Getting that enforced isn't easy How is that even possible ? How does the state mandate that some random provider step in and subsidize higher payments to providers in order to encourage them to take on more new patients?
By preventing them from selling their insurance on the state-run exchange if they don't meet the standards.
OK, name one case where that has actually happened -- where the state has successfully coerced a doctor to accept new patients at a loss or a provider to overpay to make such a doctor/group choose to accept new patients.
There is a good article on this problem (many doctors not accepting new patients, leaving regions without care except for ERs) on the front page of the 5/18/15 San Jose Mercury News.
Insurance I had as self-employed for 12 years gave up in 2015 and would not renew. Crap bronze plan with highest possible deductible is almost 4x what I was paying.
The part I particularly don't like is that this is compulsory. I'd rather see private insurance destroyed than expanded under penalty threats. Or better, go back to barter.
To me as someone living in the UK, this is bizarre. Why would you need an deductables at all for it not to be expensive? This in itself indicates that your entire healthcare sector is entirely dysfunctional. In 2013/2014, the UK National Health Service spent $2928/year per person. This is the average, and includes everything from the costs of births to the costs of expensive heart transplants or cancer treatments. Ge…
People have written about this before, but basically the US subsidizes medical expenses for the entire world. That was able to happen because, unlike virtually anywhere else in the world, medical insurance in the US is private. If the US changes that (which will never happen) I would expect medical costs to go up everywhere else to compensate, either that or research slows down. One thing that might, might, help is f…
It's true that the US has historically been a leader in medical research, but that largely comes from the federal government through the NIH ($32 billion in 2016.)
Random personal anecdote. When I was a teenager, my family took a trip to Europe. This was summer of 1999, IIRC. Anyways, near the end of the trip, when we were in Italy, my dad came down with a cough and sore throat. Rather than try to gut it out for another week and then have to fly back to the US sick, we decided to try to find a doctor. After consulting with the front desk at our hotel, we were directed to a smal…
When I first started reading about American health care being a foreigner I saw a persistent argument that in single-payer system "people will die in lines". Yet here in the United States the lines in medical institutions are greater than anything I've seen abroad, open slot for appointment with a doctor in one month is a usual deal. And why can't I buy antibiotics without a prescription. Don't I have a right to heal…
And why can't I buy antibiotics without a prescription. Don't I have a right to heal myself?
Misuse and overuse of antibiotics is a huge global problem. Common bacteria are developing resistance, and the reason is the overexposure to antibiotics due to agricultural and medical overuse. If things continue like this, soon we'll have people dying of tuberculosis again in developed countries.
If people can buy antibiotics without a prescription, they tend to take short treatments for random flu-related symptoms. This is doubly bad: the antibiotic doesn't do anything against the viral infection, and unrelated bacteria will be exposed to a weak antibiotic and be able to develop resistance.
I have health care through the exchange and it drives me crazy that I pay $300+ monthly and if I have to see a doctor I still have to cover the expense myself because I have to spend several thousand dollars out of pocket before my insurance begins to cover anything. It seems to me that ~$4,000 annually is a lot to pay for what is effectively disaster insurance. But if I don't pay it not only do I pay a fee but I run…
My employer is a big group of people and has the power to bargain with the health insurance companies. I think there are groups you can join that provide the same advantage. But what you might not understand (and I'm about to sound like a big jerk) is the idea that maybe the system that works best for the country might not work the best for you specifically. That doesn't make the entire system a disaster. There's per…
HN devolves into non-scientific anecdote city whenever politics are discussed on this site and everyone goes from analytical to happily biased at the drop of a hat.
I wouldn't take any one off experiences here as anything other than that; isolated incidents which most likely don't represent the overall picture.
I am okay with paying more to cover others who can't afford it. What I'm not okay with is losing my plan, my doctor, and my benefits, all while paying more.
When you think about it, the two are really the same thing. A lot of people (some 15 million) got coverage, and they're not paying for it, you are.
When I read this stuff, I'm a little astounded about how bad the situation must be in other states. Here in the Pacific Northwest, my premiums have actually been going down and the plan offerings are getting better. The provider I was on did go out of business so I had to switch, and I'm now paying less for more services. And, to be totally frank, having had a pre-existing condition that kept me from buying any insur…
Unfortunately, your situation must be specific to Oregon. I'm in Washington, and the closest plan we could get to what we had pre-Obamacare went from a $2500 deductible to $6300 with a premium increase of around 40-50%. In my opinion, the problem was never the unavailability of insurance. The problem was (and still is) the out-of-control pricing of medical care -- $5000+ for non-sterile gloves [1] is a bit extreme. […
I agree with you. I wish more people would realize their quibbling over a treatment for a symptom when they're hashing out a regulated private insurance marketplace v. single-payer. Our existing insurance system allows a lot of perversions of the marketplace and contributes to the root cause, but having the government sign a blank check isn't the answer either. We need to return ordinary market dynamics to health care if we want something that's sustainable over the long term.
When I read this stuff, I'm a little astounded about how bad the situation must be in other states. Here in the Pacific Northwest, my premiums have actually been going down and the plan offerings are getting better. The provider I was on did go out of business so I had to switch, and I'm now paying less for more services. And, to be totally frank, having had a pre-existing condition that kept me from buying any insur…
Yeah, it's pretty crappy in NC. First year of ACA we only had one company even offering any insurance in my county. And yeah, it's county-based for some reason - if I lived 2 miles in another direction I'd have had multiple options about 10-15% cheaper than what I had available. Second year we had another option in our county which was about 15% higher than BCBS (which had gone up about 25% from the year before). App…
"Bring on single payer" - like the veteran's administration? Because that works so well?
I understand premiums going up annually. I don't understand 30-50% increases year on year.
It's was pretty easy to predict: allowing enrollment after a diagnosis was politically popular but a terrible economic disincentive to not buy insurance (because at that point, it isn't insurance -- it's a subscription plan for your treatments). The young and healthy needed to enroll for the economics to work, but the individual mandate was delayed for years -- because coercion isn't popular politically, and there wa…
You're unfamiliar with how the American political system works. Presidents can't repeal laws, only Congress can do that.
When I read this stuff, I'm a little astounded about how bad the situation must be in other states. Here in the Pacific Northwest, my premiums have actually been going down and the plan offerings are getting better. The provider I was on did go out of business so I had to switch, and I'm now paying less for more services. And, to be totally frank, having had a pre-existing condition that kept me from buying any insur…
It isn't ACA that has caused me problems, or at least the law itself. The description given matched my experience with insurers before ACA. My problem with ACA is Healthcare.gov (still). It is possible to go through the entire application process, make one mistake or fail to provide the right detail, and end up disqualified from buying insurance through Healthcare.gov (in my case, I used a mail forwarding service add…
The traveling full time "problem" affects me as wel. When some company or another asks, "Where do you live?" My response is preceeded by an audible shrug.. I seems that many companies actually plan to come visit me and are put out when I explain that my physical location is really of no concern to them. For example, banking. If I give a Texas address and agree to Texas terms and conditions, why would it matter that I spend 11 months a year in Europe. My mail arrives, I do my transactions online.. So what's the problem? Twentieth century thinking, that's what.