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Thread: Let The Death Spiral Begin

  1. #71
    Senior Member swampcollielover's Avatar
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    JDogger....beats talking about "lobster".....


  2. #72
    Senior Member Gerry Clinchy's Avatar
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    I would add that the administration never counts at all the number of people who lost their policies to arrive at a "net" figure of "newly" insured. Krugman also conveniently overlooks that number. Krugman doesn't mention that the CBO has dramatically changed its estimate of what O-care will cost v. the numbers given prior to the passing of the law. Of course, that has become such a common occurrence that it may not be worth mentioning for Krugman.

    O-care is also NOT supposed to include illegal residents. With all the fraud in Medicaid, do we have any reason to believe that no illegals have enrolled? Do we have any idea how many people in Oregon enrolled? None were able to enroll through the state exchange. Did they enroll via the Fed exchange? Did they enroll directly with insurors? Do we know if they were previously insured? Do we know how many of the 8 million enrolled were previously insured? We do know that many of them were previously insured and had to change plans due to the law. Do we know how many enrollments were for Medicaid? How many will receive subsidies?

    Estimates have been that only about 1 million previously uninsured are now insured. That would be about 3% of the 30 million estimated previously insured. Some say the uninsured were as high as 40 million. then the %-age would be 2.5%.

    Jay Carney's statement was "we don't have hard numbers, but their numbers are wrong". Is that what we would call spin?

    Krugman says the insurance companies are "satisfied"? Why not? The taxpayers will pick up their losses for 3 years. What's not to like? The insurors who have opted out of the exchanges, I guess, are also satisfied with their decisions?

    The doctors and hospitals that have opted out of the exchanges may be quite satisfied with their decisions as well. I'm guessing that rhose who got exemptions from O-care are quite satisfied as well.
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  3. #73
    Senior Member Golddogs's Avatar
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    Maybe not such a bad idea after all.


    Death rate in Massachusetts falls after health care overhaul

    By Sabrina Tavernise


    New York Times


    BOSTON — The death rate in Massachusetts dropped significantly after it adopted mandatory health care coverage in 2006, a study released Monday found, offering evidence that the country’s first experiment with universal coverage — and the model for crucial parts of President Barack Obama’s health care law — has saved lives, health economists say.

    The study tallied deaths in Massachusetts from 2001 to 2010 and found that the mortality rate — the number of deaths per 100,000 people — fell by about 3 percent in the four years after the law went into effect. The decline was steepest in counties with the highest proportions of poor and uninsured people.

    In contrast, the mortality rate in a control group of counties similar to Massachusetts in other states was largely unchanged.

    A national 3 percent decline in mortality among adults under 65 would mean about 17,000 fewer deaths a year.

    “It’s big,” said Samuel Preston, a demographer at the University of Pennsylvania and an authority on life expectancy. Preston, who was not involved in the study, called the study “careful and thoughtful,” and said it added to a growing body of evidence that people with health insurance could reap the ultimate benefit — longer life.

    Experts said the study, which was published online Monday in the Annals of Internal Medicine, will not settle the long-debated question of whether being insured prolongs life, but it provides the most credible evidence yet that it might. Still, health improvements can take years to surface in mortality data, and some researchers were skeptical of the magnitude and suddenness of the decline.

    “Health care is a much more involved process —you don’t just sign up and suddenly get well,” said Joseph Antos, a health economist at the conservative American Enterprise Institute.

    Massachusetts is whiter and more affluent than most states, and has more doctors per capita and fewer uninsured people. But researchers said that the state’s health insurance law nevertheless amounted to the best natural experiment the country has had for testing the effects of a major insurance expansion on a large population.

    Another study, in Oregon, found that Medicaid, the insurance program for the poor, improved mental health and financial security, but not physical health, and the study was too small to gauge mortality effects.

    “This is an important piece of the puzzle,” Katherine Baicker, a professor of health economics at the Harvard School of Public Health, who took part in both studies, said of the Massachusetts one. “Putting the evidence together paints a very strong picture that expanding insurance substantially improves the well-being of people who get it.”

    The authors identified 513 counties in 46 other states that were most similar to Massachusetts before reform in demographics and levels of poverty and insurance, then compared mortality rates. They found the rate declined 2.9 percent in Massachusetts, but remained flat in counties outside the state.

    Researchers also examined death rates for people 65 and over, a population that had been minimally affected by the insurance overhaul. Mortality patterns over time in that age group were the same in Massachusetts and in the control counties.

    Dr. Benjamin Sommers, the lead author who is a health economist and a physician at the Harvard School of Public Health, cautioned that researchers did not have individual data on the 270,000 people who had gained insurance in the state, and could not tell for sure whether it was the expansion that had driven the mortality decline.

    Still, experts said it was the best attempt yet to isolate the effects of insurance.

    David Meltzer, a health economist from the University of Chicago, who was not involved in the study, said one of the study’s strengths was its size. It looked at 4 million people in Massachusetts - the entire population ages 20 to 64 - and compared them with more than 44 million people in control counties.

    “In the hierarchy of evidence, this ranks way above everything we’ve seen in the past in terms of the effects on mortality,” Meltzer said.

    The biggest declines happened for conditions that are more likely to be deadly if not caught early - for example, infections from complications of diabetes, heart attacks and cancer.

    Researchers have long debated whether health insurance and better access to medical care saves lives, but it has been hard to construct a study to settle the issue.

    In 2002, the Institute of Medicine estimated that a lack of health insurance was responsible for 18,000 deaths a year in the United States. But in 2009, a researcher from the University of California found that the survival rate of uninsured people resembled that of insured people.

    There will be more evidence, as well, in coming years. The Affordable Care Act is its own sweeping experiment, as only about half the states expanded Medicaid.
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  4. #74
    Senior Member Gerry Clinchy's Avatar
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    I can think of some things that will take longer to find out about MA v. ACA. One of the issues with ACA is the withdrawal of many doctors and hospitals from the exchange programs. If wait times to see doctors (as with VA) are too long, the figures for ACA may not match up favorably with MA.

    Massachusetts is whiter and more affluent than most states, and has more doctors per capita and fewer uninsured people.
    MA also has the highest health care costs and longest dr. wait times. This could be an important factor in comparing MA to other states or to what will happen with ACA.

    Also does not take into account the extra regs that are coming along with ACA ... like the extra detail of the electronic records requirement.

    Will be interesting to see what happens in MA when ACA goes into effect. Are there still uninsured in MA? If so, how many, and why are they still uninsured? If all there state plans will also have to comply with ACA, what will happen to costs there?

    If compensation to providers under the expanded Medicaid is not better than it has been, will those insureds still have a tough time getting care? Will doctors still be refusing to take on new Medicaid patients due to the low reimbursements?

    We might find that it's a better idea to let the states use plans they design for their individual state's needs?

    Interesting that Medicare death rates have remained stable. Since everyone over 65 gets Medicare, that might be a good study to do. How has death rate and age of death changed since Medicare came into existence? When did it level off? When were the most gains visible, i.e. after 3 yrs, 5 yrs, 10 yrs?
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  5. #75
    Senior Member JDogger's Avatar
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    Quote Originally Posted by Gerry Clinchy View Post
    I can think of some things that will take longer to find out about MA v. ACA. One of the issues with ACA is the withdrawal of many doctors and hospitals from the exchange programs. If wait times to see doctors (as with VA) are too long, the figures for ACA may not match up favorably with MA.


    MA also has the highest health care costs and longest dr. wait times. This could be an important factor in comparing MA to other states or to what will happen with ACA.

    Also does not take into account the extra regs that are coming along with ACA ... like the extra detail of the electronic records requirement.

    Will be interesting to see what happens in MA when ACA goes into effect. Are there still uninsured in MA? If so, how many, and why are they still uninsured? If all there state plans will also have to comply with ACA, what will happen to costs there?

    If compensation to providers under the expanded Medicaid is not better than it has been, will those insureds still have a tough time getting care? Will doctors still be refusing to take on new Medicaid patients due to the low reimbursements?

    We might find that it's a better idea to let the states use plans they design for their individual state's needs?

    Interesting that Medicare death rates have remained stable. Since everyone over 65 gets Medicare, that might be a good study to do. How has death rate and age of death changed since Medicare came into existence? When did it level off? When were the most gains visible, i.e. after 3 yrs, 5 yrs, 10 yrs?
    Why don't you cite some sources?
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  6. #76
    Senior Member Gerry Clinchy's Avatar
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    I just referenced an article in the past couple of days that mentioned the costs in MA & wait times. The electronic records requirement is well known, as is the withdrawal of providers from exchanges and taking no new Medicaid patients due to reimbursements. The recent news about the VA scandal should also be common knowledge. (There is a thread on that.)

    There are times when sources are pertinent, and times when common knowledge should suffice.
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  7. #77
    Senior Member Buzz's Avatar
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    Quote Originally Posted by Gerry Clinchy View Post
    and times when common knowledge should suffice.
    All righty then, case closed. At least in one universe.
    "For everyone to whom much is given, of him shall much be required." -- Luke 12:48

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  8. #78
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    Quote Originally Posted by Gerry Clinchy View Post
    .................................................. ..........................

    There are times when sources are pertinent, and times when common knowledge should suffice.
    Nail hit on the head. Like when a person can not get in to see the Dr.
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  9. #79
    Senior Member Buzz's Avatar
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    Quote Originally Posted by charly_t View Post
    Nail hit on the head. Like when a person can not get in to see the Dr.
    Things must be really bad where you're at. I have lots of friends and relatives in both South Dakota and Michigan who are on medicare and have never heard any of them complain about not being able to get into the doctor.
    "For everyone to whom much is given, of him shall much be required." -- Luke 12:48

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  10. #80
    Senior Member Gerry Clinchy's Avatar
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    Quote Originally Posted by Buzz View Post
    All righty then, case closed. At least in one universe.
    I choose not to respond in kind.
    G.Clinchy@gmail.com
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