The ACA/ Obamacare Website Fiasco Thread

[Chopstick]

There ya go..it's the "manager's" fault.

http://www.usatoday.com/story/opini...website-obama-health-care-law-column/3691463/

What engineers know that lawyers and politicians often don't is that in the world of things, as opposed to people, there's no escaping the sharp teeth of reality. But in law, and especially politics, inconvenient facts are merely inconvenient, something to be rationalized away.

When our country has accomplished great things in the past, there has usually been a great engineer running the program: Hyman Rickover with the nuclear submarine program, or Wernher von Braun with the Apollo space program, for example. Rickover and von Braun were famously stern taskmasters, but they did not substitute wishes for reality.

Which may be why they were able to launch submarines, and rockets that astounded the world. While today, we can't even launch a website.

 

[TLDR20]

Someone earlier asked if there were any positives from this ACA fiasco. Looks like there are some:
http://www.washingtonpost.com/natio...3-9e2c-e1d01116fd98_story.html?wpmk=MK0000205

 

[Dame]

Someone earlier asked if there were any positives from this ACA fiasco. Looks like there are some:
http://www.washingtonpost.com/natio...3-9e2c-e1d01116fd98_story.html?wpmk=MK0000205

The legal hookers in Nevada love it. They can finally get health care as independent contractors with pre-existing conditions.

 

[AWP]

Someone earlier asked if there were any positives from this ACA fiasco. Looks like there are some:
http://www.washingtonpost.com/natio...3-9e2c-e1d01116fd98_story.html?wpmk=MK0000205

I'm one of those who asked the question and I thank you for following up. While I applaud their success, this one quote is striking and leads me to a bit of a rant:

One reason is that the state set up its own health-insurance exchange, sidestepping the troubled federal one.

The reality is that maybe there are programs some states can't administer because of the cost, but if you ever needed a reason to decentralize our Federal gov't, here' ya' go. Federal vs. State powers and responsibilites go back to the founding of our nation, so this argument isn't anything new. In fact, it formed the basis for a little internal dispute in the 1860's. As our Federal gov't grows, ask yourselves how much of that is necessary and how much of that could be run at the State level. Seriously. How big does Washington need to be?

I'll bet a dollar that when good news pops up we'll see the success stories (or more of them) coming from states which took a different path than the bloody fetus thrust upon us by Washington.

This isn't a right vs. left battle, or it shouldn't be, this is about how big does Big Brother need to be and your quality of life.

 

[Chopstick]

Someone earlier asked if there were any positives from this ACA fiasco. Looks like there are some:
http://www.washingtonpost.com/natio...3-9e2c-e1d01116fd98_story.html?wpmk=MK0000205

Im just wondering how is it that people who smoke have to pay significantly higher premiums in the exchanges but there is no problem for the smokers in this story getting Medicaid. Even the picture with the article shows a guy smoking a cigarette. I wonder how much a month they spend on those cigarettes?

You smoke?” Lively asked, going through a few routine questions.
“Right- and left-handed,” he quipped as she typed.

“All right,” Lively said after a while. “You are covered.”

“I’m covered?” Fletcher said. He slapped the table. He clapped twice.

“Woo-hoo! I can go to the doctor now?” he asked Lively. “I’m serious. I need to go.”

Donna Robinson had already enrolled, and now she arrived for her 2 p.m. with her son Gary Gross, 36, a skinny man with spiky copper hair, worn-out jeans and a thin tank top.

“Now,” Lively began. “Any income?”

“Naw,” Gross said.

“You smoke?”

“Yeah,” Gross said, adding that he did quit drinking. “It’s hard to quit, I tell you. I got cirrhosis already. I’m only a two on the scale of four, not too bad.”

“That’s already bad,” his mother said.

“Okay,” Lively said after a while. “You’re covered for a medical card.”

http://www.foxnews.com/politics/2013/11/25/obamacare-policies-slam-smokers-could-backfire/

ObamaCare may have backfired in its goal of making smoking so expensive that users quit, public health experts say, as sky-high insurance premiums force smokers to drop coverage altogether and lose smoking cessation programs along with it.

"Tobacco surcharges are not proven to help tobacco users quit and there are major concerns that they will prevent people from getting health care coverage," the American Lung Association's Jennifer Singleterry said.

In a worst-case scenario, an older couple who smokes could be "literally impoverished" by ObamaCare premiums, said the report. That couple could pay an $11,352 health care premium, or one-half their annual income of $23,000. By comparison, a non-smoking person over 59 years old would pay 90 percent less, or just $952 after federal subsidies.

 

[TLDR20]

Im just wondering how is it that people who smoke have to pay significantly higher premiums in the exchanges but there is no problem for the smokers in this story getting Medicaid. Even the picture with the article shows a guy smoking a cigarette. I wonder how much a month they spend on those cigarettes?





http://www.foxnews.com/politics/2013/11/25/obamacare-policies-slam-smokers-could-backfire/

I guess people could quit smoking...(easier said than done I know. 6 months off of a can a day dipping habit) I don't know what your looking for here, I don't know why it is different. Maybe because it is a government program and they can't say no to people who smoke? I think it is good these people will get a chance to go to the Doctor though.

 

[Chopstick]

I guess people could quit smoking...(easier said than done I know. 6 months off of a can a day dipping habit) I don't know what your looking for here, I don't know why it is different. Maybe because it is a government program and they can't say no to people who smoke? I think it is good these people will get a chance to go to the Doctor though.

Im saying that as far as I know smoking is the only "pre-existing condition" that is not getting a pass under Obamacare but the people jumping onto Medicaid are not penalized for it. Who is picking up the tab?

ETA another feature of Obamacare. The "Cadillac Tax".
http://investigations.nbcnews.com/_...macare-cadillac-tax-in-reducing-benefits?lite

Aaron Baker, 36, his wife Billie and their two young children are covered under a generous health insurance plan offered by the private Midwestern university where he’s worked for 10 years. When they opened their benefits notice this year, they were pleased to see their $385 premium is only up by four dollars next year. However, they were shocked to discover that instead of covering the first dollar they spend with no deductible, the Baker’s plan now includes a $1,000 deductible and a $2,500 out of pocket maximum. They also will still have small co-pays for services.

According to the enrollment notice, the changes are “to relieve future health plan trend pressure and to put the university in a position to avoid the excise tax that becomes effective in 2018.” The 40 percent excise tax—often called the “Cadillac tax”— is part of Obamacare and is levied on the most generous health plans. It’s designed to bring down overall health costs by making companies and workers more cost-conscious. The thinking is that if consumers have to pay more expenses themselves, through higher deductibles and out-of-pocket expenses, they’ll avoid unnecessary or overly costly procedures. And that is supposed to make care more affordable for everyone.

Billie Baker doesn’t think much of that concept. “I think that saying that your insurance is too good so we're going to give you a penalty,” she said, “is sort of outrageous to me.”

 

[JHD]

I have always been of the opinion since obesity and smoking related diseases cause the most expensive burden on the healthcare system, that Big Tobacco and the fast food industry should kick in money to a pool that would be used to subsidize health care costs. Cancers, heart related illnesses, and breathing issues, etc., are the most common occurrences of, and the most expensive things to treat.

 

[TLDR20]

I have always been of the opinion since obesity and smoking related diseases cause the most expensive burden on the healthcare system, that Big Tobacco and the fast food industry should kick in money to a pool that would be used to subsidize health care costs. Cancers, heart related illnesses, and breathing issues, etc., are the most common occurrences of, and the most expensive things to treat.

Are you fucking kidding me? Nobody makes anyone smoke, nor do fast food companies put Big Macs in fat people mouths.

 

[JHD]

I had a distinct feeling you would disagree. And, yes, I agree that these companies don't force people to engage in acts horrible for their bodies. My belief is that since they make the detrimental products available and make a ton of money off of the sale, better they chip in to pay for the increased costs rather than than those people that try to take better care of themselves.

Health care costs and health insurance costs are what they are because of the long term, expensive care and treatment for fighting these diseases.

 

[Totentanz]

No one is responsible for my decisions - good or bad - but me.

 

[JHD]

No one is responsible for my decisions - good or bad - but me.

That is true. But if you have ever had a close loved one that made this choice and as a result had heart disease, emphysema, and cancer all at the same time from years of smoking, you would see what these diseases cost. Both from a personal and practical point of view.

Heart attacks, home health care, MRIs, stress tests, EKGs, constant hospital stays of weeks due to recurring pneumonia due to lung issues, surgeries, ambulance transportation, etc. Add multiple medications to treat all of the above, in addition to various breathing apparatuses and monitors. Multiply that one person by the multiple people suffering from these diseases. This is our healthcare catastrophe.

 

[TLDR20]

That is true. But if you have ever had a close loved one that made this choice and as a result had heart disease, emphysema, and cancer all at the same time from years of smoking, you would see what these diseases cost. Both from a personal and practical point of view.

Heart attacks, home health care, MRIs, stress tests, EKGs, constant hospital stays of weeks due to recurring pneumonia due to lung issues, surgeries, ambulance transportation, etc. Add multiple medications to treat all of the above, in addition to various breathing apparatuses and monitors. Multiply that one person by the multiple people suffering from these diseases. This is our healthcare catastrophe.

People making poor decisions is our healthcare catastrophe? Well then I guess we should take away their right to make personal choices. Or we could force them to even out the amount that is paid by them by forcing them to have health insurance..... Oh wait....

 

[JHD]

People making poor decisions is our healthcare catastrophe? Well then I guess we should take away their right to make personal choices. Or we could force them to even out the amount that is paid by them by forcing them to have health insurance..... Oh wait....

Not exactly. Not take away their right, see my first post. And my father had excellent health care as a disabled veteran. But nonetheless, takeing all emotion out of the situation and looking at it objectively, the rest of the non-smoking, non-overating people are already paying for the increased costs. Now, we will be paying more via increased taxes and increased insurance costs with the Obamacare blessing. Hence, my reasoning for Big Tobacco and McDonald's et al for helping pick up the tab rather than others.

Personal choice is fine, but don't expect others to pick up your tab. Even with insurance coverage, I still helped my mom with other associated expenses.

Your rights end where mine begin.

 

[Dame]

My belief is that since they make the detrimental products available and make a ton of money off of the sale, better they chip in to pay for the increased costs rather than than those people that try to take better care of themselves.

Health care costs and health insurance costs are what they are because of the long term, expensive care and treatment for fighting these diseases.

That is true. But if you have ever had a close loved one that made this choice and as a result had heart disease, emphysema, and cancer all at the same time from years of smoking, you would see what these diseases cost. Both from a personal and practical point of view.

Heart attacks, home health care, MRIs, stress tests, EKGs, constant hospital stays of weeks due to recurring pneumonia due to lung issues, surgeries, ambulance transportation, etc. Add multiple medications to treat all of the above, in addition to various breathing apparatuses and monitors.

OK, I'm going to make some rather strong and possibly unpopular statements about all this.

First, the tobacco industry already does exactly as you propose, to the tune of $206 billion. I know because I help administer the awarding of that money to grantees.

The Tobacco Master Settlement Agreement (MSA) was entered in November 1998, originally between the four largest United States tobacco companies (Philip Morris Inc., R. J. Reynolds, Brown & Williamson and Lorillard – the original participating manufacturers) and the attorneys general of 46 states. The states settled their Medicaid lawsuits against the tobacco industry for recovery of their tobacco-related health-care costs, and also exempted the companies from private tort liability regarding harm caused by tobacco use. In exchange, the companies agreed to curtail or cease certain tobacco marketing practices, as well as to pay, in perpetuity, various annual payments to the states to compensate them for some of the medical costs of caring for persons with smoking-related illnesses. The money also funds a new anti-smoking advocacy group, called the American Legacy Foundation, that is responsible for such campaigns as The Truth. The settlement also dissolved the tobacco industry groups Tobacco Institute, the Center for Indoor Air Research, and the Council for Tobacco Research. In the MSA, the original participating manufacturers (OPM) agreed to pay a minimum of $206 billion over the first twenty-five years of the agreement.

http://en.wikipedia.org/wiki/Tobacco_Master_Settlement_Agreement
This settlement was reached after the tobacco companies were proven to have lied to the American public about the correlation between their product and the diseases you mentioned. The fast food industry doesn't have that luxury. We know it's bad and we call it junk food.

Second, not only does no one make you smoke or eat fast food, no one makes you spend extreme amounts of money to keep yourself alive. (At least until this not-so-affordable/avoidable care act and its penalties for not participating.) There are plenty of people in this world who decide to exit it without bankrupting their families and many of them did not bring the disease upon themselves. Cancer can strike anyone. It is extremely expensive to treat. Given a diagnosis of certain death, God forbid I should put my family through that kind of financial and emotional train wreck.

 

[Chopstick]

Alcoholism and drug addiction are covered under the ACA as "chronic diseases" and must be covered components for a healthcare plan to be an Obamacare compliant policy. Nicotine has been shown to be more addictive than heroin. Why is nicotine addiction not a covered chronic disease?

 

[TLDR20]

Alcoholism and drug addiction are covered under the ACA as "chronic diseases" and must be covered components for a healthcare plan to be an Obamacare compliant policy. Nicotine has been shown to be more addictive than heroin. Why is nicotine addiction not a covered chronic disease?

There is a huge difference in the reasons nicotine is more addictive. It has just as much to do with Psychological and social reasons as it does for physiological reasons. Opiates cause a physical dependency, which nicotine certainly doesn't do to the same level.Opiates withdrawal can kill someone. Nicotine withdrawal not so much. Tell anyone who has been through opiate withdrawal that nicotine is more addictive, you will get laughed out if the room.

 

[JHD]

This settlement was reached after the tobacco companies were proven to have lied to the American public about the correlation between their product and the diseases you mentioned.

I agree. This settlement was for past actions, not current ones. My big problem with the initial settlement was that the funds come with no strings attached. Yes, the money has done some good at getting smoking levels reduced somewhat, but there are also states that use the money for pothole repairs and subsidizing their tobacco farmers. There are no requirements on how the funds must be used. A change in governors can result in a change as to how the trust fund is implemented, which can either be directed to or away for smoking related issues.

Also, you are correct as to cancer striking those who don't smoke. But this is FAR less common than those being struck down with cancer from first hand smoke, not to mention those breathing polluted air with second or third hand smoke. Similar to the cigarette tax industry, I wouldn't mind seeing the fast food industry penalized in a similar manner. Let the people that want to eat this stuff pay more for it, and reduce the cost of the healthy options. I realize this won't be a popular position either, but JMOO.

Lastly, as to the heartache, I understand what you are saying. My father's cancer wasn't discovered until a few weeks before he died. The heart and lung disease did him in before the cancer could. No certain immediate death, just a long, slow, expensive decline over a 15 year period.

 

[DA SWO]

I have always been of the opinion since obesity and smoking related diseases cause the most expensive burden on the healthcare system, that Big Tobacco and the fast food industry should kick in money to a pool that would be used to subsidize health care costs. Cancers, heart related illnesses, and breathing issues, etc., are the most common occurrences of, and the most expensive things to treat.

Tobacco has already paid states for medical costs, the states (for the most part) did not use the money for health care.

 

[JHD]

From the Coca Cola thread, I disagree with you @TLDR20 on diabetes being the most expensive health issue. A google search yielded this from a 2012 Forbes article:

1. HIV $25,000

2. Cancer $49,000

3. Transplant $51,00

4. Stroke $61,000

5 Hemophilia $62,000

6. Heart Attack including Cardiac Revascularization (Angioplasty with or without Stent) $72,000

7. Coronary Artery Disease $75,000

8. Neonate (premature baby) with extreme problems $101,000

9. End-Stage Renal Disease $173,000

10. Respiratory Failure on Ventilator $314,000

WebMD listed heart issues as number 1 out of 12, with diabetes at number 7 out of 12. Cancer at number 3, breathing/lung at number 5, and high blood pressure at number 10, and high cholesterol at number 11.

I am also thinking I won't be getting your vote when I run for President.