Obamacare and you

[CountDeMoney]

LOL, you are just repeating what I said, with mouth foam added.

I can do that if I want.  You never have enough foam anyway.

[CountDeMoney]

Im not sure what is lulz worthy is this.  Everyone has 2 months still until they have to do anything since nothing happens until Jan 1.  Why sign up for something that early, especially if you are strapped for cash?

I was ripping on the web failures.  It's an abysmal system, I can't believe they let it roll out like they did.

For instance, it asks for your phone number, and provides 3 boxes to fill in, for xxx-xxx-xxxx.
It will then reject your submission because "your phone number must fit the correct xxx-xxxx format".

It's bad, man.

[sbr]

Im not sure what is lulz worthy is this.  Everyone has 2 months still until they have to do anything since nothing happens until Jan 1.  Why sign up for something that early, especially if you are strapped for cash?

I was ripping on the web failures.  It's an abysmal system, I can't believe they let it roll out like they did.

For instance, it asks for your phone number, and provides 3 boxes to fill in, for xxx-xxx-xxxx.
It will then reject your submission because "your phone number must fit the correct xxx-xxxx format".

It's bad, man.

Ah ok.

[dps]

That's not entirely true.  Insurers do negotiate discounts with providers.

One of the greatest perversities of our current system IMO; people with the least ability to pay--the uninsured--pay the highest prices.

As to the first part of your post, not really.  Insurers generally offer coverage which allows access to health care providers who agree to insurers rates.  That is often inefficient as the insurer may not be able to attract the necessary (or appropriate) providers of that service.  ie the insurer has limited bargaining power.   

And the usual result of this when it involves employer-provided health insurance benefits is that many employee find that their preferred provider isn't an approved provider under their insurance plans.

[CountDeMoney]

Also, it doesn't give you the option to go straight in and choose a plan;  I based one plan on what I earned last year, but that will be different with this years' tax returns;  and as I am unemployed, it only offered me Medicaid assistance  .

And as much fun and as fulfilling it would be to directly siphon off derspiess' taxes, that's not what I want to do.

  I HAVE MONEY, I JUST DONT HAVE A JOB

[Berkut]

Seedy, any interest in going to NYC and watching the Wildcats and maybe Duke in the NIT Preseason tournament semis and finals in late November?

[CountDeMoney]

I'll give you a call sometime tomorrow about it. 

[crazy canuck]

That's not entirely true.  Insurers do negotiate discounts with providers.

One of the greatest perversities of our current system IMO; people with the least ability to pay--the uninsured--pay the highest prices.

As to the first part of your post, not really.  Insurers generally offer coverage which allows access to health care providers who agree to insurers rates.  That is often inefficient as the insurer may not be able to attract the necessary (or appropriate) providers of that service.  ie the insurer has limited bargaining power.   

And the usual result of this when it involves employer-provided health insurance benefits is that many employee find that their preferred provider isn't an approved provider under their insurance plans.

One of the things I dont understand about the fear mongering about single payor systems is the notion that people wont be able to choose their doctor.  Under your system, your choice is limited to the restrictions of whatever plan you might have.  Under our system there is no such restriction - all doctors and all specialists are covered under the same plan.

[Baron von Schtinkenbutt]

One of the things I dont understand about the fear mongering about single payor systems is the notion that people wont be able to choose their doctor.  Under your system, your choice is limited to the restrictions of whatever plan you might have.  Under our system there is no such restriction - all doctors and all specialists are covered under the same plan.

Some of the fear, I think, is that a single-payer system would be a return to the bad old days of HMOs where you have to designate a PCP that you must use for everything and cannot change but once a year, and whose permission/referral you need to so much as take a piss at any medical facility.

[crazy canuck]

Some of the fear, I think, is that a single-payer system would be a return to the bad old days of HMOs where you have to designate a PCP that you must use for everything and cannot change but once a year, and whose permission/referral you need to so much as take a piss at any medical facility.

I agree that would be a silly way to create a single payor system.  Another of the efficiencies of a single payor system is, properly designed, it does away with a lot of administrative overhead.  There is no need to regulate referrals because the single payor regulates the cost for everyone.  Therefore it makes no sense for an administrator to be tasked with the job of deciding whether the patient should see doctor A or B.

Under our system doctors make the decisions regarding treatment.  No third party regulates or questions a doctors decision to refer a patient to a specialist or to another doctor or any other medical decision for that matter - so long as the treatment falls within that which is covered (which is pretty much everything that is medically necessary).

[Admiral Yi]

There is no need to regulate referrals because the single payor regulates the cost for everyone.

The purpose of the gatekeeper is to regulate usage, not to price shop.

[Grey Fox]

There is no need to regulate referrals because the single payor regulates the cost for everyone.

The purpose of the gatekeeper is to regulate usage, not to price shop.

In your system, how are those 2 things different?

[sbr]

If it is covered and a liscenced doctor says you need it why would you need a gate keeper?

[crazy canuck]

There is no need to regulate referrals because the single payor regulates the cost for everyone.

The purpose of the gatekeeper is to regulate usage, not to price shop.

As I said, if you wanted to design a bad system you would have such a gate keeper rather than relying on the medical judgment of the treating physician.  In a non-single payor system that becomes important because the referral may be to someone who is more expensive than the plan would allow.  In a single payor system those sorts of judgments make no sense.

I understand the Baron's concern that a piss poor system might be designed.  But that is more a criticism of your political process than anything else.

[Admiral Yi]

In your system, how are those 2 things different?

Patient walks in, says I think I have a brain doomah.

A price shopper would call up 4 CAT scan places and ask what they charge.

A gatekeeper would say you just have a headache, take some Advil.