Obamacare - practical discussion

Obamacare - practical discussion
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#228

Yes, but ACA plans actually purchased are mostly Silver and to a lesser extent Bronze (for cost reasons, as you say). The average deductible is over $4k. This is in contrast to the average group plan where the average deductible is more like $1-2k.

In addition, deductibles have been rising for a given plan. So if you get the benchmark Silver plan, the deductible is maybe 5-10% higher now than it was 4 years ago when the ACA started. Of course that’s not too much pain compared to the deductibles that doubled from the pre-ACA days and premiums that have more than doubled since then. See the table below:

I don’t know about national inflation metrics, but it’s clear insurance for individuals is now over twice as expensive as it was before.


#229

You seem to “forget” I’ve done so umpteen times.

Prior to the ACA, the number one reason BY FAR for bankruptcy was uninsured/underinsured medical bills.

The ACA basically ended that. I’m not sayin’ it’s zero, but it’s taken rather extraordinary circumstances since.

No.

Which has what to do with the price of eggs in Singapore ?


#230

Eh, because none of that’s true.


#231

You’re comparing apples and alligators. It’s not real-world “premium increases” when cheap premiums on policies that are worthless goto premiums for comprehensive healthcare insurance policies.

It’s like leasing a Yugo for $50/month versus leasing a Chevy for a real-world cost.


#232

Do you have a link that lists causes of bankruptcies by percentage from before the ACA and after?

Okay. What is your definition of super expensive and do you have a link that says what the median amount of healthcare debt was for people that declared bankruptcy because of healthcare debt?

I said that an increase in poverty was unlikely. You said that it is a certainty and asked where I was prior to the ACA, which (to me) implied that the ACA resulted in a decrease in poverty. That is why I pointed out that the poverty rate has been steady for decades - to essentially refute your implication.


#233

That’s a bad statistic that was bandied about by left wing politicians and the last president for their politicial gain, but it’s just not true. They counted anyone with any medical debt when they filed or who cited medical expenses as a contributing cause (among many) for their bankruptcy. If you were a deadbeat who stiffed your CCs for $100k and also your doctor for $100, you had a “medical bankruptcy” in their book. The real number is probably 5%, nowhere close to the 2/3 talking point.

Dranove and Millenson critically analyzed the data from the 2005 edition of the medical bankruptcy study. They found that medical spending was a contributing factor in only 17 percent of U.S. bankruptcies. They also reviewed other research, including studies by the Department of Justice, finding that medical debts accounted for only 12 percent to 13 percent of the total debts among American bankruptcy filers who cited medical debt as one of their reasons for bankruptcy.

http://www.pnhp.org/news/2018/march/the-myth-that-medical-bankruptcies-are-rare

… it turns out that the existing evidence for “medical bankruptcies” suffers from a basic statistical fallacy; when we eliminated this problem, we found compelling evidence of the existence of medical bankruptcies but discovered that medical expenses cause many fewer bankruptcies than has been claimed.

Policymakers’ beliefs about the frequency of medical bankruptcies are based primarily on two high-profile articles that claim that medical events cause approximately 60% of all bankruptcies in the United States. In these studies, people who had gone bankrupt were asked whether they’d experienced health-related financial stress such as substantial medical bills or income loss due to illness. People were also asked whether they went bankrupt because of medical bills. People who reported any of these events were described as having experienced a medical bankruptcy. This approach assumes that whenever a person who reports having substantial medical bills experiences a bankruptcy, the bankruptcy was caused by the medical debt. The fact that, according to a 2014 report from the Consumer Financial Protection Bureau, about 20% of Americans have substantial medical debt, yet in a given year less than 1% of Americans file for personal bankruptcy, suggests that this assumption is problematic. Clearly, many people face medical debt but do not go bankrupt.

the magnitude of the bankruptcy effect is much smaller than previously thought: we estimate that hospitalizations cause only 4% of personal bankruptcies among nonelderly U.S. adults, which is an order of magnitude smaller than the previous estimates described above.


#234

I think medical bankruptcy is a catch all term for going broke because of an illness. Maybe not the partially-insured medical bills, but from being unable to work for an extended period.

Whether the medical bills did it, or the long-term disability, is a difference without a distinction to someone getting put out on the street


#235

Where were you when this was all endlessly being reported during the 18 months it took the ACA to progress through congress, did you occupy Dick Cheney’s old cave he had been hiding in ?

No.

Good grief. I wasn’t referencing the entire population. Just those impacted by massive medical bills that would bankrupt them.

Yikes.


#236

Sorry, but the “Fraser Institute” is just a RightWing front group. Nuthin’ but worthless well-financed propaganda.

Oh, and for your elucidation, “OP-ED” is short for OPINION-EDITORIAL.


#237

Exactamundo.


#238

I have heard the stat before claiming healthcare debt is the #1 reason for bankruptcy and dispute it (see @xerty 's post above). Regardless, I am not asking for proof of that stat, I am asking for a cite that shows that stat changed after the ACA was enacted. That was your claim.

So when you said “poverty”, you actually meant “poverty among people with expensive illnesses without insurance.”? That’s much more specific group, so I suppose you understand my confusion.

What is the current poverty rate among that group and what do you think it will rise to?


#239

You keep referring to past policies as being “worthless” and I wonder why? I use to be happy with my $40/month insurance coverage. It was far from worthless - it was issued by major insurers, and covered everything after the deductible like any other plan. The deductible just happened to be $20,000. Which is exactly what I wanted - to cap my exposure to potential expenses from a catastrophic illness/injury - but can no longer get because folks like you declared them “worthless”. Now I have (until recently, mandated) $400/month premiums for coverage that has benefited me the exact same amount as those past $40 policies ever did…


#240

~ A study released in 2014 [PDF] by the American Journal of Medicine finds a large increase, almost 20%, in medical bankruptcies between 2001 and 2007. Of all bankruptcies filed in 2007, 62% were tied to medical expenses. Three-quarters of those who filed for bankruptcies in 2007 had health insurance.

(This data from 2007, prior to the financial collapse, meaning the numbers likely became far more bleak in the subsequent seven years.)

~ A study from NerdWallet Health (imagine that), based upon an update of a previous Harvard study, released in 2014, found that three in five bankruptcies in 2014 would be due to medical bills.

“NerdWallet Health chose to include only bankruptcy explicitly tied to medical bills, excluding indirect reasons like lost work opportunities. Thus we conservatively estimated medical bankruptcy rates to be 57.1% (versus the authors’ 62.1%) of US bankruptcies. We also used official bankruptcy statistics, released this month through March 2013, from US Courts.”

That’s not a dispute. (See my post above).

Depends how quickly things collapse back to where they were. There already really isn’t any ACA or “Obamacare” anymore. The GOP can’t cut one leg off a three-legged stool and still call it a stool, and offer that to the American people to sit on to access healthcare.


#241

Because so many were.

AFAIK you can still purchase high-deductible plans, but of course, if you had read my earlier post, you would have already been aware that was not what I was referencing.


#242

I’m sure anything with Elizabeth Warran as an author should be dismissed likewise, especially if she’s as flexible with her statistics as she is with her ancestry to get the outcomes she wants, which incidentally includes both your sources below. The Nerdwallet just uses the medical bankruptcy data from the Warran paper, with various tweaks, and hence suffers from the same flaws.

Basically, these studies set out to find medical costs as a primary cause of bankruptcy and did so because they wanted a left wing talking point. Misleading statistics are easy to create - here they asked if medical expenses or illness of the oneself or a family member was “a reason” that contributed to bankruptcy. The fact that the majority of these so called medical bankruptcies involve people with health insurance and have somewhere around $5k in average medical debt (much less than the average total debt) should be clues the real cause lies elsewhere.

Guess what? Credit card debt is “a reason” that contributes to 99% of bankruptcies, because nearly all BK cases involve credit card debt. Apparently the average CC debt in BK is $25k, and somehow that’s less of a problem than the $5-8k of medical debt? Clearly we need to reform the credit card system, right? Here’s a study by debt collectors (who would know), citing the largest debts of BK filers are CCs in about 3/4 of cases, with medical being about 20% (most of the rest).

http://www.centerforconsumerrecovery.org/ResourceCenter/CenterForConsumerRecovery2013BankruptcyStudySummary.pdf

Asking BK lawyers about their clients suggest that top causes of BK is overspending followed by job loss, with divorce and medical debts much less common.


#243

For the most part no, they couldn’t still be purchased. The high deductible plans were, as was the whole point, far too profitable due to the relatively low risk of claims.

My point is that all those policies served a purpose and were only “worthless” to people who were dazzled by the low premiums but still expected to get comprehensive coverage no matter what the terms stated.


#244

I disagree with most, if not all, of your post, but I’m liking it because somehow you and meed were able to get joefriday to actually post a real source which actually purports to substantiate the statements he was making.


#245

That was quite a feat lol, but I still wasn’t able to get him to post a source for his claim that the ACA brought down the number of healthcare debt bankruptcies.


#246

Here’s some shaky numbers from the first study @JoeFriday cited. They are difficult to explain if you are being completely honest with the numbers:

  • Debtor said medical bills were reason for bankruptcy 29.0%
  • Medical bills >$5000 or >10% of annual family income 34.7%
  • Mortgaged home to pay medical bills 5.7%
  • Medical bill problems (any of above 3) 57.1%

That 57% number includes some overlap, since 29+34+5 is more than 57. But how much overlap should there be? Let’s make a safe assumption. No one would mortgage their home to pay a medical bill that is less than $5,000. So the 5.7% of people that have mortgaged their home all fall into the 34.7% that have medical bills over $5,000. So that means there is only 6.6% overlap between the group of people that say medical bills were the reason for their bankruptcy and the group that says they had over $5,000 in medical bills. This study is trying to say that 22.4% of people that went through bankruptcy AND claimed that medical bills were the reason for their bankruptcy DID NOT HAVE OVER $5,000 in medical debt. If you don’t question the conclusion of this study after reading those numbers, I don’t know what to tell you.

Additionally, this study counts bankruptcies of people that have lost income due to an illness as a medical bankruptcy. That’s fine, but it makes it’s overall number of 62.1% worthless for our discussion here. The ACA is about health insurance, not lost wages insurance. It will not fix the problem of people declaring bankruptcy because of lost income from an illness. The study even says that only 31% of people filing for medical bankruptcy didn’t have insurance at time of filing bankruptcy, which was the same percentage of people filing for non-medical bankruptcy. The only indication that more insurance would help is that 7% more medical bankruptcy households had a lapse in coverage than non medical bankruptcy households. So we’re talking about 7% of people that MIGHT be helped by the ACA.

The only fair number to gather from this study as to the percentage of people that have filed bankruptcy because of medical debt is the self reported “Debtor said medical bills were reason for bankruptcy” number. That is 29%. And the belief that Obamacare would have helped a large number of them avoid bankruptcy is not borne out in the study.


#247

OK dude WTF does Elizabeth Warren and her ancestry have to do with anything?

Keep the personal political attacks out of it.