Weren't We Told Health Care Reform Would Contain Costs?

[Conan71]

Seems to me we were sold a bill of goods by President Obama and others that the government could make a serious dent in controlling health care costs if they could just pass the health care overhaul bill.  We needed to pass this bill so we could find out all the great things it contained.  According to Medicare's office of the actuary, overall health care spending will increase from 17% to 20% of the total U.S. economy.  These are projections nine years out and are bound to change, and I would assume not for the better.

On a comparative basis of how much they are saying the Obamacare mandates will increase the cost is small over (+ @ $300) what would happen with the costs otherwise (basically it would still increase almost as much w/o Obamacare).  What is not happening is "bending down" the cost curve of health care.  That was a central element which was pitched to us, and now the administration is having to admit perhaps they over-sold this just a tad.

"That's because the new law would have virtually no effect on the upward trajectory of health care spending, while bringing insurance coverage to an additional 32.5 million people and ending the worst insurance company abuses.

Put another way, the controversial reform measure has enough cost controls to deliver protections to more Americans for roughly the same money as would have been spent otherwise. What it doesn't have is enough controls to prevent health care from growing at unsustainable rates much higher than inflation. That's not a reason to repeal health reform, but it is reason to revisit it.

Health care spending continues to surge in part because, once deductibles and co-payments are satisfied, patients and providers are largely free to play with insurers' money. This creates incentives to overprescribe, overtest and overtreat — and to develop high-priced new drugs and other products that are only marginally better than existing ones. There is a lack of any real push toward efficiency. The price for all of this is passed along in the form of higher premiums and soaring outlays for government benefits.

" Bending the cost curve on health care is hard to do," President Obama conceded at Friday's news conference, something he downplayed while selling his plan to a skeptical public and Congress.

http://www.usatoday.com/news/opinion/editorials/2010-09-13-editorial13_ST_N.htm

Hmmm, there's that word unsustainable again...yikes!

WASHINGTON — The nation's health care tab will go up – not down – as a result of President Barack Obama's sweeping overhaul. That's the conclusion of a government forecast Thursday, which also predicts the increase will be modest.

The average annual growth in health care spending will be just two-tenths of 1 percentage point higher through 2019 with Obama's remake, said the analysis from Medicare's Office of the Actuary. And that's with more than 32 million uninsured gaining coverage because of the new law.

"The impact is moderate," said Andrea Sisko, an economist with the nonpartisan unit that prepared the report.

Factoring in the law, Americans will spend an average of $13,652 per person a year on health care in 2019, according to the actuary's office. Without the law, the corresponding number would be $13,387.

...."We really haven't trimmed health care spending," said Robert Bixby, executive director of the Concord Coalition, which advocates for reducing the federal deficit. "Even if we found a way to provide more people with coverage, we still have the same fiscal problem we always did. Frankly, it's a little bit more difficult to solve now because we have made a major new commitment."

Bixby's group raised concerns about the cost of the health care legislation, but did not oppose it."

http://www.huffingtonpost.com/2010/09/09/health-care-overhaul-will_n_710225.html

And here comes the Obama Apologist Choir with such hits as:

1) It's the insurance companies fault
2) Obama didn't say that
3) It's this way because the Republicans are blocking everything
4) A former Governor from Kansas knows medicine better than doctors
5) It's only XX% of GDP!

And that golden oldie:

6) It's all Bush's fault!

[guido911]

As for the choir, you left out:

7.  You are a racist (I can't believe you forgot that one);
8.  You are an Islamaphobe;
9.  What Obama really meant to say was _________ .

[nathanm]

Perhaps you could wait to start crowing until the meat of the bill actually takes effect. You know, the part that actually reduces insurance costs.

The biggest part of the problem here is that doctors order far more expensive procedures than are really necessary, in an attempt to head off malpractice suits (which is ineffective at its stated purpose) and when doctors don't do that, patients demand them because they think they really have to have that MRI for a headache. After all, they could have the brain cancerz!

None of this was addressed by the bill because that would be tantamount to DEATH PANELS!!one

There is some good stuff in the bill, but it does very little on the cost containment side.

[Cats Cats Cats]

What it doesn't have is enough controls to prevent health care from growing at unsustainable rates much higher than inflation. That's not a reason to repeal health reform, but it is reason to revisit it.

Wow, I didn't think you were a communist.

[guido911]

Perhaps you could wait to start crowing until the meat of the bill actually takes effect. You know, the part that actually reduces insurance costs.

The biggest part of the problem here is that doctors order far more expensive procedures than are really necessary, in an attempt to head off malpractice suits (which is ineffective at its stated purpose) and when doctors don't do that, patients demand them because they think they really have to have that MRI for a headache. After all, they could have the brain cancerz!

None of this was addressed by the bill because that would be tantamount to DEATH PANELS TORT REFORM!!one...

FIFY

[Conan71]

Perhaps you could wait to start crowing until the meat of the bill actually takes effect. You know, the part that actually reduces insurance costs.

Nathan, there is no part which reduces insurance costs.  You simply cannot demand that insurance companies provide additional coverage without the costs going up.  Insurance costs will never go down as a result of Obamacare.  That's a fairy tale.

All you have now is Sebelius sending out Rahm Emanual-esque missives on her letterhead to companies who are increasing premiums to cover the cost of additional coverage mandates.  The interwebs are lit up this morning calling her actions extortion and comparing them to the mob:

"We will not stand idly by as insurers blame their premium hikes . . . on the requirement that they provide consumers with basic protections," she wrote in a letter to the insurance industries' trade association.

At the very least, she noted "bad actors" could be excluded from new government-run health-insurance exchanges that will begin operation in 2014 under the law. That could cost insurers as many as 30 million customers nationwide. People also might not be able to use government subsidies to buy insurance from companies that don't toe the administration line. What's next? Only companies that write checks to the Democratic National Committee can participate? Have too many employees contribute to the wrong candidate, and you get a visit from the insurance commissioner?

Read more: http://www.nypost.com/p/news/opinion/opedcolumnists/obamacare_extortion_iQ5A2V2Nu2NoaBKQq2m9xK#ixzz0zQANP4Ii

'As a consequence of us getting 30 million additional people health care, at the margins that's going to increase our costs—we knew that," President Obama said at his press conference Friday in response to a question about rising health spending.

That wasn't how he sold the plan, but, anyway, that's a truism. Here's another: The White House was always going to blame insurance companies for any cost increases, even when its own policies cause them.

Witness Kathleen Sebelius's Thursday letter to America's Health Insurance Plans, the industry trade group—a thuggish message even by her standards. The Health and Human Services secretary wrote that some insurers have been attributing part of their 2011 premium increases to ObamaCare and warned that "there will be zero tolerance for this type of misinformation and unjustified rate increases."

Zero tolerance for expressing an opinion, or offering an explanation to policyholders? They're more subtle than this in Caracas.

What Ms. Sebelius really means is that the government will prohibit insurers from doing business if reality is not politically convenient for Democrats. ObamaCare includes a slew of mandated benefits for next year, such as allowing children to remain on their parents' plans until age 26 and "free" preventative care (i.e., no direct out-of-pocket cost sharing for consumers). The tone of Ms. Sebelius's letter suggests that she doesn't understand that money is exchanged for goods and services, and that if Congress mandates new benefits, premiums will rise.

The Administration estimates that these regulations should increase all premiums by 1% to 2% on average. Even if that turns out to be right—on average—that isn't what insurers are finding in practice in the local, price-sensitive individual and small business insurance markets, where coverage is typically less comprehensive to hold down costs. For some current policies in some states, the one-year increase jumps as much as 9%.

http://online.wsj.com/article/SB10001424052748703597204575483900330728436.html

[Conan71]

Wow, I didn't think you were a communist.

Huh? That's quoted material.  What about that makes me a communist, Trog?

Have another cup of coffee and then re-read.

Oh and Guido, you are right I don't know how I forgot this one:

7.  You are a racist (I can't believe you forgot that one);

My CD has a scratch on it and it keeps repeating.

[Cats Cats Cats]

Huh? That's quoted material.  What about that makes me a communist, Trog?

Have another cup of coffee and then re-read.

Oh and Guido, you are right I don't know how I forgot this one:

7.  You are a racist (I can't believe you forgot that one);

My CD has a scratch on it and it keeps repeating.

You are pushing government controlled costs of health care.

Unless of course you disagree with the portions of your article that you bolded.

[Conan71]

You are pushing government controlled costs of health care.

Unless of course you disagree with the portions of your article that you bolded.

What?  To deflect a flat-out lie we were fed on what HC reform would do, you are calling me a communist?  Really?  FWIW, I don't consider government regulation which impacts cost of anything as communism, it's not even close.

Were we not told during the sales pitch that Obamacare would reign in health care costs?  I'm not making a value judgement on whether or not I think cost controls are good, I'm asking where are these cost controls which were going to "bend down the curve"?  I highlighted this sentence because it identifies a shortfall in the program which we were assured was not there.  

Add song #10 to the list:

10) You are a communist because my reading comprehension (and/or critical thinking skills) sucks.

[nathanm]

Nathan, there is no part which reduces insurance costs.  You simply cannot demand that insurance companies provide additional coverage without the costs going up.  Insurance costs will never go down as a result of Obamacare.  That's a fairy tale.

Hmm, so bigger risk pools don't reduce premiums? That's a new one on me. Pull the other one.

The biggest failure in the HCR bill was that it didn't create one, very large, risk pool, and instead allowed us to continue with our balkanized insurance scheme.

[Conan71]

Hmm, so bigger risk pools don't reduce premiums? That's a new one on me. Pull the other one.

Nope, not when you have a bunch of previously un-insured (or un-insurable) adverse risks suddenly introduced to the pool.  It's increasing exposure.

[Cats Cats Cats]

What?  To deflect a flat-out lie we were fed on what HC reform would do, you are calling me a communist?  Really?  FWIW, I don't consider government regulation which impacts cost of anything as communism, it's not even close.

Were we not told during the sales pitch that Obamacare would reign in health care costs?  I'm not making a value judgement on whether or not I think cost controls are good, I'm asking where are these cost controls which were going to "bend down the curve"?  I highlighted this sentence because it identifies a shortfall in the program which we were assured was not there.  

Add song #10 to the list:

10) You are a communist because my reading comprehension (and/or critical thinking skills) sucks.

"controls to prevent health care from growing at unsustainable rates much higher than inflation."

The only for the government to "control" the cost of health care is for the government to limit profits or run it.  This isn't about "impact".  This statement is about controlling cost increases regardless of the actual cost to the insurance companies.  That is how you control the costs from increasing at rates higher than inflation.

I never heard that this was going to force health care to not increase.  I heard that the original public option would have done such a thing.  But that isn't want the Republican's wanted.  So now we just have more people covered and hopefully less in the emergency room.  You must be talking about the original plan.

[nathanm]

Nope, not when you have a bunch of previously un-insured (or un-insurable) adverse risks suddenly introduced to the pool.  It's increasing exposure.

At this point, yes. When the individual mandate kicks in, the healthy people will also be buying insurance. I think this is just as fair as me having to have liability insurance despite never having been involved in a collision.

My point was that the bill should help make health insurance less expensive relative to the cost of medical procedures. Unfortunately, it does nothing about the latter.

Also, the bill should have done for other particularly high cost diseases what was done for people with end stage renal disease, taken them out of the private system and made them eligible for Medicare. That one thing would reduce the cost of insurance dramatically. There are several not-so-rare lifelong conditions that cost millions of dollars a year to treat where, thanks to modern medicine, the person can live pretty much indefinitely.

[Gaspar]

I am sure it will make things less expensive.  If there is anything I am convinced of it is that:

1. Government is excellent at containing costs.
2. All Government programs operate more efficiently than private sector programs.
3. The quality of care that government can require/provide always exceeds what can be purchased in the private sector.
4. Money taken by Government is always spent in accordance to its primary and original purpose.

I mean, have there ever been ANY exceptions to the above?

I certainly can't find any!

[Cats Cats Cats]

At this point, yes. When the individual mandate kicks in, the healthy people will also be buying insurance. I think this is just as fair as me having to have liability insurance despite never having been involved in a collision.

My point was that the bill should help make health insurance less expensive relative to the cost of medical procedures. Unfortunately, it does nothing about the latter.

Also, the bill should have done for other particularly high cost diseases what was done for people with end stage renal disease, taken them out of the private system and made them eligible for Medicare. That one thing would reduce the cost of insurance dramatically. There are several not-so-rare lifelong conditions that cost millions of dollars a year to treat where, thanks to modern medicine, the person can live pretty much indefinitely.

As the Republican's pushed in the 1990's I agreew with the healthy and insurance.  I would however agree to dropping the "penalty" if we try to get everybody insured.  You can opt out and not face a penalty but all of your personal property can be taken to pay for your medical bills.  If you are insured then if you can't pay your medical bills your home/etc. is not able to be taken.