Obamacare cost...

[smokymountainrain]

Just as was described above. You can't be denied coverage. It is not really insurance any more . The system makes zero spence, but they are still calling it insurance.

Here's a timeline.

So the catastrophic event happens on, say, March 13. You're in the hospital from March 13 to March 25. During that 12 day stay, you rack up 200k in medical bills. Sometime either during that stay or when you're out of the hospital you "sign up" for coverage. Coverage is effective April 1 at the earliest. Possibly during the next open enrollment. Good luck with that.

[Katy Lied]

April 1.

But you paid your fine, so feel free to take advantage of the ER. It's not like they're going to toss you out for not having insurance. And since you obeyed the government (meaning you either paid your fine or you obtained insurance), the ER should suit you just fine. And all follow up care (after April 1) will be covered by the insurance you just purchased in hospital. In fact, if I were the hospital, I'd let you sit in the ER with a minimal amount of care until April 1 rolls around. Back load all that health care, baby. In fact, if I were the ER manager, I'd sign you up and I'd have the hospital pay your premiums for 1 month. Then instead of having to chase payment from you over time, I'd just back treat you and file a claim on April 1.

Now slow-moving chronic conditions, those diseases are tailor made for obamacare.

[smokymountainrain]

* Start off with no insurance
* Catastrophic event = get diagnosed with cancer, or have a child diagnosed with a congenital heart defect, etc. Basically anything where you all of a sudden find out that you're going to need a crapload of health insurance.
* Sign up for insurance. Can't be denied due to pre-existing conditions.
* Get your cancer or CHD treated and covered under your newly obtained insurance.

QED

Catastrophic event = you have an accidental fall and break your back and are in the hospital for two weeks.

I think the real question is when does coverage become effective? If it's the beginning of the next month, you're screwed in my hypothetical catastrophic event. If it's during the next open enrollment (which I believe is the case under the ACA) you're screwed even under your scenario of a catastrophic illness.

[Goatnapper'96]

Certain implementation decisions were purely political, not taking efficiency, effectiveness, or marketability into consideration. I think it can be likened to Bush's Iraq War. Since the Bush Administration hung their hats on the war, I'm sure some of the war-related decisions were purely political, and I'm sure some disgruntled soldiers had a lot to say about the war's implementation.

The Obama Administration hung their hats on the ACA, and some of their web site implementation decisions were purely political. Here are two simple examples that Uncle Ted has previously cited:

1. Normally the government will hire a managerial vendor who acts like a general contractor, hiring and coordinating and communicating between all the IT subcontractors. The Obama administration made the decision to act as its own general contractor to control the insertion of political strategies into the entire process. So we have a lot of government people involved in the web site design and implementation, from beginning to end. Government people who poorly understood the needs and timelines and importance of testing and other best practices.

2. Normally, web sites will furnish free quotes to people shopping their websites. So you can get a price for that urn you've been lusting after on antiquesrus.com. Even though the shipping and handling will differ depending upon your personal info (where you live, how fast you want it, etc) The obamacare web site was initially set up to furnish quotes this way. However, the quotes were coming in too high, because without personal information the web site could not reduce your premiums by the expected subsidies you might qualify for. The Obama Administration made the political decision to not allow the web site to provide any quotes unless the subsidies were calculated into the premium price, so they forced insurance shoppers to enter in a bunch of personal information, and then the obamacare website had to talk to other websites suchs as the IRS website, the Insurance Clearinghouse website, etc to verify the information. This resulted in a manitude increase on the demands of what the website had to do.

Like my earlier example from the Bush Administration, the insertion of political objectives, whether into a "market" or a war will create a lot of disincentives and inefficiencies. And I'm being equal opportunity here, not merely calling Obama the Great Satan.

The reality is government is not very good at doing things because profit motivation, as the primary motivator, is removed from the equation. There are things government must do but the things government does are usually going to be done really poorly. I know that is greedy and doesn't poll well with understanding the pain of the middle class and it is likely not popular with the wankers high up in the ivory towers of academia but it seems to be a pretty consistent reality.

However, I am entirely confident that government will take its website from its current state of putridly failing and move it up to inneffectively poor and this will cause EJ Dionne more nocturnal emissions than SoCalCoug had as a result of his Honors Pre-Algebra class! Because from where I stand I bet most liberals just believe the poor are getting health insurance because that was the ideal put forward. Nuts and bolts of the real world result, who follows that shit? Usually just greedy people who want to make money, thats who!

[smokymountainrain]

April 1.

But you paid your fine, so feel free to take advantage of the ER. It's not like they're going to toss you out for not having insurance. And since you obeyed the government (meaning you either paid your fine or you obtained insurance), the ER should suit you just fine. And all follow up care (after April 1) will be covered by the insurance you just purchased in hospital. In fact, if I were the hospital, I'd let you sit in the ER with a minimal amount of care until April 1 rolls around. Back load all that health care, baby. In fact, if I were the ER manager, I'd sign you up and I'd have the hospital pay your premiums for 1 month. Then instead of having to chase payment from you over time, I'd just back treat you and file a claim on April 1.

Now slow-moving chronic conditions, those diseases are tailor made for obamacare.

Either I'm misunderstanding you, or you don't get it. Yes the ER will see you, but you still pay the cost of the medical in March. The hospital and doctor bills from March 13 to March 25 will not be covered. That is the bulk of the cost. Sure the follow up after April 1 will be covered, but those bills from prior to that won't be. You pay for dates of service. Again, good luck with that.

[Katy Lied]

Either I'm misunderstanding you, or you don't get it. Yes the ER will see you, but you still pay the cost of the medical in March. The hospital and doctor bills from March 13 to March 25 will not be covered. That is the bulk of the cost. Sure the follow up after April 1 will be covered, but those bills from prior to that won't be. You pay for dates of service. Again, good luck with that.

Yes, in your very limited example, you are out of luck. Declare bankruptcy and have the hospital chase you for payment. Like they did back in 2013. And not feel bad about it because you paid your fine, you took one of the acceptable alternatives outlined to you by the government. (There's a whole discussion on this a couple of pages back-- see the late picking your kids up from preschool example.)

But outside of trauma, there is a whole slate of slow moving catastrophic events that you can manage over time. Working with the hospital, you can get most of that stuff managed and paid for by insurance you purchase after the diagnosis.

[byu71]

The spin is starting to come together. I am hearing a theme from both the media and the democrats.

The Republicans blocked the necessary funds in order to have the system up and running efficiently. The only reason this won't work will be because the Republicans won't cooperate in coming up with easy fixes to Obamacare that the democrats are quite willing to make.

Lastly, the rollout of medi something in '06 was really bad, but everyone worked together to fix it and now it is very popular. The rollout was so bad I can't even remember what the program is??

[smokymountainrain]

Yes, in your very limited example, you are out of luck. Declare bankruptcy and have the hospital chase you for payment. Like they did back in 2013. And not feel bad about it because you paid your fine, you took one of the acceptable alternatives outlined to you by the government. (There's a whole discussion on this a couple of pages back-- see the late picking your kids up from preschool example.)

But outside of trauma, there is a whole slate of slow moving catastrophic events that you can manage over time. Working with the hospital, you can get most of that stuff managed and paid for by insurance you purchase after the diagnosis.

Very limited example? People are having serious injuries that cause inpatient hospital stays every day. To say it's limited is embarrassingly naive. If you're under the age of 40 (which is what we're talking about here of a young, healthy family that doesn't need day to day coverage), if you are going to have a catastrophic event, chances are it's going to be due to an injury, not a slow moving illness.

[chrisrenrut]

Very limited example? People are having serious injuries that cause inpatient hospital stays every day. To say it's limited is embarrassingly naive. If you're under the age of 40 (which is what we're talking about here of a young, healthy family that doesn't need day to day coverage), if you are going to have a catastrophic event, chances are it's going to be due to an injury, not a slow moving illness.

Some common catastrophic events that could be put off a few weeks after an ER visit:
Cancer (find a lump in a swimsuit region)
Joint/soft tissue injury (torn ACL, rotator cuff, dislocate shoulder)
Broken bone in hand, foot

[Pelado]

Very limited example? People are having serious injuries that cause inpatient hospital stays every day. To say it's limited is embarrassingly naive. If you're under the age of 40 (which is what we're talking about here of a young, healthy family that doesn't need day to day coverage), if you are going to have a catastrophic event, chances are it's going to be due to an injury, not a slow moving illness.

As long as we're playing the probabilities, chances are the under-40 won't have that catastrophic event.

[byu71]

As long as we're playing the probabilities, chances are the under-40 won't have that catastrophic event.

In this conversation do you exclude accidents from catastrophic events and just count a health issue. If this is true it sure seems you would be right. How many under 40's get cancer or have a heart attack vs those over 40?

[smokymountainrain]

As long as we're playing the probabilities, chances are the under-40 won't have that catastrophic event.

So the under 40 are less likely to experience a catastrophic accident/injury? I guess that could be true, but I doubt it, if for no other reason that Accidental Death and Dismemberment plan premiums don't increase based on age. I'd think insurance companies offering those plans have a pretty decent handle on those probabilities.

[Pelado]

So the under 40 are less likely to experience a catastrophic accident/injury? I guess that could be true, but I doubt it, if for no other reason that Accidental Death and Dismemberment plan premiums don't increase based on age. I'd think insurance companies offering those plans have a pretty decent handle on those probabilities.

No, not less likely than others, less likely than not suffering a catastrophic accident/injury. That's what insurance used to be for - protecting yourself and/or family against an unlikely yet possible future catastrophic event. Now "insurance" has morphed into plans that contain a whole lot of services that could somewhat easily be planned and budgeted - a prepaid medical expense component.

[Color Me Badd Fan]

Aren't you putting the cart before the horse here? All of these considerations exist nowadays but still healthy people choose not to buy health insurance. As long as a healthy person is informed on the inability of the government to collect the tax penalty, they're still not going to buy health insurance. In fact, now they're asked to subsidize all the healthy people and is therefore more expensive, they're really not going to buy it. Obamacare doesn't change the risk associated with an unexpected or catastrophic injury/illness.

[ERCougar]

I had a few minutes last night so I thought I'd try out the website. I fully expected to run into the clusterf*** that everyone has been talking about, and was pretty surprised to get through the whole process in about 15 minutes, and had 5 plans to choose at the end. Yes, the premiums were all a few hundred dollars higher than what I'm paying, but I expected that, since we're all healthy. Of course, I didn't select a plan, because I wasn't expecting to get through at all, and I think my current plan qualifies, but I can't imagine there was much more beyond that step. Also, I didn't apply for government help with premiums, but I'm doubting that's much of an issue.

Overall, I was pretty surprised at how slick the website was given everything I'm hearing.