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Aetna voices 'serious concerns' on ObamaCare sustainability 2/1/16 The Hill

Discussion in 'Other Health News and Research' started by *GG*, Feb 3, 2016.

  1. *GG*

    *GG* Senior Member

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    Concord, NH
    Aetna's chairman and CEO said Monday that the country's third-largest health insurer had “serious concerns” about the sustainability of ObamaCare’s marketplaces.

    “We continue to have serious concerns about the sustainability of the public exchanges,” Mark Bertolini said on an earnings call Monday, according to prepared remarks.

    He said the company remained concerned about “the overall stability of the risk pool.”

    cont'd

    http://thehill.com/policy/healthcare/267740-aetna-serious-concerns-on-obamacare-sustainability
     
    whodathunkit likes this.
  2. Well what'd ya know? a Health insurance company CEO worried about profitability over the sick and dying....

    maybe just maybe thinking that the ENTIRE serious health care sector shouldn't be about profit.
     
    Last edited by a moderator: Feb 7, 2016
    Valentijn, L'engle, A.B. and 2 others like this.
  3. *GG*

    *GG* Senior Member

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    Not sure if you are being sarcastic or not? Anyways, your lasat paragraph makes me think of the VA and how to many Vets have died or waited for months for Health Care GUARANTEED by the gov't, and still no person has lost their job!

    GG
     
    Last edited by a moderator: Feb 7, 2016
    Never Give Up and whodathunkit like this.
  4. JES

    JES Senior Member

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    As with anything, things are not that black and white. I live in Finland where over 90% of the healthcare is public funded; nevertheless it's consider a model country of healthcare, schooling etc. The Nordic countries are all welfare states and they have the best healthcare quality in Europe according to numerous surveys. If I encounter a health issue I can choose between public and paying more to a private instance. Bottom line is that it really works well for the average person here.

    Naturally there are issues with it, in particular tied to rarer disease like CFS that don't quite "fit" into the public healthcare's vision. Although ironically, Norway has some of the best CFS research currently and it would be labelled a socialist country by many here.
     
    Valentijn, L'engle, ahmo and 4 others like this.
  5. alex3619

    alex3619 Senior Member

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    While like most countries the Australian system has problems, it also seems to work fairly well as a hybrid system. However, like in the UK, there is a move to get rid of public health systems here and require private insurance. I think this is driven more by ideology than evidence.

    One thing that would help the US system is standardization of reporting codes. I forget the exact amount saved, but it was like 25% saving on costs. A medium sized hospital in Canada, according to a report I read several years ago (Newsweek?), needs one insurance clerk. The US equivalent needed 400 people. Doctors also spend a whole day a month (but not all at once) filling in paperwork. Its not government doing that, its the myriad private insurers. One reporting code, standardized, would bring down costs and give more time back to doctors to treat patients.

    No system is perfect. They can all be improved. I do not however think a private versus public debate is the main issue. I think the real issue is managed medicine. HMOs telling patients they cannot have life saving treatment. Government bureaucrats determining what is or is not permitted for doctors to do. Standardization of treatment such that if your own best treatment is not recognized you are out of luck, regardless of whether its from private insurance or government funded treatment. Medicine needs both regulation and flexibility. People are not made from Lego blocks.

    This is where EBM, evidence based medicine, is becoming an issue. Its being used to restrict and control medical treatment. Its about denying services, and standardizing treatments. This applies equally to countries with private medicine, or state backed medicine, or hybrid models. It should be about determining better treatments as a guide, not strict rules.

    The underlying principles of EBM are sound, but it needs to be recognized they are primarily managerial not scientific methods. However how EBM is being used and promoted is very far from good public health policy. Globally we are moving to a situation where only some treatments will be available, and if they do not suit you then too bad.

    One thing I do want to say about the US system is that doctors have more latitude to fight administrative nonsense providing the doctors are not in a managed healthcare organization. I do think they are slowly losing that fight though. Something has to change.

    PS My comment is also related to issues in this thread: http://forums.phoenixrising.me/index.php?threads/medical-practice-too-standardised.42761/
     
    Last edited: Feb 3, 2016
    ahmo and whodathunkit like this.
  6. *GG*

    *GG* Senior Member

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    Seems to me a hybrid would be best as well. Seems like the would provide the most options, to everyone, NO, but information will get out, and it will get out! Which will help us eventually, is it great, NO. But it seems better than systems with large bureaucracies that are slow to move and are very much static.

    Also, the CFIDS/ME specialist I see does not take much for insurance, he is very knowledgeable, and I pay out of pocket not to see him. My insurance did cover him, but not sure it will if I get back on it. Been going for disability (not Federal/SSI or SSDI, worked for a State and was vested) now for over 2 years, hope the time is worth it!

    GG
     
  7. whodathunkit

    whodathunkit Senior Member

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    Yep. Very well said. :thumbsup:

    The U.S. is kind of a hybrid system, even before the ACA, since we've had Medicare and Medicaid for a long time. If you were sick you could get care, but like with most government healthcare, it wasn't the best.

    But unfortunately, even a hybrid system circles us back around to who's paying for it. In any socialized system, which is just a pool that everyone contributes to and takes out of, and therefore private insurance is also a socialized system, bureaucrats (be they government or private individuals) start prioritizing costs over care. If you have a majority of people in your system who are very sick and need hundreds of thousands of dollars worth of care every year, and they are more numerous than the people who are healthy and not getting much care, they could potentially run the system out of money so that there isn't enough to pay anyone (meaning doctors and nurses, let alone over-compensated CEO's). That's apparently what's happening with the ACA.

    The answer is not more taxes to increase funds. People get tired of paying more taxes for more effort, and eventually scale back their efforts. Less effort equals less production, which results in fewer tax dollars to collect. If you raise taxes again, the whole cycle is repeated. Even with private health insurance, healthy people get tired of the rising costs and drop out of the system if they can. They'd rather spend their money on a mortgage or clothes for their kids or whatever. This is why the ACA was created: to force healthy people who don't care about having insurance to pay into the system regardless.

    This is the ugly reality of socialized everything (including private insurance). It's about economics. It's NOT an advocacy for the abolishment of public and private health insurance. But this is what the real fight is about.
     
    *GG* likes this.

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