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View Full Version : Obama What part of ObamaCare makes health care cheaper?


petegz28
06-30-2012, 06:10 PM
Ok here is what I understand to be the bullet points...

1. People can't have their insuance benefits capped
2. Pre-exisiting conditions have to be accepted
3. A person's out of pocket expenses are capped
4. Taxes on medical devices goes up
5. Taxes on brand name prescription drugs goes up
6. Insurance companies are now mandated to spend $X's on care and care only


So what in the above is incorrect or left out and how does it make health care cheaper?

Guru
06-30-2012, 06:32 PM
None of that makes it cheaper. Because it won't be cheaper. It will at least double what you are paying now.

petegz28
06-30-2012, 06:34 PM
None of that makes it cheaper. Because it won't be cheaper. It will at least double what you are paying now.

I fear this will be in Poly-Sci text books a few decades from now discussing how good intentions aren't always good enough.

FD
06-30-2012, 07:06 PM
None of that makes it cheaper. Because it won't be cheaper. It will at least double what you are paying now.

Did prices double in Massachusetts?

Brainiac
06-30-2012, 07:23 PM
Did prices double in Massachusetts?
Your question is based on the demonstrably incorrect assumption that Obamacare and Romneycare are the same thing. I know a lot of people on this site love to make that claim over and over, but repeating it over and over doesn't make it true.

FD
06-30-2012, 07:29 PM
Your question is based on the demonstrably incorrect assumption that Obamacare and Romneycare are the same thing. I know a lot of people on this site love to make that claim over and over, but repeating it over and over doesn't make it true.

I'm sorry, but essentially nobody who studies health policy will dispute that Obamacare is based on Romneycare and works in an almost identical fashion. Thats just a fact. Your argument that they are different is based on how they are funded, and while its also the case that they are funded in almost the same way (taxes and Medicaid/Medicare), thats not even relevant for the question I was asking.

If you think the observable changes in health insurance premiums in Massachusetts after a nearly identical health insurance reform do not help us predict those same changes nationally, then you need to explain why they will be different, citing specific provisions of each law. Otherwise, its safe to assume that one will be a good predictor of the other.

Iz Zat Chew
06-30-2012, 08:25 PM
Ok here is what I understand to be the bullet points...

1. People can't have their insuance benefits capped
2. Pre-exisiting conditions have to be accepted
3. A person's out of pocket expenses are capped
4. Taxes on medical devices goes up
5. Taxes on brand name prescription drugs goes up
6. Insurance companies are now mandated to spend $X's on care and care only


So what in the above is incorrect or left out and how does it make health care cheaper?

It doesn't and those that already have health care will end up paying more than they do presently.

petegz28
06-30-2012, 08:33 PM
I'm sorry, but essentially nobody who studies health policy will dispute that Obamacare is based on Romneycare and works in an almost identical fashion. Thats just a fact. Your argument that they are different is based on how they are funded, and while its also the case that they are funded in almost the same way (taxes and Medicaid/Medicare), thats not even relevant for the question I was asking.

If you think the observable changes in health insurance premiums in Massachusetts after a nearly identical health insurance reform do not help us predict those same changes nationally, then you need to explain why they will be different, citing specific provisions of each law. Otherwise, its safe to assume that one will be a good predictor of the other.

K, let me ask you this. Did Mass raise taxes on device and drug makers?

AustinChief
06-30-2012, 09:59 PM
One of the most important problems (I feel it is the single most important) with health care is the almost complete lack of transparency when it comes to pricing. What SPECIFICALLY does Obamacare do to address this issue? I can't imagine it isn't addressed at all, but I'm not finding any specifics.

BucEyedPea
06-30-2012, 10:07 PM
Your question is based on the demonstrably incorrect assumption that Obamacare and Romneycare are the same thing. I know a lot of people on this site love to make that claim over and over, but repeating it over and over doesn't make it true.

Yet, Massachusetts is one of the state where lots of people have been leaving. My family, who are no where near like me politically all HATE it.
I heard Deval Patrick has gutted the market-orientated aspects of Romneycare anyway. This is the danger with govt in charge. Never who will get elected next.

mlyonsd
06-30-2012, 10:07 PM
One of the most important problems (I feel it is the single most important) with health care is the almost complete lack of transparency when it comes to pricing. What SPECIFICALLY does Obamacare do to address this issue? I can't imagine it isn't addressed at all, but I'm not finding any specifics.There isn't any. But believe you me, it will be cheaper.

BucEyedPea
06-30-2012, 10:07 PM
One of the most important problems (I feel it is the single most important) with health care is the almost complete lack of transparency when it comes to pricing. What SPECIFICALLY does Obamacare do to address this issue? I can't imagine it isn't addressed at all, but I'm not finding any specifics.

That's true with medical code billing too. Try to find out what something may cost before hand is often like pulling teeth. You have to have a code to get the info.

AustinChief
06-30-2012, 10:13 PM
There isn't any. But believe you me, it will be cheaper.

So, are you saying I should just accept all procedures before I can read the cost of them? Where I have heard something like that before....

BucEyedPea
06-30-2012, 10:21 PM
Here's a Forbes article on what Deval Patrick has done to Romney-care. I recommend all of you on the right or who lean right read this article. It's really the Democrat's altered version of Romney care. Mitt actually vetoed parts of the law which they overrode later—the market orientated parts. Yet, the Democrats today continue to claim it's his plan. They are LIARS! Also costs of emergency room visits actually went up. Doctors saw fewer patients while people had to wait. Romney has yet to directly criticize his successor with such changes in his plan. But Mass has had some of the highest healthcare costs in the nation due primarily to things Dukakis did which were eventually repealed. I remember when I was still there even in the 90's OBs were leaving the state.

http://www.forbes.com/sites/aroy/2012/04/12/how-deval-patrick-gutted-romneycares-market-oriented-reforms/

mlyonsd
06-30-2012, 10:21 PM
So, are you saying I should just accept all procedures before I can read the cost of them? Where I have heard something like that before....Reading them and accepting them will eventually be a wasted effort. Take a number.

cosmo20002
07-01-2012, 12:10 AM
That's true with medical code billing too. Try to find out what something may cost before hand is often like pulling teeth. You have to have a code to get the info.

Funny. you would think the market would work that out. I would think an insurance company and doctors group could really appeal to customers by having a big board like at McDonalds. Yet, none have done it.

AustinChief
07-01-2012, 12:45 AM
Funny. you would think the market would work that out. I would think an insurance company and doctors group could really appeal to customers by having a big board like at McDonalds. Yet, none have done it.

In part you don't get that because the large heath providers have agreements in place with big insurance that will not allow that to happen. So far I have seen NOTHING from Obamacare that addresses this issue in the least. The idea that the market can work things out on its own is a solid one.. but can't work in the current environment because of the lack of transparency. The practices of the big players in health care are unethical and it's hard to imagine why they are even legal. You want to ACTUALLY address the problem and you start there... not with another giant subsidy like Obamacare.

From all I have seen, Obamacare makes the core problem WORSE... much worse.

BucEyedPea
07-01-2012, 08:40 AM
Funny. you would think the market would work that out. I would think an insurance company and doctors group could really appeal to customers by having a big board like at McDonalds. Yet, none have done it.

See Austin's post just above mine. It's what I would have told ya'. When you understand markets better let me know when you want to continue an educated conversation instead of progressive talking-points.

headsnap
07-01-2012, 08:47 AM
See Austin's post just above mine. It's what I would have told ya'. When you understand markets better let me know when you want to continue an educated conversation instead of progressive talking-points.


the reason that Liberals(cough cough...) middle of the roaders like cosmosis are the way they are is because they have no understanding of markets.




oh, they think they do though...

RedNeckRaider
07-01-2012, 09:03 AM
the reason that Liberals(cough cough...) middle of the roaders like cosmosis are the way they are is because they have no understanding of markets.




oh, they think they do though...

cosmo is not a even close to the middle. That said I will admit I have very little knowledge about markets, I would wager few here really do understand how they work~

stonedstooge
07-01-2012, 09:07 AM
White House talking points today. ObamaCare is NOT a tax. That's not what the Supreme Court said. Obama has lowered taxes for the middle class. IT'S A PENALTY NOT A TAX

BucEyedPea
07-01-2012, 09:30 AM
cosmo is not a even close to the middle. That said I will admit I have very little knowledge about markets, I would wager few here really do understand how they work~

If you admit to having "very little knowledge about markets" then how would you know who here in order to know how many do? I wouldn't say it's "few." The right has a better grasp than the left in general. Most study, Keynesianism and a mixed-economy approach in college—even in those who study business and finance. A mixed approach is still an improvement over this false idea that markets are intrinsically unstable which the left promotes. The left hates markets because it punishes the right people. So when they claim they don't work what they mean is they don't like the outcomes because they're not getting something at someone else's expense. The only economic school that has studied markets, how they are in reality based on what has happened, is the Austrian School. The Chicago School aka the Milton Friedman school or Monetarism is an improvement but they still believe in a central bank with some inflation just a milder amount.

patteeu
07-01-2012, 09:51 AM
I heard Deval Patrick has gutted the market-orientated aspects of Romneycare anyway. This is the danger with govt in charge. Never who will get elected next.

This is a huge problem for which I have no solution. There is no government program that democrats can't make worse.

RedNeckRaider
07-01-2012, 09:56 AM
If you admit to having "very little knowledge about markets" then how would you know who here in order to know how many do? I wouldn't say it's "few." The right has a better grasp than the left in general. Most study, Keynesianism and a mixed-economy approach in collegeóeven in those who study business and finance. A mixed approach is still an improvement over this false idea that markets are intrinsically unstable which the left promotes. The left hates markets because it punishes the right people. So when they claim they don't work what they mean is they don't like the outcomes because they're not getting something at someone else's expense. The only economic school that has studied markets, how they are in reality based on what has happened, is the Austrian School. The Chicago School aka the Milton Friedman school or Monetarism is an improvement but they still believe in a central bank with some inflation just a milder amount.

LMAO I said "wager" which is a term that means "bet, gamble or guess". That clearly indicates I "do not know" but would wager, bet, gamble or guess most here do not. I also have not studied Psychiatry, so I would have to wager, bet, gamble or guess why you were offended by my post. I could very well lose my wager if the majority of posters here indeed have educated themselves on the subject of markets~

BucEyedPea
07-01-2012, 11:40 AM
LMAO I said "wager" which is a term that means "bet, gamble or guess". That clearly indicates I "do not know" but would wager, bet, gamble or guess most here do not. I also have not studied Psychiatry, so I would have to wager, bet, gamble or guess why you were offended by my post. I could very well lose my wager if the majority of posters here indeed have educated themselves on the subject of markets~

Regardless, my point stands.

RedNeckRaider
07-01-2012, 11:41 AM
Regardless, my point stands.

LMAO as does mine~

BucEyedPea
07-01-2012, 11:42 AM
LMAO as does mine~

Fair enough.

Pawnmower
07-01-2012, 03:38 PM
So what in the above is incorrect or left out and how does it make health care cheaper?

According to theory, a couple of additional reasons why costs have been going up lately:

1) people who do not choose to buy health insurance, and do not want health insurance tend to be younger people who have little risk of health problems. Having less of these people in the 'insurance pool' makes costs higher, as the people left in the pool are riskier and cost more. Having more younger and healthier people in the insurance pool makes costs go down.

Also, people who choose not to purchase health insurance when you are younger, often choose to purchase it later on in life when they are at more of a risk for problems....again this is causing the insurance pool to become ever riskier as the population ages. So, unless we can balance this by getting more people to join the pool earlier, costs will continue to go up.

2) People who are uninsured tend to skip out on their medical bills at a higher rate......and so their costs must be paid by taxpayers ANYWAY. Hospitals do give some money to charity work, but a latge portion of unpaid hospital bills are paid for by A) tax payers and B) hospitals raising their rates to balance the books. Then, in turn, insurance companies have to raise their rates to cover the increases.

3) also individuals should be able to buy from private exchanges, thus setting up a system where you have the power of group purchases effectively lowering the cost and placing people together as a group to have purchasing power.


In theory, adding more people to the insurance pool will spread the risk out, and get some uninsured people into the insurance pool. In theory, this will help to mitigate the crazy rise of costs that is already happening even without ObamaCare. The exchanges are another way that costs may be lowered.

I personally don't care about ObamaCare and I am not arguing for it, I am just trying to answer your question in an unbiased way.

cosmo20002
07-01-2012, 03:56 PM
Funny. you would think the market would work that out. I would think an insurance company and doctors group could really appeal to customers by having a big board like at McDonalds. Yet, none have done it.

In part you don't get that because the large heath providers have agreements in place with big insurance that will not allow that to happen. So far I have seen NOTHING from Obamacare that addresses this issue in the least. The idea that the market can work things out on its own is a solid one.. but can't work in the current environment because of the lack of transparency. The practices of the big players in health care are unethical and it's hard to imagine why they are even legal. You want to ACTUALLY address the problem and you start there... not with another giant subsidy like Obamacare.


So, my point that the market doesn't take care of all problems--such as lack of transparency--was cracked on by at least 3 people who apparently agreed with Austin that the reason is large health providers have agreements with big insurance not to allow transparency. That makes no sense.

Isn't that the point of the market--to overcome these agreements? That if enough people want it, the providers (or at least some) will give them what they want? It hasn't happened.

AustinChief
07-01-2012, 04:52 PM
So, my point that the market doesn't take care of all problems--such as lack of transparency--was cracked on by at least 3 people who apparently agreed with Austin that the reason is large health providers have agreements with big insurance not to allow transparency. That makes no sense.

Isn't that the point of the market--to overcome these agreements? That if enough people want it, the providers (or at least some) will give them what they want? It hasn't happened.

Seriously? Is this post serious? You can possibly be this obtuse.

You basically just said.. isn't the point of a free market to overcome things like not actually being a free market!

You don't HAVE a free market in this case... since the free market relies on a certain amount of transparency. Which is why, I would have no problem with government intervention to enforce transparency.

Chocolate Hog
07-01-2012, 04:55 PM
Your question is based on the demonstrably incorrect assumption that Obamacare and Romneycare are the same thing. I know a lot of people on this site love to make that claim over and over, but repeating it over and over doesn't make it true.

Gruber has debunked your bullshit repeatedly. He would know considering he helped with both plans.

Romney even supported the mandate.

<iframe width="420" height="315" src="http://www.youtube.com/embed/JKN1RC2j92w" frameborder="0" allowfullscreen></iframe>

Guess you can stop lying now.

AustinChief
07-01-2012, 04:57 PM
According to theory, a couple of additional reasons why costs have been going up lately:

1) people who do not choose to buy health insurance, and do not want health insurance tend to be younger people who have little risk of health problems. Having less of these people in the 'insurance pool' makes costs higher, as the people left in the pool are riskier and cost more. Having more younger and healthier people in the insurance pool makes costs go down.

Also, people who choose not to purchase health insurance when you are younger, often choose to purchase it later on in life when they are at more of a risk for problems....again this is causing the insurance pool to become ever riskier as the population ages. So, unless we can balance this by getting more people to join the pool earlier, costs will continue to go up.

2) People who are uninsured tend to skip out on their medical bills at a higher rate......and so their costs must be paid by taxpayers ANYWAY. Hospitals do give some money to charity work, but a latge portion of unpaid hospital bills are paid for by A) tax payers and B) hospitals raising their rates to balance the books. Then, in turn, insurance companies have to raise their rates to cover the increases.

3) also individuals should be able to buy from private exchanges, thus setting up a system where you have the power of group purchases effectively lowering the cost and placing people together as a group to have purchasing power.


In theory, adding more people to the insurance pool will spread the risk out, and get some uninsured people into the insurance pool. In theory, this will help to mitigate the crazy rise of costs that is already happening even without ObamaCare. The exchanges are another way that costs may be lowered.

I personally don't care about ObamaCare and I am not arguing for it, I am just trying to answer your question in an unbiased way.

1) supposedly will drive down the cost of health INSURANCE not the cost of health care

2) this is true but minimal... but you are correct it could be SOME cost savings

3)again, you addressing insurance costs.. my understanding was that pete wanted to know what it does to make the ACTUAL cost of health care cheaper, not the consumer cost for insurance, etc (but I may be wrong here)

Pawnmower
07-02-2012, 01:04 AM
1) supposedly will drive down the cost of health INSURANCE not the cost of health care

3)again, you addressing insurance costs.. my understanding was that pete wanted to know what it does to make the ACTUAL cost of health care cheaper, not the consumer cost for insurance, etc (but I may be wrong here)

For most people, the cost of health care insurance is a big part of the overall health care costs. For many, it is the vast majority of those costs.

AustinChief
07-02-2012, 01:14 AM
For most people, the cost of health care insurance is a big part of the overall health care costs. For many, it is the vast majority of those costs.

I get that.. I just thought he meant the ACTUAL costs, not the cost a person pays. A person may only pay $1000 for a CT Scan but the hospital actually charges $5000 and the rest is covered by insurance.

The CORE problem is that there is no excuse for a CT Scan costing $5k, no matter who actually pays that bill. Without transparency and a true free market.. I can't see ANY reason for the prices to come down unless you implement jack-booted price controls. Obamacare does none of this.

J Diddy
07-02-2012, 02:53 AM
I get that.. I just thought he meant the ACTUAL costs, not the cost a person pays. A person may only pay $1000 for a CT Scan but the hospital actually charges $5000 and the rest is covered by insurance.

The CORE problem is that there is no excuse for a CT Scan costing $5k, no matter who actually pays that bill. Without transparency and a true free market.. I can't see ANY reason for the prices to come down unless you implement jack-booted price controls. Obamacare does none of this.

I agree, but that's a different battle for a different day. Obama said healthcare, and he delivered. Next step is what you said, medical transparency. I remember watching the SC decision on CNN and then, shortly after, seeing a report on hospital charges and I thought this is where the next fight lies.

AustinChief
07-02-2012, 03:20 AM
I agree, but that's a different battle for a different day. Obama said healthcare, and he delivered. Next step is what you said, medical transparency. I remember watching the SC decision on CNN and then, shortly after, seeing a report on hospital charges and I thought this is where the next fight lies.

see, I think this is backwards. Obamacare will make it even more difficult to address this issue. If everyone has insurance and no one pays cash or cares what the charges are... nothing will get done. THIS ISSUE should have been what was addressed FIRST.

It's a giant scam and Obamacare only helps to fund it and push the real issues out of the public eye.

BWillie
07-02-2012, 04:14 AM
What part of Obamacare makes it cheaper? Just playing devils advocate, but many people that don't have insurance never ever pay for their care or plan to. What do you think that does to the health care rates of those with insurance and/or willing to pay? They pay more for their own care subsidizing those who never pay. Drs have to get paid some how, they got medical school and Hummers to pay for

Comrade Crapski
09-10-2012, 05:49 AM
Looks like all those naÔve kids that voted for that asshole are going to get it rammed up their asses good and hard! LMAO

The future frightening payoffs of college loans are taking a backseat to the immediate and soaring costs of health insurance students are getting slapped with as they return to school this fall, all thanks to Obamacare. Because of a rule in the Affordable Care Act that lifts caps on policy payoffs, the cheap insurance policies typically healthy students previously got are skyrocketing, some over 1,000 percent. The reason: Without payoff caps, insurance firms are boosting prices to cover their potential losses.

http://washingtonexaminer.com/obamacare-shock-college-insurance-prices-soar/article/2506342

Saulbadguy
09-10-2012, 07:05 AM
None of that makes it cheaper. Because it won't be cheaper. It will at least double what you are paying now.

Do you actually believe this? Just curious, no reason to argue.

HonestChieffan
09-10-2012, 07:27 AM
HC cannot become cheaper by decree. Nor is it free to add millions to the system. And the impact on availability of doctors and the strong probability that we will end up with fewer hospitals will not reduce cost.

The simple fact is that the vast majority of supporters of this monster have no interest in its cost. Cost is not an issue.

Trying to rationally discuss this with an economics POV with the emotional supporter of ObamaCare is folly.

RubberSponge
09-10-2012, 07:39 AM
I get that.. I just thought he meant the ACTUAL costs, not the cost a person pays. A person may only pay $1000 for a CT Scan but the hospital actually charges $5000 and the rest is covered by insurance.

The CORE problem is that there is no excuse for a CT Scan costing $5k, no matter who actually pays that bill. Without transparency and a true free market.. I can't see ANY reason for the prices to come down unless you implement jack-booted price controls. Obamacare does none of this.

I'm thinking it works more along the lines of this...

You go to the doctor, depending on plan you pay or don't pay a co-pay. You may be responsible for additional monies owed if you have a deductible. Doctor submits bill for office visit to insurance minus co-pay. Doctor may bill insurance $155 for office visit. Insurance says no, we will not pay you $155, we pay out x amount instead for office visits. Either you accept that or you can stop accepting patients who carry our insurance. Insurance sets the costs of healthcare, not doctors or hospitals.

InChiefsHell
09-10-2012, 07:47 AM
I'm thinking it works more along the lines of this...

You go to the doctor, depending on plan you pay or don't pay a co-pay. You may be responsible for additional monies owed if you have a deductible. Doctor submits bill for office visit to insurance minus co-pay. Doctor may bill insurance $155 for office visit. Insurance says no, we will not pay you $155, we pay out x amount instead for office visits. Either you accept that or you can stop accepting patients who carry our insurance. Insurance sets the costs of healthcare, not doctors or hospitals.

As I recall from my time in the insurance industry, the prices were negotiated and set. So if a doctor wanted to have patients with Insurance Company X, they had to agree to the prices they charged per service. The Doctors might have a different price for the same procedure depending on the negotiated price with the insurance company. They ALWAYS charge medicare and medicaid full price.

That was back in the 90's. Who knows how it is now.

Lightrise
09-10-2012, 08:22 AM
What makes it cheaper for one is the 716 Billion that hospitals, the insurance companies and the drug companies gave away in return for being able to leverage the broader base of patients. It was the tax cut the republicans believe solves every problem in the world, including potholes.

Direckshun
09-10-2012, 08:53 AM
The cost of healthcare rises to three times the speed of inflation.

The past two years, it has risen under 4%.

Cave Johnson
09-10-2012, 01:38 PM
Here's one, Pete.

That would be the provision of the law, called the medical loss ratio, that requires health insurance companies to spend 80% of the consumers’ premium dollars they collect—85% for large group insurers—on actual medical care rather than overhead, marketing expenses and profit. Failure on the part of insurers to meet this requirement will result in the insurers having to send their customers a rebate check representing the amount in which they underspend on actual medical care.

http://www.forbes.com/sites/rickungar/2011/12/02/the-bomb-buried-in-obamacare-explodes-today-halleluja/

vailpass
09-10-2012, 01:43 PM
Here's one, Pete.



http://www.forbes.com/sites/rickungar/2011/12/02/the-bomb-buried-in-obamacare-explodes-today-halleluja/

Any word on how that will be accounted/enforced?

Cave Johnson
09-10-2012, 01:58 PM
Any word on how that will be accounted/enforced?

Accounting, I think, is through HHS. As for enforcement, if a health insurer falls below to 80-85% threshold, they have to rebate a certain amount back to policyholders.

vailpass
09-10-2012, 02:18 PM
Accounting, I think, is through HHS. As for enforcement, if a health insurer falls below to 80-85% threshold, they have to rebate a certain amount back to policyholders.

So it's HHS against the insurance company's accountants and tax attorneys? That does not engender confidence in the prospects of money savings being realized.
It gives visions of medicare billing practices.

patteeu
09-10-2012, 03:12 PM
The cost of healthcare rises to three times the speed of inflation.

The past two years, it has risen under 4%.

That's due to Obama's economic malaise, not Obamacare (which hasn't been fully in effect for the past two years). Three cheers for the Jimmy Carter of our times!

Cave Johnson
09-10-2012, 03:44 PM
So it's HHS against the insurance company's accountants and tax attorneys? That does not engender confidence in the prospects of money savings being realized.
It gives visions of medicare billing practices.

Oh noes, accountants and lawyers. Might as well give up, then.

Velvet_Jones
09-10-2012, 03:45 PM
I’m not going to get into a full fledged argument here about the 80/85 rule but actuarially it is not a sound assumption that the claims incurred will always be less then 100% of the premium charged. In insurance, you are always anticipating future losses and have to be able to cover those losses by “Reserving” premium to cover them. What happens when an insured requires 300% of premium for a procedure? Where does that money come from?

It’s obvious to anyone remotely involved in the medical insurance industry that ObamaCare is set up solely to collapse the medical insurance industry. When the collapse happens, the government will get the big prize that they are hoping for and that is this stupid notion of a single payer system that the government will control. Oh is this going to be a shock to the public. Services will go down, research and development will go down, wait times will go up and it will end up being freakin’ mess. There is no other way to look at it.

Additionally, the market has already adjusted. Benefit products are now being offered that can not be considered insurance plans and therefore do not fall under the rules of ObamaCare. I’m sure that the federal government will change the rules on and eventually call these products insurance just to make ObamaCare not die on the vine. We will change again and the whole Charley Foxtrott will start all over again. This is going to happen because the consumer does not want ObamaCare, therefore, there will be a market of FREE people to sell our products to.

Some things to ponder:
1 – There is no state or province in the United States that allows pre-existing condition limitations provided the insured had like prior coverage. This is a strawman argument to support a socialized medical system. If the person had no prior coverage, then there is a limitation but the limitation is waived after 3 months to 36 months of coverage and would then be considered a covered expense. This keeps people from gaming the system and only getting insurance when they get sick. Do you get auto insurance only after you have had a wreck?

2 – Insurance companies pay a state and federal tax on premium collected that can be as high as 10%. If the tax stays the same then the 80/85 rile is now 90/95. Another way to help the medical insurance industry to collapse.

3 – MediCare reimburses physicians and facilities at right around 50% of what is expected from a private insurance company. The providers simply transfer the lost revenue from MediCare patients to privately insureds or they simply refuse to treat Medicare patients. Where is the lost revenue going to come from when the government cuts al reimbursement by 50%. I have heard more than one physician (mostly internalist and physical surgeons) say that they lose money on all MediCare patients.

4 – Private insurance companies in most states must comply with law that requires settlement a claim within a specific length of time. MediCare has to abide by no such law and often take three or 4 times as long to settle a claim.

5 – Private insurance companies have staff that work with healthcare providers to insure that their clients are getting the best, most appropriate and most efficient care. There is no such oversight with MediCare. With MediCare, there is no coordination between healthcare providers and this is simply how people die by hands of the medical system. Private insurance companies have a vested interest in getting the best treatment for the lowest cost. The government has no interest in that at all and just pays people what the government wants to pay.

7 – Most states require private insurance companies to pay for routine exams that really cannot and should not be considered the responsibility of an insurance company. If you want that kind of coverage, there are many companies that offer that as a supplement to insurance. You don’t have insurance to get the oil changed on your auto. Also, if the insurance companies didn’t pay for these then the cost to the consumer would go down.

6 – Physicians are smart people. They will not flock to an industry where there is no money to be made. They will go do something else.

ObamaCare does not consider any of the above points as well as many more I could list.

vailpass
09-10-2012, 03:52 PM
Oh noes, accountants and lawyers. Might as well give up, then.

That seems like a childish response to a valid concern.

vailpass
09-10-2012, 03:54 PM
Iím not going to get into a full fledged argument here about the 80/85 rule but actuarially it is not a sound assumption that the claims incurred will always be less then 100% of the premium charged. In insurance, you are always anticipating future losses and have to be able to cover those losses by ďReservingĒ premium to cover them. What happens when an insured requires 300% of premium for a procedure? Where does that money come from?

Itís obvious to anyone remotely involved in the medical insurance industry that ObamaCare is set up solely to collapse the medical insurance industry. When the collapse happens, the government will get the big prize that they are hoping for and that is this stupid notion of a single payer system that the government will control. Oh is this going to be a shock to the public. Services will go down, research and development will go down, wait times will go up and it will end up being freakiní mess. There is no other way to look at it.

Additionally, the market has already adjusted. Benefit products are now being offered that can not be considered insurance plans and therefore do not fall under the rules of ObamaCare. Iím sure that the federal government will change the rules on and eventually call these products insurance just to make ObamaCare not die on the vine. We will change again and the whole Charley Foxtrott will start all over again. This is going to happen because the consumer does not want ObamaCare, therefore, there will be a market of FREE people to sell our products to.

Some things to ponder:
1 Ė There is no state or province in the United States that allows pre-existing condition limitations provided the insured had like prior coverage. This is a strawman argument to support a socialized medical system. If the person had no prior coverage, then there is a limitation but the limitation is waived after 3 months to 36 months of coverage and would then be considered a covered expense. This keeps people from gaming the system and only getting insurance when they get sick. Do you get auto insurance only after you have had a wreck?

2 Ė Insurance companies pay a state and federal tax on premium collected that can be as high as 10%. If the tax stays the same then the 80/85 rile is now 90/95. Another way to help the medical insurance industry to collapse.

3 Ė MediCare reimburses physicians and facilities at right around 50% of what is expected from a private insurance company. The providers simply transfer the lost revenue from MediCare patients to privately insureds or they simply refuse to treat Medicare patients. Where is the lost revenue going to come from when the government cuts al reimbursement by 50%. I have heard more than one physician (mostly internalist and physical surgeons) say that they lose money on all MediCare patients.

4 Ė Private insurance companies in most states must comply with law that requires settlement a claim within a specific length of time. MediCare has to abide by no such law and often take three or 4 times as long to settle a claim.

5 Ė Private insurance companies have staff that work with healthcare providers to insure that their clients are getting the best, most appropriate and most efficient care. There is no such oversight with MediCare. With MediCare, there is no coordination between healthcare providers and this is simply how people die by hands of the medical system. Private insurance companies have a vested interest in getting the best treatment for the lowest cost. The government has no interest in that at all and just pays people what the government wants to pay.

7 Ė Most states require private insurance companies to pay for routine exams that really cannot and should not be considered the responsibility of an insurance company. If you want that kind of coverage, there are many companies that offer that as a supplement to insurance. You donít have insurance to get the oil changed on your auto. Also, if the insurance companies didnít pay for these then the cost to the consumer would go down.

6 Ė Physicians are smart people. They will not flock to an industry where there is no money to be made. They will go do something else.

ObamaCare does not consider any of the above points as well as many more I could list.

Very insightful post, thank you. Am I correct in thinking you are in the insurance industry or a parallel industry?
You illustrate the concerns of many I know that the incentive for our best & brightest to go through the arduous process of becoming a doctor will be greatly lessened under single payer, as will the $ for R & D.

Cave Johnson
09-10-2012, 04:00 PM
That seems like a childish response to a valid concern.

Ok, here's a less flip response. Health insurer spending on tax lawyers and accountants in an effort to circumvent the 15-20% cap would, presumably, come directly out of that portion of their expenditures. So they're somewhat limited in their ability to hire armies of lawyers to do what you suggest.

vailpass
09-10-2012, 04:02 PM
Ok, here's a less flip response. Health insurer spending on tax lawyers and accountants in an effort to circumvent the 15-20% cap would, presumably, come directly out of that portion of their expenditures. So they're somewhat limited in their ability to hire armies of lawyers to do what you suggest.

There would be no extra expenditures. Accountants and tax attorneys are already on the payroll and in abundance. I'm not suggesting all-out deception, but it's unrealistic to think there wouldn't be numerous methods discovered and used to circumvent the process.
Insurance doesn't want to be killed.
Read Velvet's post.

Velvet_Jones
09-10-2012, 05:01 PM
Very insightful post, thank you. Am I correct in thinking you are in the insurance industry or a parallel industry?
You illustrate the concerns of many I know that the incentive for our best & brightest to go through the arduous process of becoming a doctor will be greatly lessened under single payer, as will the $ for R & D.

I'm a partner of a TPA (Third Party Administrator) which markets and administrates health insurance to the segment of the US economy that larger insurance companies don't want to spend the effort on. We specialize in groups of 1 - 50 primary insureds. We have 65,000 insureds.

We are highly automated, very competitive and very efficient. None of which the government will be.

vailpass
09-10-2012, 05:04 PM
I'm a partner of a TPA (Third Party Administrator) which markets and administrates health insurance to the segment of the US economy that larger insurance companies don't want to spend the effort on. We specialize in groups of 1 - 50 primary insureds. We have 65,000 insureds.

We are highly automated, very competitive and very efficient. None of which the government will be.

Your insight is appreciated, wish you'd post more when you have specific knowledge to points being discussed here.

AustinChief
09-10-2012, 05:18 PM
7 Ė Most states require private insurance companies to pay for routine exams that really cannot and should not be considered the responsibility of an insurance company. If you want that kind of coverage, there are many companies that offer that as a supplement to insurance. You don't have insurance to get the oil changed on your auto. Also, if the insurance companies didn't pay for these then the cost to the consumer would go down.


This one burns me up the most. When consumers never see the cost, they never makes value judgments. Instead, they simply abuse the shit out of the system.

I'd be happy to see ALL insurance go away other than catastrophic care. Let consumers pay cash for everything else and you'll see some drastic changes in the market. Yes I know this is unrealistic.. but one can dream.

VAChief
09-10-2012, 06:55 PM
Iím not going to get into a full fledged argument here about the 80/85 rule but actuarially it is not a sound assumption that the claims incurred will always be less then 100% of the premium charged. In insurance, you are always anticipating future losses and have to be able to cover those losses by ďReservingĒ premium to cover them. What happens when an insured requires 300% of premium for a procedure? Where does that money come from?

Itís obvious to anyone remotely involved in the medical insurance industry that ObamaCare is set up solely to collapse the medical insurance industry. When the collapse happens, the government will get the big prize that they are hoping for and that is this stupid notion of a single payer system that the government will control. Oh is this going to be a shock to the public. Services will go down, research and development will go down, wait times will go up and it will end up being freakiní mess. There is no other way to look at it.

Additionally, the market has already adjusted. Benefit products are now being offered that can not be considered insurance plans and therefore do not fall under the rules of ObamaCare. Iím sure that the federal government will change the rules on and eventually call these products insurance just to make ObamaCare not die on the vine. We will change again and the whole Charley Foxtrott will start all over again. This is going to happen because the consumer does not want ObamaCare, therefore, there will be a market of FREE people to sell our products to.

Some things to ponder:
1 Ė There is no state or province in the United States that allows pre-existing condition limitations provided the insured had like prior coverage. This is a strawman argument to support a socialized medical system. If the person had no prior coverage, then there is a limitation but the limitation is waived after 3 months to 36 months of coverage and would then be considered a covered expense. This keeps people from gaming the system and only getting insurance when they get sick. Do you get auto insurance only after you have had a wreck?

2 Ė Insurance companies pay a state and federal tax on premium collected that can be as high as 10%. If the tax stays the same then the 80/85 rile is now 90/95. Another way to help the medical insurance industry to collapse.

3 Ė MediCare reimburses physicians and facilities at right around 50% of what is expected from a private insurance company. The providers simply transfer the lost revenue from MediCare patients to privately insureds or they simply refuse to treat Medicare patients. Where is the lost revenue going to come from when the government cuts al reimbursement by 50%. I have heard more than one physician (mostly internalist and physical surgeons) say that they lose money on all MediCare patients.

4 Ė Private insurance companies in most states must comply with law that requires settlement a claim within a specific length of time. MediCare has to abide by no such law and often take three or 4 times as long to settle a claim.

5 Ė Private insurance companies have staff that work with healthcare providers to insure that their clients are getting the best, most appropriate and most efficient care. There is no such oversight with MediCare. With MediCare, there is no coordination between healthcare providers and this is simply how people die by hands of the medical system. Private insurance companies have a vested interest in getting the best treatment for the lowest cost. The government has no interest in that at all and just pays people what the government wants to pay.

7 Ė Most states require private insurance companies to pay for routine exams that really cannot and should not be considered the responsibility of an insurance company. If you want that kind of coverage, there are many companies that offer that as a supplement to insurance. You donít have insurance to get the oil changed on your auto. Also, if the insurance companies didnít pay for these then the cost to the consumer would go down.

6 Ė Physicians are smart people. They will not flock to an industry where there is no money to be made. They will go do something else.

ObamaCare does not consider any of the above points as well as many more I could list.

Private insurance companies have one vested interest. Profits. They could care less what quality of care you get. They are betting the odds you don't get sick, or quit paying (lose your job) before you get sick. We don't need bookies, I mean health insurance companies. Sorry, its your business so I understand the commitment to the gravy train, but I've worked in the industry too, and it is big f'ing sham on the consumer.

The scare tactic doctors will quit because they are so low paid is laughable. Why do they accept as much as 1/10th from the benevolent insurers (who of course only want top care) than they charge the uninsured? You don't think they would love to get rid of the assholes nit picking them to death and driving up their administrative costs?

You raise some valid points, but the whole health insurers only want the best for your health is a crock of bullcrap.

qabbaan
09-10-2012, 06:59 PM
It's common sense that you can't ram tens of millions more people into the system, while simultaneously promising to decrease the money you pay into it.

Velvet_Jones
09-11-2012, 09:35 AM
Private insurance companies have one vested interest. Profits. They could care less what quality of care you get. They are betting the odds you don't get sick, or quit paying (lose your job) before you get sick. We don't need bookies, I mean health insurance companies. Sorry, its your business so I understand the commitment to the gravy train, but I've worked in the industry too, and it is big f'ing sham on the consumer.

The scare tactic doctors will quit because they are so low paid is laughable. Why do they accept as much as 1/10th from the benevolent insurers (who of course only want top care) than they charge the uninsured? You don't think they would love to get rid of the assholes nit picking them to death and driving up their administrative costs?

You raise some valid points, but the whole health insurers only want the best for your health is a crock of bullcrap.

Wrong. You have bought into the BS that resulted in ObamaCare. Of course private insurance companies are concerned with profits. If they werenít then what is the purpose of getting into that business?

It's obvious you have never dealt with a State Department of Insurance (DOI) complaint. These state departments are ruthless and hold the insurance companies in account, which is normally a good thing. The DOI can at any moment revoke the insurance companyís ability to do business in that state which the insurance company has spent millions to establish.

Let me give you an example of why an insurance company may get involved in the direction of the treatment of an insured. Letís say an insured suffered a knee joint injury. The discovery portion of the treatment is to take an x-ray and determine that there is no fracture involved. If no fracture then the physician requests a CT Scan. The insurance company knows through experience studies that 87% of all people requiring a CT Scan for a knee joint injury will need an MRI for further diagnosis. The CT Scan and the required reading is $600 and the MRI is $1400. The insurance company will suggest just doing the MRI because actuarially, it makes more sense because of a loss of $1400 is better than $2000. This directly affects loss ratios which directly affects premiums. This is how an insurance company remains competitive. I see nothing wrong with being a good steward of healthcare delivery and cost. Apparently you do.

Itís funny that you donít understand business. It also funny that you think if you lose your job you wonít be required to carry and pay for coverage under ObamaCare.

Velvet_Jones
09-11-2012, 09:36 AM
It's common sense that you can't ram tens of millions more people into the system, while simultaneously promising to decrease the money you pay into it.

5 out of 4 people like VACHIEF don't understand math.

Bump
09-11-2012, 12:17 PM
Your question is based on the demonstrably incorrect assumption that Obamacare and Romneycare are the same thing. I know a lot of people on this site love to make that claim over and over, but repeating it over and over doesn't make it true.

quoted from one of the people who actually wrote the bill itself.

"It's the same fucking bill"

FishingRod
09-11-2012, 12:40 PM
Monaco and the US both have a defense budget

Rhode Island and Texas have cows.

Rosanne Barr and Jessica Alba both have an ass.

Doesn't make them the same thing

KILLER_CLOWN
09-11-2012, 12:41 PM
Monaco and the US both have a defense budget

Rhode Island and Texas have cows.

Rosanne Barr and Jessica Alba both have an ass.

Doesn't make them the same thing

I would rather have single payer than either of those shit bills, Go strong or don't go at all.

FishingRod
09-11-2012, 12:52 PM
I would rather have single payer than either of those shit bills, Go strong or don't go at all.

Honestly as much as I hate to admit it a real socialized health system is probabably better. If we are not willing to let people suffer for their decisions and or bad luck as we do now, you are already paying for everyone.

vailpass
09-11-2012, 12:53 PM
Private insurance companies have one vested interest. Profits. They could care less what quality of care you get. They are betting the odds you don't get sick, or quit paying (lose your job) before you get sick. We don't need bookies, I mean health insurance companies. Sorry, its your business so I understand the commitment to the gravy train, but I've worked in the industry too, and it is big f'ing sham on the consumer.

The scare tactic doctors will quit because they are so low paid is laughable. Why do they accept as much as 1/10th from the benevolent insurers (who of course only want top care) than they charge the uninsured? You don't think they would love to get rid of the assholes nit picking them to death and driving up their administrative costs?

You raise some valid points, but the whole health insurers only want the best for your health is a crock of bullcrap.

Profits are evil11!!!!
The government is much more efficient at running enterprises because They don't care about profit11!!
Just look at FedEx vs. the US Post Office11!!
I want the government to run everything and take care of me11!!

How absolutely blind can you get? Do you really think government can run health care in the best manner possible for ALL citizens (not just the poor?)

KILLER_CLOWN
09-11-2012, 12:53 PM
Honestly as much as I hate to admit it a real socialized health system is probabably better. If we are not willing to let people suffer for their decisions and or bad luck as we do now, you are already paying for everyone.

It's like we have socialism everywhere and pay for it but don't get any of the perks. We need to go one way or the other, lukewarm never gets it done.

vailpass
09-11-2012, 12:54 PM
Wrong. You have bought into the BS that resulted in ObamaCare. Of course private insurance companies are concerned with profits. If they werenít then what is the purpose of getting into that business?

It's obvious you have never dealt with a State Department of Insurance (DOI) complaint. These state departments are ruthless and hold the insurance companies in account, which is normally a good thing. The DOI can at any moment revoke the insurance companyís ability to do business in that state which the insurance company has spent millions to establish.

Let me give you an example of why an insurance company may get involved in the direction of the treatment of an insured. Letís say an insured suffered a knee joint injury. The discovery portion of the treatment is to take an x-ray and determine that there is no fracture involved. If no fracture then the physician requests a CT Scan. The insurance company knows through experience studies that 87% of all people requiring a CT Scan for a knee joint injury will need an MRI for further diagnosis. The CT Scan and the required reading is $600 and the MRI is $1400. The insurance company will suggest just doing the MRI because actuarially, it makes more sense because of a loss of $1400 is better than $2000. This directly affects loss ratios which directly affects premiums. This is how an insurance company remains competitive. I see nothing wrong with being a good steward of healthcare delivery and cost. Apparently you do.

Itís funny that you donít understand business. It also funny that you think if you lose your job you wonít be required to carry and pay for coverage under ObamaCare.

Rep

HonestChieffan
09-11-2012, 02:13 PM
Private insurance companies have one vested interest. Profits. They could care less what quality of care you get.



Government agencies are known for service, compassion, delivering far more than the customer expects. And they are efficient. This is the very nature of government. People who only serve to help their fellow man.

Comrade Crapski
09-13-2012, 02:30 AM
The costs associated with the Affordable Care Act (ACA) continue to stack up. According to the Committee on Ways and Means and the IRS, compliance with the new healthcare law will take 80 million man-hours per year. Perhaps that sounds like a successful jobs program, as it will keep 40,000 people fully employed, filling out paperwork and sorting through a confounding pile of government regulations. Only problem is, that work is entirely wasteful and creates zero wealth for America as a whole.

http://taxfoundation.org/blog/compliance-obamacare-estimated-80-million-man-hours?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%253A+TaxPolicyBlog+%2528Tax+Foundation+-+Tax+Foundation%2527s+%2522Tax+Policy+Blog%2522%2529

"Affordable" Care Act. LMAO

How Orwellian.

DaneMcCloud
09-13-2012, 02:36 AM
It's common sense that you can't ram tens of millions more people into the system, while simultaneously promising to decrease the money you pay into it.

Bullshit.

You act as if "Tens of millions" of people that were previously uninsured will suddenly become sick with deadly illnesses or need quadruple bypasses or brain surgery.

That's fucking scare tactics and nonsense.

DaneMcCloud
09-13-2012, 02:37 AM
The costs associated with the Affordable Care Act (ACA) continue to stack up. According to the Committee on Ways and Means and the IRS, compliance with the new healthcare law will take 80 million man-hours per year. Perhaps that sounds like a successful jobs program, as it will keep 40,000 people fully employed, filling out paperwork and sorting through a confounding pile of government regulations. Only problem is, that work is entirely wasteful and creates zero wealth for America as a whole.

http://taxfoundation.org/blog/compliance-obamacare-estimated-80-million-man-hours?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%253A+TaxPolicyBlog+%2528Tax+Foundation+-+Tax+Foundation%2527s+%2522Tax+Policy+Blog%2522%2529

"Affordable" Care Act. LMAO

How Orwellian.

So, what is YOUR solution?

As a veteran of the health care industry (as was my wife, for nearly 14 years), I have solutions to ease the cost.

Do you?

DaneMcCloud
09-13-2012, 02:41 AM
Rep

No offense but your "Rep" is unwarranted, as he's simply describing the current situation.

Why should an MRI or any simple procedure cost $600 to $1200 dollars for someone that's insured? That is INSANE. It's like saying that the Soda Machine at your office takes $10 dollars for every soda dispensed.

That is fucking BULLSHIT.

Corporations are earning BILLIONS off of your health, your children's health, my health, etc. Health Care in the 21st CENTURY United States should not be a FOR PROFIT enterprise.

Wake up, people.

DaneMcCloud
09-13-2012, 02:47 AM
As I recall from my time in the insurance industry, the prices were negotiated and set. So if a doctor wanted to have patients with Insurance Company X, they had to agree to the prices they charged per service. The Doctors might have a different price for the same procedure depending on the negotiated price with the insurance company. They ALWAYS charge medicare and medicaid full price.

That was back in the 90's. Who knows how it is now.

It is the SAME exact way.

Each insurance company negotiates a rate, whether it's an overnight stay, procedure, etc.

And they're all different: If you have United Healthcare, your rate is different than if you have Blue Cross.

Until this changes, we're all fucked, regardless of political affiliation.

DaneMcCloud
09-13-2012, 02:47 AM
That's due to Obama's economic malaise, not Obamacare (which hasn't been fully in effect for the past two years). Three cheers for the Jimmy Carter of our times!

Wrong.

But then again, that should be your avatar this election cycle.

Wrong, wrong, wrong.

mlyonsd
09-13-2012, 07:17 AM
It's common sense that you can't ram tens of millions more people into the system, while simultaneously promising to decrease the money you pay into it.QFT.

philfree
09-13-2012, 01:42 PM
It is the SAME exact way.

Each insurance company negotiates a rate, whether it's an overnight stay, procedure, etc.

And they're all different: If you have United Healthcare, your rate is different than if you have Blue Cross.

Until this changes, we're all ****ed, regardless of political affiliation.

I'd like to see the difference between what my insurance company pays and what I would pay for medical care. Is it 10% less or is more than that?

VAChief
09-13-2012, 06:08 PM
I'd like to see the difference between what my insurance company pays and what I would pay for medical care. Is it 10% less or is more than that?

It is a lot less than 10%, as much as 90% less depending on how big of a group in your area and the rates they negotiated (hospital stays, but including what they allow for your doctor). It's some f'ed up stuff.

VAChief
09-13-2012, 06:51 PM
Wrong. You have bought into the BS that resulted in ObamaCare. Of course private insurance companies are concerned with profits. If they werenít then what is the purpose of getting into that business?

It's obvious you have never dealt with a State Department of Insurance (DOI) complaint. These state departments are ruthless and hold the insurance companies in account, which is normally a good thing. The DOI can at any moment revoke the insurance companyís ability to do business in that state which the insurance company has spent millions to establish.

Let me give you an example of why an insurance company may get involved in the direction of the treatment of an insured. Letís say an insured suffered a knee joint injury. The discovery portion of the treatment is to take an x-ray and determine that there is no fracture involved. If no fracture then the physician requests a CT Scan. The insurance company knows through experience studies that 87% of all people requiring a CT Scan for a knee joint injury will need an MRI for further diagnosis. The CT Scan and the required reading is $600 and the MRI is $1400. The insurance company will suggest just doing the MRI because actuarially, it makes more sense because of a loss of $1400 is better than $2000. This directly affects loss ratios which directly affects premiums. This is how an insurance company remains competitive. I see nothing wrong with being a good steward of healthcare delivery and cost. Apparently you do.

Itís funny that you donít understand business. It also funny that you think if you lose your job you wonít be required to carry and pay for coverage under ObamaCare.

Lighten up Francis, you took it too personally. I'm sure you are care very deeply about the quality of care of those you insure. We can disagree as to whether this is an industry wide phenomenon.

The second issue I had regarding doctors leaving the profession due to a loss of income I regarded as hyperbole.

I never asserted that you wouldn't have to pay for your insurance if you lost your job, but at least you could keep your preferred rates instead of the inflated rates of the uninsured.

VAChief
09-13-2012, 06:58 PM
Profits are evil11!!!!
The government is much more efficient at running enterprises because They don't care about profit11!!
Just look at FedEx vs. the US Post Office11!!
I want the government to run everything and take care of me11!!

How absolutely blind can you get? Do you really think government can run health care in the best manner possible for ALL citizens (not just the poor?)

Where did I say anything about government run health care or anything else you assumed in your bunched up knickers?

Direckshun
09-16-2012, 04:50 PM
http://www.rwjf.org/files/research/67188costs.pdf