REAL WORLD EVENT DISCUSSIONS

Checkup: Obamacare

POSTED BY: SIGNYM
UPDATED: Tuesday, August 23, 2016 19:37
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Tuesday, August 16, 2016 9:26 AM

SIGNYM

I believe in solving problems, not sharing them.


United Health, the USA's largest health insurer, left the almost all state exchanges last April. http://www.businessinsider.com/impact-of-united-health-leaving-obamaca
re-2016-4



Aetna and Humana have both decided to sell off their Medicare operations to Molina, affecting about 300,000 in 21 states,
http://www.forbes.com/sites/brucejapsen/2016/08/02/aetna-and-humana-to
-sell-medicare-plans-and-may-exit-obamacare/#21e9c60a6b8d


After evaluation, Aetna is reducing its role to just four states.
http://www.governing.com/topics/health-human-services/tns-aetna-obamac
are.html


However, Cigna has entered the field in the Chicago area. Discussion of insurers in Illinois, including Humana, Aetna, Land of Lincoln Health, United Healthcare, and Cigna:
http://www.chicagotribune.com/business/ct-cigna-aetna-obamacare-illino
is-0727-biz-20160726-story.html


Half of all health insurance cooperatives have failed in the past year
Quote:

It started in February, when CoOportunity Health, which operated in Iowa and Nebraska, was ordered into liquidation. In July, Louisiana’s insurance department announced it was shuttering that state’s co-op. The following month brought news that Nevada’s co-op would also close. On September 25, New York ordered the shutdown of Health Republic Insurance of New York, which had the largest enrollment of all of the co-ops. Then, within the space of a week in mid-October, the number of failures doubled from four to eight, as state insurance regulators announced that they were closing the co-ops in Kentucky, Tennessee, Colorado and one of the two in Oregon. Last week came news that South Carolina’s co-op will be closed, followed this week by the announcement that Utah’s co-op is also being shut down.

In sum, of the 24 Obamacare co-ops funded with federal tax dollars, one (Vermont’s) never got approval to sell coverage, a second (CoOportunity) has already been wound down, and nine more will terminate at the end of this year.


http://www.forbes.com/sites/theapothecary/2015/10/29/why-obamacare-co-
ops-are-failing-at-a-rate-of-nearly-50/#745fbbd11b0a



Overall, thirteen insurers are leaving and seven will enter
Quote:

Adelberg at FaegreBD has been tracking marketplace newcomers and departures. By his count, at least 13 insurers have announced they’ll leave the Obamacare marketplaces. This figure likely underscores the severity of the problem, as two of those insurers, UnitedHealth and Humana, sell in multiple states.

At the same time, it looks like seven new carriers will come onto the market. But those insurers tend to be smaller, typically selling in just one or two states.

"In 2015 there was a good story about participation going up from 2014," Adelberg says. "And in 2016 there was a good story about holding participation steady amid a shifting market. The story will be harder this time around."

This means there will be more places in the United States where consumers have less choice of plans — if any choice at all. The Kaiser Family Foundation estimates that 664 counties will have a single marketplace insurer in 2017, up from 225 of these counties in 2016.


http://www.vox.com/2016/8/4/12368180/obamacare-markets-competition-aet
na


-----

One independent metric of ACA's success is The Pulse shooting. NPR had a story on the cost of the massacre, and one fact that came up over and over for surviving victims was how many were NOT covered by health insurance. I thought Obamacare was supposed to fix all that?


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Tuesday, August 16, 2016 11:07 AM

REAVERFAN

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Tuesday, August 16, 2016 11:09 AM

REAVERFAN


Quote:

One independent metric of ACA's success is The Pulse shooting. NPR had a story on the cost of the massacre, and one fact that came up over and over for surviving victims was how many were NOT covered by health insurance. I thought Obamacare was supposed to fix all that?


Florida was one of the republican states that did everything they could to fuck up ACA. My state did the same.

So, once again, you can blame Republicans.

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Tuesday, August 16, 2016 3:03 PM

THGRRI


Quote:

Originally posted by reaverfan:
Quote:

One independent metric of ACA's success is The Pulse shooting. NPR had a story on the cost of the massacre, and one fact that came up over and over for surviving victims was how many were NOT covered by health insurance. I thought Obamacare was supposed to fix all that?


Florida was one of the republican states that did everything they could to fuck up ACA. My state did the same.

So, once again, you can blame Republicans.



Yep, remember Bushes Medicare D plan. It was the Democrats that helped Bush make a go of it. All the Republicans have worked to do is destroy all of what Obama has tried to accomplish on behalf of those who are less fortunate. That said, with all of SIG's posted bullshit supposedly supporting the little guy, you would think she would show her disappointment over this program having problems. Instead her glee shows through in her being able to start a new thread. A big government bitch celebrating a big government program having problems. What a sicko.


It's tempting to conclude that "Medicare D" has flopped because of Republican disdain for government. And that is indeed part of the problem. It's hard to think of a major federal program or initiative (other than military procurement and domestic espionage) that has thrived under Bush

http://www.slate.com/articles/news_and_politics/the_big_idea/2006/01/d
rug_addled.html
[/qoute]

____________________________________________


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Tuesday, August 16, 2016 3:40 PM

SECOND

The Joss Whedon script for Serenity, where Wash lives, is Serenity-190pages.pdf at https://www.mediafire.com/folder/1uwh75oa407q8/Firefly


How does Obamacare decision making and thinking get so confused and disordered in state and national legislatures? I found an answer that also covers many different matters of law and administration other than Obamacare:
Quote:

Q: You’ve had really big jobs, you’re around influential people. People whose opinions matter. How do ideas like this that are not backed by theory or practice, how do they get stuck in people’s heads?

A: That’s a good question. And one that I’ve puzzled a lot about. The first thing that really struck me when I went from academia to the White House was that there was almost no one with a scientific background. They were lawyers. And very, very few of the lawyers had majored in any science.

There is something about the mindset of a scientist that is different—an awareness of uncertainty, modeling, proof. I began my career as a physicist. And in the White House my buddies were the people from the White House office of science and technology policy. But a lot of the people were lawyers. They like winning an argument, but science-based, evidence-based reasoning was just sort of not in their framework.

Q: Has that changed much?

A: No. Basically, it’s the nature of who gets drawn into political life. I would say if anything, matters are worse because of the distortions to our society brought about by the financial sector.

The financial sector has so distorted salaries that physicists are getting drawn into the financial sector. All that has led to an undersupply of people committed to the public sector. That filters up into the whole system of who is in government today.

http://qz.com/744854/joseph-stiglitz-euro-future-of-europe-book/

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Tuesday, August 16, 2016 3:50 PM

THGRRI


quote SECOND

The financial sector has so distorted salaries that physicists are getting drawn into the financial sector. All that has led to an undersupply of people committed to the public sector. That filters up into the whole system of who is in government today.


This reminds me of someone mentioning that as more and more job opportunities became available to women, our education system started to erode in this country.

____________________________________________


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Wednesday, August 17, 2016 9:11 AM

SECOND

The Joss Whedon script for Serenity, where Wash lives, is Serenity-190pages.pdf at https://www.mediafire.com/folder/1uwh75oa407q8/Firefly


Quote:

Originally posted by THGRRI:
Quote:

SECOND

The financial sector has so distorted salaries that physicists are getting drawn into the financial sector. All that has led to an undersupply of people committed to the public sector. That filters up into the whole system of who is in government today.



This reminds me of someone mentioning that as more and more job opportunities became available to women, our education system started to erode in this country.

Aetna CEO Mark Bertolini sent a letter that politely told the Department of Justice that if it opposed his merger with Humana he would fuck them and Obamacare. When Bertolini was a little boy, he decided to go to business school rather than into the Mafia. He could have been a great gangster. What a sad loss for crime.

Here is Mark Bertolini, Aetna CEO. He planned expanding Obamacare into 5 more states in 2017, but when his merger was not approved, he immediately made a 180 degree turn and left 11 states. It was the code of the Mafia, you hurt me I will hurt you:


www.huffingtonpost.com/entry/aetna-obamacare-pullout-humana-merger_us_
57b3d747e4b04ff883996a13?posfhutkt021brzfr

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Wednesday, August 17, 2016 10:47 AM

SIGNYM

I believe in solving problems, not sharing them.


Quote:

Aetna CEO Mark Bertolini sent a letter that politely told the Department of Justice that if it opposed his merger with Humana he would fuck them and Obamacare
Link please???

It's hard to imagine a CEO of ANYthing that would abandon markets in which it was MAKING MONEY. That seems pretty self-defeating, and difficult to explain to your board and major shareholders. My guess is that the reasoning behind this twist is that Aetna felt that it COULD make money in certain markets if it merged with Humana .... they would be able to "streamline operations" (dump duplicative staff), raise prices in a less-competitive market, and do all the things that merged companies do to boost revenues. However, once the merger was nixed, Aetna decided to focus on their more lucrative markets.

One of the things that didn't play out as I expected was that I thought Obamacare was a big wet kiss to pharmas and insurances. It turns out that only pharmas seem to have gotten wealthy out of the deal, the insurances not so much.

The problem of higher costs associated with sicker people is a transient one. Once those people are getting routine, effective medical care, their costs should go down. IT may take about 5 years, AND the care really has to be effective ... chronically ill enrollees who are simply bumping along on high-deductible plans with untreated heart failure, diabetes, and other chronic conditions will still be using ER $ervice$ as primary treatment.

But another problem of the program is the inability to enroll young healthy people - like the people at Pulse - who would bring down the PER PERSON cost of insurance. So the only way to make this health insurance work is to make it truly universal, along with inescapable payments.

--------------
I think it's time you disabused yourself of that pleasant little fairy tale about our fearless leaders being some sort of surrogate daddy or mommy, laying awake at night thinking about how to protect the kids. HA! In reality, they're thinking about who to sell them to so that they can get a few more shekels in their pockets.

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Wednesday, August 17, 2016 11:06 AM

THGRRI


Quote:

Originally posted by second:
Quote:

Originally posted by THGRRI:
Quote:

SECOND

The financial sector has so distorted salaries that physicists are getting drawn into the financial sector. All that has led to an undersupply of people committed to the public sector. That filters up into the whole system of who is in government today.



This reminds me of someone mentioning that as more and more job opportunities became available to women, our education system started to erode in this country.

Aetna CEO Mark Bertolini sent a letter that politely told the Department of Justice that if it opposed his merger with Humana he would fuck them and Obamacare. When Bertolini was a little boy, he decided to go to business school rather than into the Mafia. He could have been a great gangster. What a sad loss for crime.

Here is Mark Bertolini, Aetna CEO. He planned expanding Obamacare into 5 more states in 2017, but when his merger was not approved, he immediately made a 180 degree turn and left 11 states. It was the code of the Mafia, you hurt me I will hurt you:


www.huffingtonpost.com/entry/aetna-obamacare-pullout-humana-merger_us_
57b3d747e4b04ff883996a13?posfhutkt021brzfr



I think the old numbers were 70% wanted universal health care. Don't quote me on that. If the health care industry continues to push back then our next President can start anew. This includes negotiating drug prices.

If Clinton wins as big as it looks she may bring a lot of new governors, senators and hopefully congress members with her. Enough to get something done that makes all in the republican party and health care industry sorry for creating a situation that allowed for single payer health care to pass.

I said before that Trump may quit. Let's hope he doesn't. Let's also hope there are no more skeletons in Clinton's closet that come out. At least not till after the election. As qualified as she is I wish we had a better choice. I would have liked John Kerry. I thought he would have made a good VP choice for Clinton as well.

____________________________________________


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Wednesday, August 17, 2016 2:15 PM

SECOND

The Joss Whedon script for Serenity, where Wash lives, is Serenity-190pages.pdf at https://www.mediafire.com/folder/1uwh75oa407q8/Firefly


Quote:

Originally posted by SIGNYM:

Quote:

Aetna CEO Mark Bertolini sent a letter that politely told the Department of Justice that if it opposed his merger with Humana he would fuck them and Obamacare
Link please???

www.washingtonpost.com/blogs/wonkblog/wp/2016/08/17/aetna-warned-it-wo
uld-drop-out-of-obamacare-exchanges-if-its-merger-was-blocked
/
www.motherjones.com/kevin-drum/2016/08/memo-aetna-pulled-back-obamacar
e-because-doj-opposed-merger-humana

www.huffingtonpost.com/entry/aetna-obamacare-pullout-humana-merger_us_
57b3d747e4b04ff883996a13?posfhutkt021brzfr

http://qz.com/760449/aetna-tried-to-use-obamacare-as-a-hostage-in-its-
merger-negotiations-with-the-us-government
/

Quote:

Originally posted by SIGNYM:

It's hard to imagine a CEO of ANYthing that would abandon markets in which it was MAKING MONEY.

If a CEO's business is breaking even, he can still drop out of a market if he wants to send a message to Obama and Hillary along the lines of "you fucked me, I fuck you." You're making the argument that since you can't imagine it happened, therefore it didn't, even though it did. You should work in politics.

This particular CEO broke his neck in 5 places and after a year he was back at work. This is a tough guy.
https://en.wikipedia.org/wiki/Mark_Bertolini

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Wednesday, August 17, 2016 4:56 PM

SECOND

The Joss Whedon script for Serenity, where Wash lives, is Serenity-190pages.pdf at https://www.mediafire.com/folder/1uwh75oa407q8/Firefly


More info about how Aetna CEO Mark Bertolini has the heart of a mobster:

Why Is Aetna Pulling Out of Nice, Profitable Pennsylvania?
www.motherjones.com/kevin-drum/2016/08/why-aetna-pulling-out-nice-prof
itable-pennsylvania


Last night I linked to a letter from Aetna to the Department of Justice explaining what they would do if their merger with Humana wasn't approved. The answer, basically, was that they'd pull out of a bunch of Obamacare exchanges. As insurance pro Richard Mayhew puts it:

TLDR: Nice exchanges there, be a pity if anything happened.

But Mayhew points out something else. Aetna "claims" that they're not really threatening the Obama administration. They're "losing" money! If the merger isn't approved, they really have no choice but to pull back from the exchanges. It's sad, but what are you gonna do?

And yet —— in 2015 Aetna made $13.6 million in the individual market in Pennsylvania. That's a very healthy 19 percent of premium revenue. But one of the states they're pulling back from is...Pennsylvania. Nice, profitable, Democratic-leaning Pennsylvania. It's very peculiar, isn't it?
www.balloon-juice.com/2016/08/17/aetna-cynicism-and-pennsylvania/

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Thursday, August 18, 2016 10:25 AM

SIGNYM

I believe in solving problems, not sharing them.


Quote:

But Mayhew points out something else. Aetna "claims" that they're not really threatening the Obama administration. They're "losing" money! If the merger isn't approved, they really have no choice but to pull back from the exchanges. It's sad, but what are you gonna do?

And yet —— in 2015 Aetna made $13.6 million in the individual market in Pennsylvania



SECOND, I believe Mayhew is comparing apples and oranges. There are at least four ways to sell insurance (probably more): To individuals through the ACA exchanges where subsidies are available, to individuals privately, and to groups (such as employers) privately and to groups through the ACA.

I don't know what Mayhew means by the individual market. The private one or the exchange one? Or both? Privately-offered insurance comes with A LOT FEWER restrictions that ACA-offered insurance.

The ACA imposes many requirements on insurance companies, http://obamacarefacts.com/obamacare-health-insurance-rules/ primarily that the exchanges must not exclude applicants do to pre-existing conditions. In the ACA, each kind of plan (platinum, gold, silver, bronze) has to include at least the "minimum essential coverage" which includes predefined elements such as screening tests, so that consumers can make apples-to-apples comparisons. ACA-insurance has to spend at least 85% of its income on patient care (There are a lot of dodges on that, but even so, it does serve to limit gouging.) etc.

In addition, the penalty for NOT carrying coverage is cheaper than the premiums, so of course people who feel they don't need to coverage would rather pay the penalty. This definitely skews the insured population to the sick.

I'm not sympathetic to Aetna's arguments. Basically, what they want is a healthcare monopoly in some markets so that they can raise their profits even more, and they're using their leverage on the ACA markets to pressure the Obama administration. They're still treating the health of the USA population as a golden goose of revenue.

But the rules and assumptions governing the ACA just don't pencil out very well, which explains why so many non-profit health cooperatives have gone out of business trying to serve the ACA market.

From the very start, I have been for single-payer healthcare, as has 60-70% of the USA population, and not this clusterfuck that Max Baucus set up, and Obama approved. That would take Aetna, Humana, Anthem, and all of the nightmare insurers out of the picture. They could sell supplemental insurance, but the essentials would be covered.

--------------
I think it's time you disabused yourself of that pleasant little fairy tale about our fearless leaders being some sort of surrogate daddy or mommy, laying awake at night thinking about how to protect the kids. HA! In reality, they're thinking about who to sell them to so that they can get a few more shekels in their pockets.

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Tuesday, August 23, 2016 7:37 PM

JEWELSTAITEFAN


Quote:

Originally posted by reaverfan:
Obamacare Has Been Even More Successful Than Expected


At destroying health care in America, certainly.

Now 7 states have no health care option, they only have one provider, so you are forced to pay whatever they charge.

http://www.bloomberg.com/news/articles/2016-08-16/aetna-quits-most-oba
macare-markets-joining-other-major-insurers

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