Aetna signficantly reducing Obamacare participation

[glenn1]

The problem is that the medical industry has priced itself so that even routine and recurring medical services are disasters to most people. When paying cash routine doctor visits can run $300+ dollars, and another hundred or so for the medication. That might not be too much money for you or I, but for many, maybe even most, Americans they have to go into debt to pay it. Get into even simple surgical procedures and you run $10k+, and amount many Americans will never be able to pay off.

Understood it's expensive but you know what else is? The health "insurance" to cover those costs. Personally I don't think the certainty of paying five figure premiums to avoid the possibility of a $300 cost (or even several of them) is a smart choice, but public policy has made it where no one has that choice anymore. Which again was why I advocated my prior position; even with spitball numbers it's easy to see that offering true insurance risk pooling to cover catastrophic costs should be far less than the $17,545 the average health "insurance" family policy costs per year and the remainder in a Health Savings Account should typically cover the lesser cost services and medications.

 

[Meghan54]

Bullshit.

Medical insurance doesn't cover accidents, your motorcycle insurance does.

Sorry, but this is wrong and idiotic. Health ins. certainly does pay for "accidents" via things like, you know, ER visit, follow up MD visits, etc.

Now, if there is another payer required to pay for the hospital visit, the health ins. co. will go after that other provider to attempt to get them to contribute/pay.

But to say health ins. won't cover immediate and follow up care for an accident, that's just ignorance of ins.

 

[Thump553]

AEtna is one of the largest employers in my area. This decision has little to nothing to do with the ACA-it is a rather heavy handed political attempt by AEtna's CEO to pressure the Justice Department to withdraw their opposition to the proposed merger between AEtna and Humana.

Those that think this has something to do with ACA/Obamacare are being played like fiddles by the big boys of finance-yet again.

Here's a link to the headline article in today's local paper about this smoking gun letter:

http://www.courant.com/topic/business/aetna-inc.-ORCRP000343-topic.html

 

[SMOGZINN]

Understood it's expensive but you know what else is? The health "insurance" to cover those costs. Personally I don't think the certainty of paying five figure premiums to avoid the possibility of a $300 cost (or even several of them) is a smart choice, but public policy has made it where no one has that choice anymore. Which again was why I advocated my prior position; even with spitball numbers it's easy to see that offering true insurance risk pooling to cover catastrophic costs should be far less than the $17,545 the average health "insurance" family policy costs per year and the remainder in a Health Savings Account should typically cover the lesser cost services and medications.

I agree with you. That is why I personally carry high deductible insurance with a HSA. I think that for most people it is by far the most intelligent choice in health insurance. In fact it is hard to find a situation where it is not. But people are not always rational beings, and insurance companies are for profit. There job is to exploit those fears, and poor math skills, to make money for their shareholders.

 

[zinfamous]

The USA stopped barring immigrants to the USA who have HIV/AIDS a long time ago and as a consequence we have a lot of immigrants who show up here with unmanaged infections. These people get counted in our statistics for healthcare outcomes even though our healthcare has nothing at all to do with their condition when they arrive in the USA.

what the fuck?

 

[zinfamous]

Obamacare is a disaster. Why?

• It is based around lies told repeatedly by Obama
• It was passed in a totally partisan manner in the dead of night
• It does not address real problems, it is based in perceptions
• It was passed for political reasons, not as a means to improve healthcare

Honest question: Do you expect people to read the rest of your post when you open up with such a premise, then follow it with explanations based on suppositions and un-quantifiable "belief" statements?

None of your "points" are actual data. To call a major policy like the ACA a disaster, you need to bring actual data to the table in order to form a cogent argument. These are things that can be tracked and then argued based on those merits. Making such a statement and then presenting belief-structured assumptions as your "data points" does not present you in a respectable light.

--"Based on lies" is not a data point
--"Passed in a totally partisan manner in the dead of night!" Also not data. But here's the greater problem here: so what? Should it matter if it was passed in this way if the results were positive? No, of course it doesn't. You need to present the actual results.
--"It does not address real problems, only perceptions" It doesn't? Why not? What do you perceive as perceptions of real problems?
--"political reasons" pretty much the exact same ..."point" you made with #2. But this is also pure supposition. Unless you know the man and his team, you really can't make an accurate statement about Obama's intentions either way, and neither can the so-called sources with which you choose to aggregate and filter this kind of pablum. Do you know Obama? Do you actually know how long he has been working at overhauling healthcare? (I don't know him, either, but I did attend a speech and a rally of his, prior to serving on the US senate, where his primary interest was in reforming US healthcare. This was well before he considered running for POTUS; and certainly before he started working to hide his secret muslim non-US credentials and ruin your life, kick your dog, sleep with your wife, and steal your healthcare in some elaborate evil scheme to take effect some 8 years later)

 

[sportage]

Healthcare for profit is a nasty system.
Insurance providers rely on profit, and sick people do not generate profit.
Naturally, if any insurer is not making a bucket full of money, or too many sick people
show up at their door, that provider will freak.

We have to realize what is going on here.
Insurance companies are in the business of insuring, but not in the business of losing.
Paying a claim is always a loss for them.

Insurance companies and providers are just like any other business out for profit,
During the board meeting, companies expect to show a gain in profits during the next year.
To project a healthy gain in profits from their last year, year after year, Never ending profit gain.
Exactly as the Walmart's, Best Buys, or pizza shacks down the street.
Insurance companies expect profits to rise too.
If not, they must do something drastic to change that.
Which is all good and dandy if...... that business is selling pizza or electronics.
But when selling health and healthcare, and dealing with the sick?
A system reliant on profit? Not so good.

All health coverage world wide should be based on single payer and universal insurance.
For the sake of all humanity.
Profiting off the sick is not the best idea ever invented, and it weakens society as a whole.
There are plenty of products and services that make for good business.
Pizza, stereos, TV's, cars, houses, clothes, and so on.
But treating healthcare as a business, given all business strives for profit, is a train wreck in the making.
No society nor business can strive or survive relying on healthcare for their financial profits.
For the sake of society and the strength of the any nation, only their government should control healthcare.
And if government is not capable of taking on such a task, government needs to be fixed so that it can.

Government is fix-able and universal healthcare is do-able.
We just need builders and creators to set up the system, and never politicians.
Put smart people in charge, builders and thinkers, like Trump hires to make his golf courses.
And government healthcare must be totally insulated from politics, because politicians only smell the money and that amounts to nothing more than the failed healthcare for profit system we now have.

 

[agent00f]

If disasters were what it covered then it really would be insurance. But instead insurance pays for almost every conceivable medical service, including the routine and recurring. And Obamacare added more, such as the mandate to cover contraception 100%. Now you can make the argument that doing so is good public policy (and I would tend to agree) but again you've further bastardized "health insurance" into something that's more like a prepaid medical services account. Or one of those "all-inclusive" vacation resorts where you pay for every possible service they could conceivably offer, including those you have no interest in. Again, that's fine for those who consider that type of pricing arrangement to be the one they like, but I don't want to be forced into it myself.

What Obamacare should have been was (A) taxpayer provided vouchers to procure universal true catastrophic insurance (e.g. high deductible, $10-20k or above?), (B) expanded use of Health Savings Accounts to account for the smaller health events (e.g. acute illnesses, non-life threatening urgent care, etc) and routine goods and services like medications and wellness checks, and finally (C) free clinics to provide medical services for the poor and indigent.

Basic medical care is a public service if there ever were one. People have no problem with the gubmint building roads to get from point A to B, and I would think basic assurance you're not going to die after contracting some treatable illness is a higher social priority.

In the US, essentially that public service was historically privatized, and we ended up with this same clusterfuck today as if there were only private toll roads.

 

[glenn1]

Healthcare for profit is a nasty system.
Insurance providers rely on profit, and sick people do not generate profit.
Naturally, if any insurer is not making a bucket full of money, or too many sick people
show up at their door, that provider will freak.

We have to realize what is going on here.
Insurance companies are in the business of insuring, but not in the business of losing.
Paying a claim is always a loss for them.

Insurance companies and providers are just like any other business out for profit,
During the board meeting, companies expect to show a gain in profits during the next year.
To project a healthy gain in profits from their last year, year after year, Never ending profit gain.
Exactly as the Walmart's, Best Buys, or pizza shacks down the street.
Insurance companies expect profits to rise too.
If not, they must do something drastic to change that.
Which is all good and dandy if...... that business is selling pizza or electronics.
But when selling health and healthcare, and dealing with the sick?
A system reliant on profit? Not so good.

All health coverage world wide should be based on single payer and universal insurance.
For the sake of all humanity.
Profiting off the sick is not the best idea ever invented, and it weakens society as a whole.
There are plenty of products and services that make for good business.
Pizza, stereos, TV's, cars, houses, clothes, and so on.
But treating healthcare as a business, where all business strives for profit, that is a train wreck in the making.
No society nor business can strive or survive relying on healthcare for their financial profits.
For the sake of society and the strength of the any nation, only their government should control healthcare.
And if government is not capable of taking on such a task, government needs to be fixed so that it can.

Government is fix-able and universal healthcare is do-able.
We just need builders and creators to set up the system, and never politicians.
Put smart people in charge, builders and thinkers, like Trump hires to make his golf courses.
And government healthcare must be totally insulated from politics, because politicians only smell the money and that nothing more than the failed healthcare for profit system we now have.

So government run healthcare is great and something we should pursue so long as we restrict the people in charge of the government from being involved in it?

Yeah, we should totally do that. We can get some really smart people in charge of it also, for simplicity we'll just call them "insurance companies." What could possibly go wrong with that plan? Except for reality, human nature, and common sense.

 

[glenn1]

Basic medical care is a public service if there ever were one. People have no problem with the gubmint building roads to get from point A to B, and I would think basic assurance you're not going to die after contracting some treatable illness is a higher social priority.

In the US, essentially that public service was historically privatized, and we ended up with this same clusterfuck today as if there were only private toll roads.

Very poor example. Most of the public transportation (roads, railroads, canals, etc.) was built by private companies and subsidized by the government via land grants, tax breaks, etc. Hell, survey party routinely reported the value of land grants exceeded the cost of construction by 3-4 times and unlike the one-time expense for building the land grant became the builder's asset in perpetuity.

http://www.landgrant.org/history.html

 

[agent00f]

Very poor example. Most of the public transportation (roads, railroads, canals, etc.) was built by private companies and subsidized by the government via land grants, tax breaks, etc. Hell, survey party routinely reported the value of land grants exceeded the cost of construction by 3-4 times and unlike the one-time expense for building the land grant became the builder's asset in perpetuity.

http://www.landgrant.org/history.html

That's because you didn't understand the point of the example, which is that people perfectly recognize the value of the gubmint oversight over roads/transportation as a public service. To make it more simple, recollect from above that the swiss have private providers and gub oversight of prices/standards/etc, and the result is better value than the US.

You seem to have this notion that all gub employees fit either the fat lazy dmv dunce or sleezebag politician archetype, when the reality is healthcare is better managed in every other first world peer (and many poorer places) than whatever the hell we're doing.

 

[glenn1]

That's because you didn't understand the point of the example, which is that people perfectly recognize the value of the gubmint oversight over roads/transportation as a public service. To make it more simple, recollect from above that the swiss have private providers and gub oversight of prices/standards/etc, and the result is better value than the US.

You seem to have this notion that all gub employees fit either the fat lazy dmv dunce or sleezebag politician archetype, when the reality is healthcare is better managed in every other first world peer (and many poorer places) than whatever the hell we're doing.

People recognize the value of roads and other common goods exactly because they are common, which healthcare most certainly is not. A rich person doesn't get more miles of road built for his exclusive use than does a poor person and everyone shares the roads equally (special situations like bike lanes, HOV only lanes, etc. being niche exceptions). If you build a new road or resurface an existing one then I'll likely benefit from it as much as you will and so will the Bill Gates and the poorest person in the ghetto.

Now compare a theoretical 'universal' provision of healthcare. Now the paradigm shifts to the exact opposite of roads, where only the exceptions are the ones that provide public benefits but most everything else is a zero-sum game where it only benefits you personally. Beyond the low service/low cost services like primary care and vaccinations that could be public goods, basically every single procedure is bespoke to you and provides me with absolutely no benefit whatsoever. Completely unlike roads where I could drive on the road in front of your house, if you get a heart transplant I can't share the benefit and it's of no use to me at all (apart from maybe ensuring you don't die on my doorstep).

 

[ivwshane]

People recognize the value of roads and other common goods exactly because they are common, which healthcare most certainly is not. A rich person doesn't get more miles of road built for his exclusive use than does a poor person and everyone shares the roads equally (special situations like bike lanes, HOV only lanes, etc. being niche exceptions). If you build a new road or resurface an existing one then I'll likely benefit from it as much as you will and so will the Bill Gates and the poorest person in the ghetto.

Now compare a theoretical 'universal' provision of healthcare. Now the paradigm shifts to the exact opposite of roads, where only the exceptions are the ones that provide public benefits but most everything else is a zero-sum game where it only benefits you personally. Beyond the low service/low cost services like primary care and vaccinations that could be public goods, basically every single procedure is bespoke to you and provides me with absolutely no benefit whatsoever. Completely unlike roads where I could drive on the road in front of your house, if you get a heart transplant I can't share the benefit and it's of no use to me at all (apart from maybe ensuring you don't die on my doorstep).

That is false. A healthy citizen can affect many people directly and indirectly. If a coworker is sick your workload can increase. If an employee is sick that could lead to reduced or inferior service to the consumer. A sick employee also negatively affects an employers bottom line.
So maybe it may seem like health care only affects the individual but a country as a whole that is healthy has a positive affect on the entire society. It is in everyone's interest to have healthy citizens.

 

[BonzaiDuck]

That's because you didn't understand the point of the example, which is that people perfectly recognize the value of the gubmint oversight over roads/transportation as a public service. To make it more simple, recollect from above that the swiss have private providers and gub oversight of prices/standards/etc, and the result is better value than the US.

You seem to have this notion that all gub employees fit either the fat lazy dmv dunce or sleezebag politician archetype, when the reality is healthcare is better managed in every other first world peer (and many poorer places) than whatever the hell we're doing.

His thinking and some others on the view of what should be provided publicly and what should be provided privately has aspects that are totally ludicrous.

Some time within the last decade, I came across an op-ed by someone at Heritage Fdn or Cato Inst who proposed selling off highways to monopolists who would then maintain them, collect monopoly profits and charge tolls. Simply the history he provided in his link of government versus transportation industry interaction and legal action shows how our transportation system evolved from the post-civil-war era.

Lately I've noticed how Republicans of that ilk try to ignore the vast literature and experience in microeconomics pertaining to monopoly. They try to tout the benefits of market domination by a range of entities analyzed as "imperfect competition" and ignore the excesses and general damage they do on the playing field. A lot of things were settled in a consensus that resulted from Theodore Roosevelt, the Sherman Anti-Trust Act and the breakup of the Great Northern Trust.

The only way that this approach to things like roads or even railways would be meaningfully feasible is totally absurd: just let everyone or various private entities build their own roads. Then the transportation land-use required would be totally unfeasible. And it's not much less absurd that treating roads as a private good is no different to someone asking to buy back their share of the I-15 to Vegas: you would then sell them a chunk of concrete and they could do what they would with it -- which completely omits "getting to Vegas and the slots."

Pure Public Goods have an indivisible or difficult-to-separate collective aspect. They can only be provided collectively, and may even be described as having no other efficient way of provision.

Long ago, after the discovery of smallpox vaccine but going back again to the 19th century, the notion of public health emerged, for instance -- with the mathematics of epidemics and the idea of universal vaccination. So it is reasonably justifiable to extend the notion of personal health back in that direction if you impose an idea of a right-to-life if the threats to your life can be removed by medical treatment.

Then there's the notion of externalities -- the imposition of industrial cost on the non-industrial public by pollution of air and water when those costs should be internalized to the entities which manufacture them.

Otherwise, we retreat to a notion of social Darwinism which is to some degree absurd.

We have these people running around with their "small-role-of-government" concept totally oversimplified, absurd and just plain wrong. It is as though they have no concept of history, the forward march of economic theory and economic science, and other aspects. These are the same voices that want everything but national defense provided privately.

The human race has to move forward. a lot of the ideas I've heard from armchair Chucklehead Tea Party enthusiasts are almost psychotic.

 

[nixium]

Maybe the plan all along was to have the whole system crash and burn to the ground, at which point some sort of single payer system could be created to clean up the mess.

 

[poofyhairguy]

That's because you didn't understand the point of the example, which is that people perfectly recognize the value of the gubmint oversight over roads/transportation as a public service. To make it more simple, recollect from above that the swiss have private providers and gub oversight of prices/standards/etc, and the result is better value than the US.

You seem to have this notion that all gub employees fit either the fat lazy dmv dunce or sleezebag politician archetype, when the reality is healthcare is better managed in every other first world peer (and many poorer places) than whatever the hell we're doing.

I don't like to speak for other countries, maybe they have a more effective government system. Ours is fundamentally broken at almost every level, which is why I hesitate to give our bureaucrats any more power.

For example, you throw out roads as an example of good government oversight which is 100% the opposite of my experience. Where I live the only decent roads that have been built in years are all toll roads. Where I live the local government did everything they could to avoid road development (via a stupid "if you don't build it more people won't come" philosophy), and they created this huge problem where my city has traffic jams that outpace larger metropolitan areas due to their incompetence. Only private toll roads are built fast enough to actually alleviate this issue, and I pay $300+ a month to use those private roads because the "public" roads provided by my local incompetent government would add hours every week to my commute if they were the only option. It sucks that not everyone can afford to use those roads like I can, but given the choice I (like every rational person) will chose a situation that works some of the time over a situation that never works.

That is one specific situation, but the scary part is I can't think of an example of amazing US government competency that isn't in some history book (like 1960's NASA or something). Instead I see cities crumbling from the inside due to government incompetence (Chicago, Detroit, etc.), deficits going through the roof due to government incompetence and BS wars, an American Ambassador that was killed due to government incompetence (I won't pin Benghazi on Hillary alone but that was a massive screw up), and a health care system that couldn't get people enrolled when it launched due to -you guessed it!- government incompetence.

As I said I like single payer in theory, but I want to see some proof OUR (and not some other county) government can manage the responsibilities they have NOW before we put them in charge of my health. Until then I will stick with the devil I know, which is the Blue Cross that allows me to see the competent doctor I have come to trust with reasonable co-pays.

"We have to do it, we have no other choice!" isn't a plan, it's an observation of how bad the situation is.

 

[Londo_Jowo]

Now compare your costs and your insurers cost for a similar procedure anywhere else in the world.

Let's also compare what the average person who get's universal healthcare pays in taxes. I'm working with some guys from Switzerland and they complain about all the taxes and health insurance premiums they pay for their so called free healthcare.

 

[glenn1]

That is false. A healthy citizen can affect many people directly and indirectly. If a coworker is sick your workload can increase. If an employee is sick that could lead to reduced or inferior service to the consumer. A sick employee also negatively affects an employers bottom line.
So maybe it may seem like health care only affects the individual but a country as a whole that is healthy has a positive affect on the entire society. It is in everyone's interest to have healthy citizens.

That's a shiity deal unless you somehow think that "positive effect on the entire society" has a higher expected return on investment to me over the taxes I need to pay to achieve it. Otherwise it's just the same argument about how giving to poor more welfare will somehow create some magic benefit which is simply bullshit. The "employers bottom line" is also something I don't give a damn about and completely reject that it's something my tax dollars or anyone else's should go towards; corporations get too many tax subsidies already.

 

[BonzaiDuck]

I don't like to speak for other countries, maybe they have a more effective government system. Ours is fundamentally broken at almost every level, which is why I hesitate to give our bureaucrats any more power.

For example, you throw out roads as an example of good government oversight which is 100% the opposite of my experience. Where I live the only decent roads that have been built in years are all toll roads. Where I live the local government did everything they could to avoid road development (via a stupid "if you don't build it more people won't come" philosophy), and they created this huge problem where my city has traffic jams that outpace larger metropolitan areas due to their incompetence. Only private toll roads are built fast enough to actually alleviate this issue, and I pay $300+ a month to use those private roads because the "public" roads provided by my local incompetent government would add hours every week to my commute if they were the only option. It sucks that not everyone can afford to use those roads like I can, but given the choice I (like every rational person) will chose a situation that works some of the time over a situation that never works.

That is one specific situation, but the scary part is I can't think of an example of amazing US government competency that isn't in some history book (like 1960's NASA or something). Instead I see cities crumbling from the inside due to government incompetence (Chicago, Detroit, etc.), deficits going through the roof due to government incompetence and BS wars, an American Ambassador that was killed due to government incompetence (I won't pin Benghazi on Hillary alone but that was a massive screw up), and a health care system that couldn't get people enrolled when it launched due to -you guessed it!- government incompetence.

As I said I like single payer in theory, but I want to see some proof OUR (and not some other county) government can manage the responsibilities they have NOW before we put them in charge of my health. Until then I will stick with the devil I know, which is the Blue Cross that allows me to see the competent doctor I have come to trust with reasonable co-pays.

"We have to do it, we have no other choice!" isn't a plan, it's an observation of how bad the situation is.

What do you think has been going on since Reagan, seldom discussed in the press, but only implied -- beginning with Watts' mismanagement of Interior, a failure to listen and act when a low-level career civil servant brought indications of the 911 plot to attention of superiors before it happened, the FEMA debacle over Katrina run by former horse-show manager, the IRS frenzy over confusion of the 501(c) loophole, the GSA extravagance for "training" in Las Vegas, the Minerals Management sloppiness uncovered in the Deep Horizon blowout, and -- as already mentioned -- the bad press about problems with the ACA web-site -- result of insufficient contract oversight and systems test?

Since the mid-80s, they've been corrupting the career service. They had a philosophy that they wanted any "competent" people to work in the private sector, and an unspoken policy of discouraging talent and promoting mediocrity. Now why would they do that? Because they thought it OK to mismanage the public's business and institutions, given that they didn't believe in those institutions to begin with. Around the mid-80s, you would see the staff of some defeated GOP congressman coming into an agency in waves, to take positions in which they neither believed in nor took seriously.

Elliot Richardson -- an exceptional Republican and great public servant -- spoke out about this in a Wall Street Journal article during the latter part of the Reagan years.

 

[Fanatical Meat]

Let's also compare what the average person who get's universal healthcare pays in taxes. I'm working with some guys from Switzerland and they complain about all the taxes and health insurance premiums they pay for their so called free healthcare.

So add you total healthcare costs to your taxes. I bet they're pretty similar to the Swiss guys.
The inescapable reality is our healthcare system is so broken and its cost are completely out of line from anywhere else in the world and we get pretty mediocre results for what we pay.

 

[stormkroe]

We need price controls on medications and services. It's getting ridiculous.

Agreed. I think this would have went a long way to fixing our pre-aca system.

 

[stormkroe]

Price controls have never worked. But lets try it one more time. But this time with our health. What could go wrong?

I took it to mean price controls in an 'anti-gouging' way, i.e., no more $55 sponges or $500 pills. Is that not the what you think he meant?

 

[ivwshane]

That's a shiity deal unless you somehow think that "positive effect on the entire society" has a higher expected return on investment to me over the taxes I need to pay to achieve it. Otherwise it's just the same argument about how giving to poor more welfare will somehow create some magic benefit which is simply bullshit. The "employers bottom line" is also something I don't give a damn about and completely reject that it's something my tax dollars or anyone else's should go towards; corporations get too many tax subsidies already.

Except single payer health care would result in less taxes and lower overall costs for most citizens.

And its also been proven that means tested welfare does indeed have a higher return of investment compared to tax cuts.

So far the only bullshit I see has been your argument.

 

[openwheel]

Ironically, today's self proclaimed "fiscal conservatives" that stand with the extreme right wing are not exactly fiscally conservative. They are simply "cheap". Afraid of being taxed an extra few dollars to pay off our deficit. Afraid of being taxed an extra few dollars to pay for health care. Afraid of paying extra dollar to feed the poor in the next town via food stamps. Bottom line is, the fiscal conservatives are no longer the Republican party (nor Libertarians either). They are the Democrats ironically.

 

[Londo_Jowo]

So add you total healthcare costs to your taxes. I bet they're pretty similar to the Swiss guys.
The inescapable reality is our healthcare system is so broken and its cost are completely out of line from anywhere else in the world and we get pretty mediocre results for what we pay.

Funny, I've never experienced the mediocrity or high cost to me since I started working after getting out of the Navy. Right now I pay $45 a week for medical, dental, vision, and a supplemental insurance that covers my deductible and most of my copay. My max out of pocket is $2,500. It comes no where close to the premium of 8% of my salary like the Swiss pay for healthcare premiums.