# More bad news for ACA....



## Chuck Smith (Feb 22, 2005)

http://www.msn.com/en-us/money/insuranc ... id=DELLDHP



> In a surprise announcement, the nation's largest health insurer said it's scaling back its marketing efforts of insurance plans offered under the Affordable Care Act and warned that it may pull out of Obamacare altogether.
> 
> UnitedHealth also lowered its profit expectations for the year, blaming what it calls the continued deterioration of its individual insurance plans offered through the government-run exchanges established by the ACA.
> 
> ...


Read this article and then what is in bold and underlined..... It is exactly what I predicted.

This whole ACA can't stay afloat without government backing or subsidies. So if the government wants to make it work.... they will have to inject money into it. WHICH WE DON'T HAVE!!! So they will raise taxes on things. Just wait... that will be the next thing that will happen.... thank god the election is coming up so that wont happen right away. :bop:

I love to read the comments by people who say all that matter is "PROFITS".... well yes that is what matters. What they don't realize is that the profits are part of the reserves there to pay for things. Lets do the math:

Lets just say if all the clients of that company in the ACA needs to have $10,000 worth of medical bills paid for by the company.... that is 550,000 x $10,000 = $5.5 Billion!!!!

So if everyone of those people had an illness, accident, etc..... that is over what they made in "profit" as a whole. So now people will say that will never happen. You are right but by you insurance "contract" that you buy from the company makes that company be accountable. By law they have to have that reserve!!!! They have to have the means to pay for every single person they have a contract with.

Yes people it is that simple of math.


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## Habitat Hugger (Jan 19, 2005)

My biggest pet peeve was that the ACA did NOTHING to decrease overall costs. By simply making everyone get insurance , itself a well meaning thing to force who I call " medical freloaders" to pay their share, it did nothing To reduce any of the overall costs.
For instance, when the AMA recommended stopping direct advertising of drugs to consumers ( a HUGE list of reasons why this is necessary and would decrease costs dramatically. Not allowed in any other country other than New Zealand which has Universal Care)" immediately the huge pharmaceutical lobby descended on Washington along with the radio, TV, press people who,all make millions from,this,stupid only in America Advertising, this recommendation got squelched quickly. Did I say Descended? Wrong! They were already there! lol! ,
Meanwhile there is story after story for example of,the what ? Going from meme pry here? The pill that was raised from a few bucks to what 16 thousand or so, and there are a lot of other examples. Should have written them down when I saw hem but then I'd have writers cramp! I just read this am that the cost of,ISUREL, a drug that was OLD when I went to medical school 50 years ago and was absolutely dirt cheap, now has skyrocketed in price! If you need it during your next heart attack, run quickly to Canada or some other medically civilized country! lol And this is but a few examples of dogs---there are as many abou equipment pricing and duplication of,services, etc. ad nauseous....if the general public just knew what they are paying for,there be a mass revolt! 
I could go on and on about stupid things with the medical system, but the original post was about themACA! It might stumble on, especially if we don't get a decent candidate for president, but we will still lag not near but AT the bottom for ridiculous waste and over servicing and overcharging and. Out of medicine. Quality is going down too, though few Americans will believe that TRUTH!
Back to the original. Only United is threatening pulling out, Pugh a number of other big nam insurance companies claim they are doing OK....not getting rich, but hanging in there. Time will tell, but the way the ACA is set up is sure not the way I would have done it! But nobody asked me....I'm too busy huntin and fishin!
Now of that over expensive medical industry could only get me an AIM TRANSPLANT I wouldn't have missed th biggest buck I've seen in years, yesterday!


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## Chuck Smith (Feb 22, 2005)

Habitat.....

You hit the nail on the head....It was something I said from day one during the debating of this bill. It does nothing to actually lower the cost of doing medicine in the USA. So if the cost of doing medicine increases so will insurance.

Now what you are saying about the advertising and among other things the cost to actually bring a drug to market. The figure I heard once was that to bring a drug to market was something like over a Billion dollars. That is all the money needed to be invested before you can sell one pill. Then the US government allows for a 10 year patent on that pill or product so you can recover your costs.

Now I am not saying drop requirements for the safety of the drug. But maybe instead of having 10 tests it has to pass but move that to 7 or something. Then you can drop the 10 year patent on the pill so others can get in there and make generics and what not.

Then like you mentioned all of the advertising expenses that the consumer pays for.... help cut that.

But yet this bill did nothing of the sort.

Anyways.... back on topic....

There are many exchanges that are folding because the "state" run can't keep up or the "local" options are failing. That was the back bone of this bill. Everything was going to be handled at a "state" level. Which now is showing isn't going to happen.

Then when you have insurance companies pulling the plug.... well the options for shopping around will be gone. Which again was another piece of this pie.... You could "shop" for better coverages or coverages that fit your price point. Which they are all fading fast.

But again all of this fell on deaf ears when debating it over 7 years ago. People were just so blind sided and were fed up with "Bush"... so they thought what ever the new option was would be a savior. Well the chickens are coming to roost with everything going on....not just the ACA. But again... that is another topic.


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## Habitat Hugger (Jan 19, 2005)

You are correct with most of your points Chuck. The ACA as presently conceived I predict will be limited until consumers start to widen up and demand SOMEBODY do something Bette. Then Maybe, just MAYBE Th powers that be at that time ( I'll likely be dead and not able to see the fights!) and look at every other civilized country in the world and find out what works, what doesn't, etc. till then costs will just keep going up,and we can all blame Obamacare! LLOL


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## Chuck Smith (Feb 22, 2005)

HAHA..... well Obamacare will be partial blame.... :beer:

Just because we are now forced to buy the product. Compared to before you could roll the dice and not buy it.

But when people "have to buy" a product.... it puts all the pricing power in the hands of the people who control the product.

That is why subsidies will keep going up for the people who can't afford it. The reason why is because more and more companies are fleeing the exchanges. The exchanges are failing or folding. So the people left in the game will beable to price how they feel or can to make it work. SO to make if affordable subsides will have to rise.....So where will that money come from???

HH.... I have said there are some good things in the ACA..... 
1. Like parents able to keep kids on their plans until 28 (I think). that way until the kid finds a good job with good benefits and knows where they will want to call home. They are covered.
2. The costs measures or checks and balances for the insurance companies. What I mean is that they now have to show more indepth why the rate increases and what not. Before there wasn't the stringent look at why. 
3. The medical record sharing..... good thing and "should have lowered" costs or the need for not duplicating tests and what not.... But they forgot to add in the "Tort" reform... so that missed its mark.

One thing that would help to lower costs would be some of the stuff I mentioned above with the medical costs of bringing a drug to market would help..... But Tort reform would be another. Make it harder to sue. Hospitals could lower some of their costs and hopefully that would get passed on to the patients.

People like to blame insurance companies and talk about the "profit".... well hospitals need to work for profit otherwise they close doors. And where do hospitals get paid.... FROM INSURANCE COMPANIES...... again it is that simple of thinking.


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## Habitat Hugger (Jan 19, 2005)

Very true, Chuck! Insurance companies will hang in there much longer than you think, IMO! United though HUge but has never been a very good buy, IMO, whenever I've looked at Medicare supplements. But it might be a better company for others. One size doesn't necessarily fit all.
Yep, roll the dice and if you lose, run, as many many did! Harder if you are married with kids, etc. then you do,a bankruptcy and the taxpayers will help! Help? Naw, they'll pay for it, and ***** on April 15! 
Where will the subsidy money come from? Easy question....same place it always has long before Obamacare in this country. From the taxpayers on April 15, who else? Can't afford insurance yet want a new pickup or boat or TV or some other gadget- easy- stick the taxpayers with the bill. This method of funding health care has been around long before Obama or even Trump was born. Most modern countries have progressed past this, but it will be a long time before we catch up. All Obamacare has done is shift what method the taxpayers pay! Nothing more, nothing less. But the bottom line is if you can't or won't pay for medical care in USA you'll get it, and,the Taxpayers will pay for it! Always has been, always will be until someone gets serious about looking at cold,hard facts! As long as we have something or somebody to blame like Obamacare, it'll never happen! 
There'll NEVER be a perfect solution regardless. Healthy people will have to chip in to help unhealthy people in any modern society! We are no different! The only difference is HOW we pay.


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## Chuck Smith (Feb 22, 2005)

HH....

What do you think will happen to medical costs if a minimum wage of $15 for fast food workers gets approved??

Do you think someone working maintance at the hospital who is getting $16 an hour will want to work that hard when he can say "you want to super size that" for a buck less an hour?? Or will they complain and want to get a raise of $5 or so??? Then if they get a raise... what about the electrician working for the hospital will start to charge.... etc.

That is another issue that isn't directly linked but it is linked to high medical costs..... think of all the positions in a hospital..... and what they get paid or when they ask for raises and get them.... how do those get paid???? Who gets billed??? Plus like what Habitat Hugger stated... people still get free care that gets passed onto the tax payers and people with insurance.

It is like if you get into a fender bender..... You say you will pay out of pocket and not take it to your insurance company... you get one price... if the insurance company pays for it... it is another price!!! Works the same with medical procedures to a certain extent. Mark up is incredible.

Yet the ACA never touched on this subject. :beer:

The stuff mentioned by Habitat Hugger and myself are things to look at to help lower costs. If someone wanted to really make a difference and not bow to the lobbyists. But again all of Washington bows to lobbyists because that is how their pockets get lined. uke:


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## Habitat Hugger (Jan 19, 2005)

Excellent points, Chuck! There has been a slight move towards putting " find the cheapest price" and real competition into medical costs, but usually when someone goes in for surgery for instance, they do not look at prices, nor shop around, as long as insurance psys for it!
I was advised to have a new surgery that insurance did not cover, so for the first time in my life I did shop around! Found published results (quality) was essentially the same, but PRICES were all over the map, from a low of around 40 K all the way to close to,100! These were all well known tertiary medical centers. I tried to get hard facts on European and Canadian prices and Pugh harder to pin down, these varied between around 10 to 24 K or so! I could see why some insurance companies offshore some of their expensive surgeries to Europe, India, places like,that! 
The point is that if we put competition into medical care prices would drop! Free enterprise at work! In close to 50 years of doing surgery and delivering babies, etc. I cannot recal a single time when anyone ever asked what it costs, or at least my share of,the total cost! 
Long story short....I ended up with a different far more radical surgery than originally proposed, had an excellent result ( back fused from chest to tailbone with plastic, titanium and genetic produced bone forming stuff, all kind of,space age stuff) and. Can now walk, run, hunt all day though still miss easy shots, paddle,a kayak for hours, ride a bicycle for 75 miles a day, etc. and I'm pushing the north side of 70! The down side is,that I'm still getting bills and notifications of bills sent to Medicare and my supplements and for the hell of it still adding them up! So far more than 200 K! I could afford that though it,would,take a huge bite out of my retirement, but how many others could afford that? Worth it to me, but how many could afford it without insurance of some kind? In the old,days you sat in your wheelchair took your pain meds and whined! Now hopefully we get back close to normal, hopefully! But where will,the cost end up and who,will,pay for,the,majority of,people who need this kind of,thing, the numbers of needy baby boomers increasing daily! A friend told me the other day that a " simple" heart attack is around 100 K on up. I hope never to find out for sure but it sure isn't cheap! 
Take care Chuck! Just about every one of your points hit a nail or two right on the head! I hope you,shoot pheasants that well! LLOL
My point is that with less insurance, there'd be more looking around and price gathering and more price competition back in the system, for better or worse! Obamacare arguably does just the opposite in a lot of,ways! At least no improvement!


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## Chuck Smith (Feb 22, 2005)

> I hope you,shoot pheasants that well! LLOL


Some days... yes... others not so much... HAHA

Have a happy thanksgiving and glad you are back doing the things you love with that surgery. :thumb:


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