What exactly is Obamacare and what did it change?

http://www.reddit.com/tb/vbkfm

by memset • 14 years ago

1 1 14 years ago

aginn• 14 years ago

This is a poor and misunderstood version of what Obamacare will actually do. Having worked in healthcare tech for two years and healthcare investment banking, the analysis this person put forward is rudimentary understanding of how our healthcare system works.

Here are a few highlights - 50% of all regulations are behind schedule, bundled payments, payment sunshine, are just a few highlights

- "The decision over whether or not your claim is approved is still in the hands of your insurer. However, now there's an appeals process so if your claim gets turned down, you can challenge that. And the government watches that appeals process to make sure it's not being unfair to customers." => there already is an appeal process. The real nugget is "unfair". What the crap is unfair? How do you regulate unfair? Notice, there is no mention of AMA's power of setting CPT codes and reimbursement schedules.

- "The PPACA actually very specifically says you can keep the insurance you have if you want." => First, everyone's insurance has already changed with the implementation of MLR rules. Second, how can the government fulfill this promise. It cannot. Premiums increase between 10% to 20% a year. Think people. It is an empty promise to make you feel good inside.

- "The PPACA very specifically says that the Secretary of Health and Human Services (who is in charge of much of the bill), is absolutely not to promote any regulation that hinders a patient's ability to get health care, to speak with their doctor, or have access to a full range of treatment options." => no way to fulfill this promise. If you are giving access to 20 million people, there are still only 600,000 practicing physicians. Supply is basically fixed (with a 20 yr cycle). Unless you failed economics, there is no possible way the government can actually deliver on this.

- "Additionally, the bill cuts some stuff from Medicare that's not really working, and generally tries to make everything work more efficiently" - HAHA! $500 billion in imaginary savings. Not to mention the author forgets that the DocFix is not included in the bill. How do they reach $500 billion? Cutting doctors payments by 32%.

- "Also, the increased focus on preventative care (making sure people don't get sick in the first place), should help to save money the government already spends on emergency care for these same people. Basically, by catching illnesses early, we're not spending as much on emergency room visits." Preventive care INCREASES utilization. ER visits are "falsely" expensive because the "costs" are typically based upon gross charges. ER visits are super expensive but it is a scape goat for preventive medicine or the individual mandate. The free-rider problem does not exist.

- "They had been reading it over and over for a half a year. This thing was being tossed around in debates for ages." - Not true. I know the people on the hill who wrote the bill. It was put together over a month.

What exactly is Obamacare and what did it change?

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