http://finance.yahoo.com/news/now-know-real-reason-aetna-132900946.html (http://finance.yahoo.com/news/now-know-real-reason-aetna-132900946.html)
Well, it looks like Aetna lied. Big Surprise! Aetna cited the large losses that the company has incurred from the exchange business â€"
$200 million in the second quarter alone â€" when explaining its decision to roll back its business.These statements, however, appeared to be a dramatic turnaround from the company's first-quarter earnings call in April, when CEO Mark Bertolini said the firm planned to stay in the exchanges and that the company was "in a very good place to make this a sustainable program.
"Now, however, it appears a large reason for the shift in tone was the Department of Justice's lawsuit to block Aetna's merger with rival Humana.
Quote from: wolf39us on August 18, 2016, 09:46:10 AM
http://finance.yahoo.com/news/now-know-real-reason-aetna-132900946.html (http://finance.yahoo.com/news/now-know-real-reason-aetna-132900946.html)
Well, it looks like Aetna lied. Big Surprise! Aetna cited the large losses that the company has incurred from the exchange business â€"
$200 million in the second quarter alone â€" when explaining its decision to roll back its business.These statements, however, appeared to be a dramatic turnaround from the company's first-quarter earnings call in April, when CEO Mark Bertolini said the firm planned to stay in the exchanges and that the company was "in a very good place to make this a sustainable program.
"Now, however, it appears a large reason for the shift in tone was the Department of Justice's lawsuit to block Aetna's merger with rival Humana.
If you think insurance companies suck, stick around. The older you get the more they suck.
https://amp.businessinsider.com/aetna-humana-merger-reason-for-leaving-obamacare-2016-8
This makes three large insurers that have pulled out of Obamacare. I'm not sure I understand the reasons. Well, I understand them but I'm suspicious that the whole story is not being articulated. This move sounds like it's meant to put pressure on the Department of Justice which is blocking Aetna's merger with Humana (one of the other large companies that has already pulled out of Obamacare). From what I understand, Aetna could still profit, but in the short term, it will be involved with expensive litigation with the DOJ, which makes the expensive startup costs of Aetna expansions less profitable for the company's bottom line, or so they say. If the Department of Justice backs down, it sounds like Aetna would stay in the exchanges, and even expand. If they don't get their way, they can threaten to weaken Obamacare to the point of collapse.
If enough insurers pull out of Obamacare, it could cause the system to collapse, which could re-open the door to single payer legislation, but that's my pie in the sky hope. Insurance companies don't want that, and Aetna and the others are sure to calculate that possibility into their strategies. Obama's answer to health care, like the banking scams so far, seems to be centered around subsidizing private insurers, and I'd expect more incentives funded by taxpayers, possibly in the form of supposedly necessary "bailouts" to insure corporate profitability. I also don't think Democrats in Congress want to revisit health care, either. It's an ugly political battle, and Republicans would be sure to point to the failure of Obamacare and use that as a "therefore single payer would be even a worse failure" argument to muddy the waters even more. In addition, politicians, including some Democrats are indebted to insurance companies, and have no intention of killing the golden goose.
For Republicans, they don't even have to indebted to insurance companies. It's just good politics to use against Democrats, and single payer if it ever happens at all, will only be passed by a Democratic congress.
My mother is a VP for a major insurance company. Insurers are losing their shirts on Obamacare according to her. If it's not profitable they will stop doing it and there may be no more deep s reason than that.
Quote from: SGOS on August 18, 2016, 11:06:08 AM
https://amp.businessinsider.com/aetna-humana-merger-reason-for-leaving-obamacare-2016-8
Well, I understand them but I'm suspicious that the whole story is not being articulated. This move sounds like it's meant to put pressure on the Department of Justice which is blocking Aetna's merger with Humana (one of the other large companies that has already pulled out of Obamacare). From what I understand, Aetna could still profit, but in the short term, it will be involved with expensive litigation with the DOJ, which makes the expensive startup costs of Aetna expansions less profitable for the company's bottom line, or so they say. If the Department of Justice backs down, it sounds like Aetna would stay in the exchanges, and even expand. If they don't get their way, they can threaten to weaken Obamacare to the point of collapse.
If enough insurers pull out of Obamacare, it could cause the system to collapse, which could re-open the door to single payer legislation, but that's my pie in the sky hope. Insurance companies don't want that, and Aetna and the others are sure to calculate that possibility into their strategies. Obama's answer to health care, like the banking scams so far, seems to be centered around subsidizing private insurers, and I'd expect more incentives funded by taxpayers, possibly in the form of supposedly necessary "bailouts" to insure corporate profitability. I also don't think Democrats in Congress want to revisit health care, either. It's an ugly political battle, and Republicans would be sure to point to the failure of Obamacare and use that as a "therefore single payer would be even a worse failure" argument to muddy the waters even more. In addition, politicians, including some Democrats are indebted to insurance companies, and have no intention of killing the golden goose.
For Republicans, they don't even have to indebted to insurance companies. It's just good politics to use against Democrats, and single payer if it ever happens at all, will only be passed by a Democratic congress.
Aetna should not be trusted to stay in the exchanges with/without merger. Humana already pulled out and it is likely, Aetna was just posing for the cameras when beginning the merger strategy and declaring it would be staying with the exchange. I do not believe it is in the best interest of any for profit corp to stay involved with obamacare (looking at it from a profit only aspect).
https://en.wikipedia.org/wiki/Aetna
As far as Dem vs Rep, Obamacare had its chance for single payer. At that time, both the house and senate were in democratic control. They did not need the republicans to push it through. Single payer did not go through because of democrat hesitation/obligation-to-corp contributors.
Obamacare is a disaster for the working poor/lower end of the wage spectrum. It is basically a 10% wage cut for a product you cannot use because of deductibles. Locally, the news has been doing reports on people insured getting extreme bills because, in my not so humble opinion, hospitals are deliberately placing out of network employees into these situations to increase their profits. One local example was an $18K bill for a doctor in a different state watching and advising via skype and conveniently out of network.
I am not convinced the collapse of Obamacare would be a bad thing.
merged related topics
Quote from: wolf39us on August 18, 2016, 12:53:52 PM
merged related topics
That's good to know. I got a notification that Nonsensei and replied to my other thread, and when I tried to access it via my email, I kept ending up in the shout box, so I just went to recent topics and found it in this thread. I forgot this thread had already been started. I know it's not a big deal, but I apologize for starting a similar thread. Naw, not really, but I'm happy you combined the threads and eliminated the redundancy. Naw, not really about that either. I really don't care one way or the other.
Anyway, I feel validated by the other opinions here.
Quote from: Nonsensei on August 18, 2016, 12:42:21 PM
My mother is a VP for a major insurance company. Insurers are losing their shirts on Obamacare according to her. If it's not profitable they will stop doing it and there may be no more deep s reason than that.
My first intuition might be wrong. I hate to challenge your mother's claim, but I usually assume that losing their shirts means not profiting as much as they want. But what I do know about insurance companies is that their business practices have continually shown up on the shady side of integrity. This is mostly from NPR, which is the only life news feed that I get, since I don't have TV.
Before I was on Medicare, I had Blue Cross at one time through my employer, and their first response was to try to screw me on a major claim. It was for an emergency operation and long hospital stay for a severe bleeding ulcer. They denied payment saying it was a pre-existing condition. I had only been with that employer for 6 months at the time. It was not a preexisting condition. I never had a problem with an ulcer before that. There was no record or source of information to justify their first response. Later, I heard reports that many insurance companies were routinely rejecting claims using various bluffs to see if the claimant would buy it and leave them alone. However, I hired a lawyer, and they stopped that bullshit after a couple of months.
Another insurance company, many years later, one which I actually liked, had all kinds of special rules you had to follow or the claim would be dismissed. I fucked up once on a cancer operation, and didn't inform them prior to some expensive preliminary tests and they denied my claim, but I pleaded my case (which was ignorance of that rule), and they let me off with a warning. I actually felt good about them understanding I was truly ignorant of the rule and having them decide to pay the claim. Considering what happened with Blue Cross, I thought that was righteous of them.
Now I'm on Medicare, and I don't have to put up with that annoying insurance company wrangling. It's good not to have to screw with insurance companies. I hope this isn't too offensive knowing that your mother is a corporate VP.
Quote from: SGOS on August 18, 2016, 02:20:49 PM
That's good to know. I got a notification that Nonsensei and replied to my other thread, and when I tried to access it via my email, I kept ending up in the shout box, so I just went to recent topics and found it in this thread. I forgot this thread had already been started. I know it's not a big deal, but I apologize for starting a similar thread. Naw, not really, but I'm happy you combined the threads and eliminated the redundancy. Naw, not really about that either. I really don't care one way or the other.
Anyway, I feel validated by the other opinions here.
My first intuition might be wrong. I hate to challenge your mother's claim, but I usually assume that losing their shirts means not profiting as much as they want. But what I do know about insurance companies is that their business practices have continually shown up on the shady side of integrity. This is mostly from NPR, which is the only life news feed that I get, since I don't have TV.
Before I was on Medicare, I had Blue Cross at one time through my employer, and their first response was to try to screw me on a major claim. It was for an emergency operation and long hospital stay for a severe bleeding ulcer. They denied payment saying it was a pre-existing condition. I had only been with that employer for 6 months at the time. It was not a preexisting condition. I never had a problem with an ulcer before that. There was no record or source of information to justify their first response. Later, I heard reports that many insurance companies were routinely rejecting claims using various bluffs to see if the claimant would buy it and leave them alone. However, I hired a lawyer, and they stopped that bullshit after a couple of months.
Another insurance company, many years later, one which I actually liked, had all kinds of special rules you had to follow or the claim would be dismissed. I fucked up once on a cancer operation, and didn't inform them prior to some expensive preliminary tests and they denied my claim, but I pleaded my case (which was ignorance of that rule), and they let me off with a warning. I actually felt good about them understanding I was truly ignorant of the rule and having them decide to pay the claim. Considering what happened with Blue Cross, I thought that was righteous of them.
Now I'm on Medicare, and I don't have to put up with that annoying insurance company wrangling. It's good not to have to screw with insurance companies. I hope this isn't too offensive knowing that your mother is a corporate VP.
I'm not offended at all. Shes the compliance VP, which means it's her job to keep the company she works for on the right side of the law and on the right side of CMS.
I think what you experienced was standard procedure. Insurance companies often deny large claims initially and then when you insist they give in. Its not really meant to deny you coverage, its actually an attempt to spread out losses as much as possible. They basically moved the loss that is your insurance payment to a different part of the timeline which evens out spikes and stuff on the financial charts. Spikes look bad to shareholders even though, in the end the same amount of losses are accrued at the end of the year. Spikes can mean the underwriters are doing a poor job judging which risks are good and bad.
As to whether or not these large companies are really losing money or just not making as much as they want to, I can;t personally verify anything since I'm getting this from a second hand source but she told me they have lost "billions" on Obamacare since it was enacted. Doesn't sound like they're just being cranky. Sounds like they're terminating a bad buisness deal.
She has all sorts of facts on exactly why obamacare has been a financial loss for most insurance companies that I can't remember. If you want I can ask her to send me a more detailed explanation.
As a side note my mother actually worked for BCBS of Tennessee a few years back. They fired her mere months after hiring her, as part of a power play in upper management. Essentially the guy that hired her lost the power struggle and the winners didn't want her around. Pretty fucking scummy to begin with considering she picked up her life and moved it 1300 miles to work for them, but there was also sexual discrimination going on against her and she had it well documented. They knew it, and ended up paying her a quarter of a million dollars to just go away.
She took it because lawyers fees are a bitch. Point is, not all insurance companies are shit but I'm pretty sure BCBS is literally shit. In all ways.
Any society that is going to spend an exponential amount of GDP on medical care ... is bankrupt. It isn't just the insurance companies, it is the whole country. The government can fund it temporarily, like a blood bank dumping ever great transfusions into a hemophiliac. But in the end the patient dies anyway. Health care is where modern civilizations go to die.
Quote from: Nonsensei on August 18, 2016, 06:14:28 PM
She has all sorts of facts on exactly why obamacare has been a financial loss for most insurance companies that I can't remember. If you want I can ask her to send me a more detailed explanation.
Don't knock yourself out, but if it's not too much trouble, I would be curious about this. I've assumed, but not without any factual data, that Obamacare was a windfall for insurance companies. I based that assumption on the government forcing everyone to buy insurance, and subsidizing a large number of those who can't actually afford it. While they eliminated the pre existing clauses, they claim that a huge number of previously uninsured are now buying insurance. Supposedly, the previously uninsured young who don't need medical care are forced to buy insurance, but aren't expected to make many claims. That was supposed to eliminate the need for doctors and hospitals to overcharge the uninsured and bring down medical charges across the board for all consumers, (I suspected that was bullshit, and that we would never see it), but on Medicare I really don't know what an office call costs anymore. But it seems like all this would be good for insurance companies, and I always felt that Obamacare was passed instead of single payer because they were lobbied hard by the corporate world.
Incidentally, while Medicare is comparatively good, it still costs me almost as much as my employer was paying for my insurance when I retired 20 years ago. That's because of out of pocket costs of Medicare part B and my AARP supplemental insurance. But that's apples and oranges. Medicare covers more, and so far, I haven't dealt with deductibles and copayments. However, since I've been on Medicare, my out of pocket insurance costs are still greater than my medical expenses. I don't have prescription drug insurance at all, so that's an out of pocket cost that I'm not figuring in. Although, my prescription drugs are still minimal. but I have talked to one guy who claimed to be taking some drug that costs $20,000 a month. I hope I never see anything like that.
Quote from: Baruch on August 18, 2016, 06:23:10 PM
Any society that is going to spend an exponential amount of GDP on medical care ... is bankrupt. It isn't just the insurance companies, it is the whole country. The government can fund it temporarily, like a blood bank dumping ever great transfusions into a hemophiliac. But in the end the patient dies anyway. Health care is where modern civilizations go to die.
Yeah Baruch, we'll all be sure to pray for you next time you get sick since you won't be using any sort of healthcare..
Quote from: My MomThe rates that the ins companies need to set to offset the cost of taking care of very sick people on obamacare are denied and cut by the insurance commissioners in the States in which the company operates in. Therefore, they can't make any profit and lose money. They (Aetna) lost $500M last year.
The commissioners have final say over the rates, and can lower them without having to explain. And they do.
Also, the risk pool of members on Ocare is much, much sicker than what was originally planned for. Healthy people are not signing up, leaving the ins companies to care for only very sick people, and with lower reimbursement rates. That's a 'lose money by the truckloads" scenario. There is penalty (on people who refuse to sign up) but the rates are so high, even with the commissioners holding them down somewhat, that it's cheaper to take the penalty. Rates are increasing by double digits. Average increase requested by ins companies this year is over 13%. The penalty is static, and was quickly overcome by the increasing insurance premiums.
Quote from: Nonsensei on August 18, 2016, 10:03:24 PM
The rates that the ins companies need to set to offset the cost of taking care of very sick people on obamacare are denied and cut by the insurance commissioners
That is a strange partnership. The regulating agency should have access to the corporation's records, and should know at a glance what rates are un-sustainable. I did hear people talk about paying the fine instead of buying the insurance, but I thought it was just grumbling. The fine would have to be significantly lower than the rate for most people to take the risk of being uninsured. I can understand going with the cheaper option, but in the face of catastrophic risk, it would have to be way cheaper.
Obamacare is completely different than any healthcare system so far devised. It's like congress rejected workable programs currently in use, and in their ultimate wisdom, thought they could build a better program. Although, most Americans don't seem to like Obamacare, some because of it's shortcomings, and some because they would never give Obama credit for anything. Maybe the government can force it to work, but more than likely, they probably don't care. The debate is over, the law has been passed, but it's hard to continually advocate for something that has been so half-heartedly received.
Quote from: Nonsensei on August 18, 2016, 10:03:24 PM
The rates that the ins companies need to set to offset the cost of taking care of very sick people on obamacare are denied and cut by the insurance commissioners in the States in which the company operates in. Therefore, they can't make any profit and lose money. They (Aetna) lost $500M last year.
The commissioners have final say over the rates, and can lower them without having to explain. And they do.
Also, the risk pool of members on Ocare is much, much sicker than what was originally planned for. Healthy people are not signing up, leaving the ins companies to care for only very sick people, and with lower reimbursement rates. That's a 'lose money by the truckloads" scenario. There is penalty (on people who refuse to sign up) but the rates are so high, even with the commissioners holding them down somewhat, that it's cheaper to take the penalty. Rates are increasing by double digits. Average increase requested by ins companies this year is over 13%. The penalty is static, and was quickly overcome by the increasing insurance premiums.
Listening to NPR while driving today, these specific points were all confirmed by the guests on "Fresh Air" or maybe it was the Diane Reams Show. Also, apparently Obama was quoted saying, "It may be time to revisit single payer." That sounded like an indirect way of admitting defeat.
Quote from: AllPurposeAtheist on August 18, 2016, 07:25:44 PM
Yeah Baruch, we'll all be sure to pray for you next time you get sick since you won't be using any sort of healthcare..
You and the Single Provider can kiss my healthy ass ;-)
I am a human being, of infinite worth, and socialist ... so I claim all your quatloos ... because I am needy.
The Soviet Union of medicine will save you. France has good public health care ... because they don't pay for Nato.
See, this is why I believe basic health care should just be provided as a human right, not as a privilege -- as long as a corporation is looking to profit from it, they are going to put their profit motives ahead of the consumer's health needs.
Quote from: trdsf on August 21, 2016, 09:25:13 PM
See, this is why I believe basic health care should just be provided as a human right, not as a privilege -- as long as a corporation is looking to profit from it, they are going to put their profit motives ahead of the consumer's health needs.
OK define basic health care.
Quote from: chill98 on August 21, 2016, 09:57:24 PM
OK define basic health care.
This is a bullshit question. How about just being able to have an emergency appendectomy or get treated for cancer without having to sell everything and then go bankrupt anyway, or just see a fucking doctor in the first place so maybe major medical action later doesn't become necessary? I'm sick to the fucking teeth of people pretending that's a serious objection to universal health care. If you have a serious pain in your chest, are you really going to stop and ask if that's a basic medical problem, or are you going to go to the emergency room? If you can't walk without a limp, are you going to question if it's medically necessary to get that checked out, or are you going to make an appointment with your GP?
Personally, I'm satisfied with that which is determined medically necessary by a doctor. So, a boob job for the sake of having 40Es, not so much. Post-mastectomy reconstructive surgery, sure.
Also, advertising prescription drugs should be banned. The general public does not have a background in pharmacology and has no business making prescription decisions -- that's for the trained professionals, not the guy watching football on Monday night. And maybe, just maybe, pharmas could lower their prices since they won't be wasting millions on advertising at people who aren't trained to make drug decisions.
Quote from: trdsf on August 21, 2016, 10:29:01 PM
This is a bullshit question. How about just being able to have an emergency appendectomy or get treated for cancer without having to sell everything and then go bankrupt anyway, or just see a fucking doctor in the first place so maybe major medical action later doesn't become necessary? I'm sick to the fucking teeth of people pretending that's a serious objection to universal health care. If you have a serious pain in your chest, are you really going to stop and ask if that's a basic medical problem, or are you going to go to the emergency room? If you can't walk without a limp, are you going to question if it's medically necessary to get that checked out, or are you going to make an appointment with your GP?
Personally, I'm satisfied with that which is determined medically necessary by a doctor. So, a boob job for the sake of having 40Es, not so much. Post-mastectomy reconstructive surgery, sure.
Its not a bs question. Each and everything provided as 'basic medicine' costs money. Your appendectomy example is perfect. Why the hell does it cost so much for an operation that has been perfected many, many years ago? And its not just me wondering these things:
http://www.cbsnews.com/news/cost-of-an-appendectomy-reddit-user-posts-55000-bill/
http://www.livescience.com/36277-appendicitis-medical-care-costs.html
The basic topic is Aetna (not single payer) and here's snippets from marketwatch opinion article:
1. They’re a scam. The entire health-insurance industry consists simply of taking our money â€" and then paying us back around 80 cents on the dollar, or less.
3. They waste money hand over fist. Aetna said it has lost $430 million on Obamacare plans during the first two years. During that same time the company spent $23 billion on administration, marketing, paperwork, junkets, bonuses and other overhead. That’s a ridiculous 26 cents for every dollar it paid out in actual benefits.
4. They’re booming.... Since Obamacare passed in March 2010, Aetna’s stock has rocketed 270%, with dividends reinvested.
5. They avoid sick people. The No. 1 way to make a profit in health insurance isn’t somehow to provide “better†insurance or “better†service for customers.
It’s to sell health insurance to people who won’t need it.
6. They deny treatment whenever they can. It’s not malice â€" it’s math. Private health insurers only make money if they keep payouts below premiums.
http://www.marketwatch.com/story/aetna-obamacare-and-health-insurers-10-dirty-secrets-2016-08-19
Now a further question for you. Do you have any idea how much it will cost to implement single payer? The estimates I have read vary widely.
Obamacare did nothing to address the actual cost of healthcare in the USA. It just shifted the burden onto people in general. Robbing peter to pay paul; and in this case, its robbing working slobs to pay for Aetna's private jets.
Quote from: chill98 on August 21, 2016, 11:24:10 PM
Its not a bs question. Each and everything provided as 'basic medicine' costs money. Your appendectomy example is perfect. Why the hell does it cost so much for an operation that has been perfected many, many years ago? And its not just me wondering these things:
No, it's bullshit. It completely misses the point of health care and the fundamental question of whether it's a right or a privilege.
The point about the excessive cost is, however, exactly on target: my sister works for an insurance co, and the final expenses for my uncle's last stay happened to cross her desk. If there had been no insurance, they would have billed my grandparents $89,000. However, they were perfectly happy to accept a tenth of that from the insurer and call it even.
Clearly, the real cost is not $89,000, if they were only going to bill $8,900. Why were my then-eightysomething grandparents expected to be liable for ten times what they ultimately charged a very profitable corporation who could have paid the full amount without a noticeable bump in their bottom line?
And this goes back to what I said about taking the profit motive out of providing health care, because it obviously gets in the way of actually
providing health care.
Quote from: chill98 on August 21, 2016, 11:24:10 PM
Obamacare did nothing to address the actual cost of healthcare in the USA. It just shifted the burden onto people in general. Robbing peter to pay paul; and in this case, its robbing working slobs to pay for Aetna's private jets.
I'm going to defend the ADA here -- because of the ADA, I got affordable and usable medical coverage for the first time in fifteen years. What had been offered to me by my agency (I was working as a long term temp) would have cost me a third of my pay, and wouldn't have covered a thing until I was already $5,000 out of pocket. ADA coverage wasn't perfect, but it was a lot more affordable and a lot less restrictive on what it'd cover.
If you want to complain about Aetna's jets, the problem is for-profit medical insurance, not the ADA, and the solution is single-payer, or a public-private hybrid system where private insurers are not allowed to deny coverage. And the ADA didn't make spend their profits on non-medical things, that was Aetna's decision. It may not work perfectly but it's better than the Republican program of hoping people die before they're old enough to qualify for Medicare and can't be denied state coverage anymore.
Quote from: trdsf on August 21, 2016, 11:45:22 PM
No, it's bullshit. It completely misses the point of health care and the fundamental question of whether it's a right or a privilege.
Again, the TOPIC was Aetna. I just asked you to define 'basic healthcare'. So you drifted and I followed along. You still haven't explained how basic health care is a right. Beyond that, how can you call it a right when you are obliged by law to pay for it? I understand 'right of free speech' but the government doesn't demand I attend any particular 'free speech' or pay a fine (tax). Social security tax isn't a right but this isn't that either. Its being forced to fund a bunch of private corps - most of the time, chosen by your employer for you. And that shitty employer offered bronze plan that the ACA requires you to take prevents you from getting a better silver plan cuz you don't qualify for the tax break/help with premiums - your employer has found one that pays 60% of the doctor bill AFTER you have met your $6600 deductable - minus 9.5% of your wage.
Quote from: trdsf on August 21, 2016, 11:45:22 PMThe point about the excessive cost is, however, exactly on target: my sister works for an insurance co, and the final expenses for my uncle's last stay happened to cross her desk. If there had been no insurance, they would have billed my grandparents $89,000. However, they were perfectly happy to accept a tenth of that from the insurer and call it even.
The question is, why the hell do people need insurance to negotiate a reasonable price? Maybe the answer is regulating the amount doctors/hospitals can charge, like a public utility. Maybe the law should be all hospitals have to print a menu of costs upfront and if I can find a same/cheaper place to get my xray, the insurance has to pay for it. I've heard the whining about then doctors will quit. Well fine, let 'em get jobs flipping hamburgers like the rest of us poor working slobs.
Quote from: trdsf on August 21, 2016, 11:45:22 PM
I'm going to defend the ADA here -- because of the ADA, I got affordable and usable medical coverage for the first time in fifteen years. What had been offered to me by my agency (I was working as a long term temp) would have cost me a third of my pay, and wouldn't have covered a thing until I was already $5,000 out of pocket. ADA coverage wasn't perfect, but it was a lot more affordable and a lot less restrictive on what it'd cover.
Your agency must be one of the exempt (under 50 employees) places. Or your agency is trying to get around various tax rules:
http://www.nytimes.com/2015/02/15/business/yourtaxes/employee-or-contractor-health-care-law-raises-stakes.html
Under the ADA, your coverage could only cost 9.56% (max) of your wage (I do not know what dependent allocation is) but could be up to $6650 deductable (max) ($12,700 family plan) to be considered 'affordable'. And thats what my temp agency offered me last december to get in line with the ACA. They have offices in multiple states and adding all the places together puts them over the employee limit. In my state? nope. In several other states they are in? Nope. But add it all together (and ACA requires that-so they said) its over the line. Back to the avoiding obligation above, there is a hefty penalty for offering an insurance that does not meet the ACA minimum. So if your employer is playing with the rules as outlined in the above link, the fine is something like 35K PER employee. BUT I don't know how the ACA cost rule applies to family plans. My situation is single and I don't feel like digging out the paperwork from last year.
If you agency does offer you ACA qualified insurance, you will have to take it. Technically I mean. I know several people taking a chance on getting caught signed up for ACA gov sponsored health insurance because the employer type is so awful. Simply put, they have health issues and can't afford a 20-50% (family) of their annual income in deductions (plus premium). So where exactly did the ACA help people afford insurance? I am talking about the majority of people who are working for some company that offers this kind of insurance.
Quote from: trdsf on August 21, 2016, 11:45:22 PM
If you want to complain about Aetna's jets, the problem is for-profit medical insurance, not the ADA, and the solution is single-payer, or a public-private hybrid system where private insurers are not allowed to deny coverage. And the ADA didn't make spend their profits on non-medical things, that was Aetna's decision. It may not work perfectly but it's better than the Republican program of hoping people die before they're old enough to qualify for Medicare and can't be denied state coverage anymore.
Well, just to remind you, the topic was Aetna and it wasn't me complaining, it was market watch. Denying coverage is exactly what made insurance work for years and years. Just as Market watch points out. There are people who have benefited from the ACA but I see a shitload of problems.
I even asked you what single payer would cost because I have come up against a lot of conflicting information. I guess you have no idea cuz you haven't looked beyond your own needs and wants.
And wtf do republicans have to do with the obamacare situation? It was a Democratic House and Senate and President that passed this law. It was a Democratic house/senate/president that did NOT produce a single payer system when they had the opportunity.
HOUSE:
Democratic yea (219)
Democratic nay (34)
Republican nay (178)
SENATE:
Democratic yes (58)
Independent yes (2)
Republican no (39)
Republican not voting (1)
https://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act
Follow the money! You see, I think the ACA is terrible. You seem to be confused about what people are really getting with the actual ACA as implemented. The only thing saving you financially is the outside-of-your-employer access. The majority of people still cannot afford an emergency appendectomy and they have eaten a 9% wage loss. Same thing with cancer. The 6600 dollar deductable starts all over again Jan 1st. You couldn't afford your health insurance for 15 years and neither can the people 10-15 years younger than you.
http://www.huffingtonpost.com/dan-arel/hillary-clintons-war-on-u_b_9080772.html
Hoping people died? Not exactly:
QuoteSo we can observe that for men, for example, almost 54% of the them could expect to live to age 65 if they survived to age 21, and men who attained age 65 could expect to collect Social Security benefits for almost 13 years (and the numbers are even higher for women).
https://www.ssa.gov/history/lifeexpect.html
1/2 of them would be dead before 65. Not all of them.
Quote from: chill98 on August 22, 2016, 04:53:32 AM
The question is, why the hell do people need insurance to negotiate a reasonable price? Maybe the answer is regulating the amount doctors/hospitals can charge, like a public utility. Maybe the law should be all hospitals have to print a menu of costs upfront and if I can find a same/cheaper place to get my xray, the insurance has to pay for it. I've heard the whining about then doctors will quit. Well fine, let 'em get jobs flipping hamburgers like the rest of us poor working slobs.
Only cogent point you've made. The rest just tells me you weren't really interested in what I had to say.
Quote from: trdsf on August 22, 2016, 03:34:19 PM
Only cogent point you've made. The rest just tells me you weren't really interested in what I had to say.
If you were able to refute my claims you would, but I think you haven't put any time into researching the various positions.
You refuse to even recognize it was the Democrats that inflicted this TAX on households! Worse yet if they actually get sick. The median income for individuals is $29K. 6-9% just for premiums PLUS the 5 to 6 (to 12K family) deductible is a hell of an income hit if you are sick (5K deductible is 17% of your gross at the median individual income). 5% premium puts your liability at 22%. 9% premium puts your liability at 26% of your gross. Household income of 52K with a $12,700 deductible is 24% of that households gross income for the year. Fun Stuff the ACA!!
Oh and its even richer than that. That shit insurance your employer offers you is 100% deductible at tax time for your employer. Stuck with a 5K bill using that crap? Well, if its less than 25% of your gross AND you do not pay it off 100% in the tax year you are claiming, you don't get to deduct it on your taxes. You paid 10% of the bill? Not tax deductable unless that 10% is 25% of your gross income.
Did you follow the money even? Healthcare is approx 17% of GDP. If they manage to lower the cost the GDP drops. Get it yet?
Quote from: chill98 on August 21, 2016, 09:57:24 PM
OK define basic health care.
Unfortunately, that costs about $100,000 per lifetime, and the price will escalate as soon as the government is paying for it. Most human beings don't earn that much after taxes and expenses, in their whole lifetime. Shall we forgo eating for 60 years, to save money for health care?
Frankly I think all Americans ... but nobody else, deserves to not have to work for a living, and live the big easy ... at the expense of the non-Americans. That is what America has been all about since Jamestown. Get someone else to pay for our stuff. How
does France get away with it? They didn't pay for the Cold War, the Korean War, the Vietnam War nor the War On Adjectives.
In the last two administrations, the US gave away 22 trillion dollars of IOUs ... I hope to die before the collection agency comes to collect that. That doesn't include health care for 7 billion people for 60 years or so each .. even if we stop having any babies. In the end your appendectomy will be instructions to you, by Seri or Cortana, telling you how to do it on yourself. A Soviet doctor stuck in Antarctica had to do that, pre-I-Phone ... and got a medal for it. That is all you can afford, because iPhone and Android already own your souls.
Quote from: trdsf on August 21, 2016, 10:29:01 PM
So, a boob job for the sake of having 40Es, not so much.
Where are your priorities man? Big boobs should be a right.
Corporations never complain when they are making money…..when they start complaining,,,,little peeps about to be shit on.