Obamacare

[moevillini]

Did there used to be rules against advertising perscription drugs on TV, or was it just that no one thought of doing it until the last decade or so? Either way, they have got to be the most annoying ads on television. 99% of the airtime seems devoted to the disclaimer talking about all the bad possible side effects of the drug.

And what's with the two people in the Cialis commercial sitting outdoors holding hands in side by side tubs? Does anybody actually see that and think it looks romantic, because to me it looks like the weirdest date ever.

I agree that the Cialis ad is stupid. It has always struck me as very odd - two bathtubs in the middle of a prairie? Really? And why would you be in separate bathtubs anyhow?

And yes, it used to be against the rules to advertise them. Don't recall exactly when it changed, but I think it started about when my daughter started high school ('99) because all the sudden on the subway & buses you started seeing ads for Claritin, which at the time was prescription only.

 

[moevillini]

It's kind of like how medical costs started soaring when insurance coverage become more widespread because employers started offering it as a benefit to their employees. Fifty or sixty years ago, there was much more "fee for service" and costs were much lower. Gotta give those insurance companies and their executives their cut, you know.

 

[Siro]

Shorthand Answer-sexual advertising involving "prurient interest" can be regulated. The tobacco advertising can be limited due to the harm. Lots of case law on this. Consumers have the right to be informed regarding pharma and what is available to them. Again, the ads must be accurate. Based on all the current precedent in this area (a simple google searxh will show you cases), restricting these pharma ads will be a nearly impossible battle.

That was an ancillary point anyway. If we become a single payer, even if we remove the cost of all ads, r&d $ would cut in half.

Restricting pharma ads is not impossible and can be easily done. I don't even disagree with what you're saying about the big picture, but restricting commercials part is irrelevant. We have numerous regulations regarding all sorts of speech with numerous different justifications. "Prurient interests" is just like saying "it conflict with what we're used to". It's as flimsy a justification as justifications get. A thousand justifications can be made up to restrict pharma ads. It's not like the legal system would be at a loss as how to regulate this specific issue.

 

[Joe Bagadonuts]

It's kind of like how medical costs started soaring when insurance coverage become more widespread because employers started offering it as a benefit to their employees. Fifty or sixty years ago, there was much more "fee for service" and costs were much lower. Gotta give those insurance companies and their executives their cut, you know.

It is such a bad system. Insurance companies will tell you that their role is to spread the risk among the group, protecting each member against catastrophic loss, but in order to do this and still turn a profit (and they are obviously turning large profits) simple mathematics tell you that the total premiums must be far greater than total claims. The bottom line is as you say. Insurance is one of the big factors that has caused health care expenditures to skyrocket.

Mandatory insurance under Obamacare is accelerating this process even more. This is especially true because when an insurance company is required to accept applicants with pre-existing conditions (who will almost certainly have greater covered medical expenses) they have exactly one way to make that work financially: raise everybody's rates. So where you used to be paying a rate based on spreading the risk among policy holders with similar risk, low risk policy holders are now paying large premiums in order to cover high risk patients.

And to make matters worse, if someone chooses to remain uninsured because they don't expect any medical costs, but then something happens to them and suddenly they want coverage, the insurance companies are required to oblige. Essentially these people are buying insurance after their house burns down, and all of the policy holders are being charged to cover the additional risk that these uninsured people present.

 

[Joe Bagadonuts]

When I was a kid if anyone had talked about getting and keeping an erection in front of the children my parents would have had a heart attack. Nowadays it's the most ordinary thing in the world for a 5-year-old girl to know what to do about an erection lasting for more than four hours. This is not a step in the right direction, IMO. I'd definitely be in favor of getting rid of these ads and I'll bet the vast majority of the public would too. Not holding my breath, though, because as far as I know nobody is even trying to accomplish this.

 

[fishonjazz]

I hate insurance. I hate the concept of it even. Paying for something that may or may not even happen or be needed.
And it's so expensive. I can't imagine the astronomical number difference there is for how much money I have spent on car, home, medical insurance vs how much I have got back from it. I never get in car accidents or get tickets, im very healthy and rarely go to the dr, and I have never used my house insurance yet I spend tons on those things.

And to make matters worse, if you actually use your car insurance (get in accidents) then your rates skyrocket and sometimes they even drop you.
If you have health issues then it's hard to even get certain types of coverage (long term healthcare is one). It pisses me off.

I don't ever even pay the insurance when gambling in wendover or vegas and the dealer has an ace showing.

I also feel a similar way about paying for warranties. Bad idea most of the time imo. I never have needed one

 

[JAZZGASM]

Restricting pharma ads is not impossible and can be easily done. I don't even disagree with what you're saying about the big picture, but restricting commercials part is irrelevant. We have numerous regulations regarding all sorts of speech with numerous different justifications. "Prurient interests" is just like saying "it conflict with what we're used to". It's as flimsy a justification as justifications get. A thousand justifications can be made up to restrict pharma ads. It's not like the legal system would be at a loss as how to regulate this specific issue.

My definition of prurient interest (and the Sup Ct's) differs from yours, but I wont get into that as it is an ancillary issue.

IMS Health v. Sorrell and it's progeny (and another Virigina case from the mid 70s iirc) protects pharma ads as commercial speech that informs consumers. There have been multiple lawsuits on this issue, and pharma wins these cases. Legislatures have tried to restrict these ads and failed after long periods of litigation. These companies will fight tooth and nail to keep these ads legal. I read that for every dollar in pharma ads $4 is made. An industry will not roll over on an issue like this and they have current case law on their side. I am not saying it is impossible, but the chances are slim. It definitely won't be "easily done". The AMA has tried, politicians have tried, and yet the ads are still protected speech.

 

[JAZZGASM]

I hate insurance. I hate the concept of it even. Paying for something that may or may not even happen or be needed.
And it's so expensive. I can't imagine the astronomical number difference there is for how much money I have spent on car, home, medical insurance vs how much I have got back from it. I never get in car accidents or get tickets, im very healthy and rarely go to the dr, and I have never used my house insurance yet I spend tons on those things.

And to make matters worse, if you actually use your car insurance (get in accidents) then your rates skyrocket and sometimes they even drop you.
If you have health issues then it's hard to even get certain types of coverage (long term healthcare is one). It pisses me off.

I don't ever even pay the insurance when gambling in wendover or vegas and the dealer has an ace showing.

I also feel a similar way about paying for warranties. Bad idea most of the time imo. I never have needed one

It is good and bad. Prior to the 20's we largely paid direct for services, but the quality of care was poor. We now pay out the *** but have had amazing advances in care.

I hate pharma ads, and insurance, which largely exists due to governmental regulations, has caused costs to skyrocket. Similarly, government interference in student loan rules (expansion and protection to lenders) has caused the cost of education to skyrocket. Well meaning goverment regulations have hurt us.

 

[BabyPeterzz]

Since insuring those with pre-existing conditions is where most are seeing the benefit, how would premiums and deductibles have been affected under the previous system? What about the states, including Utah, who have not expanded Medicaid?

Let's discuss this honestly, many of us are paying more for insurance so that people who could not get insurance, who should have access, can get the coverage they need. Reducing emergency room visits and helping the poor avoid bankruptcy and, in turn, homelessness saves our country more than money. Opposition to some of the measures in the ACA should keep costs up, but those who need care are getting it and not selling their entire lives to get it, well most who need care, at least. I would be very interested to see what happened to costs if all states expanded Medicaid, like to plan calls for.

 

[Miggs]

I hate insurance. I hate the concept of it even. Paying for something that may or may not even happen or be needed.
And it's so expensive. I can't imagine the astronomical number difference there is for how much money I have spent on car, home, medical insurance vs how much I have got back from it. I never get in car accidents or get tickets, im very healthy and rarely go to the dr, and I have never used my house insurance yet I spend tons on those things.

And to make matters worse, if you actually use your car insurance (get in accidents) then your rates skyrocket and sometimes they even drop you.
If you have health issues then it's hard to even get certain types of coverage (long term healthcare is one). It pisses me off.

I don't ever even pay the insurance when gambling in wendover or vegas and the dealer has an ace showing.

I also feel a similar way about paying for warranties. Bad idea most of the time imo. I never have needed one

Soon enough you should get life insurance. Don't be foolish.

 

[Saint Cy of JFC]

Soon enough you should get life insurance. Don't be foolish.

Clear your inbox

 

[Miggs]

Clear your inbox

Done.

 

[fishonjazz]

Soon enough you should get life insurance. Don't be foolish.

Already got that ****.
Going to up it next year

 

[Miggs]

Already got that ****.
Going to up it next year

Good man.

 

[VINYLONE]

The ACA was never about making healthcare affordable. Anyone who thought or thinks otherwise is drinking the kool aid. I am ****ing extremely thankful and fortunate that healthcare is paid through my union. Granted, I have quarterly dues of $225.00 but that's nothing compared to some of the horror stories I hear about.

I think most folks premiums have gone up every year since before ACA was enacted.

 

[Harambe]

The ACA was never about making healthcare affordable. Anyone who thought or thinks otherwise is drinking the kool aid. I am ****ing extremely thankful and fortunate that healthcare is paid through my union. Granted, I have quarterly dues of $225.00 but that's nothing compared to some of the horror stories I hear about.

I think most folks premiums have gone up every year since before ACA was enacted.

You're going to see growth in premiums. It was almost guaranteed that going in, particularly if young people didn't sign up. Many still haven't, those terrible awful scumbags.

But compare the out of pocket and yearly premium rate increases from 1999-2008 to 2008-present, and you'll see why it's not a "pants on fire" lie that the ACA saves you money.... just a hard to see, highly objective truth.

aka; Get more numbers and do more math than I care to right now and it mostly makes sense.

 

[jimmy eat jazz]

Is there anybody out there who still thinks this is a good thing?

I'm just asking because my insurance rates keep on going up, and I'm the very definition of low-middle class. I thought this **** was supposed to help me?! I'd be better off if I were a single parent, no job, and "disabled".







/insurance rant over

Wouldn't a better measure of the ACA's performance be the trend of overall insurance premiums/costs, rather than one person's?

Yes, I still think it's a good thing. Millions of people now have access to health insuance who did not before. Insurance companies can no longer deny coverage for pre-existing conditions. Etc. To me, it's an acceptable tradeoff that someone now has access to live saving drugs or medical procedures, even if it results in some insurance premiums increasing. I'm sorry, but my criteria for judging the success of any national public policy is not how it affects you or any other individual.

The ACA does face some problems/issues, and can and should be improved. I am concerned, for example, that some insurance companies are not doing well and may opt out. I'm open even to a radical fix, and if conservatives have a viable solution, I'm willing to listen (e.g., the ACA is based on conservative think tank ideas), but I'm not willing to simply throw out the baby with the bathwater. (Although I have no confidence that Republicans can come up with a viable solution given the death grip the tea baggers and other wingnuts have over it at the moment.) We simply cannot go back to being and the only developed nation, and richest one at that, which does not provide universal access to health insurance.

 

[Stoked]

I think the ACA is a flawed thing. Some benefited, some didn't. Some ideas were good, some were merely OK and some were bad.

 

[Stoked]

Wouldn't a better measure of the ACA's performance be the trend of overall insurance premiums/costs, rather than one person's?

Yes, I still think it's a good thing. Millions of people now have access to health insuance who did not before. Insurance companies can no longer deny coverage for pre-existing conditions. Etc. To me, it's an acceptable tradeoff that someone now has access to live saving drugs or medical procedures, even if it results in some insurance premiums increasing. I'm sorry, but my criteria for judging the success of any national public policy is not how it affects you or any other individual.

The ACA does face some problems/issues, and can and should be improved. I am concerned, for example, that some insurance companies are not doing well and may opt out. I'm open even to a radical fix, and if conservatives have a viable solution, I'm willing to listen (e.g., the ACA is based on conservative think tank ideas), but I'm not willing to simply throw out the baby with the bathwater. (Although I have no confidence that Republicans can come up with a viable solution given the death grip the tea baggers and other wingnuts have over it at the moment.) We simply cannot go back to being and the only developed nation, and richest one at that, which does not provide universal access to health insurance.

https://www.forbes.com/sites/theapo...miums-by-avg-of-41-subsidies-flow-to-elderly/

41 states are seeing hikes in their premiums. New York had the largest decrease of 40% while Nevada had the highest increase of 179%.

 

[jimmy eat jazz]

https://www.forbes.com/sites/theapo...miums-by-avg-of-41-subsidies-flow-to-elderly/

41 states are seeing hikes in their premiums. New York had the largest decrease of 40% while Nevada had the highest increase of 179%.

Ok, but what's the counterfactual? Premiums have been increasing for a long time now, so are they now increasing at a faster rate, slower rate, or about the same than historical and/or recent trends?

For what it's worth, I don't see that premiums have to fall to claim ACA is a success. I'm willing to trade off increased cost for increased access, although I'd obviously prefer decreased cost. I do, however, think an important, but not sufficient, indicator of success is how it affects the long-term trend in overall health care cost.

All, or most public policies, are matters of trade-offs (Pareto Optimality be damned), there's inevitably winners and losers. I'm willing to look at what these trade-offs are and how they play out and have a rational discussion about how we assess them.