and keeps the care consistent in the pool of patience s/he serves. Something like this could, too, encourage more doctors to be a primary care physician because of the limited pool one can serve in a concierge capacity. The notion is similar to the number of hours a truck driver can safely drive. It's an artificial scarcity based on real, measurable results to encourage safety and service while allowing the doctor the freedom to practice as s/he best sees fit.
6. Ask for doctor's to post "menus" of common procedures/appointments so there is price awareness. Such menus can also offer a "cash option" that is already employed by some doctors who (for example) would rather take $20 cash for an appointment than get $25 from an insurance company for all the time, hassle, paper, and employee hours wasted in the processing of a visit. We have seen separate and lower cash options at gas stations and with a recent class action lawsuit against credit card companies, many retailers are allowed to surcharge for CC (in this case a middleman processor like an insurance agency) use over cash. Or, conversely, they price all their products on the presumption of CC payment and offer a discount when cash is used.
7. While not directly related to healthcare, schools would do their students wonders by teaching economics, accounting, and other money skills to their students to help prepare them for life in actually understanding concepts of insurance.

Each of these require very little if any government "forcing" of behavior. They empower the individual to make his/her own choices as appropriate for their specific circumstances/geography/education/etc.

There you go. There are some "right" options if you'd like to discuss them more.

Pterocarya frax...

1. Wrong: http://voices.washingtonpost.com...

2. Wrong: http://healthcare.dmagazine.com/...

3. There is some merit to HSA's and high deductible plans, if done properly.

4. I have no clue what you are trying to say.

5. "concierge care completely cuts out insurance companies"--wrong--doctors are only one small part of health care costs.

"compels the doctor to provide quality care at lower cost"--How???

"encourage more doctors to be a primary care physician because of the limited pool one can serve in a concierge capacity. The notion is similar to the number of hours a truck driver can safely drive. It's an artificial scarcity"---If you are claiming limiting the number of patients a family physician can see, and compelling her/him to provide services at lower cost, how in the world can you claim that more doctors will be primary care physicians? That makes no sense whatsoever, and "artificial scarcity" always raises costs.

6. I went and saw my primary care physician for an annual, preventative checkup yesterday. That was a $180 appointment, for which my insurance covers all but $20. I handed the office manager a $20 bill, and by the time an assistant had weighed me and checked my blood pressure, the office manager probably had the bill submitted to my insurer which will have sent an electronic check for $160 within 10 days. I don't know any doctor's office that will accept even $40 for that appointment to pay 2 assistants and the physician, rent, utilities, overhead, malpractice insurance, etc.

7. As my dear friend Contango would say: off topic.

The Big Dog's back

Good work.

anthras

I do not think the article from the Washington Post would apply.

State Farm Insurance sells auto insurance across the country and states do have different requirements for casualty insurance. Some states have no fault insurance and others don't. The limits of liability are also different as well of many fine print items.

State Farm or any other casualty insurance company that sells across the state lines would just write their coverage to comply with the requirements of each state. Can anyone show a reason that health providers could not do the same?

The Hero Zone's picture
The Hero Zone

I will gladly have your hand in this dance, madame! I appreciate your response. Allow me to do the honor of taking the lead again before passing it back. And a one, and a two, and a...

1. Using a source that itself claims is neutral and I presume we can agree on (http://www.kaiserhealthnews.org/...) 'The Republican proposal is a serious, honest concept that is worth doing, if you don't promise the moon,' said AEI’s Miller. He acknowledged that any such effort would need a framework to ensure consumer protections, solvency standards and accountability but he believes those measures would not be as restrictive as the provisions now in the federal health law.

He says that other industries that were once strictly state-based, such as banking, have worked well with interstate competition. 'It doesn't mean you're not regulated,' he said. 'You'll have better competition,' and still have safeguards."

Did you presume I wanted a completely unregulated wild west? If so take comfort in our commonality that that is not the case. The point of allowing the increased competition is to decentralize policy making as seem to be the current trend where we outsource our lives, decisions, and such to D.C.

2. You'll note where I said it would play a minor role, yes? The article you cite shows that the number of cases has gone down drastically because of it. That's great as it seems to really separate the chaff from the wheat. But if a hospital doesn't use the saved money or manpower to defray costs that's on them. If people were used to paying a certain amount before, why charge less? I guess that's pessimistic but I can see that happening. Or instead of hoarding the money and manpower saved, perhaps the hospitals used it toward charity care, community involvement, a new cancer wing, etc.? Again, here is a source perhaps you can appreciate: http://www.huffingtonpost.com/gl...

3. I very much agree, similar to point one above. There is so much personal empowerment that can be had with such a system.

4. This could dovetail into what you may consider "proper" handling of HSAs. It could be a static amount deposited into the individual's account on an annual or monthly basis depending on income level similar to SSI/D. Or it could very much function like the "prebate" contained in the Fair Tax (http://www.fairtax.org/PDF/Preba...)

5. Doctors I think are a greater part of the cost of healthcare than you think as they are the ones who administer it. In a normal transaction I would go to the doctor, give him the money he asks for his services (presumably based on the cost of materials, time, with a margin of profit to use towards new hires, equipment, asset purchases, etc.) and that's that. But there are times when I don't have a lot on hand and this is where insurance companies come into the mix. They say to the doctor, "Hey buddy, we'll provide you a book of business and you will be paid by us but if you accept our terms we will only pay you what we think you should be paid." So the doctor trades greater individual payments for an average of insurance which also mitigates his risk of failure to be paid. He just gets X% less. But if a doctor (or in the aggregate all acting as a bit of a cartel) get together and increase their costs the insurance company would increase their output even though it is still a reduced percentage. And so it escalates in an ever-increasing ratchet effect that outpaces normal inflation. There are other factors involved that even you alluded to (and the tort reform impacts if only minimally), but the doctors are the ones who buy supplies, sell service, etc.

As for part two, my statement was meant to make primary care just as much a "specialty" as a cardiovascular surgeon or oncologist. I would not compel the doctor to provide services at any cost. That would be up to him/her. Overburdened doctors (not implying there is an epidemic of them) do nobody a service nor favor including themselves as well it will provide incentive based on their individual geographical region, population demographics, etc. It would allow for efficiency in care, competition, etc. I wouldn't mandate that all primary care physicians be concierge-style, but I can see where those that practice that way could be more cost efficient and effective by cutting out insurance companies and processing.

6. The monetary figure I used was an example only but as you can see relates to all the points above. It like everything else is a small portion that all add up to the total. I too had my wellness checkup (and a small bruise on my arm from the blood sample to prove it) not long ago. What if the staff and equipment wasn't needed, or needed as much, with the removal of insurance processing? What would that do to reduce costs at the office and then for you as a consumer?

As I said, all this builds up to form the "plan" that was requested in the original question. Now we have hundreds of millions of people with cash on hand to directly pay for their care in most everyday instances. And for the times they are t-boned and need a flight to Toledo? That's where the high deductible plan kicks in. I'll gladly pay the $5,000 for $500,000 worth of care and therapy after it happens. In the mean time the plans are cost effective and it is easier to pay, say, $100 for a doctor visit without the complicated forms. And if I am in poverty? Prebated HSA money or the like.

7. Contango has been rather mum lately. I hope all's alright. But in addition to me half-conceding it was a side note it was relevant enough to bring up because how many 17 year olds know what insurance is and how it works? How many know how a bank account operates? How businesses do business? When you hit 18 you are suddenly thrust into an entirely different world than I don't think many have had the opportunity to prepare for through schooling or parental influence. Amazing what one birthday makes when you can suddenly be sued into financial oblivion, go to super jail, have your voice counted in elections, or be started on a debt spiral from which you will never escape?

I figured you and I could agree that education is the greatest tool for empowerment and equalization? There are absolutely no drawbacks to teaching economics and accounting in high school to help prepare the students for life and understanding what things mean, are, how they work, etc. Else we see those that pander for their money and votes continually throw out bumper stickers to appeal to their lack of knowledge. That, not interstate insurance sales, is the true "race to the bottom".

Thank you for the dance, Pter, I look forward to following your lead now!

The Big Dog's back

Even when proven wrong you always try to justify your right wingnut talking points. At least research neutral sites.

The Hero Zone's picture
The Hero Zone

Meanwhile where I did just that...

The Big Dog's back

Did you even read the article from Huffpo?

The Hero Zone's picture
The Hero Zone

Yes else I would not have included it. If you are leveling an accusation then out with it.

The Big Dog's back

0.02%. Just like I stated a month ago.

The Hero Zone's picture
The Hero Zone

What are you talking about? I am not connecting your answer with my answer to your question.

EDIT: If you mean impact on costs, after taking some more time to think about it, you are correct. It DOES have an impact. I was also correct in stating that it was minor. None of the above are single silver bullets. But as I explored with Pter, the money that otherwise would have gone to litigation may not be offered in direct discount of services but rather used elsewhere to provide care or build modern facilities.

OMG.LOL.WT_

I wonder how the people in Massachusetts like it. Oh, that is different. I guess it's Romneycare there.

LifeIsShort

The population is about 315 million. 8 million signed up (not paid) which is 2.5 percent of the total population. Awesome!

coasterfan

Actually, 8 million is awesome. That's 8 million people for whom we/you/I previously had to cover 100% of their healthcare costs. The ACA forces them to be responsible for at least a portion of their own healthcare costs. I thought Republicans were always whining about personal responsibility. This is exactly what Obamacare is about.

Gotta love when Republicans do a complete about face on their former platforms....

Donegan

After the millions that lost coverage from Obama you are just breaking even moron.

JMOP's picture
JMOP

How come now that the numbers are where Obama wants them to be, the White House seems to be able to produce signup figures and break down the data in real time, whereas for months when things were horrible we were told that coming up with any precise figures was simply impossible to do?

Which lie should I buy?

The Big Dog's back

The one you always believe from the "We Deceive, You Believe" network. (fox)

JMOP's picture
JMOP

Deflection of my question Big Dog.

I'll give you credit though. At least you didn't call it faux.

Dr. Information

Remember though. You can keep everything you have period, ehhhhh siiiiiikkkkeeeeee!!!!!!

JMOP's picture
JMOP

Oh yes, and according to Carney Jon Stewart was Obama's toughest interviewer. I laughed so hard when I first saw this.

http://m.youtube.com/watch?v=9At...

KURTje

Those that are against if you or loved ones are getting Medicare/Medicaid/Social Security, please return those checks. Thank you.

JMOP's picture
JMOP

Yeah, good luck prying that out of my parents democratic hands!

anthras

Re:"Those that are against if you or loved ones are getting Medicare/Medicaid/Social Security, please return those checks. Thank you."

I do not have medicaid and as I did not have any choice on medicare and social security as the government did force me to pay for it I will get back what I can. If I die young the government will keep the unused money that I paid into social security but did not receive. What I invested on my own my children will get the portion that I do not use,

The Big Dog's back

So if you never use your car insurance or your home owners insurance should your kids get that money back?

anthras

Re:"So if you never use your car insurance or your home owners insurance should your kids get that money back?"

My investments will continue until the money is gone and as I stated there will be money left for my children.

When I purchase auto or home owners insurance I am purchasing a specific coverage for a specific term and if there are any losses I would collect if not the insurance company would have earned the money I paid for protection for that specific term as they did assume the risk of providing coverage for me and if I needed coverage beyond that term I would need to renew by paying for an additional term. However if I would die prior to the term ending and no coverage was needed the policies could be cancelled and the unearned premium for that term would be refunded to my children.

You cannot really compare the 2 as one I am paying for protection the other is an investment and I do think that social security does pattern an investment except if I did early the government wins with my personal investment the money is fully paid out either to me or my surviving family.

The Big Dog's back

SS is an insurance policy.

pntbutterandjelly

ObamaCare will become very commonplace LONG before all the ignorant people are gone.

Dr. Information

6.5 million lost their insurance. 8 million signed up (a large chunk moved over to medicaid).

Yup, this trillion dollar blunder is working A O K. insert sarcasm.

Dr. Information

only 20-30% of the 8 million never had insurance before. CBO estimates still show 40+ million UNINSURED in 10 years.

Failure on all levels.

8ballinthesidepocket

Before we start crowing about the Unaffordable Care Act, let's wait to see what it costs and if the IRS can even process a medical claim or collect the insurance premiums that are due. Signing up is one thing, paying your premium and the country not going broke with yet another subsidy is another.