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Obamacare Is A Disaster: Co-Op Insurers Across America Are Collapsing, And Now There Is Fraud
Two weeks ago we reported that in what at the time was still a rather isolated incident, Colorado's largest nonprofit health insurer (aka co-op), Colorado HealthOP is abruptly shutting down, forcing 80,000 Coloradans to find a new insurer for 2016.
At the time, we said that the health insurer had been decertified by the Division of Insurance as an eligible insurance company because the cooperative relied on federal support, and federal authorities announced last month they wouldn't be able to pay most of what they owed in a program designed to help health insurance co-ops get established.
In other words, one of the 24 co-ops funded with Federal dollars and created to give more policyholders control over their insurers - especially those who wished to stay away from various corporate offerings, had failed simply because the government was unable to subsidize it: the same government that spends $35 billion in global economic "aid" but can't support its most important welfare program.
Fast forward to today, when we learn that another co-op, this time New York's Health Republic Insurance - the largest of the nonprofit cooperatives created under the Affordable Care Act - is not only shuttering, but was engaging in fraud.
The fate of Health Republic Insurance was first revealed a month ago when the WSJ reported it would shut down after suffering massive losses "in the latest sign of the financial pressures facing many insurers that participated in the law’s new marketplaces."
The insurer lost about $52.7 million in the first six months of this year, on top of a $77.5 million loss in 2014, according to regulatory filings. The move to wind down its operations was made jointly by officials from the federal Centers for Medicare & Medicaid Services; New York’s state insurance exchange, known as New York State of Health; and the New York State Department of Financial Services.
In a statement, Health Republic said it was “deeply disappointed” by the outcome, and pointed to “challenges placed on us by the structure of the CO-OP program.”
Health Republic has about 215,000 members, with about half holding individual plans and half under small-business coverage, a spokesman for the insurer said.
Today we learn that not only was this largest Co-op insolvent, it had also committed fraud. According to Politico, the collapsing insurance company that is creating headaches for hundreds of thousands of New Yorkers, misled state and federal officials about its finances, and will not be able to remain in business through the end of the year as originally hoped.
Because incompetence is one thing, but corruption: now that's real government work, right there.
The accelerated wind down is clearly a problem: the more than 200,000 customers insured with the co-op will lose their coverage Dec. 1, and must find a new plan by mid-November, according to the state and federal government. Health Republic insures about 20 percent of the state's individual market.
As Politico adds, the plan had been for Health Republic to make it through the end of the year. As recently as last week, company officials said there was enough in cash in reserve. But that apparently wasn't true.
Health Republic's finances are "substantially worse than the company previously reported in its filings," according to the state Department of Financial Services, which oversees insurance in New York, and the Centers for Medicare and Medicaid Services.
One wonders just how much of the over $100 million "lost" in under two years was due to incompetence, and how much due to pure embezzlement by the co-ops operators. Somehow we doubt we will find the anwer where this taxpayer money has gone.
This does, however, lead to a more serious question: the implosion of Health Republic is merely the latest in what has become an epidemic of governmental failure. In fact, there are a total of ten co-ops, all of which were created by the Affordable Care Act and seeded with billions in federal funding, that have now failed, leading to questions whether the entire business model underpinning Obamacare is unsustainanble for everyone but a select few corporations.
For some more thoughts on this disturbing, if perfectly predictable epidemic, we go to Forbes' Edmund Haislmaier who answers "Why Obamacare Co-Ops are failing at a rate of nearly 50%"
Cooperative health insurers (or co-ops) created under a federal grant and loan program in the Affordable Care Act seem to be falling like dominoes.
It started in February, when CoOportunity Health, which operated in Iowa and Nebraska, was ordered into liquidation. In July, Louisiana’s insurance department announced it was shuttering that state’s co-op. The following month brought news that Nevada’s co-op would also close. On September 25, New York ordered the shutdown of Health Republic Insurance of New York, which had the largest enrollment of all of the co-ops. Then, within the space of a week in mid-October, the number of failures doubled from four to eight, as state insurance regulators announced that they were closing the co-ops in Kentucky, Tennessee, Colorado, and one of the two in Oregon. Last week came news that South Carolina’s co-op will be closed, followed this week by the announcement that Utah’s co-op is also being shut down.
In sum, of the 24 Obamacare co-ops funded with federal tax dollars, one (Vermont’s) never got approval to sell coverage, a second (CoOportunity) has already been wound down, and nine more will terminate at the end of this year.
So what is behind this, so far, 46 percent failure rate?
To start with, the program was a congressional exercise in not merely reinventing the wheel, but doing a bad job of it.
Far from being a new idea, member-owned insurance companies—called “mutual” insurers—have a long history. For instance, life insurer Northwestern Mutual has been in business for over 150 years. Health insurers organized as mutual companies include, among others, Blue Cross plans in 10 states. Indeed, one of them, Florida Blue, converted into a policyholder-owned mutual company just last year. If having more health insurers owned by their policyholders was the goal, then there was no need for federal government action.
On the other hand, if the goal was to increase competition by stimulating the creation of new health insurers, then the ACA’s co-op program was, like other parts of the legislation, badly designed.
* * *
The program offered federal loans and grants to startup insurers but required that they be non-profits, not have anyone affiliated with an existing health insurer on their boards, and not spend any of their federal funding on marketing.
Co-ops are also subject to another provision of the ACA requiring all health insurers to pay out in claims at least 80 percent of premium revenues, or refund the difference to policyholders. By law, insurers can retain no more than 20 percent , out of which they must fund sales and administrative costs before booking any remainder as free cash. That significantly constrains a non-profit carrier’s ability to accumulate capital needed for growth, as it can’t raise funds through equity or debt offerings.
As if that wasn’t daunting enough, the law also required co-ops to focus “substantially all” of their activities on offering health insurance in the individual and small group markets—just as other provisions of Obamacare were thoroughly disrupting those markets by imposing new rules on insurers and complicated new payment arrangements for many of their customers.
Given all of the foregoing, 10 co-ops failing within two years is less surprising than the fact that 23 of them actually got to market in the first place.
As we pointed out two weeks ago, following this avalanche of failures, it will merely force even more individuals into plans offered by corporations, who as a result of the failure of their co-op competitors will have even more pricing power and premium hiking leverage.
Which means that "sticker shockers" such as the one below kindly informing them their health insurance premiums are rising by 60% crushing any desire to splurge modest "gas savings" on discretionary purchases...
... will only get worse, as the premium increase even more with every passing year, as more Co-Ops fail, as more of the publicly-held insurers merge, and as a single-payer system, one which benefits not taxpayers but a select handful of shareholders, becomes the norm.
Haislmaier's take: "The bottom line: Obamacare has made health insurance costlier and the business of offering it riskier. To survive in that new world, health insurers need to be cautious, or even pessimistic, and hope that their customers can continue to pay escalating premiums. It’s not a pretty picture."
It isn't but what are customers going to do: after all the "Affordable Care Act" is a tax (one which "boosts" GDP every quarter no less) and you must pay it by law; sadly the Supreme Court forgot that when it makes a service mandatory, corporations can charge any price they want.
And that's precisely what they are doing.
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Its only a temporary solution for insolvency...aka more taxes on the pleebs.
RIPS
Healthcare was 20% of the cost it is today before the feds got involved in 1965. Seems like one group of people write all the laws and get all the money. Peculiar isn’t it.
I'm sure they're non profit so it's ok. All non profits do god's work.
Goldman Sachs? hmmmm
This is sickening.
FRAUD????? in a government program?????? I thought that only happened when we sent funds to third world countries like Afghanistan, Iraq, and ..... oh waitow I get it. A third world country.
Who cares about fraud and waste. Its more important that we just fund everything we want to fund. If the taxpayers have to pay a bit more, that OK.
/MDB
This is going to hurt you a lot more than it's going to hurt me, now ben dover cause you have an enima coming to ya.
https://www.youtube.com/watch?v=SjbPi00k_ME
Hillary, Sanders and Trump all want some sort of socialized or single payer medical system. Where does Carson stand?
No surprises here as the ACA was designed to fail, taking down an important part of the US economy... The tip-off was the Pelosi policy of "having to vote for it before you can read it"... Just like the TPP... Never have I witnessed so many organizations, federal agencies and politicians that are hell-bent of destroying the US... Now they want us to pay for a failed health care system to provide coverage for any and all illegal immigrants, including the US created refugees from the ME...
Prior to leaving the USSA for good, I was paying $10,000 a year for a 70/30 plan with a $3500 deductible... Now, living as far away from the evil empire as I can, I pay $2100 per year for 100% coverage, zero deductible and all prescriptions paid... Fuck the corrupt system in the USSA, they can all go to hell...
Prey tell us..where do you live?
Hope you all enjoy your soup spoon full of Castor Oil for your cancers and what ails yah.
Because if you're not paying $90,000 for three months of drugs in the US that costs $900 for the exact same drugs in many other countries, then your healthcare must be horrible. Where else but in America can you find so many people so stupid?
Gee, how can it possibly be????
And The Biggest "Contributor" To Q3 GDP Was...http://www.zerohedge.com/news/2015-10-29/and-biggest-contributor-q3-gdp-was
and gee again...don't forget that this MASSIVELY ILLEGAL AND UN-CONSTITUTIONAL system is all about the MARXIST AGENDA "single-payer" BULLSHIT!!!!!! TOTAL FED-GOV-SCUM HEALTHCARE LIE which is actually total SURVEILANCE of our entire lives!!!!!
https://www.youtube.com/watch?v=LhEX3rHssJI
REMEMBER!!!! this is how they have wanted to do it to us for 150+ fucking years!!!!
And so, thusly...
"A nation can survive its fools, and even the ambitious. But it cannot survive treason from within. An enemy at the gates is less formidable, for he is known and carries his banner openly. But the traitor moves amongst those within the gate freely, his sly whispers rustling through all the alleys, heard in the very halls of government itself. For the traitor appears not a traitor; he speaks in accents familiar to his victims, and he wears their face and their arguments, he appeals to the baseness that lies deep in the hearts of all men. He rots the soul of a nation, he works secretly and unknown in the night to undermine the pillars of the city, he infects the body politic so that it can no longer resist. A murderer is less to fear. The traitor is the plague."Marcus Tullius Cicero - (106-43 B.C.) Roman Statesman, Philosopher and Orator
What America needs is a single-payer system. All the other advanced countries have it. Why not us? And no. This doesn't make me a socialist.
@ugly treasonous bird TROLL: 23 weeks, 2 days: Wrong Answer, scumbag! You aren't going to make it on this forum ever....move on. And this is why:
MAKES YOU A FUCKING RETARD FOR EVEN SAYING THAT, YOU FUCKING PIECE OF SHIT. FUCK OFF, YOU MARXIST, TREASONOUS, SOCIALIST SCUM! WE DON'T TAKE KINDLY TO YOUR KIND 'ROUND HERE EVER! You can take your statement and your bullshit link and your scumbag, socialist vomit and shove it all up your ass.
Because that's what real and true American Constitutionalists think of people like you, o-blah-blah, and Hitlery, and all the rest of you subversive, regressive, intollerant, anti-American, anti-Constitutional, treasonous fucking scumbags.
Fuck off and go move to any of the other 150+ loser, scumbag, socialist, dead broke, loser countries around the world who don't have any clue how to prosper without treasonous, corrupt politicians and losers like you who support them!
Is America DEAD BROKE and going more broke by the day??? Fuck yeah we are!!! But we here know that...we've known that for years now, and have been trying to reverse that course. So if we can reverse this Socialist treason, then that not only helps America but also the rest of the world.
The fucking problems are the treasonous, scumbag politicians not just in America but also around the world...as well as the scumbag banksters, the MIC, and all the other treasonous motherfuckers who work for all those assholes, as well as the scumbags like you.
And if all you assholes who want to take our guns think you can do it...well then, Molon Labe, motherfuckers!!! Good luck, you fucking lungers. Just keep trying to take our guns. Cuz you won't get them ever until they are all empty and if you can manage to pry them from out cold dead hands!
https://www.youtube.com/watch?v=ORYVCML8xeE
Moar of Barry's Legacy and destruction of American middle class.
Settle down Suzy, our system in Canada might not be as expensive as yours, cuz that is apparently awesome to pay ton's of your income on a monthy basis for healthcare, i'd rather have it deducted from my pay, and have good roads, decent social programs, and alright healthcare, you just walk in give them your healthcard and your fixed and it doesn't cost you extra for a cast and x ray or whatever ridiculous amount of fiat you suckers pay.
Pathetic... If there were a hint of a coherent, long-term vision for the US in your spittle-laced diatribe, I would be inclined to listen.
Police and fire departments have tended to be in the public sector in the US. Does that make the US a socialist state? Does that make cops and firefighters and the people willing to keep that in the public sector traitors or marxists or whatever? Sorry, bud... It is not -ism vs. -ism anymore. When there is a near complete merger between corporate, financial and governmental institutions, where the hell are we supposed to know where capitalism and socialism begin or end?
The simple truth is that in many countries, single-payer systems do allow the government the leverage to negotiate better prices for medecine. Of course, many if not all of those countries have the same kinds of debt problems and the same kind of dingleberry politicians and economists running the country that we do in the States. Still, I think I would prefer my country to go broke because the common man can get medical treatment than for paying $100 per load of laundry to some crony, Deep State contractor in Iraq. Sort of amounts to picking your poison...
The Supremes should be ashamed of themselves they did not nix this disaster when they had the chance. It shows they do not care about the American people either.
According to the Fire Protection Association, 70% of US firefighters are volunteers.
I remain unconvinced by your argument. Perhaps if you used more Caps and bold?
Single payer system would be most efficient, even if run by government that would have a 3% overhead cost, Problem is it will never happen due to private insurance lobby, MD lobby and need to create healthcare jobs in a global economy where manufacturing jobs are vanashing. Also general population is brain dead in believing one payer is socialism. Therefore America is getting what it deserves in huge premium increases and rich getting tax loopholes and lower proportional taxes. However their children and grandchildren will suffer under present system. But who cares, everyone is living for today in a debt ridden society thinking they are upper crust. DUH !
So, is this Liftoff?
It's not a bug. It's a feature.
People forget that Americans are paying the cost of R&D for those drugs whereas other countries are negotiating a much lower pricer for them. The pharmas are accepting that because they are making it up in America. The compounds themselves cost nothing. If pharmas were tougher outside of the US things would balance out. However, I'm sure everyone on this board is of the "all pharmas are evil" and make poison BS.
Don't worry. TPPA and TPIP are going to make sure that all those free loading nations start to pay their fair share - but don't expect Americans to start paying less! Everyone else will just pay more. And pharma gets their patents extended as an added bonus. Equal oportunity profit taking. How's that for balanced out, motherfucker.
"We defrauded some folks."
Hope you all enjoy your soup spoon full of Castor Oil for your cancers and what ails yah.
You've been drinking the koolaid too long if you think the US has the best medical care on the planet... In fact, the US ranks number 37 in health care... Where I live in Asia is a hub of medical tourism and the health care system is excellent... All prescription medications are available as in the US and at a fraction of the cost...
Yeah, and you probably live under a Communist regime. Pick your poison.
Prey tell us..where do you live?
I live in Thailand now and could not be happier...
I'll stay in Canada for now. A gainfully employed single white male only has to pay around Cdn$1450.oo/ year to get swabbed on a regular basis.
Does not matter a rats ass where anyone stands.
Obama's plan was always socialized medicine and he has come very close to acheiving that with Obamacare.
If all the people enrolled in the failed co-ops don't re-enroll with someone else they will still be covered by Medicare. Fait accompli.
Which is what should have happened in the first place without nationalizing and mandating health care plans for everyone... Just put the indigents on Medicare and be done with it, but no, Barry and crew wanted to interject their version of reality and fuck things up even worse...
I could hardly call it socialized medicine when you are forced to buy insurance from a private company.
How much would general motors charge for a vehicle if you were forced to buy GM vehicles? ie no competitiion
Call it what you want ... Obamacare allowed the government to be even more heavily involved than it was before and things are now much much worse and the system is broken. Even so, the Utopians here believe total government involvement through single payer is the real solution. Unbelievable, but a typical response from those who live in Fantasyland.
As with anything, if you only look at the symptoms, you will never find a cure. America needs to examine WHY is it that its healthcare costs 20% of GDP when the rest of the developed world pays half that amount AND has better outcomes in terms of basic measures such as infant mortality, longevity etc.
Part of it is lifestyle-related but the "Fee for Service" model has never succeeded in controling costs anywhere in the world, especially in countries such as the US where Corporate corruption is rampant and litigation is common practise.
And of course the ONLY reason the Republicans did not, as promised, defund ACA when they took control of Congress is that ACA was written by their friends in Big Pharma, Insurance and Hospitals, who wrote it to their advantage. And Big Pharma's dirty little secret is that it makes 90% of its profits in one country alone, that country being of course The US. That is why if you read the annual reports of Pharma Companies, you will always find revenues broken down by geographical region but NEVER profits.
Compunding the issue is the belief amongst Americans, the result of years of propoganda, is that US healthcare is the best in the world when it clearly is not based on the facts. This prevents Americans from "Voting with their feet" and going overseas for healthcare. In many cases a nice medical vacation in Thailand, where the Specialists are ALL US trained and the private hospitals superb, the cost comes in at less than half US costs overall, including Business Class airfares and good hotels. You can make a start by buying drugs in Canada or Mexico. With a bit of research, generic drugs from a reputable manufacturer are of the same quality as the original Brand name drug and will cost a fraction, especially outside The US. Ins tead of paying a huge annual insurance premium, put some funds, perhaps half of the premium, into escrow to be used as needed as above.
It isn't actually rocket scoience but, like everything else, it requires some personal responsibility, research and action.
Spot on. Obama promised that "No family's existing health care premiums would go up."
Ours went up $600/yr+.
Fucking lying cock-socking worthless Congressional scum/ president. Oh, & Fuck the NSA. You copy?
PS. The vast majority of Primary care visits for coughs and sneezes are a complete waste of time and money, made generally becuase they are "Covered". And physicians typically ramp up the cost by running largely unnecessary tests, in part to ramp up their re-imbursables and in part to protect against malpractise suits. For the same reasons they will always prescribe the latest and most expensive brand name medicines.
So again do some research, there is a wealth of practical information available on the net, and self-medicate using (Preferably generic) OTC medicines. Most insurance premiums are wasted (Well, they are actually "Profits" for the Insurer) and do NOT consume more expensive hospital care so why pay tens of thousands of dollars for services and medicines which, with a bit of research, can be bougtt for a few hundred dollars.
Had some extensive blood work. The lab charged the insurance not knowing that I was not covered for that. The insurance claim from the lab was $1300. Once the lab claim was rejected, the lab sent me a bill for $370 which I negotiated down to $145 claiming that this was all I had clear on my credit card. They immediately accepted.
That is not as important as the following calculation. Had I had coverage for that lab work, I would have to copay 20% that would be $260 compare to $145. Insurances capitalize on human fear.
Typical experience. I rest my case, except to the extent that my estimate of 50% waste, corruption and inefficiency was conservative? From $1300 to $145 shows the amount of excess and corruption within the system.
Actually, the original concept of insurance as a "Risk Pool" remains essentially soung but it has, as with everything else, been corrupted by Corporate America. These Insurance Co=ops, even without Government subsidies, are essentially agood idea and should work except for:
self insured-paygo, healthy to begin with(why wouldn't ya be-da), essential oils, organics, juice reularily and exercise. hello, exercise, repeat- exercise. fuck slobs and their cost to be "healthy". i refuse to pay for slobs that don't give a fuck about being healthy and expect health care to be subsidized by healthy payees.
merica is soooooooooooooooooooo fucked...
The rest of the world pays less because we subsidize them just like we did with defense during the cold war. As for Americans shorter lifespan, it is almost 100% due to lifestyle. Where else in the world can you find so many greasy fast food joints? The US is the second most obese country in the world after Mexico. If you think that doesn't contribute to diabetes, cancer, and heart disease, then you are kidding yourself.
For the last few years I drive once or twice a year between Detroit and Dallas. The endless amount of fast food joints just along the freeways just has me shaking my head.
Yes, as I noted, part of it, perhaps a large part of it, is lifestyle=related but it IS a little more complicated than that. The UK, which has a single-payer system and costs less tha half of The US system, and also has an obesity problem, still has far better outcomes in terms of the standard metrics. I suggest to you that half of the cost in The US is due to corruption, waste and inefficiency. I also put it to you that there is going to be an enormous healthcare crisis in The US on the coming years because the middle class is going to be denied healthcare cover by Corporations and will not be able to afford privare coverage. Health economics is more complex than you might believe.
Incidentally, please explain further just how The US is subsidizing healthcare for the rest of the world, other than by having its Pharma Companies screw the US population on drug prices, which is, I suppose, a type of "Subsidy", but mostly to the Corporate bottom lines. There is also the matter of Research Tax credits. But these could easily be changed if Congress was not being paid off by Big Pharma? And, in any event, I'm sure that you were not aware of either of these, so please do explain?
And the attitude of foreign Governments (Who have single-payer systems and control drug prices) towards that would be, fine, if the American population is so stupid to allow this to happen to itself, so be it. There are VERY few drugs, mostly in the cancer arena, which explains why Big Pharma is focused there, which cannot be bought as Generic versions for a fraction of the price. And in most countries indeed are so purchased. Unless you wake up to what is going on, you will continue to get screwed.
And if you believe it is ALL lifestyle, then the solution is simple: change lifestyles and stop buying Insurance?
Word has got round in Nigeria, Ghana, India, Pakistan and other 3rd world countries that it is possible to receive treatment on the UK taxpayer without restraint and cheaper than paying in their own countries.
With such open-ended spending in the UK, the predictable has occurred. The NHS faces a 30 billion pound deficit by 2020 and, according to Tim Kelsey, director for patients and information at NHS England, is set to "run out of cash."
http://newsbusters.org/blogs/cal-thomas/2013/07/12/cal-thomas-column-les...
NHS may be forced to abandon free healthcare for all, says Britain's top doctor as he warns service needs radical change.http://www.dailymail.co.uk/health/article-2918003/NHS-forced-abandon-fre...
spot on... drop the microphone, we're done here +1
"This is going to hurt you a lot more than it's going to hurt me, now ben dover cause you have an enima coming to ya."
For those who are over 30 and have forgotten what it's like to be utterly sophomoric...The above quote translates to: I'm still in highschool and it's difficult for me to respond with intelligent or helpful comments, but I still want to participate and I want to appear as if I SO get what is going on and also appeal to the other 13 year olds who post here... Never mind those with IQs higher than 100... it's funny right? Up vote me and I will continue to post useless comments... Down vote me and perhaps I will be forced think and post intelligently... until the latter happens, pull my finger.. Der-hert..
End translation. You're welcome.
Mr President, what have you to say about the rash of insurance failures?
Fore! Get outta my way, sonny, I wanna birdie this hole!
"You like your corruption, you can keep your corruption"...
except, cannot even keep that in United Soviet Amerika.
YOU SHUT YOUR WHORE MOUTH !
Oblammie is doing Gods work.
Is like he is cleaning wheat from chaff.
USA oligarchs get wheat, peasants get the chaff.
We corrupted sum folx
Hey Boris, hat tip on your twitter account; that shit is fucking hilarious.
https://twitter.com/BorisAlatovkrap
Boris, man you need to take this on the road. Maybe you already are? If not get that Boris suit together sit down and put together two or three 45 minute routines and hit the road. If money is been cut for me a little maybe I could for you help write. But seriously you are the master at this. The zeitgeist is perfect. The world is ready for... drumroll... Ladies and Gentlemen...Dami i Gospoda... from the wilds of Kiev, Sankt-Peterburg on the banks of the cold cream in the Nivea, from the frozen tundra of Siberia, the hipster bars of Sochi, and late of the internet's famous Zero Hedge, Twitter, and some other shit, please welcome to the L.A. Improv BORIS ALOTOVCRAP. (crowd goes wild)
Spasibo! But you are mispell Boris' surname. Boris is one day like visit Louisiana.
Ha! The Boris has fed-exed all the soviets to USA. Is now our problem to deal with cabbage-heads.
Talking shit about Obamacare? That's raciss!
'scuse me....it's RAYCISS!!! /gag refleckz
"I'm sure they're non profit so it's ok."
So the CEO made 25 million a year then. Or more likely 50 million a year with a 100 million severance package.
"leading to questions whether the entire business model underpinning Obamacare is unsustainanble for everyone but a select few corporations. "
Well, duh, we've got a system that allows mega-corps to be enriched until we meet the ulitmate goals of the progressive's...single payer. Everything in ObamaCare is designed to fail so that we will clamor for single payer to relieve us from the oppression and confusion of our new health scare insurance. Where we're told to go get a clonoscopy at a cost of $40 co-pay, only to learn, three months later, that we need to pay nearly $400 for the procedure. Or that pain management is $40 a visit, until you find out, month later, that you owe over $500. Welcome to ObamaCare. Transparancy is unfortunately held up by HIPPA, so any dollar commitment you make is arbitary until your fucking insurance company informs you.
In the meantime, you get statements and referrals that tell you that you owe $40 for the procedure, because Hippa doesn't allow your carrier to tell your fucking group what you fucking coverage really is! This is Pelosis's, we don't know what's in it until it passes shit was all about. You don't know what covered, how much it costs, how much your shitty insurance covers, nor how much you actually owe, until this whole shit festival gets over and you get a bill...FROM YOU'RE FUCKING INSURANCE COMPANY TO PAY THE DOCTOR!!
I'm pretty sure that Co-ops with huge losses was expected, and part of the plan. The plan was that the FedGov would subsidize the Co-Ops to cover their losses, and eventually this would become a de-facto single-payer system. Where the plan went wrong, was when the citizenry betrayed their Democrat benefactors by electing a Republican house.
Nope. Co-ops were built to wilt. Observe all the design restrictions, which left the most profitable markets to privately owned insurers and barred co-ops from pursuing them. The Democratic Party wouldn't have done anything differently, not even for you. Besides, the Heritage Foundation designed that policy -- there really is no difference between a Democrat voting to mandate middlemen in healthcare disbursement and a Republican voting for the same policy, despite what the woo-woo partisans would have you think.
I recall going to the doctor in the 50s and it was understood that if the bill was large we could make payments. I don't recall anyone going to the hospital though and asume they didn't and just croaked.
At least you got in to see a doctor. I'm tapped out just paying the insurance premium.
I pay over $700/month and still must spend $7k out of pocket before I get my first dime of coverage.....no copay. This is what I pay 100% for my employees as well and they think they have shit insurance. I agree.
That's a big reason why I went galt recently.
For 2016 my income will be right on the edge of medicaide 100% subsidized, or an ACA 80/20 $2500 deductible policy for $85/month. Yes, I'm saying fuck it and joing the FSA.
Posting this so others might be inspired. Boycott this corrup gov that robs everyone blind so that niggers and illegals can have everything free.
Boycott the fed and their phoney money, which has destroyed the incentives to save and be able to afford a decent home.
Would love to join you, but Galt hasn't whispered in my ear so far. I guess I'm a moocher.
Meantime I keep trying to do my job at the best performance I can give it. Getting old, and my company hasn't sent me to any kind of training, ever. All I know is what I learned in various tasks over the last forty years. Want to Galt, but haven't been invited.
Best wishes to you oldphart. Folks on ZH are the best of this crazy country. Others are mostly just blind sheep.
+100!
I got furloughed just months from 62... so, I will use the generous unemployment program to pay my bills (I have no debt) and coast to SS. Then, tech school is free. They have a need for part-time water techs around here, so I plan to get my treatment cert and go under the table or part-time below the penalty amount.
Like Jethro Bodene, I have been applying for brain surgeon and fry cook jobs, which nobody wants to hire me for.
The feds started ruining healthcare during the central planning on steroids imposed by FDR and Congress during WWII. That's when they tied healthcare insurance as a "benefit" of employment. A.non taxable income category when the employer provided it. That way of doing things spread like wildfire and became "normal" here.
FDR, the Socialists' Friend!
And interestingly, many of FDR's new-dealers were former apparatchiks of the central planning system that Woodrow Wilson imposed during world war one.
As FDR said many times, he came to save capitalism from itself. If it had not been for WWII, Fred Koch and his fellow industrialists would all have been riding lamp posts, and we wouldn't be bowing to gods and masters just to keep from getting killed.
this is what we call the corporatization of politics for plebeian profits
Madison, Federalist 57
Those who write the laws must also be subject to those same laws, and in full effect.
That is the promise of our form of government...and how did that change?
Small outfit insurers collapsing is the mission...not a surprise...One Payer is the goal.
Socialists love big mergers and fewer players...it makes the takeover easier.
Ever look at an itemized hospital bill? Everyone should at least once. It is one of the most educational things one can do. If only to see what insantiy really looks like. You also realize the West is totally fuked. The underlying forces driving the distortions you see on that bill are a proxy for what is destroying our society.
Ever look at what we are paying for in an annual $ 600 Billion + defense budget ? A 20 % reduction would pay for a lot of healthcare without sacrificing national security. Of course there would be a lot less foriegn milliomaires in Afgan, Iraq, Syria and less profits for Defense Industry. It's all about priorities which define a sick society.
Its been a fraud from the gitgo.
It was such a good scam- the other big corporations got together and ginned up the TTP
Time for a little trust busting!!
Let hte mellianls pay the bills, they voted for obama
If stawkz are run mostly by algos, is it far fetched that e-votes are already cast/counted prior to 1st Tues in Nov.?
Do any humans still bother with their yearly prayer to the Gawdz of Demawkcracie?
Choice for President: "Scrooge McDuck"
Is that your final answer?
Fuck you.
Answer is locked in.
And It's "Donald Trump"
Fuck You.
And the winner of the 2016 Presidential Election is....
Jeb Bush!!!
Fuck You!!!!
No, Fuck You!
I must say, for two old professors, Cloward and Piven are hard at work.
No fishing or time for the grandkids for those two!
How to create a social state by Saul Alinsky:
There are 8 levels of control that must be obtained before you are able to create a social state.
The first is the most important.
1) Healthcare — Control healthcare and you control the people
2) Poverty — Increase the Poverty level as high as possible, poor people are easier to control and will not fight back if you are providing everything for them to live.
3) Debt — Increase the debt to an unsustainable level. That way you are able to increase taxes, and this will produce more poverty.
4) Gun Control — Remove the ability to defend themselves from the Government. That way you are able to create a police state.
5) Welfare — Take control of every aspect of their lives (Food, Housing, and Income).
6) Education — Take control of what people read and listen to — take control of what children learn in school.
7) Religion — Remove the belief in the God from the Government and schools.
8) Class Warfare — Divide the people into the wealthy and the poor. This will cause more discontent and it will be easier to take (Tax) the wealthy with the support of the poor.
http://www.nationalreview.com/corner/388560/why-hillarys-alinsky-letters...
The lickspittles at NR are only jealous they didn't get to slap their nameplate and ethnocentrism on that plan. I wouldn't convict anyone who made them Charlie.
Gee whiz nobody saw this coming...
ahead of schedule.....SMH.....how many times was i called "hater" and "racist" and "wanted people to go without healthcare" when i said it was designed to fail and be replaced with single payer.?
Bazinga!
If it was 1990 right now-single-payer definitely!!
However its gonna be 2016-and Obama has squandered and blown the Petrodollar Privilege-and interest rates will spike to 15% as soon as they try "single-payer"
Interest rates won't be spiking anytime soon, or ever. There is no market.
Agreed Scotty.
I'll believe interest rates are going sky high if I FIRST SEE japan and most of the EU countries "go Greece". Until then the US is the safe haven for ponzi fiat.
Kudos, I spent a few years figuring shit out. I wasn't as awake.
If the Democratic Party -- not the whingeing peons who think buying a Coke makes them Warren Buffett, but the oligarchs who actually control policy -- wanted single payer, why aren't they talking about it? Don't worry none about Sanders -- he's just the Kucinich Chair. Housebroken and defanged and no danger to any oligarch.
Quick call Lois Learner!
Call her to her guillotine appointment! I do hope she's on someone's bucket list.
My bucket list is getting pretty fucking expensive.
These asshole's are everywhere and I want to be a fainting fan of all of them.
I'm sure there are many others that want to friend them, too, up close and personal.
We need to support our weird people that are so into being fainting fans of friendship with bought off pieces of shit that are owned by the same entities as their "opposition"; what a laugh riot that would be.
The owners of our media and government getting their brains spattered on live youtube channels...
obamadeathorder
Are conjugal visits allowed at Gitmo?
Always, Certainly...
and it always involves a goat.
Dont get it. Starve the beast. Self Insure.
the fucking hospitals will rape your ass coming and going. without insurance they could charge you a million dollars for an $8K operation and force you into bankruptcy. FUCKING GANSTERS!
That is exactly right, Buzz. You need an insurance company to get the real price of services. The real price here tends to be about 21% of the total billed charges. If you do not have some insurance you will get hit for the full bill.
Personal example: One day in the hospital ER, in by about 10am and out before 5pm for me was $28k. I nearly had a heart attack after seeing my tests showed I did not have any heart problems. Actual adjudicated charges were about $6k which considering the extensive tests I had was not a bad amount. Very sophisticated expensive equipment.
Without the insurance, though, most (not all) hospitals will shake you down and send you to the collection agencies. There is no charity in their hearts no matter what name is on the builiding or who owns it (Sisters of Charity, for example). Part of the reason is it is "Gotcha!" and you have already used the services. They will make more money just from the tax advantages and some dummies actually pay.
BTW, the ambulance is exactly the same and they do not discount unless it is Medicare which is about half price.
IF you can, pick your hospital like your life depended on it. Wait a minute...
The hospitals and doctors I have dealt with actually DO give you discounted rates if you choose not to use your insurance. You have to ask. If denied you tell them you will send $10/mo until paid in full. They will capitulate given the choice. Trust me on this.
hard to negociate in the middle of a stroke or just after a car accident
Yes, some hospitals do actually offer discounts and decent terms. I will estimate 1 in 4. Doctors are very reasonable and it is almost never mentioned that most still do a lot of free and virtually free work. I will confidently predict that as various forces drive their compensation down while driving their costs up (Obamacare) that these acts of charity will become much less common.
OR
you could do what I have done.
You pay the justifiable bills (I currently owe an unexpected $350 in justifiable bills) and ignore everything else.
What are they going to do? Hurt your credit? (Laughing)...You're credit rating, even after it's harmed, is still probably greater than Obams's US credit rating.
So fuck them, ignore them.
And point at that dumbfuck we've got in the white house to sort it out.
nerve damaged twitchy fingers...and a lot of tequila and beer, lead to this double post. Sorry, Zh.
You can thank the nigs and mexicans for that. Someone has to pay, and it's always the whites.
Plane ticket to Thailand and $2K for same surgery = Priceless
Exactly, you can't go uninsured. Even the simplest of visits can bankrupt you.
Best thing is for everyone who can qualify, get medicaid. The system will crush if a large amount of people sign on and use it.
In a world of the gig economy, 1099 Bullshit as companies don't want to hire its the best option for a lot of people.
all i know is that ever since all the owebomba scumbags came on board my premiums have fucking tripled. fuck owebomba. fuck blue cross. fucking die comrade congress bitchez.
And deductibles are way up too. Obamacare was written by insurance companies.
And rammed through by lying fucking crony-socialists.
That too, though I would add that the real socialism in play was of the fascist variety. The insurance companies get to collect premiums at the barrel of the taxman's gun. The auto insurance carriers have been doing this for years with mandatory insurance (in FL as you probably know, only PIP, which covers medical bills, is mandatory). It was only a matter of time before the health insurers got in on the action. And who is the biggest winner in all of this? The insurers and healthcare industry. The biggest losers? All of us.
Communist or fascist makes no difference to me, they're both people controlling fucktards.
The difference is, I'm NOT FORCED to buy a car therefore not required to have a license or insurance, not yet anyways.
By definition it is not socialism and fascism is closer to apt.
That is, profits, capitalism, in bed with government occupation of the field, is what is at play.
Nmewn and others repeatedly rail against a monster that isnt there in a room that doesnt exist.
This is capitalism + government mandate and you are fucked and a handful of big insurers arent.
In zero ways is it socialism.
Fucking bite me, after all the blood drenched misery inflicted by "socialism"...from Mao to Hitler to Pol Pot it''s hard to imagine anyone still defending it or "trying to make it work".
You already know what's gonna happen (they-you?-can't help themselves), first it's "advice" then it's a "suggestion" then it's a "mandatory requirement".
You fuckers are insufferable.
What has gotten lost in the conversation over the past few decades is the concept of social responsibility paired with individual responsibility.
Both camps take it too bizarre extremes, where the group and the individual exhibit pure selfishness and are completely devoid of any form of responsibility whatsoever.
And you are a dumb, whiny cunt who refuses to learn the basics of the very topics you bloviate the most about.
Let me repeat the dumb part, because I fuckin' mean it, sugartits.
And go learn what a false dichotomy is for fucks sake.
Criticizing right wing myopic fatheads, the war party, and the public school dropouts who post on breitbart and drudge does not, Without more, make one a 'commie' or 'socialist' which by the way are not the same fucking thing.
Left libertarians are not commies, statists, or any other misused term of opprobrium you repeatedly employ.
Insufferable are people on the far right and far left who can not imagine the wide and verdant fields of reasonableness, freedom, and creativity that exist between the dumb fucks at the extremes.
Heres a tip: respond to what someone says with fact based rejoinder. Do not cry, and shit your pants, and think youve done anything but look like a fuckin' baby.
Now - go get your shine box, faggot.
Men are talking.
P. s. Hey lter - too much? ;)
Sugartits is a nice touch, though I've come to like Nmewn because he's passionate about what he believes. The thing about ZH is that many of the posters here see things in black and white. For them, there is no middle ground. I can't grasp the appeal of ideological purity in the real world, but who knows. Maybe in a few years we'll wake up and billions of people around the world will stop behaving as human beings have for all of their existence and stop following asshole sociopath leaders and we won't need to band together to keep the sociopaths in check.
My turn.
"Left libertarians are not commies, statists, or any other misused term of opprobrium you repeatedly employ."
I submit there is no such thing as a "left libertarian" and if you think there is, you need to supply the definition or ideoogical example of the person/state/group that is and everyone will quickly find they are the person/state/group that propose to use the state to control peoples behavior, wealth and "liberty".
A Libertarian has never proposed the state ban/register/confiscate guns or proposed that the state force anyone to buy anything (health insurance or otherwise) or proposed the state separate people along racial/ethnic/class/wealth lines because its not some grand statist-social experiment they're interested in, they're more interested in the state leaving them and everyone else...alone.
This is diametrically opposed to anything on "the left" where leftists simply can't get enough Big Government interference in their lives and as a general rule, think everyone else is too stupid (or in your own words..."dumb") to make decisions for themselves without guidance from a government technocrat.
The false socialism narrative about Obamacare is believed by probably 95% of the country -- those who like it, and those who hate it. Got to hand it to these fuckers. They are good.
The biggest lie in this category is the widely held belief that Hitler and Mussolini did not emerge from the left embracing leftist rhetoric, jargon, goals and methods. Fascism in both cases was a branch off of socialism.
So socialism is a gateway drug?
Yes. Hitler's hatred of Communism was genuine; once in power, Germany was put on a socialist path. Benito, on the other hand, left "socialism" when he saw a chance for power through the facsisti. He had some great socialist experiments like spending public capital to colonize Africa, which failed, since there was no water for the exported farmer-pioneers to farm with. Pure Italian genius at work!
Has it ever occurred to you that the entire Socialism v. Fascism v. Communism argument, is simply SHUFFLING FUCKING DECK CHAIRS ON THE GODDAMED TITANIC?
All three systems, with a side Democracy thrown in, are simply Totalitarian states designed to legally allow Statists to slowly skull fuck ALL TAX LIVESTOCK....especially those not old enough to vote. /rant -off
As someone once said, socialism is just communism by the drink, not the keg.
if you're an insurance salesman in the US and you aren't living the fat life, you're doing it wrong...
I can't think of many industries where the rules are more heavily stacked in favor of the house than insurance in the US... Vegas would kill to operate the way they do...
It's easy to see the dysfunction when one puts on their money and market decoder glasses.
Medical is a mixed market. There are three kinds of markets: elastic, inelastic and mixed.
The rules for each of these market types are different. In other words, if one wants lowest cost value, then approach to an industry needs to be tailored to type of market it represents.
For example, it makes little sense to heavily regulate elastic markets. Price competition exists naturally in elastic markets, as there are choices that can be made, which rationalizes prices.
For inelastic market, regulation delivers lowest cost prices. This is why all successful economies have been mixed economies, so that lowest cost value can be delivered.
It makes no sense to have competing Air Forces to thus lower costs. How about competing sewer lines? Competing highways with tolls, and pick the cheapest. How about competing ports, as ports are a land feature, and hence competiton is impossible. Inelastic markets must be government owned or regulated.
Period! with an exclamation mark. This is just how it is, and nobody can claim otherwise, and if you do - you should be dismissed as being non serious. There is no room for false ideology when defining market mechanisms.
Mixed markets have elements of both inelastic and elastic. For example, most of the time medical is elastic as people can buy their own medicine at lowest cost price. But, if they get sick or are knocked out, the they don't care about prices - medical has morphed into inelastic.
What we are NOT doing as humans, is defining the problem properly, and hence we cannot tailor a solution. I'll bet those who are reading my comments, have never heard the things of which I mention.
So, where does this hypnotic grip emanate from, to then turn the sheeple into dumbed down cows? Few economist talk about markets and their nature, and most of the time they mention nothing about money and its nature.
The grip emanates from RENT SEEKING and RENT SEEKERS. They want a free lunch, and they do it by shifting away your output through prices. For example, insurers will try to rig prices to insure their profits. Drug companies will schmooze legislators to then carve out exemptions to give them high profits. Ergo, American's pay high prices for drugs, but other countries pay much less. Price shifting via the credit money system, i.e. increasing prices by taking usurious rents on Money creation are probably the most onerous burden on an economy, but medical is not far behind.
Price shifting is just as onerous as Taxes, as it is a force means for shifting and grabbing your lifeforce energy. Free Lunch grabbers want to live easy on your outputs. Free lunch grabbers are rent thieves.
That said, single payer systems in Germany are 2X less costly when normed to America. In Japan it is 3X. This means that rents in inostensibly "free" competitive American system are at least 300%. But there is no real price competion unless market is fully elastic. As Homer would say, DUUOOOOH. Rent seekers on the left want you to believe that medial is fully inelastic, and rents seekers on the right want you to believe that medical is fully elastic. Both are running rent schemes to make gains at your expense.
If one approached medical properly as a mixed market, the overall costs could be dropped to much less than 1/3 of what American's now pay. I would estimate maybe 10% of todays cost, is the real low cost value, and 90% is rents due to fraud, waste, losses, friction, and theft.
America is a super predator state, led by thieves who take rents. These rent seekers then try to hyponotized you that they are necessary to your well being, when if fact they are free lunch grabbing parasites that have no useful function.
from 'Time to start Thinking':
“Obama has just caved without firing a shot,” said a senior, non–White House adviser to Obama in early June 2009. Instead of drafting his own legislation, Obama had announced he would outsource its contents to Baucus, a six-term senator from Montana and a paragon of bipartisan Washington. Baucus, the chairman of the powerful Senate Finance Committee, was the health care industry’s favorite politician. According to Open Secrets, Baucus had received $3.8 million in donations from the health industry, which put him among the top five recipients on Capitol Hill. He took more money from health care groups in 2008 than any federal lawmaker that year. From Canada to Japan, in one form or another, every rich country’s government negotiates cheaper drug prices and offers their citizens public insurance. The absence of both is largely what makes America’s health care system the “wallet biopsy” it has become. They are a big part of the reason why other countries’ health spending consumes on average roughly half the resources of their American counterpart while achieving higher life expectancy and covering their entire populations, the three goals Obama had originally set out. This is also why U.S. employers, who continue to provide insurance to most Americans, will remain just as keen in the future to look for technology that can further reduce their head counts. “Seldom have so many waited so long for so little,” said Lloyd Doggett, a Democratic lawmaker from Texas. “This isn’t negotiation, it is capitulation to the insurance industry.”
"crony socialists"? our health system is CAPITALIST! Crony CAPITALISM doof!
You mean the $100.00 aspirin tablet isn't susstainable? Color me shocked!
Decisions decisions. On what do I spend my money?
A $100 asprin or,
A $4,000 toilet seat....
Hey Knuks <-->enjoy that Medicare while it lasts. :-P
I'm sure you have all the supplements.
BTW, Howard Hughes destroyed TWA. Carl Icahn, just finished it off.
TWA was in arrears to Icahn for almost 3 years, before he called in his chips.
TWA hedged "tickets" based on FUTURE sales. to satisfy the debt. Sound familiar? Derivatives were born.
They gave up the ticket guarantee, for flight originations, and Icahn jumped on it.[internet discounted TWA tickets]
TWA's inventory was aging, and they sold off lucrative European routes. [ no liquidity]
Finish this TRUE story for me Knuks.
As if there is a choice.
On mountain bike rides, the running joke is that the going rate for an innertube, tool, or some other bike part triples the moment it becomes a necessity for not having to walk home. Fortunately, we accept payment in pints, and laughs.
Uhh, Knux, it's 40$ for the toilet seat, the balance is in the executive bonus.
Well Gee - I guess I'm lucky. My premium only went up 40% /sarc
my admittedly very limited understanding of the ACA, as legislation, is that it was designed to basically do 3 things:
1] cash grab for Uncle Scam;
2] cause failure of smaller insurers to benefit the reprehensible cunts who literally assisted in the drafting;
3] collapse the private insurance scheme entirely to 'necessitate' some form of single payer where our money and info can be nicely collected and stored
1 is obviously true, 2 is happening and it is hard to believe drafters wouldn't know {who was that smug cunt from last year who ZH pilloried...shit..blanking....} and 3 would be in keeping with everything else...
I vaguely remember reading a couple papers about the disproportionate failure of banks outside the fed system, surely part of the plan...
it's all a rich tapestry, is my fucking point.
Raymond, the smug asshole you're trying to remember is Jonathan Gruber. The asshole that said how easy it is to dupe the American public because we're all so stupid (as the entire Obama team withheld factual information but promulgated lie after lie with regard to OvomitCare).
In the private sector, it's referred to as Fraud.
You got the scenario right and it would have happened sooner without Odouche delaying implementation for the next administration. Think they wanted to blame it on another Bush.
Think about this: the tax penalty goes UP big time next year. What better time to raise taxes tan to dump everyone off their plans without enough time to find and pay for alternate insurance?
The i rs is already running the profit projections....
Why are we so sick? I said to myself as I ate my Cheetos, downed my Budwiser, and I paid my American Express card with my unemployment benefits. Which reminds me, pit stop to Wal-Mart!
and the beer I had for breakfast was so good
I had another for dessert.
https://www.youtube.com/watch?v=6w9F7zf_2mM&list=PL1E5305F994D66B5A Sunday morning comin' down
Mcgruber could not be reached for comment
We McGrubered some folks.
Does anybody still believe government is the solution?
Only the dumbfucks and there is alot of them.
They will fucking double the cost again next year. why the fuck not? they can charge whatever the fuck they want and you have to pay. pay for yourself, pay for all the deadbeats too. They will fucking take your whole fucking paycheck and NOTHING CAN STOP THEM.
Well hell they did have to pass it so YOU could find out what was in it, snicker snicker.
Dear dark alphabet agencies,
Since you are supposedly already running the show, can you please grant me one small request this Holiday season?
The next time Obama and his assassination insurance are on stage together, can you please have them both vaporized with a drone strike?
Standard Disclaimer: I know it's a lot to ask, but the Christmas season is coming. I know with your overwhelming desire to spread Christmas cheer and peace on earth you can make this happen.
---------------------------------------------------------------------------------------------------------------------------------------
Weird things happen, or proof that the same idea can nearly simultaneously spring up from multiple individuals.
Last night I was watching the Blacklist, and they had a website where people paid money to have an assassin take out a target. I sat there dumbfounded because I've been mulling a variation of that idea for a month or so (may have even posted something to that effect here on ZH) about the exact same thing. The only real variation in the idea was more than one contributor could add money to a target...(if you're really hated, the bounty on your head could climb faster than the stock market in a paroxysm of QE...)