U.S. Politics: Confirming The Trumpocalypse

[Altherion]

4 minutes ago, Kalbear said:

I don't disagree costs are going up - but they were projected to rise significantly more without the ACA. That is sort of the point. 

This argument is obsolete. The costs did rise somewhat slower at first, but then they skyrocketed. Think about it: more people got care -- that's the driving premise of ACA. The profits of the insurance and medical industries did not decrease -- they were both at the table when ACA was designed and they made sure of that. How could the costs have decreased or even increased more slowly in a sustainable way?

[Mudguard]

20 minutes ago, Kalbear said:

I don't disagree costs are going up - but they were projected to rise significantly more without the ACA. That is sort of the point. 

I'm having trouble finding the old projections, but I don't think they were projecting a return to +5% increases so soon.  I haven't seen convincing evidence that the ACA has done anything to bend the cost curve.  The cost curve was already bending before the implementation of the ACA.

 

19 minutes ago, OldGimletEye said:

You cite this article.

And the article has:

And:

 

I didn't quote that portion of the article because it just presents conclusions without any supporting data.  It also doesn't attribute the reduction in cost growth to the ACA.  Unfortunately, the original paper on which the CNN article was based is behind a paywall. 

[Mr. Chatywin et al.]

3 minutes ago, Altherion said:

This argument is obsolete. The costs did rise somewhat slower at first, but then they skyrocketed. Think about it: more people got care -- that's the driving premise of ACA. The profits of the insurance and medical industries did not decrease -- they were both at the table when ACA was designed and they made sure of that. How could the costs have decreased or even increased more slowly in a sustainable way?

The problem isn't necessarily that more people got care, but who they were. The amount of sick people who signed up was underestimated and the number of young healthy people was overestimated.

Not surprisingly, one of the ACA's most popular provisions, kids getting to stay on their parents plans until they're 26, is hurting the exchanges.

[OldGimletEye]

4 minutes ago, Mudguard said:

I didn't quote that portion of the article because it just presents conclusions without any supporting data.  It also doesn't attribute the reduction in cost growth to the ACA.  Unfortunately, the original paper on which the CNN article was based is behind a paywall. 

So you ignored this part:

Quote

Still, health care spending increases remain restrained compared to the past.

Cause why again?

[OldGimletEye]

13 minutes ago, Altherion said:

This argument is obsolete. The costs did rise somewhat slower at first, but then they skyrocketed. Think about it: more people got care -- that's the driving premise of ACA. The profits of the insurance and medical industries did not decrease -- they were both at the table when ACA was designed and they made sure of that. How could the costs have decreased or even increased more slowly in a sustainable way?

Just going to put this in a little historical context:

https://fred.stlouisfed.org/graph/?g=ckDM

[Mudguard]

3 minutes ago, OldGimletEye said:

So you ignored this part:

Cause why again?

Like I said, health care spending growth was already decreasing before the implementation of the ACA, and now it's swinging back up.  And again, the article doesn't attribute the restraint in increases in health care spending to the ACA.  From all the CPI graphs you provided, the period between 2000-2010, most of which preceded the implementation of the ACA, showed much lower growth than the preceding 30 years from 1970-2000.  

[Ser Scot A Ellison]

20 minutes ago, Tywin et al. said:

The problem isn't necessarily that more people got care, but who they were. The amount of sick people who signed up was underestimated and the number of young healthy people was overestimated.

Not surprisingly, one of the ACA's most popular provisions, kids getting to stay on their parents plans until they're 26, is hurting the exchanges.

I said this would happen.  I said it back during the original debates we had here about the ACA.

[Rippounet]

18 minutes ago, Tywin et al. said:

The problem isn't necessarily that more people got care, but who they were. The amount of sick people who signed up was underestimated and the number of young healthy people was overestimated.

No surprise there. That's also what this article about Aetna is saying:

Quote

 

http://money.cnn.com/2016/08/15/news/economy/aetna-obamacare/?iid=EL

"Providing affordable, high-quality health care options to consumers is not possible without a balanced risk pool," said Aetna CEO Mark Bertolini. [...]
Like Aetna, a growing number of insurers on the Obamacare exchanges are voicing concerns about the viability of the program as they run up big losses. Many say that their premiums were too low and didn't cover the cost of care because their consumers are far sicker than anticipated. [...]
Large insurers aren't the only ones running into trouble. More than half of the co-op insurers, created and funded by the health reform law, have failed. This means consumers in a growing number of areas have only one or two insurers to pick from.
To cover these sicker patients, many insurers are requesting big premium hikes for 2017, some in the high double digit percentages.

 

To me this is shocking for a different reason though. So basically, insurers are saying that they only want to insure people who tend to be healthy... That's like saying you want to open an all-you-can-eat buffet, but only want customers who don't eat too much... 
The insurers want to keep their profits, which I assume to be huge, but don't care about helping sick people. They want to do business, but without the risk of doing said business. Is that really acceptable? I thought conservatives loaded entrepreneurs for their risk-taking...

In a way, it's not surprising. But it shows the core of the problem is profit. Of course, it's harder to make a profit if you have to pay for the treatment of people who are actually sick. Nonetheless, taking care of sick people is the purpose of any health care system. If the private sector doesn't want to do it, then perhaps, it shouldn't be able to do it at all.
Yeah, I'm saying this is a great example as to why stuff like health care must be fully socialized/nationalized. You just can't trust the private sector to think of people, so all areas that are vital to people should be entirely managed by the state.
So much for all the people arguing for smaller governments, deregulation and privatization...  This "failure" of Obamacare is really the failure of the private sector to prove it can do what the conservatives everywhere say it can...

[OldGimletEye]

Just now, Mudguard said:

Like I said, health care spending growth was already decreasing before the implementation of the ACA, and now it's swinging back up.  And again, the article doesn't attribute the restraint in increases in health care spending to the ACA.  From all the CPI graphs you provided, the period between 2000-2010, most of which preceded the implementation of the ACA, showed much lower growth than the preceding 30 years from 1970-2000.  

It's true that there was a significant drop off around 2008 or 2009 or so. Obviously, that was probably due to the overall drop in aggregate demand that occurred. However, since 2010, it doesn't look like healthcare inflation has picked to it's pre-2009 or pre-2008 average.

Now maybe that is due to slack demand conditions.

Or maybe it isn't.

We don't precisely know yet.

But, whatever, the reason, the Republican Party and it's supporters had little basis to go around claiming healthcare inflation because of the ACA. That was a bullshit claim by them. Along with some other dubious claims they made.

[Ser Scot A Ellison]

4 hours ago, Red Tiger said:

So will Obama make another nomination in place of the expired Garland one?

Clearing quote

[Ser Scot A Ellison]

7 minutes ago, Rippounet said:

No surprise there. That's also what this article about Aetna is saying:

To me this is shocking for a different reason though. So basically, insurers are saying that they only want to insure people who tend to be healthy... That's like saying you want to open an all-you-can-eat buffet, but only want customers who don't eat too much... 
The insurers want to keep their profits, which I assume to be huge, but don't care about helping sick people. They want to do business, but without the risk of doing said business. Is that really acceptable? I thought conservatives loaded entrepreneurs for their risk-taking...

In a way, it's not surprising. But it shows the core of the problem is profit. Of course, it's harder to make a profit if you have to pay for the treatment of people who are actually sick. Nonetheless, taking care of sick people is the purpose of any health care system. If the private sector doesn't want to do it, then perhaps, it shouldn't be able to do it at all.
Yeah, I'm saying this is a great example as to why stuff like health care must be fully socialized/nationalized. You just can't trust the private sector to think of people, so all areas that are vital to people should be entirely managed by the state.
So much for all the people arguing for smaller governments, deregulation and privatization...  This "failure" of Obamacare is really the failure of the private sector to prove it can do what the conservatives everywhere say it can...

Insurance makes money when it doesn't do what it is paid to do.  That's the nature of insurance.

[Mudguard]

11 minutes ago, Rippounet said:

No surprise there. That's also what this article about Aetna is saying:

To me this is shocking for a different reason though. So basically, insurers are saying that they only want to insure people who tend to be healthy... That's like saying you want to open an all-you-can-eat buffet, but only want customers who don't eat too much... 
The insurers want to keep their profits, which I assume to be huge, but don't care about helping sick people. They want to do business, but without the risk of doing said business. Is that really acceptable? I thought conservatives loaded entrepreneurs for their risk-taking...

In a way, it's not surprising. But it shows the core of the problem is profit. Of course, it's harder to make a profit if you have to pay for the treatment of people who are actually sick. Nonetheless, taking care of sick people is the purpose of any health care system. If the private sector doesn't want to do it, then perhaps, it shouldn't be able to do it at all.
Yeah, I'm saying this is a great example as to why stuff like health care must be fully socialized/nationalized. You just can't trust the private sector to think of people, so all areas that are vital to people should be entirely managed by the state.
So much for all the people arguing for smaller governments, deregulation and privatization...  This "failure" of Obamacare is really the failure of the private sector to prove it can do what the conservatives everywhere say it can...

Insurers are there to make money.  Of course, if possible, they would like to exclude sick people and sign up healthy people.  They are not a charity, and they aren't the government.  It's not their goal to take care of everyone.  Personally, I don't expect anything more from them.

I agree with you that the only solution is to nationalize basic health care.  The health care industry is so regulated and suffers from so many informational problems and barriers to entry that reliance on an efficient market hypothesis is hopeless.

[Mexal]

Buzzfeed posted the unverified memos. Some crazy shit in here.

https://assets.documentcloud.org/documents/3259984/Trump-Intelligence-Allegations.pdf

[TheKitttenGuard]

Trump's inauguration planner is promising a "soft sensuality"

http://www.politico.com/blogs/donald-trump-administration/2017/01/trump-inauguration-sensuality-233436

We are to going to witness the Seductive Don apparantly.

[Kalbear]

22 minutes ago, Mexal said:

Buzzfeed posted the unverified memos. Some crazy shit in here.

https://assets.documentcloud.org/documents/3259984/Trump-Intelligence-Allegations.pdf

Man, even his showers are made of gold. He's a rich guy!

[Kalbear]

Heh

 

[Mudguard]

39 minutes ago, OldGimletEye said:

It's true that there was a significant drop off around 2008 or 2009 or so. Obviously, that was probably due to the overall drop in aggregate demand that occurred. However, since 2010, it doesn't look like healthcare inflation has picked to it's pre-2009 or pre-2008 average.

Now maybe that is due to slack demand conditions.

Or maybe it isn't.

We don't precisely know yet.

But, whatever, the reason, the Republican Party and it's supporters had little basis to go around claiming healthcare inflation because of the ACA. That was a bullshit claim by them. Along with some other dubious claims they made.

I think it's reasonable to assume that providing more people with health care coverage, particularly people with pre-existing conditions that were previously denied insurance, will lead to increased health care consumption and expenditures.  In the grand scheme of things, the increase is probably relatively small, since an increase of say 10 million people getting healthcare out of 300 million people total is a relatively small percentage overall.  

When people state that health care growth rates are lower now that the historically high period of the late 60's to the early 80's, that doesn't mean much to me.  The growth rate was very large in the late 60's to early 70's due to the implementation of Medicare and Medicaid, and was high in the mid 70's to early eighties due to high economy wide inflation combined with multiple recessions.  The current growth rate in health care expenditures, with or without the ACA, would be less than these historical highs.

This paper from the CMS provides the best historical overview of the growth of health care expenditures that I've come across.  Generally speaking, whenever we've increased access to health care, as expected, like through Medicare and Medicaid, the growth of health care expenditures has gone up, and whenever we've tried restricting access to health care, like through the HMO Act, the growth rate has gone down.  This makes sense, at least to me.  Since the ACA has increased health care access by a modest amount, I would expect a modest increase in the growth rate.

[Swordfish]

2 hours ago, Ser Scot A Ellison said:

The reason I favor single payer, at this point, is that it actually deals with the problem, rising health care costs as opposed to the ACA which, is at best (with some irony) a bandaid that goes after symptoms.

How, specifically?

 

18 minutes ago, Mudguard said:

I think it's reasonable to assume that providing more people with health care coverage, particularly people with pre-existing conditions that were previously denied insurance, will lead to increased health care consumption and expenditures.  In the grand scheme of things, the increase is probably relatively small, since an increase of say 10 million people getting healthcare out of 300 million people total is a relatively small percentage overall.  

When people state that health care growth rates are lower now that the historically high period of the late 60's to the early 80's, that doesn't mean much to me.  The growth rate was very large in the late 60's to early 70's due to the implementation of Medicare and Medicaid, and was high in the mid 70's to early eighties due to high economy wide inflation combined with multiple recessions.  The current growth rate in health care expenditures, with or without the ACA, would be less than these historical highs.

This paper from the CMS provides the best historical overview of the growth of health care expenditures that I've come across.  Generally speaking, whenever we've increased access to health care, as expected, like through Medicare and Medicaid, the growth of health care expenditures has gone up, and whenever we've tried restricting access to health care, like through the HMO Act, the growth rate has gone down.  This makes sense, at least to me.  Since the ACA has increased health care access by a modest amount, I would expect a modest increase in the growth rate.

Good luck getting any of the ACA fanatics to admit this simple, obvious fact.

[Altherion]

16 minutes ago, Swordfish said:

How, specifically?

The same way as in most countries: the buyer in a monopsony (even an approximate one) gets to set prices. Of course, this would mean that profits and salaries in the medical and pharmaceutical fields would fall. The US is by far the most expensive place to get health care, even when compared to wealthy countries such as Switzerland.

[Kalbear]

I'm really surprised folks aren't flipping out here about the #GoldenShowers trending for Trump. His response has been, well, pretty angry but not particularly shocking one way or another. 

The good news is that it should be easy to corroborate various things in it like hotel stays and the like.