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View Diary: Rules finalized for the good stuff in Obamacare (106 comments)

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  •  Maybe, on the access issues. (5+ / 0-)
    Recommended by:
    3goldens, shaharazade, ferg, Vatexia, wdrath

    Unfortunately the cost of hc that has already spiraled out of control as experienced by today's insureds will continue to spin upward. The newly insured are likely to have mixed reactions where the subsidized will be in much better shape and the healthy newly insured unsubsidized will be in the same boat full of holes the rest of the county is in.

    California's ACA state exchange will be better than today for low income residents (as low as $100/mon) and the same or worse for higher income residents (up to over $1200/month).

    Access will be achieved and the basic insurance reforms have to be popular. Republicans have nothing.

    But time has run out on the cost control issue and that's the main issue for 80% of the country.

    •  evidence shows that Obamacare's already (1+ / 0-)
      Recommended by:
      doroma

      helped to keep rising health care costs down.

      •  There have been areas of lower cost increases... (1+ / 0-)
        Recommended by:
        wdrath

        ...notably Medicare where reductions may be as high as 15% and partially attributed to ACA. Premiums will continue to rise and only partially blamed on ACA. However the overall cost to non Medicare is expected to continue rising.

      •  Read Steven Brill in Time (1+ / 0-)
        Recommended by:
        wdrath

        Before further fluffing.

        •  Shame: The Bitter Pill (1+ / 0-)
          Recommended by:
          wdrath

          Bitter Pill: Why Medical Bills are killing us

          When I asked MD Anderson to comment on the charges on Recchi’s bill, the cancer center released a written statement that said in part, “The issues related to health care finance are complex for patients, health care providers, payers and government entities alike … MD Anderson’s clinical billing and collection practices are similar to those of other major hospitals and academic medical centers.”

          The hospital’s hard-nosed approach pays off. Although it is officially a nonprofit unit of the University of Texas, MD Anderson has revenue that exceeds the cost of the world-class care it provides by so much that its operating profit for the fiscal year 2010, the most recent annual report it filed with the U.S. Department of Health and Human Services, was $531 million. That’s a profit margin of 26% on revenue of $2.05 billion, an astounding result for such a service-intensive enterprise.1

          The president of MD Anderson is paid like someone running a prosperous business. Ronald DePinho’s total compensation last year was $1,845,000. That does not count outside earnings derived from a much publicized waiver he received from the university that, according to the Houston Chronicle, allows him to maintain unspecified “financial ties with his three principal pharmaceutical companies.”

          Shame
          As soon as you delve into the policy wonkery in cases like this, you are submitting to a conspiracy by the powerful against the many. The greater the sphere of disagreeable things that are “complicated”, the more it is possible to construct intricate and inscrutable bureaucracies to “arbitrate”. There will be think-tanks and policy papers, funded by people who are well-meaning (in a narrow, idiotically un-self-aware way) but very rich and powerful. The conclusions of which will be earnest and carefully researched but confined to a window not very upsetting to the very rich and powerful. Undoing the ability of plutocrat hospital “CEOs”, or bankers or lobbyists or whatever, to continue the sort of ass-rape to which their lifestyles have grown accustomed will not be on the table. A good society depends on an active public, first and foremost. A society that has allowed the predations of the powerful to become purely private matters mediated via “markets”, courts, academies, and bureaucracies, that has delegated “activism” to a mostly protected professional class, is nothing more than a herd hoping that today it is somebody else who will be slaughtered.

          Is that who we are?

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