Here's the problem with the ACA. It's simple.

[cali]

DISCLAIMER: Yes I support the ACA. Yes, I hope it helps a lot of people get needed medical care.

The problem: Insurance companies. They will look for any loophole in order to be more profitable.

I've noticed that anytime someone reports a less than glowing experience relating to the ACA, there is a cadre of people who leap in to say that they don't believe it!. I can understand the faith these folks have in the President, but he doesn't control the insurance companies.

[lostincalifornia]

1. I understand your point, but in a different connotation, the problem is the ACA isn't simple

[ProSense]

2. This

The problem: Insurance companies. They will look for any loophole in order to be more profitable.

I've noticed that anytime someone reports a less than glowing experience relating to the ACA, there is a cadre of people who leap in to say that they don't believe it!. I can understand the faith these folks have in the President, but he doesn't control the insurance companies.

...makes no sense. What does "faith" in the President and the fact that he "doesn't control the insurance companies" have to do with the fact that the insurance companies suck and most of the stories are bullshit?

[cali]

8. of course it makes sense.

what doesn't make sense is your endless adoration and worship.

[ProSense]

31. "what doesn't make sense is your endless adoration and worship."

No, what doesn't make sense is your constant desire to feel superior.

I mean, you started an OP to call out the insurance companies, but had to throw in a self-righteous anti-Obama dig.

[1StrongBlackMan]

38. +1000

Which was the sole purpose of the post ... to poke.

[Ed Suspicious]

20. faith wasn't derogatory in this instance. I think you would be well served to read more critically.

I believe cali is saying that the reason the ACA is occasionally falling short for some people has not much to do with the president, it has a lot to do with singularly focused insurance companies. They skirt the spirit of the law in order to maximize profits at all costs.

[ProSense]

33. It's was.

"faith wasn't derogatory in this instance. I think you would be well served to read more critically."

...but it will fool some people.

I've noticed that anytime someone reports a less than glowing experience relating to the ACA, there is a cadre of people who leap in to say that they don't believe it!. I can understand the faith these folks have in the President, but he doesn't control the insurance companies.

How is "faith" in the President relevant? The implication is that people are debunking the stories, not because most of them are wrong or pure BS, but because of..."faith."

Also, debunking the stories has nothing to do with believing the President controls the insurance companies.

[ProfessorGAC]

66. That's The Point You Took?

If so, the point was a "well, duh!" That's always been true.

What isn't explained is how that is due to ACA. Of course, that can't be explained, because there is no connection. If it was that way before, and the point of ACA was to expand the insurance pool, minimize uncovered people, reduce the use of emergency rooms as immediate care facilities, and increase the overall pool of payees to reduce the overall cost per person, then the insurance companies not changing is a disconnected issue.

If you supported single payer, you have a lot of very good company. But, that has nothing to do with ACA. ACA was a poliltical compromise because single payer was a political non-starter. I think it would be way better, too. But, it was never going to happen and incremental improvement should be praised if only because it's better.

The point of the OP was to make a less than subtle point about the poster's displeasure with the administration who has not achieved every single thing they said they wanted to do and that most of us here would have cheered.

It's a superiority complex that is so transparent, it's surprising you didn't catch that.

[arcane1]

3. A lot of people will be dealing w/insurance companies, and their bullshit, for the first time.

Those of us who have had experience banging our heads against the wall fighting insurance companies are going to have a different perspective. Many of those new to the system will likely blame "Obamacare" even when they are getting the same service the rest of us have had for years.

That's my theory, anyway.

[JaneyVee]

4. Are you saying insurance companies are run by piece of shit used car salesmen?

[Mojorabbit]

6. Well that was a helpful post. nt

[Autumn]

11. It's just one of those "feel good" posts

[JaneyVee]

16. C'mon, its Saturday night. Join me in feeling good.

We're just 2 anonymous souls surfing the information superhighway.

[Autumn]

19. It is a feel good Saturday. A beautiful snowy day

And I feel fine.

[JaneyVee]

18. Thank You.

[TheKentuckian]

15. No, I would not disparage piece of shit, used car salesmen in such a way as to compare them to those

wicked, twisted, soulless, greedy, malicious, cancerous dumpster fires that run the parasitic cartel.

[Autumn]

5. No Obama does not control the insurance companies. Obama got the ACA passed

and that's a good thing. There will be glitches and it's fine for people to post about them. But It's here and it's going to get better.

[babylonsister]

28. wOOt! What you said! nt

[uppityperson]

49. Yup. eom

[phantom power]

7. As I've said before, this is a game with opponents.

Very powerful, very wealthy opponents.

[tavalon]

48. Even those of us with so called cadillac plans (code for unionized people)

are getting fucked right now as the insurance companies grab for the last little bit of green they can.

[steve2470]

9. Single payer one day, hopefully much sooner than later nt

[DanTex]

10. True, ACA isn't perfect.

But, for some reason, that lack of perfection drives some teabaggers/DUers into an anti-Obama rage in which they try to blame the president for everything that is wrong in the world. Bizarre, I know. It gets to the point where certain teabaggers/DUers will (intentionally) fail to take advantage of ACA, because the temptation to blame Obama is evidently greater than the need for healthcare.

[BrotherIvan]

12. This is why a public option is absolutely essential.

Insurance companies are doing and will do everything to pay out as little as possible for care. It's an indisputable fact. I would happily pay much more for a medicare plan because I know they are not out to screw me at every turn. It's that simple.

[WhaTHellsgoingonhere]

13. Oh, this thread is talking about the Heritage Foundation model that DUers have been...

denying for 2 days.

[Jesus Malverde]

52. No Kidding...

Remember if we're not cheerleaders of the for profit partnership between corporations and the government we must be haters.

So lets cheer. The real success of the ACA have nothing to do with the core of the program offered through the exchanges.

The first success is pretending adults are children so they can use their parents "private" insurance. If the ACA really worked, these adults could buy their own "affordable" insurance from the exchanges. (Keep in mind these young adults are the ones who are least likely to get sick anyway.)

The medicaid expansion is also a real success.

Prohibiting discrimination against those who are already sick is also a win.

A partnership where the government guarantees the profits of private corporations, is the worst kind of deal. A loser of a plan, making private 1% parasites winners.



This plan benefits the 1% most of all.

[Demo_Chris]

58. Well said. nt

[truedelphi]

14. As far as the last sentence of your post:

It is true that he doesn't control the insurance companies.

It is also true, that just as we saw with his appointments regarding the world of Big Military and Big Finance, that world of Big Money and its influence totally controls him.

[TransitJohn]

17. Bottom line: Obama welshed on the public option he promised..

He could've insisted it be there when he handed over to Baucus and the rest of those sell outs in the Senate, but didn't.

[Octafish]

56. +1

Rahm's brother got in and the nurses got locked out.

[OwnedByCats]

21. If insurance companies are involved

you can bet that they are most probably guilty in many of these stories. The ACA took care of some of the underhanded things they pulled in the past, but not all. You can bet that they will do everything they can to screw their policy holders. I don't understand the denial.

It's still important to recognize what to blame these problems for and it's usually the insurance company.

[pnwmom]

22. There's another huge problem that you can't blame on the insurance companies

because it applies to single-payer health care systems, too. Price-gouging by the drug companies. The latest medication for cystic fibrosis, for example, costs more than $300K a year. It's an effective drug that extends lives, so no one wants kids to be denied this. So the drug company can price it however they want, and know they won't hit much price resistance.

So the insurers and state and national health systems try to fight back with formularies, and then everyone blames them if an expensive, worthwhile drug isn't on it.

Also, with regard to the initial high-profile poster, he was posting something about the ACA that isn't true. He said that a "friend" told him that insurers outside the exchange would ban his wife for having a preexisting condition. But the truth is that the ACA's regulations cover all insurers, both in and outside the exchanges. Insurers can no longer deny people with preexisting conditions, or charge them extra, or dump them if they get expensive illnesses, or impose annual or lifetime limits.

There are plenty of VALID criticisms to make about the ACA. We should limit ourselves to ones based on actual fact -- not lies about what the law says.

[Yogi]

23. I firmly believe...

most corporations are evil at heart, and don’t care about anything other than profits.

[Fumesucker]

39. Not so much actively evil as just amoral but powerful

It's not that they hate you and want you to die even though their actions often can lead you to think that, they just do not care, you and your concerns don't even register on the radar.

They are the windshield and you are the bug.

[Thinkingabout]

24. Several takes the opportunity to complain about ACA and if these same people

Has taken advantage of ACA and just happen to need health care will be happier to know they do not need to declare bankruptcy because of high medical care. In the end I ask the question would McCain attempt to pass any kind of healthcare, I doubt he would have.

[Texasgal]

25. ACA is not perfect

There are problems to be sure. It's better than not having anything at all though. I think we should be focusing our efforts on how we can help change ACA to work how it needs to.

[lastlib]

26. I have never understood why.....

...we even ALLOW for-profit health insurance companies in this country (or any other)...... .

[Hoyt]

27. Because they have the money to take the risks and build the systems necessary to pay claims, etc.

The latter is why they are used by Medicare and most state Medicaid programs.

Only when Congress is ready to fund a change will we be able to move quickly from this slow crawl toward Medicare/caid for a lot of folks and 3 or 4 large insurance companies for others.

[truebluegreen]

36. They were allowed into Medicare on the premise

that--being much more efficient than the wasteful government--they would cut costs. What a howler that is.

[Hoyt]

37. We don't really know what it would cost if the government did Admin directly.

Whatever the case, Congress is too stupid/ideological/xheap to appropriate the money and develop a long term plan to change the system. Any longterm initiative will be subject to whims of who is in power. We have to make sure it is Democrats.

[truebluegreen]

40. Actually we have very good information on what it costs

when the government administers a health care system, as opposed to the private sector. Medicare vs Medicare Advantage is just one example.

[Hoyt]

44. Insurance companies handle claims for traditional Medicare and Medicare Advantage.

Insurance companies also handle Tricare claims, Medicare drug program, etc.

So we we don't really know what it would cost (I'm talking about admin cost -- cost to handle processing of claims, check eligibility, ensure claims aren't fraudulent, answer patient and provider questions, etc.). But, we are talking about a relatively small cost in comparison to the payments to providers.

As I've said before, I don't think the difference in premiums for a public option would stop the griping. "In the Congressional Budget Office’s estimation, premiums for the public plan would be between 7 percent and 8 percent lower, on average, during the 2016–2023 period than premiums for private plans offered in the exchanges—mainly because the public plan’s payment rates for providers would generally be lower than those of private plans." http://www.cbo.gov/budget-options/2013/44890

Point is, changing the system is not nearly as easy as we would like it to be. Without Congress' support, it will not happen except incrementally over a long period of time. Obviously, that will not ultimately lead to a better outcome than a well thought out and funded longterm plan. But, we will never get something like that with the idiots we keep electing, especially the right wing obstructionists.

[tavalon]

43. We're uncivilized and stupid

We believe a myth of anyone being able to be a rich robber baron. It serves us not one whit.

[Sarah Ibarruri]

29. We know, we know. It's the 1st step toward something that resembles health care for all

It's not the final product. This is the first step. Single payer would NEVER and I do wish to repeat that, NEVER have been approved with the predatory Republican assholes in Congress. EVER. This approximates it. IN fact, I think it's amazing that even this got passed, really. I'm still in shock. I mean, for the first time all those people with pre-existing illnesses can get insured. There are a lot of firsts.

Now it will have to be tweaked until it functions properly

Once it is tweaked (and it will take time) it will be OUR TURN to slowly turn this into a fully single-payer system and take it from the insurance companies. We first need to change the country's mind, turn it from right wing (which it still is - it entered some really sick right wing nightmare in the 80s and it's still very much there).

I totally agree with you that he doesn't control the insurance companies, but he got the darn thing set up, and now we have to move forward with it.

[KG]

30. insurance companies were the problem with health care delivery before, so mandate

everybody participate in the farce. whoopie.

[Donald Ian Rankin]

32. The problem is the absence of state healthcare, not the presence of insurance companies.

As far as I can tell, there's not all that much difference between insurance companies in the US and here in the UK.

But here, it's entirely clear that they're a sophisticated form of bookmaking, not a social service; the entity with responsibility for caring for the sick is the NHS. They're trying to make a profit in an entire legitimate business, and there's nothing unethical about this; it doesn't cause problems because people who aren't happy with what's on offer from the insurance companies can still get perfectly good health care on the NHS.

In the USA, however, you've devolved what should be some of the responsibilities of the state onto private businesses, which are there to make a profit, not to provide a social service - and you're then angry and in some cases bewildered when this doesn't work, and they don't fulfill those responsibilities.

[tavalon]

42. There are so many places we've devolved

this is definitely one of them. There are so many places the private sector has no business being and yet, there they are, sucking our blood and our money.

[Donald Ian Rankin]

45. No, I think you have that backwards.

It's not "there they are, sucking our blood and our money", it's "there they are, partially ameliorating the problems caused by the state abnegating its responsibilities".

[tavalon]

50. I think we're both right

Frankly, I'm not sure dumping that tea all those years ago was the best move. Yeah, taxation without representation sucks but your country sure seems more civilized.

[joshcryer]

34. Good.

Then we'll get single payer sooner.

[KittyWampus]

35. There's a bigger cadre of people who shit on the POTUS & make shit up about the ACA

[tavalon]

41. Yep, get those leeches out of healthcare

I'll take the government over insurers any day.

[quadrature]

46. bigger problem... only sick people are signing up....

healthy people can wait.

[JoePhilly]

47. The ACA didn't create insurance companies.

So I'm not sure how you can blame the ACA for them.

The ACA has improved the regulations that exist around insurance companies.

[TheKentuckian]

53. It didn't create preexisting conditions either but it correctly eliminated them.

[JoePhilly]

54. Corrrect, it improved many things, but not everything.

If there was no ACA, there would still be insurance companies, and they could still drop you or deny coverage based on pre-existing conditions.

[cali]

55. I wasn't remotely blaming the ACA for insurance companies as you fucking well know

had to dig for that, didin't you?

I find your behavior utterly distasteful. It's simply not honest to write what you did and that, alas, is hardly an anomaly for you.

[JoePhilly]

57. Your OP title: "Here's the problem with the ACA. It's simple."

Then you say this ...

DISCLAIMER: Yes I support the ACA. Yes, I hope it helps a lot of people get needed medical care.

The problem: Insurance companies. They will look for any loophole in order to be more profitable.

See the second sentence there ... the one that says "The Problem: Insurance companies."

This is what YOU wrote. Its not dishonest to quote your own words back to you.

It is dishonest to act like you didn't say them.

[TheKentuckian]

59. The problem with the Wealth care and Profit Protection Act is the basis of its cure is also the

disease it is supposed to correct.

The cartel also substantively influenced the whole process. The law doesn't have to create something to be a big problem with said law. That is a silly distraction via frame.

[JoePhilly]

69. The big problem was much BIGGER before the ACA passed.

Or maybe you think we should repeal it and go back to the better times of the pre-ACA?

[TheKentuckian]

74. No, I agreed that the insurance cartel was and remains the big problem

and playing gotcha and games with frames doesn't change that a bit.

As far as the "much", I disagree and since I believe we have promoted the core problem to "Too Big to Fail" status, I'm not sure that we have not long term made bad worse even as we have been able to help some folks who desperately needed it now.

This may break our way with state experiments being the rage and superior models taking the day but we may just end up wits having further entrenched the problem, even if some of the roughest edges got filed down a bit while failing to control costs other than via adverse selection of service due to self rationing as cost sharing piles on the consumer.

We still have the same system in place it has been modified slightly and there has been an assortment of methods to fund access to that system, I do not support removing the useful alterations but I am not in any way sure that to really move the needle that this effort should be replaced rather than trying to fine tune what we have into what we need because I'm not sure we can get there from here any more than we could before. The "build it on argument" has always fell flat to me because the foundation it is built on is corrupt. I grasp the argument, I just don't agree with its application in this circumstance.

[TransitJohn]

60. No, but it entrenched them as a middle-man in health care for all time

A laughably-promised 'robust public option,' if included, would've not resulted in a Supreme Court decision validating mandated purchase of for-profit insurance by virtue of simply being born.

[JoePhilly]

67. And I guess not passing the ACA would have removed the insurance companies, right?

The PO was never going to pass that congress.

Its time to move on sparky.

You want a PO, then start advocating the states to add them to the exchanges like many of us will be doing.

[TransitJohn]

72. ..

[rhett o rick]

63. "The ACA didn't create insurance companies." Of course not, where did you get that idea?

I think that's a logical fallacy called a Strawman which is a fallacy based on the misrepresentation of the argument.

No other modern nation allows insurance companies to intervene between citizens and their primary care.

[JoePhilly]

68. The OP claims insurance companies are THE PROBLEM of the ACA.

Its right there in the OP.

[rhett o rick]

70. And isnt that true? The problem with the ACA is that insurance companies

are still involved with primary care. They are scraping off needed revenues that should be used for care. No other modern country allows this. No where does the OP say or hint that the ACA is responsible for creating insurance companies.

[JoePhilly]

71. That was a problem before the ACA.

Its less of a problem now.

The ACA was never meant to end the existence of insurance companies. No law that attempted to do that was close to viable in the congress at the time.

You want to claim insurance companies are the problem with the entire health care system, fine, they are ... and the ACA was created to increase regulations on them, not to end their existence.

[rhett o rick]

73. I agree with you. I only objected to your Strawman in post #47.

[ProSense]

51. How to strengthen Obamacare, courtesy of the Progessive Caucus.

How to strengthen Obamacare, courtesy of the Progessive Caucus.
http://www.democraticunderground.com/10024702695

Possible with five or six more public option supporters in the Senate and Democratic control of the House in 2015.

[xchrom]

61. WellPoint Raises 2014 Profit Forecast on New Customer Growth (2)

http://www.businessweek.com/news/2014-03-21/wellpoint-raises-2014-profit-forecast-on-growth-in-new-customers

WellPoint expects 1 million to 1.3 million net new customers this year, an increase helped by the public exchanges set up under the health law. The company said Jan. 29 it had added 500,000 members since enrollment under the Patient Protection and Affordable Care Act started in October.

“We’re very optimistic as to where we are” on the exchanges, said Ken Goulet, executive vice president of commercial and specialty business, at an investor meeting today in New York. The average age of those enrolled “came in right where we expected it to be,” he said.

Goulet also said he expected “double-digit” rate increases in premiums for 2015 plans on the exchanges to compensate for a reduction in government payments to insurers that were supposed to ease their entry onto the public marketplaces.

WellPoint also will continue to seek membership growth in the goverment’s Medicare and Medicaid programs, Chief Executive Officer Joseph Swedish told the investors.

[ProSense]

64. These

WellPoint also will continue to seek membership growth in the goverment’s Medicare and Medicaid programs, Chief Executive Officer Joseph Swedish told the investors.

...assholes are always trying to create the impression that they're invincible.

They're still spending millions to distort or kill the law. They were insisting that it would destroy them, and only changed their story when it alarmed investors.

[xchrom]

62. Aetna profit rises; company forecasts more Medicare customers in 2014

http://www.businessinsurance.com/article/20140206/NEWS03/140209892?tags=%7C307%7C74%7C76


(Reuters) — Aetna Inc., the third-largest U.S. health insurer, on Thursday said fourth-quarter profit rose due to the acquisition of Coventry Health Care Inc., and it forecast an increase in medical customers in its private Medicare business in 2014.

Aetna, which had 22.2 million medical customers at the end of 2013, said it expected to add 110,000 new private Medicare customers in the first quarter. Government-paid health care programs, like Medicare for older people, are among the fastest-growing businesses for insurers.

Aetna reported net income of $369 million, or $1 per share, up from $190 million, or 56 cents per share, a year earlier.

Excluding special items, earnings were $1.34 per share, compared with analysts' expectations of $1.36, according to Thomson Reuters I/B/E/S.

[tblue37]

65. But the law caps their profits. They must spend 85% of the premiums on

healthcare, and they must refund any profit beyond that 15%.