Obamacare: The REAL Rest of the Story

by Oct 17, 2013Health & Vaccines34 comments

Contrary to how the New York Times' former editor and columnist Bill Keller characterizes it, Obamacare is a shining example of crony capitalism.

Former editor and now columnist for the New York Times Bill Keller echoes Paul Krugman’s Orwellian assertion that we need government to create a market for health insurance, absurdly claiming in an article titled “Obamacare: The Rest of the Story” that the law has “spurred innovation and efficiency”. Keller begins by repeating this canard:

Unless you’ve been bamboozled by the frantic fictions of the right wing, you know that the Affordable Care Act, familiarly known as Obamacare, has begun to accomplish its first goal: enrolling millions of uninsured Americans, many of whom have been living one medical emergency away from the poorhouse. You realize those computer failures that have hampered sign-ups in the early days — to the smug delight of the critics — confirm that there is enormous popular demand.

The only person bamboozling anyone here is Bill Keller. Here again he is channeling Krugman, who in a blog post titled “Good Glitches” asserted that all the problems people were having with the HealthCare.gov website was “good, not bad, news for the program” because it showed what high demand there was for Obamacare health plans. There were “Lots of people logging on and signing up on the very first day”, he claimed. Two days later in his column, he still insisted that “Obamacare is off to a good start”.

That, of course, was a load of nonsense. Evidence for this supposed “popular demand” remains elusive, as the problems with the website have proven to be caused by the site itself being poorly designed. Krugman acknowledged two days ago on his blog that “they messed up the programming big time”. And after claiming that the problems were caused by the huge traffic load of people signing up, the actual numbers of people who have done so also remains elusive. This, too, Krugman humorously acknowledged, writing that “This morning I talked to someone who successfully signed up for Obamacare — with great difficulty, but she did succeed in the end.” His story changed from claiming that “Lots of people” were “signing up” on day one to “people are starting to trickle through”, as evidenced by the single example he was able to find. “I know,” he added, “one example — but the plural of anecdote is data.” Despite these acknowledgements, he ridiculously stuck to his story, titling his post “Obamacare Success”.

Starting to “trickle” indeed. As Krugman and Keller’s own newspaper pointed out several days ago, “just a trickle of the 14.6 million people who have visited the federal exchange so far have managed to enroll in insurance plans, according to executives of major insurance companies who receive enrollment files from the government.” A CNN reporter who has been trying since the exchange was launched on October 1 to get signed up for a plan as of two days ago still hadn’t managed to do so.

Information about just what a disaster the $400 million federal insurance exchange website is keeps rolling in. And they are not “glitches”. On the contrary, in some cases, the problems with the site were intentionally designed that way. For example, they created a bottleneck by forcing people to go through the laborious process of actually creating an account before they could shop around for a plan. Why would they do this? Simple. They wanted people to register first so that if they were eligible for subsidies this could be taken into account so they wouldn’t get sticker shock from the actual prices for the plans.

As Avik Roy points out, “Obamacare wasn’t designed to help healthy people with average incomes get health insurance. It was designed to force those people to pay more for coverage, in order to subsidize insurance for people with incomes near the poverty line, and those with chronic or costly medical conditions.” Does that come as a surprise to you? It shouldn’t. Krugman himself has pointed this fact out, responding to the criticism that Obamacare will actually result in higher premiums for young, healthy people by saying, “Well, duh!” As I wrote in my July 2012 paper about how the individual mandate is unconstitutional, “It is important to emphasize the Court’s explicit recognition of the fact that the purpose of the mandate is to subsidize the costs of insurance premiums for unhealthy individuals by forcing healthy individuals who are on the whole financially better off without it to purchase an insurance policy.”

Roy also points out that “most people will either not qualify for a subsidy, or qualify for a small one that, net-net, doesn’t make up for the law’s cost hikes.” He correctly reasons that “If the ‘Affordable Care Act’ truly did make health insurance more affordable, there would be no need to hide these prices from the public.” Elsewhere, Roy points out that “Middle-class Americans face the double-whammy of higher insurance premiums, and higher taxes to pay for other people’s subsidies.” Also, “For months, we’ve heard about how Obamacare’s trillions in health care subsidies were going to save America from rate shock. It’s not true. If you shop for coverage on your own, you’re likely to see your rates go up, even after accounting for the impact of pre-existing conditions, even after accounting for the impact of subsidies…. Rates are going higher. And if you’re healthy, or you’re young, the Obama administration expects you to do your duty and pay up.”

Essentially, Obamacare is fundamentally not about addressing the reasons why health care is so unaffordable, but simply attempts to shift costs around in a shell-game sleight-of-hand designed simply to hide the true costs from the consumers, such as how young, healthy people who generally have less income are forced to buy insurance to subsidize costs of unhealthy people, like older people who generally are financially better off, who are then taxed more in order to subsidize the costs of having to buy insurance for young people who don’t make much money. (By the way, here is an interactive map you can use to get an idea of what a health insurance plan under Obamcare might cost you in your state; my state’s data isn’t on the map yet.)

So, the bottom line is that, no, the failures of the website do not “confirm that there is enormous popular demand”, as Keller claims. It just shows that the website has a lot of technical design problems, some of them built in intentionally. As for traffic, many people visiting the site is not evidence of demand for the plans available to them there. I’ve visited the site a couple times, for instance, but wasn’t there to shop. I know, I’m just one example — but, remember, the plural of anecdote is data! That the “Most Popular” question at HealthCare.gov the day before the launch of the exchange was “How do I get an exemption from the fee for not having health coverage?” offers still more “data”.

But we’re just getting warmed up. Keller continues:

What you may not know is that the Affordable Care Act is also beginning, with little fanfare, to accomplish its second great goal: to promote reforms to our overpriced, underperforming health care system.

Actually, addressing the reasons for why health care is so unaffordable is not a goal of Obamacare. The so-called “Affordable Care Act” does nothing to address the underlying causes for high health care costs. As already noted, it just tries to further eliminate any kind of meaningful market prices and shift costs around. What Obamacare actually does is exacerbate the problems by trying to further legislate away any semblance of a free market for health care with legislation ostensibly designed to “solve” problems created by previously enacted legislation.

The individual mandate itself is an example of this, being a “solution” deemed necessary to “solve” a problem created by Obamacare itself. Obamacare forces insurance companies to insure anyone, even if they have a preexisting condition. This obviously creates an incentive for individuals to not buy insurance unless and until they require health care — precisely the opposite outcome the law was intended to produce. Hence the “solution” of unconstitutionally forcing everyone to buy an insurance policy.

The Obama administration and the law’s supporters like to boast how Obamaacare will mean tens of millions more insured Americans. Yes, mandating that they buy it under threat of penalty is one way to try to accomplish that. But it hardly seems an approach to brag about.

Keller then makes the bizarre statement:

Irony of ironies, the people who ought to be most vigorously applauding this success story are Republicans, because it is being done not by government decree but almost entirely with market incentives.

Not being done by government decree? Entirely with market incentives? WTF?

Using mainly the marketplace clout of Medicare and some seed money, the new law has spurred innovation and efficiency.

Ah, yes, the “incentives” and the “innovation and efficiency” spurred by Obamacare! For instance, how government decrees under the law that insurers must overcharge the healthy so that they can undercharge the sick, which creates a profit incentive that wouldn’t otherwise exist for insurers to create plans that attract the healthy but deter those who actually need a lot of health care. And how this artificial incentive has led insurance providers to innovatively meet the requirements decreed by government either by offering plans with lower annual deductibles but higher premiums or offering lower premiums by restricting consumer choice to smaller networks of health care providers willing to accept lower fees. Plans of the latter type would, of course, be more attractive to those rarely or never requiring health care while tending to deter those who require a lot of care.

Oh, yeah, remember when Obama said, “no matter how we reform health care, we will keep this promise: If you like your doctor, you will be able to keep your doctor. Period. If you like your health care plan, you will be able to keep your health care plan. Period.” Yes, well, that was a lie.

A bit further on, Keller elaborates on the kind of “innovation” he is referring to:

Since the Affordable Care Act was signed three years ago, more than 370 innovative medical practices, called accountable care organizations, have sprung up across the country, with 150 more in the works. At these centers, Medicare or private insurers reward doctors financially when their patients require fewer hospital stays, emergency room visits and surgeries — exactly the opposite of what doctors have traditionally been paid to do.

So here are some initial questions that should immediately pop into your head: If Accountable Care Organizations (ACOs) offer such a great business model, then why does it require the use of government force to get people to join? And think about what it means for doctors to rewarded for having patients requiring less treatment. What kind of incentive does that create? Obviously, doctors now, like insurers, will have an incentive to attract generally healthy patients while shunning those who would need a lot of care. This is indeed “exactly the opposite of what doctors have traditionally been paid to do”. But how is that a good thing?

Priceless: Curing the Healthcare CrisisJohn C. Goodman (author of Priceless: Curing the Healthcare Crisis, which I highly recommend) makes similar observations. Pointing out that “ACOs have been described as ‘HMOs on steroids'”, he comments that they “may reward doctors for underproviding care, as traditional HMOs were accused of doing.”

Pointing out that, “Eventually, the Obama administration would like to see everyone in an ACO”, Goodman similarly asks, “But if no one had any previous interest in forming ACOs, let alone joining them, what is going to cause them all to change our minds?” The answer? Why, it’s once again those “market incentives” Keller mentioned! Except, of course, that they aren’t free market incentives, but created by, yes, “government decree”.

Goodman answers: “Money. Insurers won’t be able to get premium increases unless they adopt ACO plans. Doctors and hospitals will be paid less if they don’t join. Eventually, doctors will find they are ineligible to treat Medicare patients or patients insured in the newly created health insurance exchanges if they are not practicing in ACOs. As for the patients, there won’t be any plans to join other than ACO plans.”

In other words, the ACOs can’t compete in the free market, so the government is intervening to help them gain monopolistic advantages through the use or threat of force. Obamacare is designed “to drive doctors into organizations where their behavior can be controlled” by bureaucratic central planners. “For the first time in our history, both the practice of medicine and the way money is spent on medical care will fall under federal control.”

“Moreover,” Goodman also points out, “the business model of the ACO requires that patients see only the doctors that the ACO employs. If you are getting care from an ACO, therefore, your insurance may not pay for you to see doctors outside the ACO.”

“Also, part of the ACO vision is that all doctors and nurses will practice medicine in the same way. This means that when you visit an ACO clinic, you will not necessarily see the same doctor you saw on your last visit.”

Elsewhere, Goodman writes, “you are not the real customer of the auto ACO. The third-party payer is. The ACO is not trying to meet your needs. It’s trying to meet the third-party payer’s needs.” And, once again, “When you are healthy, how your ACO functions may not matter very much. But when you’re sick, the fact that the ACO is the agent of Blue Cross instead of your agent may matter a great deal.”

Elsewhere, Goodman comments, “The Obama administration has little trust for real markets and believes that consumers are incapable of directing their own health care in a competitive market. It believes that government experts must manage consumers to protect them from unscrupulous providers. The result is a top-heavy regulatory system in which administrators in government and the ACOs could soak up health care dollars without improving patient outcomes or reducing overall health care costs.”

Scott Gottlieb, a former FDA deputy commissioner and health policy expert, similarly observes that the means by which ACOs cut costs is “restricting patient choice” by maintaining “closed networks” of doctors, with patients having to pay more to visit a doctor outside of that network; that the law sets out to help ACOs consolidate and dominate local markets for health care; that “doctors could be compelled to participate”; that they are in many ways they are modeled on HMOs, which “ultimately proved unpopular with patients, who believed that it gave doctors financial incentives to ration care”; and that, “Far from improving the delivery of care, many fear that ACOs will simply create local monopolies around hospitals, which will use their concentrated power to drive up costs.”

Gottlieb additionally points out that “doctors bound to ACOs may find that rates are set by the federal agency overseeing ACOs”; that is, that the government will even further attempt to eliminate any semblance of a free market by engaging in even more price fixing, as in Medicare and Medicaid.

Furthermore, “historically, most of the significant innovation in health care delivery has developed in for-profit companies, often started by entrepreneurs”, who “are now exiting the health care services space because the Obama plan tilts the marketplace so heavily against their endeavors.” The law “targets targets these for-profit health endeavors, in some cases with new taxes on their profits. This is not being done to improve the delivery of care but to generate additional revenue to help pay for the expansion of other government-run health programs.”

Profit motive, contrary to leftist mantra, is a good thing, a healthy incentive in markets. In a free market, after all, the way businesses profit is providing goods or services either of higher quality or lower price, or both, to satisfy consumer demand. Furthermore, high profits are a signal to investors and entrepreneurs to direct scarce capital into areas where the profits are to be had, thus drawing in competition, spurring innovation, and ultimately lowering costs. Moreover, exchanges in the free market occur voluntarily, for mutual benefit. Whereas government must use or threaten force to coerce people into behaving against their will in ways they deem contrary to their own interests. Which system sounds better to you?

So, in sum, what can people expect from ACOs?

  • Effective government-legislated local monopolies
  • Underprovision of care for the sick
  • Restriction of choice to a smaller network of doctors
  • Patients’ needs coming second to third-party payers’
  • More centrally planned medicine; total lack of personalized care; “one-size-fits-all”-type treatments decided upon by bureaucrats
  • Further elimination of market prices and the crucial signals they send to entrepreneurs and investors about where to direct scarce capital to efficiently produce goods or services to meet consumer demand
  • Less innovation
  • Continued increasing costs

In closing his article, Bill Keller remarks,

What Obamacare has wrought is the kind of market-driven reformation that Republicans pretend to believe in.

As should be self-evident to anyone just instinctively, this is pure Orwellian doublespeak. To say that the “reformation” occurring under Obamacare is “market-driven” is obvious logical nonsense. If it was being “market-driven”, it by definition wouldn’t require government coercion, and, conversely, the fact that it requires government coercion by definition means it isn’t “market-driven”. What Republicans pretend to believe in is the free market, but “What Obamacare has wrought” is by definition emphatically not the free market. It is what Republicans actually believe in, the coercive use of government power to obtain desired ends. The only difference between them and Democrats is which ends government should use force to achieve. Both parties are crony capitalist to the core.

The same goes for Bill Keller, who evidently hasn’t even a concept of what the free market actually is and who likewise prefers government coercion, as in the case of Obamacare, a shining example of crony capitalism at its finest.

***

See also my article, “Five Obamacare ‘Myths’? Debunking Bill Keller’s NYT Debunking“. Also, for more on the real solutions, check out Hunter Lewis’s new books Free Prices Now! and Crony Capitalism in America, as well as Goodman’s Priceless.

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About Jeremy R. Hammond

About Jeremy R. Hammond

I am an independent journalist, political analyst, publisher and editor of Foreign Policy Journal, book author, and writing coach.

My writings empower readers with the knowledge they need to see through state propaganda intended to manufacture their consent for criminal government policies.

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34 Comments

  1. Guest

    As Avik Roy points out, “Obamacare wasn’t designed to help healthy people with average incomes get health insurance. It was designed to force those people to pay more for coverage, in order to subsidize insurance for people with incomes near the poverty line, and those with chronic or costly medical conditions.

    Was there ever really any confusion about this? It’s called the Affordable Care Act.

    But Affordable for who? Simply put- the people who need it the most.

    But that’s not fair to healthy people with average incomes who are subsidizing the poor! See the harm it causes? It causes a negligible amount of “harm” to them relative to those who suffer physically and financially. Chances are they have jobs with employer provided coverage already, so not much changes for a large group of employed people. If they’re paying for their own coverage the ACA puts a cap on how much insurance companies can increase rates, and also requires a medical loss ratio of at least 80%. What’s more is that as a percentage of their income rates should not be significant for people with average incomes, but I think he meant median income which is less. So, median incomes are around $50,000 (51K in 2012.) Let’s just go see how much health insurance is going to cripple an average family making the median. Let’s say there are two adults age 35 and age 40, and two children in this family. (Is this generic/average enough?) In this case, this family can receive up to $517.47 per month towards their plan, and a maximum out of pocket expense of $9,000. The Platinum plan (the best) on the exchange is $1,022.08/month. After the subsidy it’s $500/ month which is CHEAP for some of the best insurance you can get.

    So who’s really hurting? I suspect this really means people making north of $100,000 are actually paying for the subsidy. The subsidies run out after that point for our example family. I’m running out of time, but would like to return to see how much the upper middle and upper class might pay assuming they don’t have employer provided insurance. And then I’d like to consider the real financial “harm” caused to these people as a percentage of their income. It could be a drop in the bucket for all I know, or it could be something absolutely outrageous like 30% of their income.

    LET’S FIND THE TRUTH.

    Sources:
    https://www.healthcare.gov/find-premium-estimates/

    http://www.bcbsm.com/index/health-insurance-help/calculators-tools/topics/buying-health-insurance/subsidy-estimator.html

    Reply
  2. Jorge's Jungle

    Oops, I just caused a glitch with the disqus comment widget which purged my post. Don’t edit comments while tweaking your user profile I guess. Anyways, I’ll try to recreate the post. Here it goes:

    As Avik Roy points out, “Obamacare wasn’t designed to help healthy people with average incomes get health insurance. It was designed to force those people to pay more for coverage, in order to subsidize insurance for people with incomes near the poverty line, and those with chronic or costly medical conditions.”

    I picked this particular quote because I hear this talking point often. Avik claims under the ACA these healthy people with average incomes are going to pay more for their coverage in order to subsidize those less fortunate in the financial and physical sense. This sounds like it could be bad for the middle class. Better do some research!

    To begin researching this we need to define some parameters. By “average income” I assume he meant the median income which is slightly north of $51,000. It’s about $60,000 if you want to use the average/mean income, but that number is skewed by those with really high salaries. Now, “healthy people” essentially means “young people” when it comes to health insurance, and the healthcare.gov site even asks whether or not you’re over 50 or under 49 as age changes how insurance companies calculate premiums. Younger equals cheaper insurance generally speaking.

    So Avik really seems to be talking about your average middle class family. Relatively young and healthy folks making around $51,000 per year. I’m going to extend this idea of the average family and say they also have two kids. Let’s be as average as possible!

    Now let’s apply our parameters using the healthcare.gov website and ehealthinsurance.com to see what our costs would look like before the subsidy is applied.

    1. healthcare.gov

    Platinum Plan: $1,000.
    Gold Plan: $860-1,125.
    Silver: $665-945
    Bronze: $513-868
    Catastrophic: $430-740

    2. ehealthinsurance.com

    Platinum Plan: doesn’t display any Platinum plans
    Gold Plan: $950-1,200
    Silver: $825-1,100
    Bronze: $948-819
    Catastrophic: doesn’t offer this selection either

    Whoa. Hold up. I heard that Obamacare limited insurance options, and yet I can get a wider range of plans from Obamacare. And what’s this? The cadillac of insurance plans, Platinum, is nearly cheaper than the cheapest gold plan available from ehealthinsurance.com!

    So now let’s calculate what this very average American family would pay after the subsidy is applied. In this case, I used this site to calculate the subsidy: http://www.bcbsm.com/index/health-insurance-help/calculators-tools/topics/buying-health-insurance/subsidy-estimator.html

    *For age I used 49/35 for the two adults with two kids making the median income

    This family qualifies for a $596 subsidy off their monthly premiums bringing the best insurance plan’s cost down to $504/month if they purchase through the exchange. Of course, they don’t have to spend that much on health insurance. They could get one of the cheaper Silver plans and only pay about $100/month.

    BUT WAIT THERE’S MORE! Through Cost Sharing Reduction this family’s out of pocket maximum is $9,000 for the year saving an additional $3,700 dollars using the Platinum plan. It’s a $3,000 reduction if you want a different plan.

    No too shabby. It appears this average family is going to benefit from the ACA quite a bit actually.

    tl;dr: This popular claim I keep hearing about doesn’t seem to be very accurate.

    Reply
    • Jeremy R. Hammond

      Avik Roy’s statement is dead on. Forcing young, healthy individuals to subsidize the costs of others is the whole purpose of the individual mandate. This is not a question or a matter for debate. This is well understood. The Supreme Court pointed it out in their ruling (which you said you read):

      http://www.foreignpolicyjournal.com/2012/07/08/the-logical-flaws-of-the-supreme-courts-ruling-on-the-affordable-care-act

      Even Paul Krugman acknowledges this fact of the law’s purpose, with a “Well, duh!”

      https://www.jeremyrhammond.com/2013/09/10/krugmans-reply-to-those-who-criticize-obamacare-for-increasing-premiums-on-the-young-and-healthy-well-duh/

      Reply
      • Jorge's Jungle

        It should be quite obvious I wished to remain anonymous when I posted comments using a pseudonym for many reasons which not only impact me but you. This is a violation of my trust and privacy. It doesn’t matter whether I personally know you or not. It’s wrong.

        You invited me to come comment here on your website knowing full well I’d be seeking to learn the truth by scrutinizing the rampant rhetoric we see in politics. I didn’t come here just to read your articles, and blindly agree with you or those you’ve quoted. I came here to have a real engaging discussion with you and other commentators on this site. Political affiliations, rhetoric, and egos be damned! I just want to know what the facts are.

        Redirecting me to other articles on your site while completely ignoring any of the information I shared doesn’t address my comment well, engage or interest me. I was under the impression you invited me here to discuss my concerns.

        I’m looking for fact based information. Data. Numbers. Real evidence. Paul Krugman saying “Well, duh!” is meaningless. Roy Avik saying average American families are going to pay more for health insurance is meaningless. Where’s the data? I’m tired of this boogeyman stuff.

        Make no mistake; I’m not here to troll. I’m here to learn why you hold the opinions you do just like millions of other well respected people, and dig into the facts so we can all have the opportunity to form the best opinion we can possibly have. I was hoping our contrasting opinions would get others to join in on the discussion, and we could all work together to crowd-source the research in order to fight our own ignorance and bias. I thought this was something you’d also be interested in doing. I was wrong.

      • Jeremy R. Hammond

        I didn’t know you’d get offended by me addressing you by your name. You were commenting publicly at LinkedIn, so I don’t see what’s different here. Anyhow, I’ve deleted it so you can maintain your anonymity, for whatever reason you desire to.

        Like I said, that the purpose of the mandate is to force young, healthy Americans to subsidize the costs of care for the unhealthy isn’t at all controversial. It is most unreasonable to get upset with me simply for providing links so you can verify this for yourself.

        I’ve done my research. I do it daily. Please refrain from insults and attacks on my character. If you wish to have a reasonable discussion, let’s please do. I would prefer that.

      • Jorge's Jungle

        Fine, ok. Laundry aired. I understand you do your research. That’s why I’m here. I want to dig into this. So what are your objections with my original comment?

      • Jeremy R. Hammond

        I thought I was clear. My objection is that you denied the truth of that quote from Avik Roy, but, as I explained, it is dead on. That is the whole purpose of the individual mandate.

      • Jorge's Jungle

        The numbers I presented tell quite a different story from what Roy Avik claims. That’s what I’d like to talk about if you don’t mind. Please explain how Avik’s quote is still “dead on” despite the numbers saying otherwise. Forget my opinion. I just want to talk about the numbers.

      • Jeremy R. Hammond

        It isn’t a “claim”. As I explained above: “the purpose of the mandate is to subsidize the costs of insurance premiums for unhealthy individuals by forcing healthy individuals who are on the whole financially better off without it to purchase an insurance policy.” This is an uncontroversial statement. It’s not a question, not a matter for debate, but a well understood fact about the law.

        As I noted, the Supreme Court also pointed out this fact. I provided the link because I explained this more fully there. Here’s the Court: “The mandate primarily affects healthy, often young adults who are less likely to need significant health care and have other priorities for spending their money. It is precisely because these individuals, as an actuarial class, incur relatively low health care costs that the mandate helps counter the effect of forcing insurance companies to cover others who impose greater costs than their premiums are allowed to reflect.”

        That is, the ACA forces insurers to provided a policy to everyone, even if they already have a condition requiring them to get extensive medical care. The lawmakers understood that this would create the perverse incentive that people wouldn’t buy insurance unless and until they get sick, which would increase the premiums for everyone who had insurance. Unconstitutionally forcing younger, healthier individuals to purchase insurance to subsidize the costs for the sick was their “solution” to this problem. I’ve long been pointing this out in my writings. Avik Roy was also just pointing this out to his readers. Paul Krugman has also responded to criticisms that the law does so by saying, “Well, duh!” That is, this shouldn’t surprise anyone; of course this was the purpose of the mandate!

        Furthermore, the law prohibits insurers from charging higher premiums to those requiring lots of care. But they naturally have to set premiums to remain profitable. Thus the law effectively mandates that the healthy are overcharged so that the sick may be undercharged for the costs of insurance.

      • Jorge's Jungle

        OK, but can we please talk about the numbers I shared in relation to Avik’s quote? You don’t need to reiterate your argument.

      • Jeremy R. Hammond

        I don’t know what you would like me to say about those numbers.

      • Jorge's Jungle

        I’m specifically talking about Roy Avik’s quote FTA which said “Obamacare wasn’t designed to help healthy people with average incomes get health insurance. It was designed to force those people to pay more for coverage”

        KEY WORDS: HEALTHY PEOPLE WITH AVERAGE INCOMES.

        Juxtaposed with the numbers I shared it proves that healthy people with average incomes actually don’t pay more for coverage. The purpose of the mandate is irrelevant to what I’m talking about right now. I’m not trying to argue what the purpose of it is. I’m simply cutting through the rhetoric by showing the numbers. Next, I plan to figure out who actually will pay more, and how much harm it will actually cause. The point being, Avik is spreading misinformation about the ACA. People with average incomes qualify for a subsidy. Anyone making up to 400% of the federal poverty level qualify for a subsidy. Avik’s quote is a mischaracterization of what the ACA will do. It’s fear propaganda made to make middle class families fearful of the ACA whether it’s intentional or not. That’s the whole point of my post.

      • Jeremy R. Hammond

        Yes, I know the specific quote you are talking about. Roy is talking about the purpose of the mandate, which is to force young, healthy individuals to subsidize the costs for the sick. This isn’t “misinformation”, it’s an unquestionable fact. It also isn’t a “mischaracterization” of the ACA to write about how it is already starting to accomplish this purpose. More about what Roy is talking about here:

        http://www.forbes.com/sites/theapothecary/2013/09/25/double-down-obamacare-will-increase-avg-individual-market-insurance-premiums-by-99-for-men-62-for-women/

      • Jeremy R. Hammond

        As for your numbers, there is not one price before and after for the entire country. Prices before and after the law are different depending on location. What zip code did you enter in ehealthinsurance.com? You looked at plans for middle-aged people with family plans. Avik looked at plans for young people (27) with individual plans. And these standardized “color” plans didn’t exist before the ACA, they were created as part of it, so I don’t know how you end up comparing, e.g., “platinum” vs. “platinum” plans. Then there were variable deductibles pre-ACA, as well as varying benefits, so did you compare the most equivalent plans? HealthCare.gov hasn’t been working, so I can’t find out anything from there.

        I hope to do a post on this subject later today if I can manage the time.

      • Jorge's Jungle

        Alright, now we’re talking!

        Prices before and after the law are different depending on location.

        Excellent first point. Pricing is different by location, so it’s difficult to measure exactly how affordable care will (or won’t) be for all individuals in all areas. (Good thing Avik said healthy people with average incomes would pay more to help narrow down the field. More on that later.) So, why are prices different before and after the law in certain locations? Perhaps the largest problem is a major lack of competition in these markets. You don’t need me to explain the impact this will have on costs. Rural areas have historically had higher than average health costs. This applies to not only the US, and it’s not a fault of the ACA. Rural health care costs are a big topic, but I don’t want to linger on this too much. More info if anyone is curious:
        http://www.public-health.uiowa.edu/rupri/publications/policybriefs/2005/PB2005-7.pdf

        http://files.cfra.org/pdf/Ten-Rural-Issues-for-Health-Care-Reform.pdf

        http://cardi.cornell.edu/cals/devsoc/outreach/cardi/programs/indicators/rvp/upload/rvp-rural_health.pdf

        Choosing not to expand medicaid as some states have done will also cause increased costs for some people. Some lower income people may find they fall in a coverage gap. Ouch! That’s not what the ACA was meant to do! But is that the ACA’s fault? Or a state issue? They had a choice, right?

        GTG, more later

      • Jeremy R. Hammond

        Again, just to reemphasize the point, the purpose of the law is to force younger, healthier people to subdidize he costs for the sick. So we shouldn’t be at all surprised when we see this happening.

        The ACA doesn’t create more competition in the market, but limits it, including through these standardized plans, which mandate what insurance products providers may or may not offer.

        Obama most certainly did lie when he said that people could keep their coverage and their doctor. These were both lies. As a consequence of the ACA, some and perhaps many will have to get a new plan and/or not be able to go to their own doctor (unless they want to pay out of pocket).

        Just tried HealthCare.gov again. “Access denied”.

      • Jorge's Jungle

        I get your point. It’s not what I’m after though.

        Here’s my problem: Nearly every article available is lacking any specific information on the law, how it will impact certain people (specifically what their income is with consideration for cost of living in their specific area, age, where they fall on the federal poverty guidelines, how quickly healthcare costs were soaring pre-ACA, etc.) Then, I’d like to see how detrimental it will actually be to these people. Are they just whiners, or do they have legitimate complaints? These articles use poor sources, cite their own work (which is essentially saying “I say it’s bad because it’s bad”,) don’t provide links to any of the data they’re using to form their polarized opinions, etc. Instead, these articles make broad generalizations without any real scientific data which just panders to either the right or left. They are part of the problem.

        Example: In the Forbe’s article linked to Avik’s quote he cites the “Manhattan Institute” as the basis for his research. He provides a link, but it links back to one of his articles. I’m sure they did this for SEO purposes, but I was expecting a website which offered some kind of comprehensive analysis to back his conclusion! Furthermore, the Manhattan Institute sounds legit, but it’s a biased source of information. It’s a libertarian think tank. Would you place your faith and trust with this source if it were a libby think tank? I didn’t think so. I wouldn’t. Two heads of the same coin. Both sides are bad. Cerberus. How many times have you said something similar (only in reference to R’s and D’s?) The article also explains how the healthcare.gov website more or less dupes people into thinking their premiums are lower by displaying the after subsidy price first so folks won’t get sticker shock. That’s not how the site works though. You don’t even have to have an account to see that. Not sure what Avik is talking about. Doesn’t matter. I’m on a mission.

        I wan’t trying to imply the ACA creates competition. Not sure where this is coming from. It doesn’t limit competition either. The competition or lack of competition is still there both in and out of the marketplace. Insurers have the option of joining a government marketplace and competing in it, or simply continuing to compete as they normally do outside the exchange. The ACA metal groups level the playing field by making companies offer more similar plans. It’s not true competition if one company offers the “52 inch LCD” while another offers the “52 inch LED.” Now, we can compare a “52 inch LED” with a “52 inch LED” with similar features. This actually boosts competition. But I’m not really trying to argue that.

        healthcare.gov works for me again today. They did post a notice about doing site maintenance overnight, but it could be anything. It would be helpful if you had the same access I seem to have.

        Anyways, this is a good sounding board, but I need to reallocate some more time to researching this further.

      • Jeremy R. Hammond

        Briefly, to your main points:

        1) Dismissing the Manhattan Institute info on the basis that it’s “a libertarian think tank” is ad hominem argumentation. Of course we shouldn’t just place blind faith in any source, but are there flaws in the information Avik Roy provided? This is the question. But, again, why should we doubt that the consequence of the law is exactly that intended, that young, healthy individuals will pay higher premiums? I don’t understand why you seem so dubious about this. This is to be expected.

        2) Roy is correct. One of the problems with the site is that it created a bottleneck by forcing people to sign up first, before they could see the prices for plans, so that their subsidy could be calculated so that they wouldn’t get sticker shock. They may have changed that by now, but that is indeed how it was set up initially.

        3) Yes, people can still get plans from insurers outside of the exchanges, but those plans still have to comply with the mandates under the ACA, which, yes, limits competition, a I already mentioned. I don’t understand how you can think that TV manufacturers don’t compete on technology. If the government mandated that all TV manufacturers offer the same standardized products, that would by definition be limiting market competition. Imagine of shoe manufacturers were forced to “help” consumers make “easier” choices by mandating that they only offer a handful of standardized shoes. The administration’s and media’s claims (i.e., NYT) that this creates competition is downright Orwellian.

      • Jorge's Jungle

        1. I’m not trying to imply the Manhattan Institute is not legit just because it’s a libertarian think tank. I’m only commenting on how the MI “sounds.” As in, the Manhattan Institute sounds like a completely independent research facility of some sort, but factually it is a libertarian think tank. You said Of course we shouldn’t just place blind faith in any source, but are there flaws in the information Avik Roy provided? That’s what I’m working on figuring out. I can’t determine if Avik’s conclusion/analysis of his source information is flawed unless I review the same source information to begin with. Right now, all I know is it’s a libertarian think tank. It’s susceptible to bias. More research is needed. I want to see how the MI did their study, and what that study indicates without Avik’s interpretation of it. I’m just going through the motions here. If you’ve reviewed this study which Avik bases his claims I’d be interested in learning more about it from you as well.

        2. The site experience you and Avik share have not been my own for whatever reason, but it’s been under continual development. Changes and refinements are to be expected. Wayback machine shows that a few days before Avik’s article was published you could retrieve estimates without having an account. It even states estimates are before any possible subsidies. Perhaps they published his article late, and in doing so gave inaccurate information.

        3. The metal groups create direct competition. You are talking about differential advantage which the ACA mostly eliminates with the metal groups. Both are forms of competition, but not all competition results in reducing prices for consumers. Without a differential advantage insurers are competing based on price, and not by offering loosely similar plans with unique advantages and disadvantages. Post ACA insurers are offering very similar plans, so consumers are simply comparing prices which in theory should force insurers to find ways to lower costs in order to continue competing in the market with other competitors. They are no longer competing based upon product differentiation but price.

      • Jeremy R. Hammond

        I don’t follow you on the Manhattan Institute. It’s libertarian, so therefore it isn’t independent? It’s libertarian, so therefore it’s susceptible to bias? Would you prefer it was a liberal or progressive think tank? Then could you consider it independent and unbiased? I don’t get your thinking here.

        Avik Roy’s reporting about the bottleneck created by the website is not innacurate. The New York Times pointed out the exact same thing.

        No, forcing insurers to offer standardized plans does not create competition. It by definition limits competition. Competing on price is nothing new, they always did that. But as you yourself just pointed out, the difference is now they can no longer compete on product. That’s by definition limiting competition. It’s more one-size-fits-all now, e.g., young, healthy people who liked paying high deductibles for low premiums will lose their plans. And the way insurers are lowing costs to compete under this perverse market is by creating smaller networks, so that many people also won’t be able to keep their doctor, as we’ve already been over.

      • Jorge's Jungle

        1. Yes, the Manhattan Institute is a libertarian think tank and is susceptible to bias just as a liberal think tank would be. Having any of these political affiliations really don’t belong in any type of research setting especially one that is politically fueled. It’s like when the cigarette industry released studies on their products putting them in a more favorable light. They funded the studies, lobbied heavily, etc. Not surprisingly the studies were often discovered to be junk science. An independent organization would be one with absolutely no political affiliations or motives which create a conflict of interest.

        2. The bottleneck…Wayback machine shows otherwise. The NYT article was published the same day as Avik’s. I’ll let you draw your own conclusions as to what that might mean.

        3. You are talking about differential advantage which is a form of competition. There are other forms of competition though, and they don’t all do the same thing. Differential advantage allows companies to offer somewhat similar products, but with various features that offer distinct advantages and disadvantages. By doing this, consumers have to place a value on these differing product features in order to subjectively decide which product is ultimately the best value. With differential advantage companies don’t necessarily need to worry about beating the competition’s pricing to win customers. They can simply sell gimmicks or add-on features, and keep the price as-is or higher. The ACA, as I said, mostly eliminates this type of competition.

        At the same time, a new form of competition has been created by using metal levels which established a measure (actuarial value) by which to group similar plans together. Most of the plans already in existence simply needed a badge- a metal. The plans that are going away don’t meet ACA minimum standards. Anyways, now consumers can more easily shop, compare prices, and see which plan offers the better value. Insurers now must find ways to lower pricing to remain competitive, and that seems to have resulted in limiting networks. This is an indirect result of the ACA as this business decision is ultimately on the insurers. But it’s a problem for the ACA and customers shopping in the exchange. Of course, they can always shop outside an exchange and find insurers offering broader networks right?

      • Jeremy R. Hammond

        Claiming bias is ad hominem argumentation. If you think there’s a problem with the information presented, you’re welcome to point it out. Again, we shouldn’t be surprised to learn that many people will pay higher rates, since that is the intent of the law. I don’t understand why you are so dubious about this.

        There is no pricing information on that page in the Wayback Machine. On the other hand, if you go to the archived homepage, you’ll see that button that exists now to “see plans and pricing” DIDN’T exist then.

        http://wayback.archive-it.org/3626/20131002172123/https://www.healthcare.gov/

        Avik Roy and the NYT are correct. There is no question that the way they had it set up initially created a bottleneck. This was widely reported and is well understood. Here’s a few more examples:

        “Much of the problem stems from a design element that requires users of the federal site, which serves 36 states, to create accounts before shopping for insurance, according to policy and technology experts.”

        http://online.wsj.com/news/articles/SB10001424052702304500404579127783931191264

        “Many of the problems appeared to stem from a last-minute change in the site’s operation, one that required site visitors to sign up before they could window shop policies. That extra step created a bottleneck, according to Andrew Slavitt, group executive vice president at Optum/QSSI, a business unit of healthcare giant UnitedHealth Group that handled that aspect of the system as a subcontractor to CGI.”

        http://www.latimes.com/nation/politics/politicsnow/la-pn-obamacare-website-house-hearing-20131024,0,1848356.story#axzz2jEevIs8k

        Like I said, the ACA doesn’t create competition. On the contrary, it severely limits it. Again, insurers could always compete on price. That is not “new”. What is new is that, like you just acknowledged, the ACA “mostly eliminates” competing on product. I is difficult to see how you can take that fact and turn it around to say that the law creates competition. That’s downright Orwellian.

      • Jorge's Jungle

        Why am I so “dubious?” My whole purpose is to cut through the rhetoric, lies, and misinformation surrounding the ACA to find the truth. It requires much scrutiny.

        Not all claims of possible bias are fallacious.There is absolute reason to believe Avik Roy is a biased source of information. He identifies himself as a conservative, has made his opposition to the ACA well known, is a “Senior Fellow” at the Manhattan Institute, a libertarian think tank, and he participated in the study he mentions in the article. Is there something wrong with admitting he’s likely to have some bias here? Even if Avik Roy magically purged any bias from his study and conclusion it’s still a good idea to review the information. I’m just pointing out some problems here. This is a very legitimate concern. And yes, I’ve told you I plan to review his study, so just hang on. More on the validity of questioning potential bias.
        http://aphilosopher.files.wordpress.com/2010/09/42-fallacies.pdf

        Yes, there is pricing information from the link I gave you. I thought I gave you a more direct link, but you can get it from the link I provided. I downloaded a rather large excel spreadsheet by correctly navigating from that page, and so can you. The button that now exists on the home page to make viewing pricing info easier is irrelevant. They put it there to find the info easier. That’s all. I found pricing information on the site well before the article was published, and both you and Avik claim it didn’t exist without A: logging in, and B: it showed prices after subsidies were applied to prevent “rate shock” or otherwise fool people into thinking Obamacare is a good deal. The archived site says otherwise. Let me show you:

        1. From the link provided scroll down to the bottom of the page. 2. Under “Quick Information” you’ll see the subheading “Plan information for individuals and families.”
        3. Click “Health Plans.”
        4. On this page you’ll see it says “IMPORTANT NOTE: The prices here don’t reflect the lower costs an applicant may qualify for based on household size and income.”
        5. Scroll down to where you can download the info. Here’s the direct link:

        http://wayback.archive-it.org/3626/20131002195125/https://www.healthcare.gov/downloads/health-plan-information-download.xlsx

        Bottom Line: This is a site design issue. Obviously people have problems navigating the site, and the site has been plagued with issues created by politics and the nature of IT (http://www.ibmsystemsmag.com/power/Systems-Management/Workload-Management/project_pitfalls/). Up to 75% of IT projects fail, and the government had one shot to get it right with no time for beta testing. This is not some purposefully deceitful thing. It’s just propaganda. Republicans creating drama. The articles you cited are simply regurgitating it, and they don’t provide any evidence to back them up. But I have!

        Explaining the different types of competition, and how they impact business is Orwellian? That actually is an ad hominem argument right there. Don’t take my word for it though:
        http://www.investopedia.com/terms/c/competitive_advantage.asp

      • Jeremy R. Hammond

        That the purpose of the law is to force younger, healthier individuals to subsidize the costs to the sick is not “rhetoric, lies, and misinformation”. So, again, I do not understand your dubiousness about it when media report that this is in fact one consequence we are seeing.

        Claiming bias rather than addressing any error in fact or logic, which you are doing, is the very definition of ad hominem argumentation.

        There is no pricing information in the archive. The Excel spreadsheet just directs visitors back to HealthCare.gov for pricing information. It is well understood that the decision was made to have people sign up first to be able to see prices after their subsidies, if any, had been calculated. This is not “propaganda”. Forbes, the NYT, the LAT, the WSJ, etc., are not just making that up.

        As for what I said about your argument being Orwellian, it is not ad hominem argumentation to point out logic that is invalid and obviously nonsensical (war is peace, freedom is slavery, eliminating competition is creating competition, etc.)

      • Jorge's Jungle

        “That the purpose of the law…”

        Once again, I’m not analyzing what the purpose of the law is. I don’t understand why you can’t separate the intended purpose of the law from my quest to identify rhetoric and propaganda. Do you understand the difference: yes or no? Please understand I’m only attempting to identify rhetoric and propaganda by doing my own research. In doing so, I should be able to find more accurate information. Please answer the question.

        “There is no pricing information in the archive.”

        Here’s the direct link yet again. Please try clicking the link this time. :-p

        http://wayback.archive-it.org/3626/20131002195125/https://www.healthcare.gov/downloads/health-plan-information-download.xlsx

        As you can see from the address it links to an excel spreadsheet. Enjoy your 7mb file. I just used this exact link yet again to download it, and also followed my walkthrough to download it. I’ve even uploaded the file to my skydrive, so you can see it there as well. Here’s the link:

        http://sdrv.ms/HjdUrI

        UNLEARN THE PROPAGANDA.

        “As for what I said about your argument being Orwellian, it is not ad hominem argumentation to point out logic that is invalid…”

        Once again, please read the link I provided. The definitions of competition are not illogical:

        http://www.investopedia.com/terms/c/competitive_advantage.asp

      • Jeremy R. Hammond

        But if the intended purpose of the law is to force younger, healthier people to subsidize the costs for the sick, then why do you think it is “rhetoric and propaganda” when media report that this is the consequence we are seeing? Again, why are you so dubious about this information when it is exactly what we should expect?

        If I hadn’t looked at the .xls I wouldn’t have been able to tell you there’s no pricing information in it, now, would I? There’s still no pricing info there. Once again, what Forbes, the NYT, LAT, WSJ, etc. reported about the bottleneck created by forcing users to sign up before they could shop for plans is not “propaganda”.

        Now you’re adding strawman argumentation to your list of fallacies. I didn’t say the definitions of competition are illogical. I said it was Orwellian to say the law creates competition by eliminating competition. This is obvious nonsense. Talk about needing to “UNLEARN THE PROPAGANDA”, as you put it. I’d offer you the same advice.

      • Jorge's Jungle

        No “buts!” I’m only trying to identify rhetoric and propaganda in the articles I read. I want to know the truth behind what politicians say and the media reports. It’s that easy! This has nothing to do with what the purpose of the law is or is not, or even what my opinion of the ACA is right now. I want a more informed opinion, and I don’t trust politicians, media, or political pundits to tell the truth or even be knowledgeable about what they discuss! I’m identifying possible propaganda, lies, and half-truths by doing my own research to determine the accuracy of what’s being reported. I want accurate information no matter whether the main subject of the article is to discuss the purpose of the law or not! Why do you think it’s “dubious” to want to find the truth or verify the accuracy behind these reports and claims? It’s not dubious to do a little fact checking, and I don’t want to simply take their word for it. That would be ignorant especially considering the highly polarized and politicized subject matter. Once again, I want to make sure the information I read is accurate no matter what the purpose of the law is. If the article has anything to do with the ACA I’m going to proceed with caution, do my research, and find the most accurate information in order to have the best opinion I can have. It doesn’t matter whether I read the article here, at Forbes, Fox, CNN, Drudge, Slate, or any other media outlet. I just want the most accurate information.

        There are two tabs on the excel spreadsheet. The first tab does not have pricing info. Tab over to the second tab where it says “Individual Market- Medical” to view pricing information. If you have a problem downloading the spreadsheet try viewing the copy I put on my skydrive.

        How do you think this 7mb spreadsheet came to be so large if it didn’t have any information on it? If your file is not 7mb there was a problem with your download. It’s 7,209 KB to be exact.

        I’m not making this up, so please try to hold off on saying this is all nonsense, Orwellian, etc. You’re making an argument from a position of ignorance. In other words, your argument is invalid. Here’s a screenshot of the spreadsheet even:

        http://sdrv.ms/1gj2WkV

      • Jeremy R. Hammond

        In other words, the answer to my question is that you are dubious about reports showing that many people are facing rate shock because you choose to disregard the fact that this is an intended consequence of the law.

        Okay, I see the pricing estimates in the second tab. All this illustrates is that anyone interested in prices would have to dig for it to find it buried there. The fact remains that the site’s market itself was set up so that people would have to sign up before being able to shop for plans. Why? Because the administration didn’t want people to see prices before calculating their subsidy so the wouldn’t get rate shock. This is not “propaganda”. You’ve got the executive from the subcontractor who built it that way acknowledging that, for goodness’ sake. So who’s arguing from ignorance?

        My comment about your Orwellian logic had nothing to do with that, so I’ll say it again: to argue that we needed to eliminate competition to create competition is obviously nonsense.

      • Jorge's Jungle

        “In other words…”

        How about we leave my explanation in my words as they don’t misrepresent my objective? I’ve said repeatedly I’m looking for potential rhetoric and propaganda, and doing my own research in order to find the truth. I just happened to select this particular talking point as I hear it often. What is so hard to understand about me wanting to find actual facts and data to verify or debunk the claims made in regards to the ACA? The article never offered up any actual research behind their final numbers, and neither does the MI. It’s like you’re trying to argue that I should reject knowledge and not look into these things further. I don’t get why you’re fighting me on this. As I’ve said, I’m not trying to argue what the purpose of the law is, or the intent of the law. I simply want to verify the claims made, and find more accurate info. Not all 27 year old males are going to pay more for health care. That’s a whopping generalization! I want to know specifically the type of people who will be getting hosed by the law. Income, age, familial status, employment, employer covered plans, possible subsidies, etc. That’s it. Please don’t make it out to be something it’s not.

        Finding the health-care plans and pricing information took me a whopping 5 minutes. You denied repeatedly the existence of such information despite offering links and a walkthrough on how to find it. You claimed/agreed with Avik that you had to login, and then they gave you the cost of a plan after the subsidy had been applied. As proven, you didn’t and don’t need to login to view pricing information, and the site is rather specific in saying prices do not reflect potential subsidies. You, Avik , and all the other media outlets were wrong on these points. That’s what I’m contesting here.

        “to argue that we needed to eliminate competition to create competition is obviously nonsense.”

        I did say after explaining the types of competition that I wasn’t trying to argue that, but rather explaining by definition the various forms of competition and how they impact pricing. I said that, so let’s not argue otherwise, OK? By definition the ACA both creates and destroys competition and they impact pricing in different ways. I think you need to more carefully consider how competition, products, and pricing work to truly understand how the ACA both eliminates and creates two different types of competition.

      • Jeremy R. Hammond

        Avik Roy didn’t say that all 27 year old males will pay more. He pointed out the fact that many will. Again, this is hardly surprising . It’s exactly what we should expect.

        Once again, the fact remains that the website was initially set up so that people would have to create an account before they could shop for plans so that their subsidy could be taken into account, if any, so that they wouldn’t get “rate shock”. This is actually obvious looking back at the homepage of the site the way it was then in the archive, as I already pointed out.

        You are still using the Orwellian logic that Obamacare creates competition by eliminating competition. Obamacare doesn’t create competition, but limits it, as I’ve already explained.

      • Jorge's Jungle

        Avik made a generalization which, quite simply, lacks specific details that I’m seeking. Where are the details in the following statement?

        As Avik Roy points out, “Obamacare wasn’t designed to help healthy people with average incomes get health insurance. It was designed to force those people to pay more for coverage, in order to subsidize insurance for people with incomes near the poverty line, and those with chronic or costly medical conditions.

        This is exactly what we should expect? What, exactly, are we to expect from statements like this? If I were a healthy person with an average income should I expect to pay more? Should healthy people with average incomes start panicking now? How many people is “many?” Can we quantify these claims in order to determine how damaging or outraged we should be over this law? What age, familial status, dependents, tax filing status, income, employer provided or sponsored insurance plans, subsidies, deductions, exemptions, and percentage of the poverty level these people have in order to actually determine whether or not they’ll pay more, less, or about the same for health coverage. How, exactly, is Avik defining “average income?” Average for who? What age group? Average in what location? Approximately how many 27 year old people, with all these considerations, are going to pay more, less, or about the same? Is it thirty, fifty, or ninety percent? This is the type of information I want to know. I don’t want to expect. I want to know, and in order to do so I must verify all sources of information, check the data, research, study the law, etc. It’s probably an impossible feat, but the more fact based knowledge I gather the better off I am in forming an opinion of the ACA.

        Your problem seems to be with the mandate, and not what I’m trying to look into, so please don’t confuse your dislike of the mandate with my goal to find the facts.

        Once again, the fact remains that the website was initially set up so that people would have to create an account before they could shop for plans so that their subsidy could be taken into account, if any, so that they wouldn’t get “rate shock”.

        The burden of proof is on you. I’ve provided evidence that shows otherwise. Do you still deny this evidence? I have provided links, walkthroughs, and excel spreadsheets to show you that A:) You, in fact, don’t need to have an account to view plans and pricing information, and B:) The pricing didn’t reflect possible subsidies as it says in large bold text on the site as archived on 10/02/2013. So prove to me how these facts somehow show that you have to login to view this information, and that they apply the subsidy so you don’t get an idea of the true health-care costs. Please provide your evidence as I have.

        I should also mention that to actually purchase a plan you must obviously complete an application which means creating a secure login. If you take issue with this you don’t understand how insurance companies generate estimates by providing basic information, and quotes by providing specific information. This is nothing new. I hope this is not what you take issue with, because you should understand the purpose of having a secure login to view quotes over estimates. If the site didn’t require people to have secure accounts or connections you’d be upset over that, so what is it exactly that you take issue with on the site aside from the obvious problems when open enrollment began? I really don’t understand how or why you’re still insisting you had to login to view plan information, or that they dupe you by showing your discounted price first.

        This is actually obvious looking back at the homepage of the site the way it was then in the archive, as I already pointed out.

        I used the archived site to find the plan and pricing information which you denied existed. You have now viewed this information after some help. It seems as though you’re still claiming you had to login to view this information, and that they applied the subsidy first before you can view plan pricing?

        You are still using the Orwellian logic that Obamacare creates competition by eliminating competition. Obamacare doesn’t create competition, but limits it, as I’ve already explained.

        So…you disagree with the definitions of differential advantage and comparative advantage? Please stop asserting that I’m claiming the ACA creates competition by eliminating it. I’ve already told you that’s not what I’m saying, and considering I’ve provided linked information explaining the differences in addition to explaining it in different ways it seems you’re grabbing at straws here. I’m simply explaining how the ACA does in fact help eliminate one type of competition while at the same time creating a different type of competition. I’m not claiming more or less competition is being made by this, but rather a different type of competition has been created which by definition impacts pricing differently. Have you read the link I gave you which explains what I’ve explained?

        http://www.investopedia.com/terms/c/competitive_advantage.asp

      • Jeremy R. Hammond

        1) If you want the details related to that quote from Avik Roy, you’ll have to read the article. I’m only concerned here with the the main point, which is that, yes, his findings are completely unsurprising and exactly what we should expect, as this is the intent of the law.

        2) Again, just compare the old homepage with the new one. Users can now click the call to action button to shop for plans before they create an account. The site originally did not have that feature. Users had to create an account before they could do that before. Hence all the media reports pointing this fact out.

        3) You explicitly argued above that by standardizing the kinds of plans they can offer (i.e., eliminating differential advantage), the ACA “creates” competition in pricing. Like I said, insurers could always compete on price. This is not some kind of “new” competition that only exists because of the ACA. Obamacare doesn’t create competition, it only limits it.

      • Jorge's Jungle

        1. Let’s not imply I haven’t read the article, and then pretend the type of information I’m seeking is in it.

        2. Users had to create an account before they could do that before.

        I found the information I shared without creating an account from the old archived site, so why you continue to claim you had to create an account before finding it is perplexing. Is that what you are claiming? If so, the burden of proof is on you.

        If you’re saying it is now easy to find pricing info without needing to create an account I agree with you. There’s a big button damn near punching you in the face to click. If you’re saying it was harder to find the information on the old site I agree with you, but you still didn’t need to create an account.

        But if you’re still saying that on the old site you had to create an account to find the pricing information, and it showed you the after subsidy price to prevent sticker shock then that’s what you should be proving now.

        3. By grouping similar plans together using the metal level criteria it creates competition by allowing consumers to shop based on price.(i.e. Not by eliminating differential advantage, but by forcing insurers to compete on price by creating metal group levels.) Yes, insurers always could compete on price if you actually found a few plans that were similar enough. This was difficult, however, and provided no incentive to compete on price. Profit maximization strategies find it’s better to offer some “gadgets or gizmos” to make it appear as though the plan has more value and therefore giving the company the ability to charge more for it. The ACA has now made price shopping of similar plans much, much, easier for the average consumer. I’m only explaining how differential advantage and comparative advantage work within the law here. As said, I’m not trying to argue it has a net gain or loss in the lumped term “competition.” It does, however, provide a gain and loss in different types of competition.

        And finally, back to 1.

        I’m only concerned here with the the main point, which is that, yes, his findings are completely unsurprising and exactly what we should expect, as this is the intent of the law.

        We have very different objectives if that’s the case. I’ve been clear what mine are, and can see there’s no point sharing any further information. Jorge’s Jungle is moving on.

      • Jeremy R. Hammond

        1) You referred to a single quote in my post above from Avik Roy and said there were no details in that quote. I was just pointing out that if you want the details he gives that put that quote in context, you’ll have to refer to the article and its references.

        The point I’m making is that your suggestion that his article is somehow propaganda is irrational, given that the results he found are exactly what we should expect, being the intent of the law.

        2) I’m saying precisely what I said: “Again, just compare the old homepage with the new one. Users can now click the call to action button to shop for plans before they create an account. The site originally did not have that feature. Users had to create an account before they could do that before. Hence all the media reports pointing this fact out.” That’s pretty clear.

        I hardly need to explain to you the implication of the way it was before, where info was buried in an .xls file you could only find by clicking through links relegated to the footer and the way it is set up now, where people can click a button and actually shop before having to create an account. This just illustrates the point, which is that it was set up so that people would create an account before shopping so that their subsidy, if any, could be calculated before they saw prices.

        3) Again, the argument that Obamacare “creates” price competition by eliminating product competition is Orwellian nonsense. Again, insurers could always compete on price. The law doesn’t “create” this kind of competition.

        Describing government intervention in the market that prohibits ways in which businesses can compete as an “incentive” for them to compete in ways not likewise prohibited is just as Orwellian.

        Obamacare doesn’t create competition. It only limits it.

        As for shopping for plans being “easier”, it would be “easier” to pick a pair of shoes if government mandated that shoe manufacturers standardize their products into only a handful of different kinds. But this would hardly be wise or serve consumers’ interests. Likewise with Obamacare’s idiotic attempts to centrally plan the health insurance market.

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