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Obama health law anniversary finds 2 Americas

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#31    ninjadude

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Posted 27 March 2013 - 08:44 PM

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The Sunday New York Time's editorial page celebrated the third anniversary of the Affordable Care Act by detailing some of its achievements, even ahead of its full implementation next year. That includes:
  • Some 6.6 million people ages 19 through 25 who have been able to stay on their parents' insurance plans and more than than 3 million young adults getting health insurance.
  • 17 million getting some kind of free preventive service, like flu shots, and 34 million Medicare recipients getting free preventive services in 2012;
  • 17 million children with pre-existing conditions being protected against being uninsured;
  • More than 107,000 adults with pre-existing conditions finally having insurance under the federally run insurance program;
  • 21 million received care from expanded community health centers, 3 million more than previously served;
  • $1.1 billion in rebates, an average of $151 per family paid by insurers that failed to meet the benchmark of 80 to 85 percent of premium revenues on medical claims or quality improvements;
  • Since 2010, more than 6.3 million older or disabled people have saved more than $6.3 billion on prescription drugs;
Beyond that, as the editorial notes, the annual growth of health care expenses has declined sharply, both in private care and Medicare. But the focus on quality of care seems to be working. "The percentage of Medicare patients requiring readmission to the hospital within 30 days of discharge dropped from an average of 19 percent over the past five years to 17.8 percent in the last half of 2012." That's largely because Medicare can impose penalties now for poor performance, but can also pay incentives for quality care.
Not a bad track record for the first three years, before the meat of the reforms kick in. What's particularly important—and so far ignored by policy-makers—is the real slowdown in the growth of health care costs. It suggests that Medicare isn't a hair-on-fire emergency right now, and that any changes to it should be dealt with outside of deficit grand-bargaining. It's not an immediate crisis.
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#32    preacherman76

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Posted 27 March 2013 - 09:19 PM

Slow down in the growth of health care costs?????????????????????????????

They pushed me right outta the game. Go peddle that BS someplace else.

Some things are true, even if you dont believe them.

#33    AsteroidX

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Posted 27 March 2013 - 09:32 PM

I puked when that Hillary advert came up. Thanks ND.

All the facts are pointing to a giant increase in the price of healthcare in general. You dont think all those uninsured Americans are in desperate need of healthcare ? That alone will spike the average cost per policy by quite a bit.


#34    Kowalski

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Posted 27 March 2013 - 09:32 PM

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Beyond that, as the editorial notes, the annual growth of health care expenses has declined sharply, both in private care and Medicare. But the focus on quality of care seems to be working. "The percentage of Medicare patients requiring readmission to the hospital within 30 days of discharge dropped from an average of 19 percent over the past five years to 17.8 percent in the last half of 2012." That's largely because Medicare can impose penalties now for poor performance, but can also pay incentives for quality care.

Didn't I just read an article that said Medicare has stopped paying bills on Medical Diagnostic tests? Oh, here it is:
http://www.forbes.co...-the-effects/1/

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There’s no clear deadline on when this will all get resolved. There’s some speculation that when the Medicare contractors submit their 2013 pricing on April 30th, they’ll have to declare their prices for these various molecular tests. Once they do, the labs should get paid retroactively. But the April 30th deadline seems soft. This could linger much longer.
There’s also a risk for labs that the individual Medicare contractors may decide not to pay for certain codes (and tests) altogether.
This sort of bungling may be without precedent, even for the Medicare agency, which is quietly viewed in Washington – among both Democrats and Republicans – as being poorly administered. This isn’t a political slur. The agency’s skill level seems to persist equitably through transitions in political power. Problems emanating from CMS have cursed both Republicans and Democrats alike.
Diagnostic tests were supposed to usher in an age of personalized medicine. Now they’re being actively priced controlled. And by a bureaucratic regime that can’t even figure out what prices they want to pay for these services.

Here's another one: http://www.forbes.co...-like-medicaid/

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There’s an astute article in today’s edition of the Wall Street Journal by veteran healthcare reporter Anna Mathews. It outlines the scope of health plans that will be offered on the new exchanges taking shape this fall. And why Obamacare is looking more and more like Medicaid.

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This is exactly what has happened with Medicaid, which treats many indigent Americans who are in poor health. Yet the higher costs of taking care of the Medicaid population hasn’t been made up with more funding, but fewer services that these patients are able to get access to. The same thing is likely to hold true in the exchanges. If the exchanges are favored by sicker patients, this outcome will occur even sooner.
Medicaid pays the full freight for most healthcare services (with few out of pocket costs) but compensates by sanding down the rates paid to providers. The result is that the Medicaid benefit has been hollowed out over time. Fewer doctors are willing to see Medicaid patients, making it hard for patients to get appointments and schedule needed services. The Medicaid benefit is great on paper, but often stingy when you try to use it.

This last statement is very true. It is extremely difficult to find a doctor, specialist, surgeon, basically ANYONE who accepts medicaid. I know many who have to pay out of pocket to see their doctor, because their doctor doesn't accept medicaid/medicare.


#35    Michelle

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Posted 27 March 2013 - 09:34 PM

http://www.timesfree...premiums/?local

Health insurance rates predicted to go up 30%.


#36    Startraveler

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Posted 27 March 2013 - 10:32 PM

View PostKowalski, on 26 March 2013 - 07:23 PM, said:


The key context there is that they're talking about the individual insurance market, the notoriously volatile little market where people without employer-sponsored insurance and with sterling medical histories look for coverage. Until now, they're best known for being poorly regulated, with skimpy insurance policies and discriminatory business practices. What's changing is that people in that market--or who want to enter it but haven't been able to thus far--are going to get access to the same kinds of consumer protections that most people (i.e. people with insurance through their jobs) already enjoy.

But most people aren't in the individual market. Only 5% of the population actually gets insurance through them now and only some subset of that sliver of the population is actually going to see these changes reflected in what they pay out of pocket for premiums.

View Postpreacherman76, on 27 March 2013 - 12:02 PM, said:

Financial assistance from who? We already spend around a trillion more then we make per year. Where the hell is that money gonna come from? Our great great grandchildren?

View Postpreacherman76, on 27 March 2013 - 09:19 PM, said:

Slow down in the growth of health care costs?????????????????????????????

Your second question answers the first. At this point, savings from the rest of the health system are going to be enough to finance almost all of the new costs over the next decade or so. That's actually unexpected, as it was thought when the law passed that only half of the new spending over the time frame would be paid for through savings. The rest was paid for by raising new revenue.

But as it turns out, health spending across the health system has slowed down so much (and so persistently) that literally hundreds of billions of dollars have melted off the price tags of Medicare and Medicaid over the next decade. Money that's freed up to help others get insurance. And yes, that slow down is very real and it's showing up in pretty much every indicator: group insurance premiums, health care price inflation, national spending numbers, Medicare per capita spending growth, the Standard and Poor's health indicators. You just have to read the news once in a while:

Health care price growth lowest since December 1997

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Health care price inflation in January 2013, at 1.5% year-over-year, was two tenths below December’s reading and the lowest level since 1.3% measured in December 1997. The 12-month moving average at 2.0% in January 2013 is the lowest since 1.9% recorded in December 1998. . .

January was the 44th month of economic expansion but health care price pressures are nowhere to be found. Indeed, lower or stable aggregate inflation measures are likely exerting downward pressure on the health price index rather than the expected opposite whereby health care prices would be adding to general inflation. Separate analysis indicates a real health care price break beginning in October 2010. This could be an early indication of a structural change caused by lower price growth targets from public payers and aggressive measures that providers are taking to become more efficient. It warrants future
scrutiny to determine its persistence.

Health insurance premiums see smallest increase in 15 years

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The cost of providing health care benefits to employees rose by just 4.1% this year, the smallest increase in 15 years, according to a survey by human resources consultant Mercer.

And employers are expecting to see another modest increase of 5% next year, the survey of 2,800 companies found. That's a far cry from the beginning of the decade, when employers reported increases of 10% to nearly 15% a year. Last year, benefit costs rose by 6.1%.

Growth In Medicare Spending Per Beneficiary Continues To Hit Historic Lows

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The slow growth in spending per beneficiary from 2010 to 2012 combined with the projections of spending growth at GDP+0 for 2012-2022 is unprecedented in the history of the Medicare program.

How Have CBO’s Projections of Spending for Medicare and Medicaid Changed Since the August 2012 Baseline?

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The Recent Changes in CBO’s Baseline Reflect Trends That Have Developed Over the Past Few Years

In recent years, health care spending has grown much more slowly both nationally and for federal programs than historical rates would have indicated. For example, in 2012, federal spending for Medicare and Medicaid was about 5 percent below the amount that CBO had projected in March 2010.

In response to that slowdown, over the past several years CBO has made a series of downward adjustments to its projections of spending for Medicaid and Medicare. For example, from the March 2010 baseline to the current baseline, technical revisions—mostly reflecting the slower growth in the programs’ spending in recent years—have lowered CBO’s estimates of federal spending for the two programs in 2020 by about $200 billion—by $126 billion for Medicare and by $78 billion for Medicaid, or by roughly 15 percent for each program.

Growth of Health Spending Stays Low

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January 7, 2013
WASHINGTON — National health spending climbed to $2.7 trillion in 2011, or an average of $8,700 for every person in the country, but as a share of the economy, it remained stable for the third consecutive year, the Obama administration said Monday.

The rate of increase in health spending, 3.9 percent in 2011, was the same as in 2009 and 2010 — the lowest annual rates recorded in the 52 years the government has been collecting such data.

Slower Growth of Health Costs Eases U.S. Deficit

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WASHINGTON — A sharp and surprisingly persistent slowdown in the growth of health care costs is helping to narrow the federal deficit, leaving budget experts trying to figure out whether the trend will last and how much the slower growth could help alleviate the country’s long-term fiscal problems. [...]

Health experts say they do not yet fully understand what is driving the lower spending trajectory. But there is a growing consensus that changes in how doctors and hospitals deliver health care — as opposed to merely a weak economy — are playing a role. Still, experts sharply disagree on where spending might be in future years, a question with major ramifications for the federal deficit, family budgets and the overall economy.

Part of the slowdown stems from “the recession and the loss of income and wealth” causing people to cut back on health care, Douglas W. Elmendorf, the director of the Congressional Budget Office, said last week. But he added that a “significant part” of the slowdown “probably arises from structural changes in the health care system.”

Annual Growth Rates Broadly Decelerate in December 2012 According to the S&P Healthcare Economic Indices

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New York, February 21, 2013 – Today S&P Dow Jones Indices announced the results of S&P Economic Healthcare Indices for 2012. Data released by S&P Dow Jones Indices for the S&P Healthcare Economic Composite Index indicates that the average per capita cost of healthcare services covered by commercial insurance and Medicare programs increased by 3.73% over the 12-months ending December 2012. This is a deceleration from the +4.46% annual growth rate recorded in November 2012 and the lowest rate in the eight- year history of the index.



#37    preacherman76

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Posted 27 March 2013 - 10:37 PM

LOL, just got off the phone with my wife. They are raising it AGAIN. Forget you star. Like I told ninja, go peddle it someplace else

Some things are true, even if you dont believe them.

#38    F3SS

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Posted 27 March 2013 - 10:51 PM

Startraveller, even though you're unlikely to ever convince me of anything good I do appreciate that your posts are well thought with substance. I wouldn't put you in the category of the ninjadudes who tow party lines and copy and paste from thinkprogress and NY Times editorials as gospel.

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#39    Queen in the North

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Posted 27 March 2013 - 11:07 PM

Can someone explain to me (without yelling, lol) why most Americans don't want a national health service, which is free at point of use?

I'm genuinely interested, I don't need anyone to rant at me about the state of the NHS in the UK at the moment.

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#40    F3SS

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Posted 27 March 2013 - 11:30 PM

View PostQueen in the North, on 27 March 2013 - 11:07 PM, said:

Can someone explain to me (without yelling, lol) why most Americans don't want a national health service, which is free at point of use?

I'm genuinely interested, I don't need anyone to rant at me about the state of the NHS in the UK at the moment.
I don't think the government can or will handle it properly is the bottom line. It ain't free either.
I can't help it. Yours is a model example. I hear it isn't good. Why would we want that?

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#41    preacherman76

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Posted 28 March 2013 - 09:31 AM

View PostQueen in the North, on 27 March 2013 - 11:07 PM, said:

Can someone explain to me (without yelling, lol) why most Americans don't want a national health service, which is free at point of use?

I'm genuinely interested, I don't need anyone to rant at me about the state of the NHS in the UK at the moment.

Well no one is offering it. But the reason I would strongly be against it is cause of the amount of open coruption we have to endure with just about everything they do. We are talking about people who just freed monsanto of persecution for any future harm they might do. They have proven over and over again that they are far more concerned with the welfare of corperations who fund thier campaigns then the people they are supose to serve. In fact it has gotten to the point where blood is probably going to be spilled. And when that happens it will be justified.

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#42    and then

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Posted 28 March 2013 - 10:48 AM

View PostQueen in the North, on 27 March 2013 - 11:07 PM, said:

Can someone explain to me (without yelling, lol) why most Americans don't want a national health service, which is free at point of use?

I'm genuinely interested, I don't need anyone to rant at me about the state of the NHS in the UK at the moment.
I won't rant -http://www.dailymail...d-patients.html

But it IS legitimate to ask how a broken system in a country many times larger than yours can benefit from the same kind of system you guys are struggling with?  It's not an attack, just a legitimate question.  The bottom line from my view (and I worked in healthcare for 15 years) is that we have a profit driven system and it will need to change FUNDAMENTALLY if a solution is to be found.  I have no confidence this is going to happen.  When the profit motive is removed from the doctors and all the healthcare workers  then very few people will want to work in this field.  It is demanding and stressful and often very thankless.  Do you know of many people who would want such a job?  Especially if they had to go to school from 2 to 10 years to do it?  Human nature tells us clearly that only the few will seek this situation - but their motives will be unimpeachable.  If the government would open free paths to educate healthcare providers this would help.  If no debt was incurred to gain employment in nursing or radiography or physical therapy or occupational therapy then many more individuals with ability might consider these positions - even at lower wages.  Basically though, we are headed for a 2 tier healthcare system.The wealthy will continue to be beneficiaries of good medicine and the rest will make do... or not.



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#43    Sweetpumper

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Posted 28 March 2013 - 03:11 PM

Kidney cancer patients denied life-extending drug as NHS watchdog declares it 'not cost effective'


http://www.dailymail...-effective.html

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#44    Queen in the North

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Posted 28 March 2013 - 04:52 PM

View Post-Mr_Fess-, on 27 March 2013 - 11:30 PM, said:

I don't think the government can or will handle it properly is the bottom line. It ain't free either.
I can't help it. Yours is a model example. I hear it isn't good. Why would we want that?
The UK isn't nearly the only country with 'free' healthcare for all.

View Postand then, on 28 March 2013 - 10:48 AM, said:

I won't rant -http://www.dailymail...d-patients.html

But it IS legitimate to ask how a broken system in a country many times larger than yours can benefit from the same kind of system you guys are struggling with?  It's not an attack, just a legitimate question.  The bottom line from my view (and I worked in healthcare for 15 years) is that we have a profit driven system and it will need to change FUNDAMENTALLY if a solution is to be found.  I have no confidence this is going to happen.  When the profit motive is removed from the doctors and all the healthcare workers  then very few people will want to work in this field.  It is demanding and stressful and often very thankless.  Do you know of many people who would want such a job?  Especially if they had to go to school from 2 to 10 years to do it?  Human nature tells us clearly that only the few will seek this situation - but their motives will be unimpeachable.  If the government would open free paths to educate healthcare providers this would help.  If no debt was incurred to gain employment in nursing or radiography or physical therapy or occupational therapy then many more individuals with ability might consider these positions - even at lower wages.  Basically though, we are headed for a 2 tier healthcare system.The wealthy will continue to be beneficiaries of good medicine and the rest will make do... or not.

I guess my first question should have been, what happens in the US if you have no insurance and no money to pay medical bills, and you develop a serious illness, for example cancer?

Edited by Queen in the North, 28 March 2013 - 04:52 PM.

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#45    Michelle

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Posted 28 March 2013 - 05:35 PM

View PostQueen in the North, on 28 March 2013 - 04:52 PM, said:

I guess my first question should have been, what happens in the US if you have no insurance and no money to pay medical bills, and you develop a serious illness, for example cancer?

We have excellent public hospitals that take patients, without insurance, where the taxpayers pick up the tabs. My uncle was a long term cancer patient in one and I was very impressed with the facilities and staff.






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