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ACA Math!
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Author:  Hopwin [ Tue May 06, 2014 8:44 am ]
Post subject:  ACA Math!
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http://finance.yahoo.com/news/one-chart ... 18815.html

Quote:
Overall, the survey mirrors other studies conducted in the final stages of Obamacare's first open enrollment period. A RAND Corp. survey released early last month found the uninsured rate dropped almost 5 percentage points. Subsequent figures from the Congressional Budget Office showed a drop to 16%. The CBO said it expects the uninsured rate to fall even farther in the coming years.


So according to the last numbers there were 45,000,000 (Million) uninsured people prior to Obamacare.

According to the CBO the cost of Obamacare is projected to be $1,000,000,000,000 (Trillion) over the next 10 years. If we assume that is a flat cost structure of $100,000,000,000 (Billion) per year we can do some fun math.

http://obamacarefacts.com/costof-obamacare.php

Assuming the 5% reduction in uninsured is true (seems high to me) we can take 45,000,000 *.05 to determine that 2,250,000 (Million) people got insurance that didn't have it before! Yay! (I know you can debate that the number is lower but let's take the administrations BEST CASE numbers here for the sake of argument)

Now we can take the cost $100,000,000,000 (Billion) and divide it by the newly insured 2,250,000 and determine that we spent $44,444.44 per enrollee for one year for health insurance. Government efficiency in full effect.
Author:  TheRiov [ Tue May 06, 2014 8:47 am ]
Post subject: 
Lets compare apples to apples here: What is the projected enrollment by the end of 10 years?
Author:  Hopwin [ Tue May 06, 2014 9:00 am ]
Post subject:  Re:
TheRiov wrote:
Lets compare apples to apples here: What is the projected enrollment by the end of 10 years?

Who cares what the projection is? Let's double enrollment (which would give Democrats a huge boner no doubt) to 10% instead of 5% while holding costs constant. That'd still be $22,222.22 per year per enrollee. Of course it seems unlikely that costs will remain flat but still that'd be your best case.
Author:  TheRiov [ Tue May 06, 2014 9:25 am ]
Post subject: 
I'm not trying to make a point here, but let's be honest about our data analysis. If you're going to throw the 10 year cost projection you have to use the 10 year enrollment projection too.
Author:  Hopwin [ Tue May 06, 2014 9:59 am ]
Post subject:  Re:
TheRiov wrote:
I'm not trying to make a point here, but let's be honest about our data analysis. If you're going to throw the 10 year cost projection you have to use the 10 year enrollment projection too.

Hence why I doubled the number. ACA was never intended to reduce the uninsured to 0%
http://www.cbo.gov/sites/default/files/ ... endixB.pdf

It was designed to reduce the number of uninsured from 45,000,000 to 31,000,000 (page 4).
Author:  Arathain Kelvar [ Tue May 06, 2014 10:17 am ]
Post subject: 
Hop, you're taking some serious liberties with the math. To be fair, you'd need to look at expenses this year, including advertising, and a portion of the set up costs, and compare that to the 2.25 million enrollees.

Expenses 10 years from now don't have the same value as expenses now. You're also assuming that the entire expense was designed solely to bring down the number of uninsured people, which is not the case.
Author:  Hopwin [ Tue May 06, 2014 10:42 am ]
Post subject:  Re:
blanket statement: Admittedly, I am very much simplying things. If you could find me a report of the one-time/non-recurring expenses for ACA I'd incorporate them but that data isn't available for public consumption.

The ACA reporting itself also fails to break down the reduction of newly insured into any sort of meaningful categories such as how many of the uninsured bought private insurance or jumped onto employer-sponsored plans that they already qualified for just to avoid the fine (which would shift the costs per enrollment up) nor does it break out people who are no longer uninsured but would've qualified for Medicare/Medicaid this year anyways. So I am doing what I can with the numbers provided.

Arathain Kelvar wrote:
Hop, you're taking some serious liberties with the math. To be fair, you'd need to look at expenses this year, including advertising, and a portion of the set up costs, and compare that to the 2.25 million enrollees.

Expenses 10 years from now don't have the same value as expenses now.
Are these not recurring costs? Will there not be advertising annually during the enrollment period? How much of the set-up cost will now roll over to maintenance, record-keeping, enforcement and administration? We don't know. So again for the purposes of the discussion I am flat-lining out the cost as if it were a 10 year long project.

Quote:
You're also assuming that the entire expense was designed solely to bring down the number of uninsured people, which is not the case.

I am sorry I was under the impression the entire legislation was designed solely to bring down the number of uninsured people. What is the secondary goal?
Author:  Arathain Kelvar [ Tue May 06, 2014 1:14 pm ]
Post subject:  Re: Re:
Hopwin wrote:
Are these not recurring costs? Will there not be advertising annually during the enrollment period? How much of the set-up cost will now roll over to maintenance, record-keeping, enforcement and administration? We don't know. So again for the purposes of the discussion I am flat-lining out the cost as if it were a 10 year long project.


Sure, some are. But I have to believe there's some upfront costs to setting up the program. Like designing and building the first year of a model of new car. The car costs x, but you just spent y on engineering. X+some smaller portion of Y will be recurring.

Quote:
Quote:
You're also assuming that the entire expense was designed solely to bring down the number of uninsured people, which is not the case.

I am sorry I was under the impression the entire legislation was designed solely to bring down the number of uninsured people. What is the secondary goal?


When they were trying to sell it to us, I heard all sorts of problems this legislation was supposed to solve. Uninsured, under-insured, rising health care costs, long waits for care, reduce health care costs for poor people, something about the children, etc. I'm sure there were many other promises.
Author:  Hopwin [ Tue May 06, 2014 1:41 pm ]
Post subject:  Re: Re:
Arathain Kelvar wrote:
Hopwin wrote:
Are these not recurring costs? Will there not be advertising annually during the enrollment period? How much of the set-up cost will now roll over to maintenance, record-keeping, enforcement and administration? We don't know. So again for the purposes of the discussion I am flat-lining out the cost as if it were a 10 year long project.


Sure, some are. But I have to believe there's some upfront costs to setting up the program. Like designing and building the first year of a model of new car. The car costs x, but you just spent y on engineering. X+some smaller portion of Y will be recurring.

This whole project is service-based, not goods-based like your car analogy. It's not like setting up an assembly line the bulk of the costs for something like this should be maintenance and administration. You would have your initial capital outlays for servers and building the software. Now you have to maintain that software and hardware, store those records (for 8 million consumers so far), audit the results (IRS Audit) and have a staff to provide "customer service" for both doctors and patients.

Quote:
Quote:
Quote:
You're also assuming that the entire expense was designed solely to bring down the number of uninsured people, which is not the case.

I am sorry I was under the impression the entire legislation was designed solely to bring down the number of uninsured people. What is the secondary goal?


When they were trying to sell it to us, I heard all sorts of problems this legislation was supposed to solve. Uninsured, under-insured, rising health care costs, long waits for care, reduce health care costs for poor people, something about the children, etc. I'm sure there were many other promises.

Under-insured would not show up in the budget outlined in the CBO, it is a cost the private-sector bears to improve their offerings. Long-waits can't really be quantified and weren't included in the CBO either, nor are changes in Health Care prices.
Author:  Xequecal [ Tue May 06, 2014 2:04 pm ]
Post subject: 
$22,222 per person doesn't really surprise me at all. Medicaid has been paying over $20k per family of four covered for at least a decade, and that's the program that underpays doctors/hospitals the most.

Price gouging by medical companies has reached astronomical levels. Dako just upped their prices on the reagents they send to our lab, claiming the medical equipment tax as an excuse.

For example, we are now paying $900/gram for silver nitrate ($900 for 100ml of 1% aqueous solution) and $3000/liter ($300/100ml) for 0.015% hydroquinone. 100ml of each is good for 50 slides. Each slide needs to be secured into the stainer via a disposable plastic clip ($16 each, can only be used once) and needs a barcode label for the machine to read it. This barcode format is proprietary so they can charge us $3 per label. The stainer itself comes with a proprietary wash solution, which is basically detergent in water, that is sold to us for $80/gallon. Simply turning the machine on costs about $26 worth of this, and it does the same flush at the beginning and end of every test run, so $52 more every time slides are run on it, regardless of how many.

Altogether, this one very very old, non-proprietary test that was first used in 1928 and has not been changed since costs the lab about $50 in material costs per slide run. That's not counting the capital costs to buy the stainer itself and the labor costs to have us prepare the slides and actually run the tests.

It must be a really nice business when you can markup the prices on the **** you sell by 50,000% and then blame it on the government.
Author:  Diamondeye [ Tue May 06, 2014 3:45 pm ]
Post subject:  Re:
Xequecal wrote:
$22,222 per person doesn't really surprise me at all. Medicaid has been paying over $20k per family of four covered for at least a decade, and that's the program that underpays doctors/hospitals the most.


Speaking of taking liberties with math. You're really going to say $22,222 per person doesn't surprise you based on a similar cost for a family of 4?
Author:  Rorinthas [ Tue May 06, 2014 4:30 pm ]
Post subject:  Re:
TheRiov wrote:
Lets compare apples to apples here: What is the projected enrollment by the end of 10 years?


Last I heard the amount of uninsured over ten years was projected to remain fairly flat.
Author:  Hopwin [ Wed Jun 18, 2014 7:26 am ]
Post subject: 
Quote:
So far this year the federal government has paid out $4.7 billion in subsidies. The Congressional Budget Office and the Joint Committee on Taxation currently estimate that the ACA’s insurance provisions will cost just under 41.1 trillion over 10 years.


http://finance.yahoo.com/news/average-o ... 00738.html
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