<p>I don’t think everything is hunky dorrie (sp?) in healthcareland, but I have to say I am fairly satisfied overall with the care I have received and the cost here in NC and I am private pay with BCBS of NC. I did have that one issue with learning the cost of a procedure, but aside from that I have been to the doctor a few times including specialists and a few assorted procedures, and everything has been great. Fortunately no hospital visits.</p>
<p>Health care is like voting in Chicago. Bill early and often. Sometimes you hit the jackpot, and someone actually pays the made-up price. Maybe even two entities for the same procedure.</p>
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<p>I didn’t say that providers shouldn’t be transparent. I think they should be. And I think forcing them to be transparent is a very good thing, since they haven’t voluntarily done it, for obvious reasons.</p>
<p>What I question is the idea that a transparent market alone will lead to affordable prices, or to equitable access.</p>
<p>There was an interesting article recently about hospital pricing in Maryland - which has the lowest prices of all the states.</p>
<p>[Maryland</a> pressing for expanded powers over hospitals - The Washington Post](<a href=“http://www.washingtonpost.com/business/economy/maryland-pressing-for-expanded-powers-over-hospitals/2013/05/24/8adf92fe-b8c1-11e2-b94c-b684dda07add_story.html]Maryland”>http://www.washingtonpost.com/business/economy/maryland-pressing-for-expanded-powers-over-hospitals/2013/05/24/8adf92fe-b8c1-11e2-b94c-b684dda07add_story.html)</p>
<p>Apparently, Maryland got a deal with the federal government back in the 1970’s where they would get higher Medicare reimbursements in exchange for regulating lower hospital payments across the state. It has worked, but no other state has gotten that deal and everyone else is basically being charged more to cover Medicare procedures which often bring in less than they cost (and other payment losses). But the system now is not working so well so they are trying to fix it. </p>
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<p>[Obamacare</a> premiums in California lower than predicted - May. 23, 2013](<a href=“http://money.cnn.com/2013/05/23/news/economy/california-obamacare-premiums/index.html]Obamacare”>Obamacare premiums in California lower than predicted)</p>
<p>I think this is a surprise to many…</p>
<p>A step in the right direction…</p>
<p><a href=“http://www.medicaldaily.com/articles/15682/20130518/obamacare-insurance-premiums-lower-expected-two-states.htm[/url]”>http://www.medicaldaily.com/articles/15682/20130518/obamacare-insurance-premiums-lower-expected-two-states.htm</a></p>
<p>So premiums are coming in lower than expected in California, Oregon and Washington. I wonder how ACA opponents are going to spin that?</p>
<p>Indurance companies are competing with each other with transparent health insurance plans and prices are coming in lower than expected.</p>
<p>If transparency becomes more widespread in the hospital world, prices will come down. The consumer wins. </p>
<p>If healthcare costs decrease, the future budget deficits of the US federal govt are lower. The
Future debt may not be the problem people think it is. </p>
<p>The budget projections are getting better.</p>
<p>I think many aca opponents are going to flip and become proponents. Aca was really a conservative program anyway so it won’t be hard to flip and take credit. </p>
<p>Private insurance companies are going to do better under Aca than single payer. It is in the interests of private insurance companies to make aca work.</p>
<p>Drug companies are going to do better. More paying customers.</p>
<p>There are people in private industry that are going to do well under ACA.</p>
<p>I think all the insurance companies like ACA. Remember the Harry & Louise advertising campaign by the industry, which killed Hillarycare? They haven’t done anything like that with Obamacare, nor should they since it’s going to bring in a whole bunch of new customers.</p>
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<p>Agreed. There is now a standard package of benefits, so the companies are going head-to-head. Before, it was almost impossible to do an apples-to-apples comparison; it was more like apples-to-bicycles. I think insurance companies have made a lot of money over the years purely out of subscriber confusion. No more. Any company which charges substantially more for the same coverage isn’t going to be in business for long, and they know it. Now THAT is free-marketism – and the consumer finally has the tools to make an informed decision! </p>
<p>Plus, we consumers will now have the same power in the insurance market as we do in, say, the restaurant market. If I don’t like the food or the service at my corner restaurant, I can choose to take my dining dollars elsewhere. With ACA, if I don’t like the way my insurance company treats me, I can take my insurance dollars elsewhere – something I have never been able to do before because of pre-existing conditions. So, not only are they going to have to price their products reasonably to GET our business, they’re going to have to treat us decently in order to KEEP our business. Pure capitalism! :D</p>
<p>I really like the way California is doing it, with the bronze-silver-gold-platinum tiers. They already have the website up, with a countdown clock, no less lol. One reason Romneycare was so successful in Massachusetts was because they had a very good website, and it looks like CA will have one too.</p>
<p>[Covered</a> California](<a href=“http://www.coveredca.com/]Covered”>http://www.coveredca.com/)</p>
<p>Las Ma, I like your post. All of it…</p>
<p>I guess I will just highlight this because it is so good…</p>
<p>"Plus, we consumers will now have the same power in the insurance market as we do in, say, the restaurant market. If I don’t like the food or the service at my corner restaurant, I can choose to take my dining dollars elsewhere. With ACA, if I don’t like the way my insurance company treats me, I can take my insurance dollars elsewhere – something I have never been able to do before because of pre-existing conditions. So, not only are they going to have to price their products reasonably to GET our business, they’re going to have to treat us decently in order to KEEP our business. Pure capitalism! "</p>
<p>I have favored single payer, but it looks like ACA is going to work pretty well and my daughter will probably work in the private health care insurance industry for a long time so screw it. My family may come out way ahead under ACA compared to single payer and that is what counts. Lol</p>
<p>Transparency at work in Oregon.</p>
<p>[Obamacare</a> Is Already Forcing Private Insurers To Lower Their Premiums | ThinkProgress](<a href=“http://thinkprogress.org/health/2013/05/10/1994331/obamacare-forcing-insurers-lower-premiums/?mobile=wp]Obamacare”>http://thinkprogress.org/health/2013/05/10/1994331/obamacare-forcing-insurers-lower-premiums/?mobile=wp)</p>
<p>^HMMM well I just received a letter from BC/BS and my direct pay premiums are going up 50% next year, Obamacare is the specific reason stated. My increases over last few years were about 5%. I currently have preferred pricing having a healthy family, but starting next year everyone is being grouped together…and some actually told the American public that Obamacare would lower premiums? Ha…I used too love my plan…to bad I probably can’t keep it now…now what did our Prez repeatedly state while trying to convince us that obamacare was a good thing? If you like your plan, you can keep it?..sure, just pay another 50%, that’s all.</p>
<p>Geeps20, which plan do you have now?</p>
<p>Which state do you live in?</p>
<p>I’m a bit worried that although things may drop at the beginning, the rates will rise and competition between insurers will give way to price-fixing between insurers. It has happened in other industries. </p>
<p>There’s also the generic drug case being considered by the Supreme Court. Apparently, drug makers can pay generic drug makers to keep their product off the market, ensuring profits for everyone (except us…). That may come to an end. </p>
<p><a href=“http://www.nytimes.com/2013/03/26/business/supreme-court-hears-case-on-deals-between-generic-and-brand-name-drug-makers.html?_r=0[/url]”>http://www.nytimes.com/2013/03/26/business/supreme-court-hears-case-on-deals-between-generic-and-brand-name-drug-makers.html?_r=0</a></p>
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<p>We were in shock when we had to pay the full cost of one of our D’s drugs recently. We decided to buy it from Canada, and then we found out that a generic version was available there but not in the US! The price difference was enormous. And this was for a drug that’s been around for 20 years or more.</p>
<p>geeps20: Are you buying insurance on your own or is it through your employer? If you’re buying it on your own, then you’ll be able to use the health exchange to select your plan and should be able to get a competitive price. If it is through your employer, then it’s totally up to them which plan they choose and how much you pay. For me, that is the most frustrating thing about our current health insurance environment. Why does my employer get to pick for me? They always choose what works best for them, not what is best for me.</p>
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<p>Gouging is prohibited under the ACA, which states that 80% of the premiums taken in by the insurer must be spent on medical claims (that rises to 85% in a couple of years). If they take in more than that, they are required to rebate the excess to the subscriber. So they can collude all they want, but they’ll just have to give it back at the end of the year.</p>
<p>The lower price (and likely for many higher-cost patients) reflects how much they have been gouging us, and for a very long time. </p>
<p>But I’m not so sanguine - I see really major, even overwhelming problems occurring in the delivery of care. We’ll see.</p>
<p>My state already has the silver/bronze/gold exchange policies, but they weren’t attractive at all (even from the same insurance company) as the private plan I purchased.</p>
<p>The mandated coverages won’t help me. For example, one of the reasons my plan is “affordable” is that it excludes maternity coverage. As a 59 year old guy, why would I want to pay for maternity coverage?</p>
<p>On the other hand, if the provision of no denied coverage goes into effect that allows you to enroll on the spot if you are hospitalized – with no penalty, no waiting period – I may seriously consider dropping my health insurance entirely. It would be a LOT cheaper to pay out of pocket for my annual physical and routine screening and the fine than it is to pay for a year of insurance. If you can sign up on the spot at any time at the same price risk-free, you’d have to be crazy to pay for insurance until you need it… The only thing that has kept people from doing that has been the waiting periods and exclusions if you have have a break in coverage.</p>
<p>We have problems with delivery care right now.</p>
<p>Whatever problems ACA is going to have, and there will be some, the problems pale compared to the benefits. This is life changing for many people. Life changing!!!</p>
<p>Mini, be optimistic. There are always the a…, the meanies… They have theirs and dont want somebody else to have. Then there are those that dont have and are afraid that ofhers may get something. There are always the naysayers. The people that say we cant do this. We cant do that. They are pretty messed up in their own minds. I used to feel sorry for them, but now I just feel disgust. </p>
<p>That is ok… Society is moving forward. Slowly.</p>
<p>The transparency that is starting to occur in the medical profession is going to help bend that cost curve lower. The ramificatons of this are huuuuuuge.</p>
<p>Some people are just never going to get it. That is ok.</p>
<p>My pessimism doesn’t have to do with meanies, or greedies. Rather, with the nature and character of the pent-up demand.</p>
<p>mini, you may be right about pent-up demand, although it seems that as ACA gets rolled out, the dire predictions are not happening. But even if there are problems delivering care, I agree with dstark that they are small compared to the help which ACA is already providing to millions of Americans. As he rightly says, this is indeed life-changing. The bugs will be many, but they do not outweigh the fact that, at long last, we will be joining the rest of the civilized world in ensuring that all of our people have access to decent health care. Single-payer would have been quicker, easier, and more cost-effective, but that was never going to happen. ACA is what we have, and it’s far, far better than what we had.</p>
<p>It’ll be tempting to assess ACA at every step along the way, but IMO this is a mistake. We should look at it maybe 5 years down the road, because it will take that long for the dust to settle. That’s how far off track we’ve been.</p>