

What exactly is Obamacare and what did it change? - memset
http://www.reddit.com/tb/vbkfm

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aginn
This is a poor and misunderstood version of what Obamacare will actually do.
Having worked in healthcare tech for two years and healthcare investment
banking, the analysis this person put forward is rudimentary understanding of
how our healthcare system works.

Here are a few highlights \- 50% of all regulations are behind schedule,
bundled payments, payment sunshine, are just a few highlights

\- "The decision over whether or not your claim is approved is still in the
hands of your insurer. However, now there's an appeals process so if your
claim gets turned down, you can challenge that. And the government watches
that appeals process to make sure it's not being unfair to customers." =>
there already is an appeal process. The real nugget is "unfair". What the crap
is unfair? How do you regulate unfair? Notice, there is no mention of AMA's
power of setting CPT codes and reimbursement schedules.

\- "The PPACA actually very specifically says you can keep the insurance you
have if you want." => First, everyone's insurance has already changed with the
implementation of MLR rules. Second, how can the government fulfill this
promise. It cannot. Premiums increase between 10% to 20% a year. Think people.
It is an empty promise to make you feel good inside.

\- "The PPACA very specifically says that the Secretary of Health and Human
Services (who is in charge of much of the bill), is absolutely not to promote
any regulation that hinders a patient's ability to get health care, to speak
with their doctor, or have access to a full range of treatment options." => no
way to fulfill this promise. If you are giving access to 20 million people,
there are still only 600,000 practicing physicians. Supply is basically fixed
(with a 20 yr cycle). Unless you failed economics, there is no possible way
the government can actually deliver on this.

\- "Additionally, the bill cuts some stuff from Medicare that's not really
working, and generally tries to make everything work more efficiently" - HAHA!
$500 billion in imaginary savings. Not to mention the author forgets that the
DocFix is not included in the bill. How do they reach $500 billion? Cutting
doctors payments by 32%.

\- "Also, the increased focus on preventative care (making sure people don't
get sick in the first place), should help to save money the government already
spends on emergency care for these same people. Basically, by catching
illnesses early, we're not spending as much on emergency room visits."
Preventive care INCREASES utilization. ER visits are "falsely" expensive
because the "costs" are typically based upon gross charges. ER visits are
super expensive but it is a scape goat for preventive medicine or the
individual mandate. The free-rider problem does not exist.

\- "They had been reading it over and over for a half a year. This thing was
being tossed around in debates for ages." - Not true. I know the people on the
hill who wrote the bill. It was put together over a month.

