ACA - aka ObamaCare and why you shouldn't be surprised.

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
MountainPharmD

MountainPharmD

custodiunt illud simplex
Lifetime Donor
Verified Member
15+ Year Member
Platinum Member
Joined
Aug 15, 2004
Messages
4,576
Reaction score
339
Members do not see this ad.
The Affordable Care Act aka The ACA aka ObamaCare was forced into law by the Supreme Court in June of 2010. Several months later hospitals started getting hit with regulatory changes brought on by the law. In 2010 if you took a look at the ACA and some of its key provisions you wouldn't be surprised at all with what's going on right now. Even a cursory read should have sent a cold chill up your spine.

Within 6 months of passage hospitals started seeing major and disturbing changes in the Medicare program. I'm clued into this more than most because of my wife's job. Very few people have grasped what the changes mean and how it's going to effect the operation of the hospital. That's why today, two years after theses changes were implemented, we are seeing hospitals start to panic. The root cause is the fact they failed to grasp the changes the ACA brought on and have failed to change the way they operate. Laying off employees is a knee jerk temporary solution that will fail in the long run. Hospitals will have to fundamentally change the way they operate. The day of the independent practitioner and independent for profit hospitals are over. Accountable Care Organizations...read up on them.

What's starting to happen should be no surprise to anyone who has been paying attention the last 2 years.
 
Last edited:
The ACA was pushed on everyone with this pie in the sky promise that the financial impact to the country would be very small because of all the cost saving provisions in the law. Obama himself went on national TV several times to discuss how cutting out all the fraud waste and abuse in the system would help pay for the new bill. Sounds great right?

If you worked in a hospital in 2010 two provisions of the ACA should have made you nauseous.

1.) Provisions to Improve Quality of Care - 10 year savings - 15 billion dollars.

Whats wrong with improving quality of care to save money? Nothing except the projected savings come from reduced payments to providers and hospitals who do not meet the governments quality standards. The governments logic is to pay providers and hospitals less so they will do more in the future to get full reimbursement that is less than it is today.

2.) Preventing Fraud, Waste and Abuse. - 10 year savings - 5 billion dollars

http://www.connolly.com/healthcare/Pages/CMSRacProgram.aspx

Nothing wrong with this right? Winners never cheat because cheaters never win right? As only the government can do everyone gets caught up in this not just the cheaters. Medicare has now gone from a pay first and audit later policy to a audit first and pay later...much later policy. If you work in a hospital and you don't know what RACs are you are way behind the power curve.

The RAC appeal process is overloaded and backlogged about two years. They can't meet the normal statutory guidelines for timely review so the government has suspended or I should say are reviewing and have yet to publish RAC audit timelines. Medicare has 5 mind numbingly complicated levels of Appeal. Below is the normal review times that apparently do not apply to RAC audits since they are 2 years behind.

Level 1 Re-determination - 120 days to make a decision
Level 2 Reconsideration - 180 days to make a decision
Level 3 ALJ Hearing - 60 days to make a decision
(Administrative Law Judge)
Level 4 Medicare Appeals Council Appeal - 60 days to make a decision
Level 5 District Court - 60 days to make a decision
 
Drove by what once was a bustling medical plaza. Now all the suites are boarded up and property up for sale.
 
wow, an all star of doom and gloom posters on this thread. harrowing.
 
You Sound like a Whiny, Greedy, and overall selfish SOB! The affordable care act is in place to help the less fortunate. Yes, That means that providers will receive less of a reimbursement however, the reimbursement they will get still over-exceeds the cost of procedures so, they are still making a profit. All this talk about doctors getting put out of business is HOGWASH. With the provisions in place primary healthcare providers can still make a sizable income. After all, with the ACA being implemented and thousands of previously uninsured now seeking healthcare would it make sense to put providers out of business? The Obama administration has definitely thought this through before implementation of ACA. The same folks whining about helping those in need by allowing them healthcare are the same hypocrites that rant and rave about helping starving children in Africa just for the tax break. Hypocrisy at it's finest. If less reimbursement to providers = Access to healthcare to those who cannot afford it. Count me in! After all if you truly do not want to help individuals why are you in healthcare.
 
Last edited:
yup thanks for posting. Unfortunately people like him will never get the point.and will only focus on the "flaws" of the law. It is an imperfect system, but it will grant more people healthcare which is a should be a basic human right in the US
 
These are cold hard facts that Mountain presents. I don't think we needed to add another underfunded program to other underfunded programs such as Medicaid, Medicare and Social Security with the amount of debt the country has. Liberal Progressive programs will cause the country to end up like Detroit. Politicians do a fine job of labeling business as the greedy bogeyman. Our gov't has a spending problem. It's not an income problem. When you tax and regulate business they will continue to move overseas and automate.

We are easily #1 in the world in defense spending. That would be a good place to start.

The real purpose of Obamacare was to expand the Democratic voting base and to redistribute wealth. No one will vote against their great provider.
 
So Did You Buy Your Vasoline, Obama Voters? - Denninger

http://market-ticker.org/akcs-www?post=224882

The following are priceless cuts from the greatest show ever, as Cher from Clueless would say,"Sparatacus". Enjoy!

Jupiter's C*ck! (Compilation) .
https://www.youtube.com/watch?v=F5MS7MCHRjM&feature=player_detailpage
Spartacus: Blood & Sand - John Hannah (Batiatus) being awesome. .
https://www.youtube.com/watch?v=ruyWq7URlN0&feature=player_detailpage
Funny Batiatus Quote .
https://www.youtube.com/watch?v=dTzw0Mg8zYo&feature=player_detailpage
 
mursepharmd said:
yup thanks for posting. Unfortunately people like him will never get the point.and will only focus on the "flaws" of the law. It is an imperfect system, but it will grant more people healthcare which is a should be a basic human right in the US
Click to expand...

As a centrist, I am taking a wait and see stance on ACA. The jury is still out but the risk of end up badly is certainly real and considerable.

On the other hand, many will argue with your assertion that healthcare is a basic human rights. Unlike voting and speech, healthcare has to be paid for by someone. So the ACCESS to healthcare maybe a right, but having it provided for free would not.

I think its been so long since entitlement programs were established that people are mistaking them as rights when they are just past legislations that can come and go like any.
 
npage148 said:
You constantly say you're a centrist but your opinions constantly contradict that

Just like health care, voting still requires money to function
Click to expand...

If i'm not then I wouldn't be taking a wait and see attitude on ACA. You constantly seem to think anyone who isn't on the left are on the right. I'm a firm believer of meritocracy, which doesn't belong to either left or right.

Voting doesn't have to take money to function. Remember the greeks? People just gathered and had their say.
 
Remember the Greek pharmacist who killed himself in public.
 
xiphoid2010 said:
Voting doesn't have to take money to function. Remember the greeks? People just gathered and had their say.
Click to expand...

Which age are you living in? You think a gathering of 120-130million people is feasible? Everything these days need money to function
 
Unchained said:
These are cold hard facts that Mountain presents. I don't think we needed to add another underfunded program to other underfunded programs such as Medicaid, Medicare and Social Security with the amount of debt the country has. Liberal Progressive programs will cause the country to end up like Detroit. Politicians do a fine job of labeling business as the greedy bogeyman. Our gov't has a spending problem. It's not an income problem. When you tax and regulate business they will continue to move overseas and automate.

We are easily #1 in the world in defense spending. That would be a good place to start.

The real purpose of Obamacare was to expand the Democratic voting base and to redistribute wealth. No one will vote against their great provider.
Click to expand...

One of the goals is to reduce cost of healthcare, which contradicts your opinion. 97 percent of small employers are exempt from the law’s mandates. Meanwhile, virtually all large companies already offer health insurance to their employees. Aside from things such as reporting requirements, Obamacare’s mandates will directly obligate only about 1 percent of American businesses to do anything different.

http://www.washingtonpost.com/opini...11e3-8ade-a1f23cda135e_story.html?tid=rssfeed

If we had had the French health care system, which is one of the most expensive in the world, it would have provided universal coverage and it also would have saved us so much money that we could have eliminated the individual income tax.

http://billmoyers.com/2013/10/03/the-us-has-low-taxes-so-why-do-people-feel-ripped-off/

Health Care reform is a winner, its just unfortunate that the republicans didnt get to it first on a national level. Romneycare (which is a model for obamacare) is successful in Massachusets (please google this before you dispute)which is the closest real world predictor of how obamacare would perform
 
mursepharmd said:
Which age are you living in? You think a gathering of 120-130million people is feasible? Everything these days need money to function
Click to expand...

We are a representative democracy. You don't need to gather 120-130 million people. Neighborhoods can vote on a representative, who votes at the district to elect another, then state level, then national level. The voting system would be different, it would still be democracy.

edit: but I personally would prefer a meritocracy system over government. "Meritocracy, in an administrative sense, is a system of government or other administration wherein appointments and responsibilities are assigned to individuals based upon their "merits", namely intelligence, credentials, and education, determined through evaluations or examinations." Instead of playing a popularity contest and buying votes by political parties, the most capable people based on merit should be in charge. We all want to grow the economy and balance the budget right? Instead of leaving to politicians, let a panel of top economists to run the show and not have to worry about votes or how much lobbyists will contribute to their "campaign funds".
 
Last edited:
xiphoid2010 said:
We are a representative democracy. You don't need to gather 120-130 million people. Neighborhoods can vote on a representative, who votes at the district, then state, then national level. The voting system would be different, it would still be democracy.
Click to expand...

LOL, This method will seriously skew the results of the election. No wonder this is not being used in the modern world.
 
France?

Did you forget notice the sovereign debt crisis? We've run out of OPM.
 
mursepharmd said:
LOL, This method will seriously skew the results of the election. No wonder this is not being used in the modern world.
Click to expand...

You think our current system is not seriously skewed? Lobbyists and non-voting sources probably hold more sway than the voters. LOL.

Then again, I don't even really like democracy all that much. You wouldn't want hospital kitchen and janitor staff voting who should be the medical director. Or pharmacists voting on who to run NASA. Meritocracy would mean people are voted into power by peers or those who have similar merits.
 
Not compared to what you suggested. Lobbyists can only vote once like everybody else
 
mursepharmd said:
Not compared to what you suggested. Lobbyists can only vote once like everybody else
Click to expand...

Going way off topic, so I'm not going to belabor the point that our current system is messed up. Can't raise taxes, can't cut spending, bunch of politicians playing games and don't have the skill or merits to really run a country. Blah.
 
A few back of the napkin calculations are handy and useful for understanding the real reason why the Republicans have shut down the government.

Obamacare is in no way a single-payor plan such as they have in Europe and Canada. But the people who make money off the status quo see it as a step trending towards single payor. I've done this calculation a couple times before on SDN, and it seems salient given the current events to do it again: let's compare and contrast the cost of the US system versus, say, the Canadian single-payor system. (FWIW I think Canada is a more pertinent comparison than European countries because Canada and the US are more culturally similar, though you might favour a system more like what France has rather than our totally public system.)

Per capita cost of US system (including public and private): $ 8,300
Per capita cost of Canadian system (similar in cost to European systems): $4,500
Difference: 8,300 - 4,500 = $3,800

So multiply $3,800 x current (okay, 2012) US population which google says is 313,900,000 = $1,192,820,000,000 in lost profits annually.

You're welcome.
 
This simpleminded "just do the math" approach ignores the variables explaining why there is such a disparity in per capita costs. Hint....the US is subsidizing health care throughout the rest of the world by fronting the capital for R+D. Drugs and Procedures etc are so much cheaper elsewhere simply because they are so expensive in the US.
 
WVUPharm2007 said:
...which is actually quite needed right now being that income stratification is choking off demand needed for a recovery...
Click to expand...

I agree that during this recession those who have benefitted the most are those with large stock portfolios and homeowners. I'm certain a majority of wealth is stuck there. The banks have been criticized for holding on to too much cash and not lending. The rules were changed for them after the 2008 crash. They are no longer penalized for retaining a surplus. After what happened I can't blame them. How do you feel this wealth should be redistributed? Close loopholes and lower the effective tax rate in order to repatriate profits? I'd like to think there is a better way than the progressives have suggested of never ending social programs. I work in a big city and I see the impact these welfare programs have on generation after generation. It really saps peoples wills to strive for more and work their way out of poverty.
 
Pharmavixen said:
A few back of the napkin calculations are handy and useful for understanding the real reason why the Republicans have shut down the government.

Obamacare is in no way a single-payor plan such as they have in Europe and Canada. But the people who make money off the status quo see it as a step trending towards single payor. I've done this calculation a couple times before on SDN, and it seems salient given the current events to do it again: let's compare and contrast the cost of the US system versus, say, the Canadian single-payor system. (FWIW I think Canada is a more pertinent comparison than European countries because Canada and the US are more culturally similar, though you might favour a system more like what France has rather than our totally public system.)

Per capita cost of US system (including public and private): $ 8,300
Per capita cost of Canadian system (similar in cost to European systems): $4,500
Difference: 8,300 - 4,500 = $3,800

So multiply $3,800 x current (okay, 2012) US population which google says is 313,900,000 = $1,192,820,000,000 in lost profits annually.

You're welcome.
Click to expand...

False. Harry Reid is on record as saying as much:

Sen. Harry Reid: Obamacare 'Absolutely' A Step Toward A Single-Payer System

http://www.forbes.com/sites/theapot...solutely-a-step-toward-a-single-payer-system/

regarding the thought/comment above about income stratification: you could narrow the wealth gap, in party, by ending corporate welfare and by discontinuing the federal student loan program and allowing educational prices to fall in line with the CPI.
 
owlegrad said:
Did you even read what you quoted? "A step towards" is not the same thing as actually being a singe-payer system.

Although really, no one is saying that obamacare is a single payer system, are they? 😕
Click to expand...

The point is that Obamacare is simply a stepping-stone to single-payer. In other words, Obamacare is not really "Obamacare"--it's simply a name for the program that will transition us to single-payer.
 
FarmD711 said:
This simpleminded "just do the math" approach ignores the variables explaining why there is such a disparity in per capita costs. Hint....the US is subsidizing health care throughout the rest of the world by fronting the capital for R+D. Drugs and Procedures etc are so much cheaper elsewhere simply because they are so expensive in the US.
Click to expand...

So it's true that Americans pay 40% of all drug costs in the world. And the pharmaceutical companies say that this disproportionate expenditure makes for disproportionate innovation. Let's break down drug costs:

From The Truth About Drug Companies: How They Deceive Us, and What To Do About It by Marcia Angell, MD (the 1st woman to serve as editor in chief of the New England Journal of Medicine):

1. The pharmaceutical industry claims to be a high-risk business, but year after year drug companies have higher profits than any other industry - by a long shot. In 2002, the top ten American drug companies had a profit of 17 percent, compared with 3.1 percent for the other Fortune 500 industries. The biggest drug company, Pfizer, had a profit of 26 percent.

2. The industry claims to be innovative, but only a small fraction of its drugs are truly innovative. Of the 78 drugs approved by the Food and Drug Administration (FDA) in 2002, only 17 contained new active ingredients, and only 7 were classified by the FDA as likely to be improvements over drugs already on the market. Most of the others were just minor variations of old drugs.

3. The most profitable drugs are variations of top-selling drugs already on the market - "me-too" drugs. There are whole families of me-too drugs, and no good reason to believe one is better than another at equivalent doses. They cash in on already-established, huge markets. The top-selling drug in the world, Pfizer's Lipitor, is the fourth of six cholesterol-lowering drugs of the same type.

4. The industry's most innovative drugs usually stem from research done at government or university labs...
Click to expand...

Other fun facts: American drug companies spent $855 million on lobbying from 1998 to 2006, according to the Centre for Public Integrity. The US is the only country in the world where there's little government regulation of drug prices.

And in 2012, the US pharmaceutical industry spent $24 billion marketing drugs to physicians. According to their own document, the industry spent $48.5 billion on research last year.

Another interesting article:

Pharmaceutical companies have a strong vested interest in maximizing figures for R&D and supporting centres or researchers who help them do so. Since the Kefauver hearings in 1959–1962, the industry's principal justification for its high prices on patented drugs has been the high cost of R&D, and it has sought further government protections from normal price competition. These include increasing patent terms and extending data exclusivity, without good evidence that these measures increase innovation (National Institute for Health Care Management, 2000; European Commission for Competition, 2008 (28 November); Adamini et al, 2009). Industry leaders and lobbyists routinely warn that lower prices will reduce funds for R&D and result in suffering and death that future medicines could reduce. The industry's view of European ‘price controls' (actually, large-volume discounts) is that they do not allow recovery of huge R&D costs so that Europeans are ‘free riders' on Americans and force US prices higher to pay for unrecovered costs the ‘free riders' refuse to pay. This claim has been shown not to be supported by industry and government reports and to be illogical as well (Light and Lexchin, 2005).
Click to expand...

And there's the under-acknowledged role of universities in the drug discovery process.
 
owlegrad said:
Did you even read what you quoted? "A step towards" is not the same thing as actually being a singe-payer system.

Although really, no one is saying that obamacare is a single payer system, are they? 😕
Click to expand...

I'm not sure Obamacare is even a baby step towards single-payor Stalinist socialist gulags-on-every-corner system that we have in Canada. But the Koch brothers don't seem to agree with me.
 
Pharmavixen said:
I'm not sure Obamacare is even a baby step towards single-payor Stalinist socialist gulags-on-every-corner system that we have in Canada. But the Koch brothers don't seem to agree with me.
Click to expand...

I hope it's a step. I hope that enough people are pushed to it that it becomes the default Healthcare plan for the majority of Americans. It will be there right along with Medicaid, Medicare and the VA system (the ultimate socialist system that veteran tea baggers have no issue with)
 
mursepharmd said:
yup thanks for posting. Unfortunately people like him will never get the point.and will only focus on the "flaws" of the law. It is an imperfect system, but it will grant more people healthcare which is a should be a basic human right in the US
Click to expand...

Gosh, I am such a *******! How silly of me to focus on the "flaws". Golly gee we should all hold hands and sing kumbaya as we marvel at how great it is that more people will have government mandated heath insurance. Forget about those pesky "flaws". Lets do what all good left wing nut tree hugging idiot liberals do...make up our own facts and beliefs based on fantasy and lies.
 
that's the spirit! I think you're making some sense now. See it isnt hard to be optimistic and accepting
 
:clap: MountainPharmD, voice of reason! We need these kind of facts to help us see the picture regarding our job survival, REGARDLESS of whose political kool-aid anyone drinks. It's bad enough pharmacy has been balkanized (clinical vs. staff pharmacists, hospital vs. retail). Let's not also be divided by political jibberish! We need to wake up, see the freight train coming, and get off the tracks before it's too late. Cause guess what? That freight train doesn't care if you're a donkey, elephant, or horse's rear orifice. As pharmacists, we need to be united, be better informed about these policies and understand how they directly affect our jobs and ability to provide top-notch healthcare.

Bottom line, as I see it, no matter if we like or don't like the ACA/Obamacare, we must deal with its consequences both as consumers and providers of healthcare.

It's great that you've shared this apparent "insider" information that so few of us have access to. I thank God almighty every single day that my husband has a job (hospital). Even without Mountain's information, it's fairly easy to see the recent impact of government policies by seeing how hospitals have begun to lay off pharmacists (and other healthcare staff), especially the ones providing only clinical, not dispensing, services. A clinical pharmacist was recently released along with his/her much-higher-salary-than-staff-pharmacists. Working at an inner-city, non-profit hospital with a huge Medicare/Medicaid patient base that's been on financial life support for the last 5 years, my husband had a pay freeze lasting 3-4 years, while the cost of gas, food, utilities went up considerably. During this time, believe me, the bean counters' ominous, ubiquitous presence has been felt, as they frequently walk through the hospital and pharmacy, breathing down everyone's necks with several layoffs throughout the hospital as a result of their recommendations.

For me, MountainPharmD's post helps encourage all of us to keep alert, pull our heads out of the sand, and be proactive, if possible, so we don't get sucker-punched any more than we already have as pharmacists and as a profession.

Knowledge is power. Keep it comin, Mountain! :highfive:

P.S. I don't agree that everyone has a right to JUST healthcare access. What KIND of healthcare, sub-par? EVERYONE SHOULD HAVE ACCESS TO TOP-NOTCH HEALTHCARE, NOT JUST HEALTHCARE, IMHO.
 
Last edited:
rxlea said:
Mountain, we're not going to see you on TV in your old CVS garb storming the capitol are we?
Click to expand...

LOL :roflcopter:

Interesting: http://www.healthcareitnews.com/news/hospitals-hammered-rac-audits

I will say this. I do think there's a a fair amount of waste due to improper billing. Recently, my office visit to an in-network tier-1 provider was erroneously processed as an out-of-network, tier-2 billing level and I was charged $164. I didn't think this sounded right. After some digging and calling the insurance company, I got them to re-bill it properly.

There's got to be a better way than this RAC nightmare. Oh, wait, the government is all about efficiency.
 
Last edited:
Pharmavixen said:
So it's true that Americans pay 40% of all drug costs in the world. And the pharmaceutical companies say that this disproportionate expenditure makes for disproportionate innovation. Let's break down drug costs:

From The Truth About Drug Companies: How They Deceive Us, and What To Do About It by Marcia Angell, MD (the 1st woman to serve as editor in chief of the New England Journal of Medicine):



Other fun facts: American drug companies spent $855 million on lobbying from 1998 to 2006, according to the Centre for Public Integrity. The US is the only country in the world where there's little government regulation of drug prices.

And in 2012, the US pharmaceutical industry spent $24 billion marketing drugs to physicians. According to their own document, the industry spent $48.5 billion on research last year.

Another interesting article:



And there's the under-acknowledged role of universities in the drug discovery process.
Click to expand...

Brings back memories of pharmacy school. :laugh:
 
Expanding Medicaid as well.


Sent from my iPhone using SDN mobile app
 
Obamacare isn't what is shrinking the middle class. The middle class has insurance through their employer. This really would mostly affect middle class people that are small business owners or otherwise not receiving healthcare through their job. Those on the other end of the spectrum get subsidies. The shrinking middle class is due to decades and decades of wealth stratification and decreased opportunity for laborers. Or, whatever, blame Obama.
 
Before Obamacare, private insurance companies can deny coverage for pre-existing conditions. If they didn't then people would only get insurance after they got sick. It is like getting car insurance right after a car accident.

Since insurances are now require to take everyone, charge them the same rate as a healthy person and many of them are not exactly healthy, they need to increase everyone's rate. Whether you are working for a big corp or a small business, your rate is going up.


Sent from my iPhone using SDN mobile app
 
People are mad that they have to pay for sick people, boohoo.


Sent from my iPhone using SDN mobile app
 
confettiflyer said:
People are mad that they have to pay for sick people, boohoo.


Sent from my iPhone using SDN mobile app
Click to expand...

I think people are mad if they have to pay for what may trend to be a higher rate of sick people in their risk pool. Insurers try to keep rates low to drive business and enrollment and the masses follow. Higher rates of sick people join a plan, it only makes sense that rates have to rise across the board to offset the additional cost. As rates rise "healthy" people see the value proposition get weaker and weaker and start to leave furthermore increasing the proportion of "sick" people. And then your death spiral gets exponentially worse as the process repeats itself and the federal govt can't make payments on its risk corridor promises to offset this.
 
confettiflyer said:
People are mad that they have to pay for sick people, boohoo.


Sent from my iPhone using SDN mobile app
Click to expand...

"Boohoo?" Who wants to pay for anyone else (sick or healthy), especially when health insurance is already as expensive as it is?
 
PharFromNormal said:
I think people are mad if they have to pay for what may trend to be a higher rate of sick people in their risk pool. Insurers try to keep rates low to drive business and enrollment and the masses follow. Higher rates of sick people join a plan, it only makes sense that rates have to rise across the board to offset the additional cost. As rates rise "healthy" people see the value proposition get weaker and weaker and start to leave furthermore increasing the proportion of "sick" people. And then your death spiral gets exponentially worse as the process repeats itself and the federal govt can't make payments on its risk corridor promises to offset this.
Click to expand...

Death spiral is certainly an important thing to consider and abate, but when a certain population of people are used to paying for a risk pool that specifically excludes sick people, and all of a sudden they're required to financially care for their fellow citizen regardless of condition, they just need to suck it up because that's how much healthcare actually costs.

Sure it's cheaper to kick people to the curb. Pretty sure that's what the Nazis were doing, you know, drag on the state kinda thing 🙄
 
Obamacare has actually helped healthy, high income earners.

Companies are passing on the cost to their employees by only offering high deductible plans with health saving account (HSA) which is like 401 k for your healthcare cost.

You max out your HSA ($3-6k) so you can avoid paying taxes on the contribution. If you are in the middle class, this doesn't help much because you don't pay much taxes anyways. But if you make a lot of money and you are healthy, these low cost, high deductible plans are a gold mine.

You get to put $18 k in your 401 k and now you get to put another $3-6 k in your HSA. That is over $21 k in tax deductions!


Sent from my iPhone using SDN mobile app
 
Ascribing a "Risk vs Value" proposition to healthcare can become problematic if done to the n-Th degree. When healthcare companies start playing hot potato to kick anyone who has a condition to the curb, then they're probably looking at it too much from a profit perspective. At a certain point we just need to cover as many as possible and feel lucky that we haven't gotten a condition ourselves "yet". Most everyone will eventually have something, it's just a matter of when and if you're lucky enough to catch it soon enough. Therefore, it's probably better to not look upon people who need to use healthcare as "risky" people or simply a financial burden to contend with as we or someone close to us will certainly be in the same position eventually.

As to Obamacare, it is doing what it was created to do:

1.) Provide some sort of healthcare to those who would otherwise have none
2.) Give some help to everyone by cutting down on how much the healthcare companies can screw you over (like pre-existing conditions) because otherwise (as we've already seen) they would indeed screw you to the n-Th degree without conscious.
3.) Slow the rise of healthcare costs (not stop it, just slow it some)

Some comements on #1: Low income people and folks in their 50s/60s (pre-medicare and not poor enough to get medicaid) would have a hard time getting healthcare. Healthcare companies don't want these people because they are too "risky" and thus could dampen their profits. For older folks, it also sucks because a lot of businesses engage in age discrimination too. These corporations like to quietly lay these people off partly because they don't want to pay for their expensive healthcare or their families. Then they get it on the other end because healthcare companies want to charge a fortune because they are considered "risky". They have no recourse but to try to get to medicare age if they can last that long.

Some comements on #3: People like to whine that the rates are still high and use that as an excuse to say that the ACA is a failure. However, all it did was slow the cost growth and also, it's actually to the benefit of some to raise the costs as much and as soon as possible. Therefore, you have forces that are pushing costs as high as possible to reap the profits.

You would need to massively change things more in order to achieve a great amount of savings and they probably will never be able to do that. Too many players making too much money to change it that much. When the ACA left the healthcare companies in place as the middle-men, you already knew right then that costs would continue to rise albeit perhaps just a little bit slower.
 
You must log in or register to reply here.

Similar threads

Mr.Smile12
AJPE: Insights And Questions For Success In A Pharmacy Academic Career
Replies
1
Views
1K
lord999
lord999
mrjbb
Applying to Pharmacy Schools and Becoming a Licensed Pharmacist with a Criminal Record
Replies
5
Views
1K
mrjbb
mrjbb
P
Excited to be here
Replies
2
Views
1K
sunnyandseventytwo
sunnyandseventytwo
L
WSJ: Why Your Neighborhood Pharmacy Isn’t So Friendly Anymore
Replies
0
Views
1K
libra08
L
C
Why is Morphine not popular?
Replies
8
Views
2K
CetiAlphaFive
CetiAlphaFive
Top