Fixing Obamacare

Robert Rossana, a professor of economics at Wayne State University, says President Obama now finds himself in the kind of mess that results from "central planning."
Dec 17, 2013

 

The professor wrote recently in his "My Policy Views" blog about the problems central to the startup of the Affordable Care Act and its website.

"The website fiasco is just the beginning of the problems that result when politicians try to micromanage a complex health care sector," Rossana wrote. "The president is now playing 'whack-a-mole' as he attempts to fix the problems caused by the Affordable Care Act, but each 'fix' creates another problem. For example, health insurance prices may need to be adjusted upward if people are permitted to keep their existing insurance policies, resulting in riskier individuals buying insurance in the exchanges."

To read the rest of Rossana's blog, "Fixing the Healthcare System," CLICK HERE.

The opinions expressed by local bloggers are not necessarily shared by the Grand Haven Tribune or its employees. They are the sole opinion of the bloggers, who are not employed by or compensated by the Tribune.

Comments

BigSwed

We(and the media)need to take a much closer look at the PROFITS of the major health care providers. None of the prime time television programs have even looked at profits. Of course insurance companies will claim they need to increase premiums to cover the costs of higher risk clients. It is ALL about profits and nothing more. My God, take a look at the profits they are already making! We are one stupid bunch of voters.

Say no to new taxes

We're the only industrialized country in the world that doesn't provide healthcare for it's citizens. We spend twice as much as the number two nation, yet have poorer results. Republicans slam Medicare (which is a single payer system) but find me one that doesn't take advantage of it when they turn 65. The rollout of healthcare.gov was a disaster, but that shouldn't overshadow the need for REAL health care reform. That can only happen when the "lobbyists" and "special interest groups" are taken out of the discussion. Till then, expect higher premiums and deductibles.

Tri-cities realist

We're the only industrialized country in the world that has our Constitution, which apparently used to mean something. We may spend twice as much, but where does the latest treatment, research, etc. occur? Innovation is not free. And the oft cited "poorer results" is a sham as Vlad previously pointed out.

Your name is say no to new taxes, yet you advocate for single payer? Ah, irony, I get it.

I think we need to differentiate between health care reform, and health insurance reform. Instead of obamacare or single payer, or any other govt mandated scheme, why not return health insurance to just that, insurance for major medical conditions, and let us pay the doctor directly when we go see them for a physical, the flu, or any other typical non-emergency type condition. Major medical insurance policies are relatively inexpensive, the savings in premiums could be put into a HSA, for the individual to manage their own health care as they see fit.

Most of us don't buy auto insurance expecting it to cover oil changes, gas, tires, brakes, etc. (you know those inconvenient things we know will happen), so why should we expect the same from health "insurance"?

Lanivan

"And the oft cited "poorer results" is a sham as Vlad previously pointed out." I don't recall any attempt by Vlad to refute this claim. Would you provide unbiased links to show us that the US does not spend more on health care with poorer results when compared with other other developed countries? Please, and thank you in advance.

"..insurance for major medical conditions, and let us pay the doctor directly when we go see them for a physical, the flu, or any other typical non-emergency type condition." Just for your edification: This type of policy is available under the ACA, just waiting for you to sign up.

Oh, and comparing US health care costs, which encompasses a whopping 24% of the US Federal budget - the largest slice of the budget pie, 1/4 of the budget, mind you - with car insurance, oil changes, gas, tires, brake, etc expenses, is lame, no?

Tri-cities realist

1) hopefully Vlad can help me out and provide the link to his comments made previously in this forum. I'll look for it too, but might take a day or 2. It basically showed that the studies which rank our healthcare low, do so because it is not as socialistic as other countries.

2) this type of policy was available before obamacare, ACA wasn't necessary.

3) I was comparing health INSURANCE to another type of insurance, namely auto. Don't like that analogy? How about homeowners insurance? Do you expect your policy to cover a new roof, someone to clean your house, or any other routine cost related to your home? Perhaps you do, but I don't. Insurance is supposed to cover the risk of the unforeseen, that someone could not otherwise afford. Why should health insurance cover typical visits to the doctor, when other types of insurance only cover the more catastrophic events? When people don't have to actually pay for services, they tend not to care about the costs, so the competition among providers is lax. I am for putting the individual back in charge of their health care, as much as possible. Is that so wrong?

Lanivan

3) Perhaps you do not have a full understanding of the ACA. It is major health reform which leaves in place a private health care system that follows free market principles; it largely relies on private companies and the free market via capitalistic insurance exchanges.

The various levels of plans available via private insurers must now cover basic common sense preventive health care measures. This 'insures' that the population is getting good basic care, which ultimately leads to a healthier, more productive, and ultimately more financially stable work force.

Your argument regarding the competitive aspect of the ACA is not convincing. The ACA encourages competition among insurance companies via the market exchanges. Your comparison of health insurance and homeowners insurance is equally silly. My annual homeowners policy costs about 50% of my monthly health insurance premium. Have you actually been affected - either negatively or positively - by the ACA?

Tri-cities realist

I understand ACA, it is your comments that have me confused. I suggested a major (catastrophic) medical plan, and letting people pay for doctor visits. You said a plan like that is available under ACA. Now you (correctly) state that for plans to comply with ACA they must cover preventative health care. So a catastrophic plan (with individuals paying out of pocket for doctor visits) is not available now due to ACA. Apparently you missed my point which was to return health care insurance, to being just that, insurance against the financial risk posed by expensive unforeseen events, you know, kind of like your home and auto insurance.

"Your argument regarding the competitive aspect of the ACA is not convincing" huh??? I was referring to the tendency of people not to shop around for less expensive services (lab testing, x-rays, etc.) since they don't actually pay for it. They sense that "my insurance company pays, so why should I care what it costs". This behavior leads to less competitive costs by providers. If people had to pay out of pocket, they might shop more wisely.

Yes I have been negatively impacted by obamacare. My employer and insurance provider will be raising our rates (with the company absorbing half of the increases) since our plan didn't comply with the ACA's new rules. So yes, I have a dog in this fight, which is why I get so mad at the Feds meddling in things that they shouldn't.

Vladtheimp

I attempted to provide the link but all links seem to trigger the spam function which precludes accepting the comment - it appears all the intellectuals who object to being given links to disprove their assertions have won the day.

You can find the article "US health care: A reality check on cross-country comparisons" on the American Enterprise Institute website from July 112, 2012. Before the intellectuals poo-poo the source, you will note that the article is written by two economics and finance professors, one from University of California, one from the University of Minnesota, and the health attaché to the US mission to the Organisation for Economic Co-operation and Development, 2005-2009. It includes 25 referenced sources. Obviously, it's thus biased and useless.

Lanivan

Oh yeah - the AEI, home of John Bolton, Paul Wolfowitz, Dick and Lynne Cheney, and Rummy, of course. I recommend another study - Annual Reviews. The Hurrider I Go the Behinder I Get: The Deteriorating International Ranking of the US Health Status, 2012.

This study argues that the very dramatic rate of deterioration in US health outcomes and mortality rankings since the 1950's has more to do with income and economic inequality, and that these important factors affect a wide range of health outcomes. And that about 1/3 of all deaths can be linked to inequality. Most disturbing is the statistic that life expectancy has been diminishing or stagnating for women in 20% of US counties since the 1950's.

Vlad's link does not successfully prove, no way-no how, that the methodology of cross-country comparisons is a sham. Nice try, tho.

Tri-cities realist

Aha! Vlad's link = bad, Lanny's link = good, and it all goes back to inequality, I get it now!!! Actually if inequality is to blame, then you've made Vlad's point: US health care is "sub par" because it is not socialistic enough. Way to go Lanny!

And so I will ask for the umpteenth time, how do we fix this inequality problem?

Lanivan

Actually, pre-Obamacare health care was very socialistic in the way it reimbursed hospital uncompensated medical costs with taxpayer money. Obamacare eliminates that whole redistributive process.

Vlad's link is not bad (many members of the supporting think tank are definitely bad). I read it and felt that it made some good points regarding methodologies. I do not feel it's underlying argument was convincing enough to explain the steady drop in outcome ratings since the 1950's. Their premise certainly could explain some of it, but I thought my link supported the premise of inequality versus methodologies as the core contributor much more convincingly.

I have attempted to answer your question a few times, the last time with several bullet points. You did not respond - maybe you didn't read it? After swimming, hot tub, sauna, and shower this morning, I'm more in the mood to shop than talk politics, so maybe I can have a rain check this time?

Tri-cities realist

No problem Lanny, shop away. Sorry, I don't recall seeing your bullet points. Although I did get a chuckle out of "Obamacare eliminates that whole redistributive process". Keep the jokes coming!

Lanivan

It took the high dose of therapeutic activities to get me in shape to face the 'Saturday before Christmas monster', but I managed to do a little damage. I am now ready to ponder wealth redistribution and inequality.

Consider my "Obamacare eliminates that whole redistributive process" as my Christmas present to you, but think about it a little before you bust a gut laughing. It's true!

Tri-cities realist

How does the ACA fund the subsidies to those with low incomes? I'll give you a hint, it starts with the letter "R", and is not "Republicans". Good luck.

Mystic Michael

No. The problems aren't due to "central planning". They're due to the President trying to be all things to all people, and to keep everybody happy. That's a sure-fire recipe for problems - and he should know that.

A single-payer system would represent much more government intervention than the current system, yet would be much simpler and more straightforward to implement and administer. Many other countries manage to do it very successfully. So why not us?

Tri-cities realist

"be all things to all people", seems an awful lot like central planning to me.

"much more government intervention than the current system, yet would be much simpler and more straightforward", talk about an oxymoron.

Why not us? Because we stubborn Americans tend to value something called liberty, and the freedom from our govt telling us how to live our lives.

Lanivan

"Because we stubborn Americans tend to value something called liberty, and the freedom from our govt telling us how to live our lives."

Although a noble thought, and flowing prose, this statement is stunning in it's naivete` and simplistic logic. Far right-wing conservative leaders, who would have us believe they value liberty and small government, are constantly demanding that government tell us how to live our lives - with their notions of 'family values', 'religious beliefs', and 'small government', of course. They constantly craft, through the bill mill ALEC, conservative think tanks, and corporate money and lobbyist influence, legislation that at it's essence destroys liberty, that chips away at the rights of US citizens, that provides loopholes that the super wealthy can buy their way out of, that limits opportunities and options for citizens and shatters the American Dream, that denies science and history, that contradicts their own previous proposals and legislation, and finally, but certainly not least, uses and abuses, for their own advantage, the beliefs of honest Americans, promoting the sham that they are motivated by conservative principles, and are working for life, liberty, and the pursuit of happiness.

Tri-cities realist

Naive? Really? Why not just call me stupid if that's what you think I am (Trib staff, it's ok if she does, I can take it, no need to censor). My beliefs are rooted in the philosophies that founded this country, and have made us the envy of the world, you know that "shining city on a hill". That may seem quaint to you, but to some Americans, we pride ourselves in promoting liberty and freedom, having the lesson of history show us what can happen with fascism, socialism, and communism.

And while you may believe conservative legislators do more harm, the left has done more to shatter the American Dream and traditional family.

Lanivan

I chose my words carefully. If I thought you were being stupid, I would have chosen that word. But I don't think that now, have never in the past, nor can imagine in the future. Upon reflection, I have come to the conclusion that I don't think any regular on this forum is stupid....except for you-know-who...:-D

I stand by my comment 100%. Freedom and liberty are not even a blip on the screens of the current far-right wing leadership. According to their corporate master handbook, they will use the words - a lot - to convince you otherwise, but upon closer inspection, their actions do not measure up.

I respect your vision - it is a noble one, but in our highly cynical political environment, it is also naive`.

Tri-cities realist

Well I will continue with my noble vision. I've never said I agree 100% with the conservative "leadership". But given the alternative on the left, I will support them when I agree with them, and voice my displeasure (at a minimum) with those who try to take away our rights.

Lanivan

So basically you are agreeing with me.

Tri-cities realist

That my vision is noble? Yes, I agree with you on that.

Lanivan

I just spent the last hour reading Professor Rossanna's blog. It reads like a less articulate Vlad comment. In fact, the professor sounds an awful lot like Vlad......hmmm - Vlad is this guy YOU??

Anyway, his referring to everybody except him as "economic illiterates" is a bit off-putting. And he might be a swell economist, but a history buff he ain't. He seems to have a very unbalanced, jaded, negative, and biased viewpoint of nearly everything American. But I suppose I'm just being "economically illiterate".

Barry Soetoro

It has a familiar ring to it, doesn't it?

deuce liti

We have socially paid police force, fire service, etc. We have a terrible health care system where doctors have become either drug company whores or insurance slaves.
We have people choosing between keeping their arm or their home. We have so many cases of medical malpractice it should shame us. I know it isn't all black and white, but with the price of beef through the roof let's try it.

Sorry in advance for the comment vomit.

Former Grandhavenite

One mostly overlooked thing I've always found weird about the ACA or 'Obamacare' is the fact that the subsidies to help the poor pay for their plans are distributed via a tax credit, instead of an up-front reduction in the premium. If a person signs up for a plan costing $300/month but qualifies for a $150/month subsidy, my understanding is that they actually have to pay the $300 bill every month. It's only the next year when they file their taxes that they would get to claim an $1800 credit to account for the subsidy.

This part of the law was clearly designed by someone who's never been poor. If you're having trouble making ends meet, you don't have that extra $150 to shell out every month, even though you'll eventually get it back. The fact that you'll be getting a nice refund in a year is no consolation when you have $200 in your bank account with a $300 premium due. The subsidy should be built right into the premium that you pay at the time that you pay it. It would be hard to evaluate before the fact whether or not someone qualifies for the subsidy without knowing their full tax and income situation, but there has to be a better way than forcing people to essentially make an interest free loan by overpaying the premium every month.

Tri-cities realist

If you think it was a plan designed to help the poor...

It is all about getting more and more people addicted to bigger govt. When people on the govt dole go to vote, will they vote for those who gave them their freebies, or those that would take them away, and actually have them work for a living? Those who don't see this are blind, naive, or just have their heads buried so far up their...

Lanivan

There's that 'n' word again! I assume you are not including in your soliloquy the Republican population that signs up for insurance policies via insurance marketplace exchanges, those who have worked steadily for decades, having insurance via their employers but now find themselves unemployed, uninsured, or worse yet, unemployed, uninsured with pre-conditions, and finding it slow going finding a job that offers the benefits of the former, or the tens of millions who work 1-2 jobs for low wages with no benefits, including insurance.

so now you're calling me blind?

Tri-cities realist

I don't care what letter they have next to their name, I will oppose those who favor creating dependency on the govt.

I was thinking more along the lines of my 3rd choice.

Lanivan

Gee - you got me there! I favor good roads that aren't littered with potholes, safe bridges and interstates; clean air, water, and food; police and fire protection. I suppose this means I'm dependent on government.

What a gentleman.....And Merry Christmas to you, too!

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