<p>There have been a few new medical schools open recently. U C Riverside opened last year, but they graduate only 50 students. But on the flip side, some med schools have cut the size of their classes, Vanderbilt is one. </p>
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</p>
<p>Not in a million years would Canadians trade their system for ours, before or after ACA. They, like the rest of the world, shake their heads on disbelief that we cling so stubbornly to a system that is so dysfunctional for so many of its people. </p>
<p>Fair enough article, good source: <a href=“https://www.aamc.org/newsroom/newsreleases/358410/20131024.html”>https://www.aamc.org/newsroom/newsreleases/358410/20131024.html</a></p>
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Precedent for this would be rent control. It is quite possible to have a customer (tenant) who has lived in a unit long enough to no longer cover the costs. </p>
<p>No doctor is “forced” to take ACA plan patients, or Medicaid patients in expansion states.</p>
<p>^ Exactly. That’s why I had to get rid of my old doc. He didn’t take Medicaid patients. (It really didn’t break my heart- he was pretty incompetent and I would’ve traded earlier if I could’ve) </p>
<p><a href=“http://finance.yahoo.com/news/house-panel-subpoenaed-trading-probe-233800098.html”>http://finance.yahoo.com/news/house-panel-subpoenaed-trading-probe-233800098.html</a></p>
<p>This sums up me apprehension of a big gov project. It is hard to stop people from bending ethics to suit their inteest when there’s so much easy money to make. Health stocks jumped shortly before they announced ACA.</p>
<p>Yes: LasMa: No doctor is forced now to take ACA plan patients or Medicaid patients. But some editorials have suggested just that. The suggestion has been that doctors have to take all patients who present at their door regardless of insurance. Some have suggested it as a condition of keeping a medical license. A very bad idea.</p>
<p>Some editorials have suggested a lot of things. Lots of editorials have proposed repealing ACA; many others have proposed going to the other end of the spectrum with the option which must not be named. Neither of those is going to happen either. As far as I know, there are zero proposals to do this from anyone who can actually make it happen</p>
<p><a href=“3,137-County Analysis: Obamacare Increased 2014 Individual-Market Premiums By Average Of 49%”>http://www.forbes.com/sites/theapothecary/2014/06/18/3137-county-analysis-obamacare-increased-2014-individual-market-premiums-by-average-of-49/</a></p>
<p>What did rates do in your county?</p>
<p>Overall, it appears there are more losers than winners cost-wise.</p>
<p>Avik Roy.</p>
<p><a href=“Putting the 'Affordable' in the Affordable Care Act”>Putting the 'Affordable' in the Affordable Care Act;
<p>The criticism of his methodolgy from the left (MSNBC) is that his numbers are for unsubsidized premiums. Of course, the taxpayers are paying the rest. It’s like saying food stamps reduce the cost of food. ACA does not bring down the cost of health care or health insurance unless someone else is paying for you.</p>
<p>Correct, Tatin. In fact, it pushes it up. Along with leaving everyone else with less money in their pockets to pay for everything else. And, decreasing jobs as a bonus. How people can’t see this I will never understand. Nothing is free.</p>
<p>It’s fair to look at unsubsidized. For those people, it is real, we know that, on this thread. My issue is he focused broadly, on states and averages. The 0-40% category is broad, could include small jumps as well as the surprises. There are no easy conclusions to draw from his report.</p>
<p>And, I looked up some zips I know and don’t see how the composites shown really inform us. One example of a zip in a 0-40% state showed men 2%, -9, -11 and women -1%, -11, +8. So, you really have to work the info to see it. And most people will just look at the summary and conclusions Roy carefully draws for them. </p>
<p>Plus, we (should by now) know, it isn’t just about premiums. </p>
<p>3/4 of premiums under ACA paid by subsidies.</p>
<p><a href=“http://blogs.marketwatch.com/health-exchange/2014/06/18/three-fourths-of-premiums-under-obamacare-paid-via-subsidies-hhs/”>Opinion and Commentary - MarketWatch;
<p>yet, people still have trouble paying premiums,</p>
<p><a href=“http://finance.yahoo.com/news/poll-many-still-struggle-pay-health-premiums-150122469--finance.html”>http://finance.yahoo.com/news/poll-many-still-struggle-pay-health-premiums-150122469--finance.html</a></p>
<p>To get a subsidized premium under $100 (under whatever amount one focuses on, for whatever policy tier,) income has to be low. So again, need to look at these reports in context. Plus this: “Missing from the report was an overall average on premiums when policyholders who don’t get tax credits are included. Further, no data are included on pricing schemes are for state-run exchanges.” I’m just saying we have to watch drawing conclusions too quickly.</p>
<p>In a GP office today doing work, was located at reception desk, had the benefit of hearing the insurance issues during my time.</p>
<p>These are 3 examples of what transpired.</p>
<p>A person came in for appointment, was told his deductible for visit was $100. Visit cost was $110 without labs if they were needed. Person was in early 40’s. Stated had subsidized plan, paid 436 for policy why the $100 deductible? Receptionist said your plan requires you to pay the first $1000 out of pocket before it picks up cost. Person left said would never need to use $1000 in care per year was no longer going to pay premiums, opt for the penalty. Said would go to CVS and self treat. </p>
<p>Another came in when verifying insurance it was found person has not paid premium since April did not have coverage. Staff said this issue was the most common the past few weeks. </p>
<p>A 20’s something y/o came in, staff showed me copy of deductible amount, 26K, kids policy was 136 a month. Wanted medical clearance for a surgery, did not understand at all would be on the hook for 26K of said deductible if opts for elective surgery.</p>
<p>Samiamy – some of those examples don’t make any sense. There is no such thing as an ACA-compliant policy with a $26K deductible – the maximum deductible for a policy could not possibly exceed maximum out of pocket of $6350/person or $12,700 for a family. So either you heard wrong or the person has a pre-ACA policy that is grandfathered in some way. </p>
<p>The first example you gave also doesn’t make a lot of sense. Either the person has a deductible + coinsurance plan or else the person has a deductible + copay. $100 copay for an office visit sounds high - but I don’t know what state you are in so I have no clue what sort of plans are offered. But if it was a coinsurance plan (patient pays 100% of the deductible before seeing benefits of insurance) - then the patient would have had to pay the full cost of the visit – $110. (Can you post your state? That might help resolve the mystery). </p>
<p>Of course if a patient doesn’t pay the premium, their insurance will lapse. That was true before ACA and it is true now. It’s why government funded, taxpayer supported single payer is the only system that can ever guarantee full coverage to all people – if the system relies on people paying their own premiums, some don’t pay. Same story with mandatory car insurance – the laws can be passed requiring the insurance, but that’s no guarantee that the careless driver who runs you down actually has coverage at the time of the accident. The government can pass a law requiring people to be covered, but it can’t actually force the people to pay the premiums. </p>
<p>One problem with all these surveys is that the people being polled are, for the most part, idiots. Take my region. We have two insurers, Blue Shield and Anthem. Anthem has a restricted network for Obamacare plans but it does have far more doctors and hospitals in its network than Blue Shield. Blue Shield is a disaster. The largest outpatient provider, Sansum Clinic, is not included nor UCLA, Cedar Sinai and numerous other hospitals. Most specialist and general practitioners have refused to join the BS network. Now Anthem is no great shakes either but it is a heckuva a lot better than BS. So, even though the BS and Anthem Obamacare plans pretty much cost the same, roughly half of the people in the individual market enrolled in BS plans. The subscribers in my region are either half-witted or just plain ignorant. </p>
<p>Also, the person who decides to self medicate and not pay premiums because he won’t use $1000 a year isn’t thinking rationally. Does he also refuse to buy car insurance because he doesn’t expect to use it? Or homeowners insurance? Insurance isn’t meant to pay out what you pay in every year. It’s meant to cover you in case of huge expenses.</p>