Collins responds to president's fix for Obamacare

My old health plan was cancelled... However, it was replaced with an upgraded version for an extra $10/week for Family. But it's actually cheaper for me because Employee + Spouse is $25/week less expensive than what I was paying. The coverage is better as well, it's Independent health's platinum package.... So for some it's more expensive, but for me it works out much better. Saving $100/month + better coverage.

If by "misguided" Collins means we should have a single-payer system, I agree. ...But that is not what Collins means.

To say that Obama "fixed" a glitch in the ACA in one breath and in another breath call the ACA "unmanageable" is a flat-out contradiction.

The key misunderstanding evident in Collins' blindside: everyone expected that pre-ACA policies would be treated as sub-standard as the law phased in. ...But Collins' rhetoric manages to avoid mentioning that these obsoleted, pre-ACA policies are inferior.

The rhetoric also puts blame on the government for the cancellations. Who is cancelling these policies? ...President Obama or the insurance industry?

Who is Collins helping by reinstating obsolete insurance policies? What a tool!

In 5 states, New York being one of them, the ACA will actually grant marginal savings. The reason why is that most of the required coverage was already enacted before Obama was even president. These 5 states also has the highest insurance premiums in the nation prior to the ACA.

In essence what is happening is that 5 states which collectively account for 1/3 the population of the nation are gaining savings at the expense of the other 45 states and 2/3rds of the population that are not.

We have approximately 17 choices in New York State plus Medicaid, in as many as 10 states, there are 2 choices plus Medicaid which offer plans 25% plus more expensive.

It is all about where you live

There are three significant 'fails' in the field of U. S. health care: 1) Failure to control the cost of health care, 2) Failure to provide access to basic health care in all markets, for all income levels and 3) Failure of the for-profit-model to do anything but exacerbate the first two failures. If "big government" isn't going to fix these problems sure-as-hell the private insurance companies offer no better solution than attrition.

How is it that anyone who wants too, can go on line and get any type of car insurance in a few minutes without the government involved.

CM, the largest single cost driver in Health care is MEDICAID and the way Government reimburses health care providers who accept it, Roughly 55 cents for every actual dollar of cost, those cost are then passed to paying patients.

here is my bit on the ACA. no matter how you feel, the ACA is law. I do not like anything shoved down my throat any more than anyone else, this law sucks. However it is the law. All of our representatives in government should be doing everything they can to fine tune this law so it is fair to everyone in cost and coverage.
I am probably in fantasy land when I say that.
when I read between the lines of Mr.Collins statement above, I read that he is a stick in the mud and he will do what ever he can to make the ACA a failure. He calls the ACA, obamacare, yes it's a cute nickname, one that is for you and me to use if we wish, but for an elected official to make an official statement and use that term, to me is very unprofessional and quite frankly immature.

The "Keep Your Healthcare Plan Act" will pass the House, but Reid and company will vote it down - IF it ever sees the floor.

And Michael, I predict that your savings will be more than offset by increased taxes needed to support this unsustainable debacle - in the not too distant future. For most of us, it will mean paying more taxes AND paying more for coverage.

I feel the need to comment on the ACA. I am a Navigator helping people get insurance in NY. I can't express to you how good it feels to tell everyone that they will get a credit to help buy insurance when most of the people who I have met and helped since this started have not been able to afford a decent health insurance plan. These are hard working people and some who have not had insurance for years. People cry because they will finally either be able to go to a doctor or not have to pay ridiculous premiums. I can't say where I work as that is considered "political" by my employer but if you want to see how this works you can check the NYStateofHealth website and I am listed as a Navigator. I do have to say that you can pick the plan you want and I have not helped anyone who has told me that the premiums are more than what they had been paying. Personally I feel that hospitals and doctors charged the insurance companies and citizens for the un or under insured for years but seeing people who didn't have any insurance and didn't go to doctors since this started has amazed me because it' happens more than I could ever imagine. Call me.

"How is it that anyone who wants too, can go on line and get any type of car insurance in a few minutes without the government involved."

Sorry, but government, of course, is involved. I presume New York has an Insurance Commissioner, to make sure us rubes don't get taken too badly by the insurance giants in the exalted 'free' marketplace.

Thanks, Mr Collins. I'll know how to vote in the next election. I wish to see single payer, like the rest of the civilized world, but I'd have settled for the market-based ACA (originally proffered by the Heritage Foundation, for heaven's sake) in the interim, to help take care of those run over by a grossly failed free-market model. Just the fact people cannot be excluded from coverage because of a pre-existing condition is victory enough for now.

Big Government and Big Business are BOTH bad. For all the same reasons.

Obamacare takes all the worst features of both and multiplies how much they can affect you. Bitch all you want about insurance companies, but you CAN fire them. You CANNOT fire your government...

"Big Government and Big Business are BOTH bad. For all the same reasons."

Yeah? So what do you recommend?

"The single biggest cause of escalating health care costs is big government."

The single largest cause of escalating health care costs is growing number of uninsured Americans seeking health care through emergency rooms during a health crisis, be it a case of the flu, or cancer. Who do you think pays the 'hidden' premium here, where the 'free' marketplace has failed?

Single payer in Europe came about NOT by popular demand, but because WWII destroyed nearly everything in Europe and they had no choice.

"Single payer in Europe came about NOT by popular demand, but because WWII destroyed nearly everything in Europe and they had no choice."

Can you explain to me the difference between popular demand and public need? As for having no choice, you are aware that we're talking about European democracies here, right?

Scott,

Medicaid reimbursement is actually the largest cost driver in health care cost, the government reimburses at about 55% of the actual cost to the provider. The balance of the real cost is then passed on to the paying patient.

Remember the DOCTOR FIXES voted on every 10 years or so, those were Medicaid reimbursement. This was exasperated by laws passed in the mid 80's which led to HMO's, this enabled negotiated payments to health care providers by insurance companies.

So it wasn't the FREE MARKET PLACE that failed, I was the FREE MARKET lace tinkered with by well meaning politicians.

I agree that there is no simple solution, but clearly charity has been gradually displaced with Government, that essentially took private citizens out of the loop over decades. The more the Federal government grows, the less control we have over or day to day lives. This is epitomized with health care spending.

Prior to the ACA, 85% of Americans were happy with their health care, covering the other 15% could have, and should have been dealt with on a State by State basis.

Take the UK, they had prior to 1939 a rudimentary insurance system much of it regionally based, some of it employer based. Prior to the war, the system was being expanded to include dependents and unemployed on a regional basis, not the grand government schema but based on private groups.

Once the War began, the bombings and overwhelming casualties forced the Government to form EMS groups, basically a government triage system that routed patients to hospitals based on the hospital census and severity of wound. Because of the constant siege in the bombings, all doctors were either absorbed into the military or these groups. In 1946, after the war the National Health System simply kept that system in place because of massive war casualties and a shattered economy. The National Health System grew out of that. Once you establish, as the British found out an entitlement based service, is simply doesn't go away, several times in the decades that followed, The cost of the National Health Service almost drove the UK to financial ruin.

The one thing missed about the European Health Care Systems and the Canadian System for that matter is that they all have long waits for procedure, little or no choice of Physician and a bureaucracy that make medical decisions based on cost rather than need.

The Employees of the UK National Health System constitute the largest block of UK voters ironically.

"I agree that there is no simple solution, but clearly charity has been gradually displaced with Government, that essentially took private citizens out of the loop over decades."

Mark, do you seriously think charity is going to stand up for the folks who get a stage IV diagnosis, lose their insurance on their next billing because of a 'preexisting condition', and then get billed until they loose their home and have to file bankruptcy (this the leading cause of bankruptcy in the United States), get ER services compensated by the county or the state, then land on family couches or in shelters to be tended by over-utilized and expensive ER services? If so, why haven't these charities stepped forward already? On a side note: Are you aware that the nation's largest provider of mental health services is the Federal Bureau of Prisons? ('Free market' insurance ain't gonna touch these losers -- they know better, there's no profit in it -- even if these losers are your brother or sister.) And where's the charity there?

"covering the other 15% could have, and should have been dealt with on a State by State basis."

I never saw anything happen on this -- except in Massachusetts. And much to the consternation of the right, Romney-care is working there. And in Massachusetts, even after a difficult roll-out of Romney-care, half of the electorate didn't fight to deny their neighbors affordable healthcare.

Bottom line for me? Health care in the United States is a national disgrace. I trust the law before charity.

"The one thing missed about the European Health Care Systems and the Canadian System for that matter is that they all have long waits for procedure

True enough, as pertains to elective, non-emergency procedures.

"little or no choice of Physician and a bureaucracy that make medical decisions based on cost rather than need."

Not so true. Cost/need is confused here with need/urgency. Services may be triaged, as not all medical conditions are as emergent as others. My bad hip can wait for your cardiac catheterization. I'm cool with that.

In Northern Canada to this day, lotteries are held in small towns to see who gets to see the visiting Doctor, that is a fact.

In bureaucracies, choices between hip replacement and catheterization are not made on need, The waiting list for catheterization in UK is 10 weeks, in Canada 6 weeks, currently in the US 2 Days.

When emotions are set aside, it really boils down to economic theory.

Franz Kafka,John Stuart Mill, Milton Friedman & Ludwig von Mises all economist believed that bureaucracies were inferior to representative government and further self reliance.

Karl Marx and Max Weber on the other hand, believed that Government bureaucracies and corporations work hand in hand and in support of each other.

Single payer, builds those bureaucracies inherently, thus feeds the very monsters that many cite as the problem.

Local and Regional solutions however, keep the administration at home and in more control of the taxpayer, and as with any system there are loopholes and voids, they are more likely to be addressed.

The dehumanizing effects of excessive bureaucracy were a major theme in the work of Franz Kafka, and were central to his masterpiece The Trial. The elimination of unnecessary bureaucracy is a key concept in modern managerial theory and has been a central issue in numerous political campaigns.

Scott, The Catholic Hospital System, The Methodist and many Jewish hospitals were charity based and thrived for many years, until regulated almost out of existence.

Did you know that MEDICARE a government entity does not cover Chemo therapy on an in patient basis, I found that out the hard way when my mother was diagnosed with Acute Myeloid Leukemia. It is a perfect example of Government bureaucracy. A government entity decided it was too costly, and she was too weak to make the trip back and forth 3 times a week.

As far as Romney Care in Massachusetts, yes it works there, but that is one of 50 States, what works in Massachusetts does not necessarily work in Kansas or Arizona.

As of 30 seconds ago, there was 319, 534,555 people in the US, diverse backgrounds, diverse locations and not the 30,000,000 in Canada or the 63, 000,000 in the UK. Both health care systems rife with bureaucracy, There is no way that a US national health care system could be anything but an expensive bureaucratic monster.

So Mark, are we to handle 300,000,000 American's burgeoning healthcare needs by charity, county resources, good feelings, or what? I'm not trying to be snarky, but as much as I admire your literary persuasions (my favorite is The Metamorphosis, and I loathe bureaucracy and bigness) I don't think our healthcare conundrum is going to find help there, or at Walden Pond.

"As far as Romney Care in Massachusetts, yes it works there, but that is one of 50 States, what works in Massachusetts does not necessarily work in Kansas or Arizona."

Umm, why not?

why should one group have to pay for the healthcare of another group....either all get the same tax credit or no one should get a tax credit....This is a system of winners and losers ...Give every one a 7000 dollar tax credit to go and buy there own insurance..

"My bad hip can wait for your cardiac catheterization. I'm cool with that." While that is noble of you, please explain how it is, in any realm, economically sustainable. When you, who works and pays for your healthcare has to get in line behind someone who doesn't pay for their healthcare (in other words you pay for theirs too) has that scenario extrapolated across millions of cases, how does A.) your hip (which may govern your ability to make a living) ever get fixed and B.) that system of healthcare not run out of money quickly without skyrocketing costs to cover what is simply a medical Ponzi scheme?

"When you, who works and pays for your healthcare has to get in line behind someone who doesn't pay for their healthcare"

Who said anyone is not paying. Most, if not all, pay in. Currently, those who don't pay in are the uninsured and the underinsured -- and guess who pays then? All of us, with higher premieums, etc. That's how it is today. Under ACA all must buy in and be adequately insured by private providers. There will be subsidies for those unable to pay the full premiem. The goal is with full participation, those planned subsidies will cost less than the anarchy of the uninsured falling through the cracks, bankrupt, etc.

" (in other words you pay for theirs too) has that scenario extrapolated across millions of cases, how does A.) your hip (which may govern your ability to make a living)"

Which may or may not govern my ability to make a living. If it did govern my ability to make a living, obviously that would make my care more urgent in triage. It's not a difficult calculation. As for the obsession with people getting by on other people's dime, that's what we have now, and is a very large part of the healthcare cost spiral.

"that system of healthcare not run out of money quickly without skyrocketing costs to cover what is simply a medical Ponzi scheme?

Only if you believe an insurance scheme, with the largest possible risk pool paying in, to insure the greatest amount of people, is a Ponzi scheme. I guess a lot of people think insurance is a Ponzi scheme. At least until they have to make a claim.

There are three significant drivers contributing to health care cost increases. Government-run programs AND private insurance are both to blame. Both prevent patients from incurring the full brunt of health care cost and in many cases there is a lack of documentation detailing cost of health care service which hampers oversight and skews the patient's ability to judge how costly services are. In any case, if the majority of the cost is covered, most insured patients could care less how much it cost.

The second factor contributing to cost increase is the reliance on technology. The technology is expensive, and often is utilized solely to defray the cost of owning and maintaining it and the personnel hired to operate it. Lab testing is similarly over-used for the same reason. Many service providers own their own lab out-right or jointly OR if not have service agreements with an outside lab.

The third factor is the lack of competition between providers. Network contracts, mandatory primary care provider referrals and market restrict the ability of patients to do preliminary cost comparison- in effect limit the ability to shop around for the lowest cost. Requiring patients to avail specialists only after referral by a primary care physician force the patient to pay BOTH the referring physician AND the specialist.

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