I have seen many patients lose their doctors because the doctors were not contracted with Covered California. The reason the doctors do not contract with Covered California is because at face value the plan appears to be just like the usual say PPO plan. But in fact it pays about 33% less than medicare (in other words, no different than Medi-Cal.
These are only some of the financial problems created by Obamacare. The problem with the government effectively taking over Health IT by way of forcing Electronic Health Records to abide by bureaucrats definitions for "meaningful use" is a completely different disaster that has resulted in marked decreases in productivity and worse care for patients.
Giant Hospital systems are taking over individual and group practices and turning them into corporate mills with little to no autonomy for physicians and terrible care for patients. All the while greedily taking in government and private dollars.
This is crony capitalism at its very worst.
I don't think it competes with, just for two obvious, off-the-top-of-my-head examples, either the Indian Removal Act or the Alien and Sedition Acts.
> I have seen many patients lose their doctors because the doctors were not contracted with Covered California.
Covered California is the California state health insurance exchange, it does not contract with doctors at all. The individual health insurance plans offered by private companies on the exchange contract with doctors.
> The reason the doctors do not contract with Covered California is because at face value the plan appears to be just like the usual say PPO plan.
Covered California is not a plan, PPO or otherwise. It is the exchange on which plans are offered. A number of different plans, PPO and otherwise, are offered on the exchange.
> The problem with the government effectively taking over Health IT by way of forcing Electronic Health Records to abide by bureaucrats definitions for "meaningful use" is a completely different disaster that has resulted in marked decreases in productivity and worse care for patients.
"Meaningful use" of EHRs is voluntary; the government involvement is providing incentives for meaningful use within the Medicare and Medicaid programs, not penalties outside those programs.
(EDIT: clarification of the meaningful use comments)
Those legislation mainly affected people who weren't US citizens, though. Obamacare does, which makes it way worse for US citizens.
Prohibition or the Japanese internments(if executive orders count) are maybe a better example.
See, I can anecdote too.
Like the report said, there's still progress to be made.
And in response to the parent, are there problems with the ACA? Of course, but let's iterate on it, instead of dismissing it completely because you happen to be one of the few who doesn't benefit from it.
Not only did we not get the healthcare that we voted for, we got mandated insurance based healthcare at even higher prices, with even more bureaucracy, and huge tech boondoggles as the icing on the cake. Sold to the public as not a tax, but then justified at the Supreme Court as a tax. 5% of the population comes out ahead and everybody else behind.
The 111th congress will go down in history as the most cowardly and counter effective we will ever see. That Obama is whitewashing and patting himself on the back like this is bordering on insanity.
You could do that before ACA.
> instead of being chained to a 8-5 corporate job
What does this lifestyle choice have to do with ACA? ACA doesn't somehow give you free time or extra money. Unless you are getting your insurance for free (which was possible before ACA, mind you). ACA often does not offer the cheapest plans either...
Aside from that, do you have any suggestions for how to improve it? It sounds like you have a useful perspective.
Monthly premiums for my wife and I are ~$700/month (both healthy, early 30s, Blue Cross Blue Shield). When our daughter arrives shortly, that will increase to $1000/month. That's a high deductible plan where we're out of pocket for everything for the first $6000/year.
I work remotely, so we're looking at moving to Central America (Panama or Belize, wherever its cheaper to dock a 40' catamaran); if you live outside the US more than 330 days/year, you're not obligated to carry insurance. I can obtain expat insurance, that covers my entire family in every country in the world except the US, for $3000/year. $9000/year after-tax savings is nothing to sneeze at.
The ACA was a sham; it measures the insured rate, not the ability of citizens to receive the care they need. On that metric, its failing terribly. But health insurance companies are doing well at least.
EDIT: I have no problem with universal healthcare. I believe greatly in it. I despise that the federal government didn't eliminate health insurance companies entirely and move to single payer through Medicare.
Medicare isn't single payer. Its actually very similar to the ACA exchange system, only with a public option alongside private options (all of which must offer at least as much coverage as the public option, and which are partially publicly subsidized for people choosing them instead of the public option.)
(And, in the case of prescription drugs, with a big hole in the public option, for which, if you want coverage, you either have to reject the public option or purchase a publicly-subsized private plan to cover that hole on top of the public plan.)
Medicare was a single payer system, back before most of the people posting on HN were alive.
Can you elaborate on this? Not because I think you're wrong, but because I haven't been able to find any data one way or the other about health outcomes and the ACA.
however, I was always under the impression that Electronic Health Records would result in a meaningful improvement care and record keeping. Can you elaborate on what problems will come from this?
11 thousand pages of new regulations can not be called reform. It is unbelievable how this new giant piece of regulation is even termed as "reform".
The reform in US healthcare could have been destroying the monopoly of AMA over supply of doctors, getting rid of complex procedures for prescription medicine, downsizing FDA and giving more flexibility to doctors to determine quality of service for day to day medical care.
I do not agree with "crony capitalism" part however. The Obama Labyrinth of Healthcare Mess is soviet style big government in action. It does not do good to pharma-companies, insurance companies, doctors or patients. All big insurance companies had to exit in few years from the government insurance exchanges.
Why not? Now, if you were complaining about someone, hypothetically, calling it "simplification", I can at least comprehend the objection, but what does the number of pages of regulation have anything to do with whether or not it can be called reform?
Having studied readmission rates, I was amazed, only to be disappointed as I looked at the Y-axis.
"Barack Obama ... don't know the cat. Oh, he has a law degree? Hm, okay, I guess his opinion might matter then."
It would be like seeing "Guido van Rossum, Dropbox Employee".
See http://jama.jamanetwork.com/article.aspx?articleid=2533068, http://jama.jamanetwork.com/article.aspx?articleid=2533066, etc.
"Barack Obama, President of the United States of America" == "Guido van Rossum, Python's BDFL"
"Barack Obama, JD" == "Guido van Rossum, Software Engineer"
Which, I'm cool with.
Then again, they're politicians and not academics so not as big a deal.
Yeah, in my field (astronomy) that would have also merited co-authorship. But, I think standards vary wildly. In astronomy, many co-authors' contributions consist solely of commenting on nearly-finished manuscripts. Some friends in ecology think that's way too generous and would instead just acknowledge people for their comments.
>These and related reforms have contributed to a sustained period of slow growth in per-enrollee health care spending
Has the rate of change in insurance premiums or healthcare spending actually slowed? I don't see it in any of the data presented.
