Poll
Question:
What's the impact of Obamacare for you (and your family)? Assuming it doesn't get defunded or delayed, of course...
Option 1: I live in a state that's embracing Obamacare and it looks like I'm set for cheaper and/or better healthcare.
votes: 9
Option 2: I live in a state that's embracing Obamacare and it looks like I'm going to be paying more and/or get worse coverage.
votes: 5
Option 3: I live in a state that's embracing Obamacare and it looks like I'm largely unaffected by Obamacare, other than the effects of the general political theatre.
votes: 6
Option 4: My state is embracing Obamacare, but I have no clue how it will impact me personally.
votes: 1
Option 5: I live in a state that's rejecting Obamacare and it looks like I'm set for cheaper and/or better healthcare.
votes: 0
Option 6: I live in a state that's rejecting Obamacare and it looks like I'm going to be paying more and/or get worse coverage.
votes: 1
Option 7: I live in a state that's rejecting Obamacare and it looks like I'm largely unaffected by Obamacare, other than the effects of the general political theatre.
votes: 7
Option 8: My state is rejecting Obamacare and I have no idea how Obamacare is going to impact me.
votes: 1
Option 9: The American health care system doesn't affect me, but I'm watching how the whole thing plays out with interest.
votes: 20
Option 10: The American health care system doesn't affect me and frankly I don't care.
votes: 8
Option 11: Some other option because the previous 10 were not enough...
votes: 6
Americans of Languish, the Obamacare deadline is almost upon you.
From what I've read, the impact is going to vary greatly between states that are working hard to implement it and make it work, and those that have rejected it completely.
In California (http://www.forbes.com/sites/rickungar/2013/05/24/unexpected-health-insurance-rate-shock-california-obamacare-insurance-exchange-announces-premium-rates/2/) it seems that the costs are even lower than predicted ($275/month vs predictions $450/month and $5200/year), and will be even lower for those who get subsidies.
Conversely (and I can't find the link right now), in states where they're actively working against the implementation people - especially poor people - are apparently set to have their costs increase.
So I'm curious, how is it likely to play out for you personally?
Believe it or not given who represents us in the Senate, Kentucky is cooperating. No idea what it'll do to my (already outstanding) coverage, but from what I'm hearing from the HR people (OF WHICH I AM NOT ONE), it's probably not going to impact our premiums in any way.
I have no idea.
If you already have employer-provided insurance it shouldn't affect you at all.
Quote from: Admiral Yi on September 25, 2013, 01:07:09 PM
If you already have employer-provided insurance it shouldn't affect you at all.
:lol:
:unsure:
Quote from: derspiess on September 25, 2013, 01:10:42 PM
Quote from: Admiral Yi on September 25, 2013, 01:07:09 PM
If you already have employer-provided insurance it shouldn't affect you at all.
:lol:
:huh:
Please explain? How will it affect you if you have employer-provided insurance? How is it affecting you?
Premiums are going up.
Quote from: derspiess on September 25, 2013, 01:15:53 PM
Premiums are going up.
For you personally or for your employer?
I expect I will continue to be without health care for the near future.
Quote from: derspiess on September 25, 2013, 01:18:39 PMBoth.
How much are we talking, roughly, if you don't mind me asking?
Heard on CNN the other day that health care inflation has fallen to 1%.
(Compared to 8% in Canada.)
Quote from: Peter Wiggin on September 25, 2013, 01:17:09 PM
I expect I will continue to be without health care for the near future.
Damn, that's a pretty bad situation for you or others to be in. :(
Quote from: Jacob on September 25, 2013, 01:19:31 PM
Quote from: derspiess on September 25, 2013, 01:18:39 PMBoth.
How much are we talking, roughly, if you don't mind me asking?
Don't know off the top of my head. I'll have to check the wife's pay advice since I'm on her Citi insurance. I know people were going apeshit here last year when they announced the premium increase and mentioned that most of it was due to the Affordable Care Act.
But doesn't it make sense that premiums would go up with insurers being forced to cover more things than they used to?
Yeah, it makes sense.
I'm just wondering if it's like $10/month, $100/month, $500/month or whatever... to get a sense of the depth of the rage.
Quote from: Admiral Yi on September 25, 2013, 01:07:09 PM
If you already have employer-provided insurance it shouldn't affect you at all.
Hmm, that's not how I've read it.
From what I understand, companies are now required to open their coverage to exchanges, allowing their employees to choose which insurance company they wish to use. I'm fairly certain that even my company, a health insurance company owned by a hospital, is required to do so.
Which makes me happy because our family doctor isn't in our current plan, but we'll have the option to choose another company on Jan 1 that does include him. :)
Hmmm. I thought the exchanges were for individuals and employers who previously weren't purchasing insurance.
Quote from: Admiral Yi on September 25, 2013, 01:44:16 PM
Hmmm. I thought the exchanges were for individuals and employers who previously weren't purchasing insurance.
Maybe it varies between states?
Quote from: Admiral Yi on September 25, 2013, 01:44:16 PM
Hmmm. I thought the exchanges were for individuals and employers who previously weren't purchasing insurance.
Not according to my Director, but she could be wrong.
This so...alien to me.
Quote from: merithyn on September 25, 2013, 01:45:17 PM
Quote from: Admiral Yi on September 25, 2013, 01:44:16 PM
Hmmm. I thought the exchanges were for individuals and employers who previously weren't purchasing insurance.
Not according to my Director, but she could be wrong.
I know that here we are getting the option of the exchange as well. They send us a million different files about it. Yay more paperwork to read?
Quote from: Grey Fox on September 25, 2013, 01:49:56 PM
This so...alien to me.
Couple of days ago I got a letter about my recent 'emergency care', not a bill or receipt, but asking if I wished not to share the it's detail with the rest of the health service; why would I not want doctors to know all of my medical details in any future care ? :hmm:
Quote from: Jacob on September 25, 2013, 01:36:40 PM
Yeah, it makes sense.
I'm just wondering if it's like $10/month, $100/month, $500/month or whatever... to get a sense of the depth of the rage.
They were being raised long before Obamacare was even close to being law, for the last 10 years.
From PBS:
QuoteThe employer survey found that 93 percent of firms with more than 50 workers offer coverage, down from 95 percent in the 2012 survey. Overall, 57 percent of all employers offer health insurance to their workers, down from 66 percent decade ago. The rate of coverage by employers with 200 or more workers remained steady, with about 99 percent offering insurance. Coverage drops off with firm size, with only 45 percent of the smallest companies offering insurance to workers, down from 55 percent in 2003.
Other findings include:
Workers pay 18 percent of the premium costs for single coverage on average, and 29 percent of the premium cost for family plans, rates that have changed little in a decade.
Health insurance premiums have risen 196 percent since 1999, with worker contributions growing 182 percent. Meanwhile, wages have grown an average of 50 percent since 1999.
Thirty-eight percent of all workers with single health insurance had at least a $1,000 annual deductible, the amount they pay before most insurance coverage kicks in. At small firms, 58 percent of those covered workers had at least a $1,000 deductible, while nearly 31 percent had deductibles of at least $2,000, up from 12 percent in 2008.
"One of the changes in this report is the growth in deductibles," said economist Paul Ginsburg of the Center for Studying Health System Change, a nonpartisan research group in Washington. The deductibles were likely "a factor behind the premium increase being as low as it was."
Workers in small firms with three to 199 employees face an average annual deductible of $1,715 compared with $884 for those in larger firms.
Small businesses generally see more volatile insurance premium rates than larger firms. Scott Hauge, who runs an insurance brokerage firm in California, says his clients have seen increases averaging around 10 percent a year for the past seven years. He doesn't dispute the findings of the survey, but added that "small businesses are not seeing those minor increases."
Analysts say premium increases are cyclical, with periods of rapid increases, such as the double-digit hikes that marked the late 1980s and the early 2000s, followed by periods of slower growth. Since about the mid-2000s, rate increases paid by employers fell below 10 percent each year, with the smallest annual growth tracked at 3 percent in the 2009-2010 employer survey. In what surprised many analysts, rates jumped by 9 percent from 2010 to 2011 before moderating the past two years to around 4 percent.
Obamacare is just the latest convenient excuse to cut costs for the employer and increase profits for the healthcare industry.
Funny though...the GOP libertariantard critics will bitch about being "forced" into Obamacare (even though nobody is), but they won't mention how employer-mandated, fascist and mandatory "Wellness" programs can cut their costs and increase employer contributions.
http://www.kaiserhealthnews.org/stories/2012/april/02/employers-financial-rewards-penalties-health-tests.aspx
Quote from: derspiess on September 25, 2013, 01:35:31 PM
Don't know off the top of my head. I'll have to check the wife's pay advice since I'm on her Citi insurance. I know people were going apeshit here last year when they announced the premium increase and mentioned that most of it was due to the Affordable Care Act.
But doesn't it make sense that premiums would go up with insurers being forced to cover more things than they used to?
The employer requirements have been suspended a year, and most of the insurer-related provisions kicked in three years ago. Prior law already prohibited denial of coverage in small group plans.
So the mechanism by which ACA is causing these premiums to go up is a bit obscure.
Perhaps "they" were mistaken or even (*gasp*) not entirely honest?
Quote from: mongers on September 25, 2013, 01:58:23 PM
Quote from: Grey Fox on September 25, 2013, 01:49:56 PM
This so...alien to me.
Couple of days ago I got a letter about my recent 'emergency care', not a bill or receipt, but asking if I wished not to share the it's detail with the rest of the health service; why would I not want doctors to know all of my medical details in any future care ? :hmm:
Its privacy laws run amok.
Quote from: derspiess on September 25, 2013, 01:35:31 PM
Quote from: Jacob on September 25, 2013, 01:19:31 PM
Quote from: derspiess on September 25, 2013, 01:18:39 PMBoth.
How much are we talking, roughly, if you don't mind me asking?
Don't know off the top of my head. I'll have to check the wife's pay advice since I'm on her Citi insurance. I know people were going apeshit here last year when they announced the premium increase and mentioned that most of it was due to the Affordable Care Act.
But doesn't it make sense that premiums would go up with insurers being forced to cover more things than they used to?
That's actually kind of funny that they said that most of it was due to the ACA. My insurance company (the one that I work for) raised insurance rates for our members and groups drastically two years ago. The reason that they did it was because the cost of healthcare had gone up dramatically and the rate increases hadn't caught up. They did a full audit and found that they needed to do a massive rate raise to catch up.
Now, with the ACA going into affect, they're only having to raise the rates by about 4%.
And Jacob, if the estimates are anything to go by, my costs may go down 50%.
Quote from: garbon on September 25, 2013, 01:52:17 PM
Quote from: merithyn on September 25, 2013, 01:45:17 PM
Quote from: Admiral Yi on September 25, 2013, 01:44:16 PM
Hmmm. I thought the exchanges were for individuals and employers who previously weren't purchasing insurance.
Not according to my Director, but she could be wrong.
I know that here we are getting the option of the exchange as well. They send us a million different files about it. Yay more paperwork to read?
In Illinois, you can do it all online.
Save the trees! :w00t:
Quote from: The Minsky Moment on September 25, 2013, 02:05:27 PM
The employer requirements have been suspended a year, and most of the insurer-related provisions kicked in three years ago. Prior law already prohibited denial of coverage in small group plans.
So the mechanism by which ACA is causing these premiums to go up is a bit obscure.
Perhaps "they" were mistaken or even (*gasp*) not entirely honest?
I thought the suspension was only for small and medium-sized companies.
Quote from: merithyn on September 25, 2013, 02:08:43 PM
Quote from: garbon on September 25, 2013, 01:52:17 PM
Quote from: merithyn on September 25, 2013, 01:45:17 PM
Quote from: Admiral Yi on September 25, 2013, 01:44:16 PM
Hmmm. I thought the exchanges were for individuals and employers who previously weren't purchasing insurance.
Not according to my Director, but she could be wrong.
I know that here we are getting the option of the exchange as well. They send us a million different files about it. Yay more paperwork to read?
In Illinois, you can do it all online.
Save the trees! :w00t:
Actually I realized that given the health plan my company has (inspired by UK/Canadian health care systems) that I likely have no benefit from an exchange.
I think my school will probably stay under Bushcare and its disastrous price increases for at least another year.
The plan I have was a great one when it started, six years ago, but Bushcare has made it less and less attractive each year. Now it is a mediocre plan, at best.
What do you mean by Bushcare, grumbler?
And what has made it less attractive? Higher cost for you? Less benefits?
Quote from: Jacob on September 25, 2013, 03:39:54 PM
What do you mean by Bushcare, grumbler?
It's a kindler, gentler, healthcare plan.
Quote from: Caliga on September 25, 2013, 03:51:08 PM
Quote from: Jacob on September 25, 2013, 03:39:54 PM
What do you mean by Bushcare, grumbler?
It's a kindler, gentler, healthcare plan.
A thousand points of coverage.
:lol:
Quote from: Jacob on September 25, 2013, 03:39:54 PM
What do you mean by Bushcare, grumbler?
The health care system(s) the country had under George W. Bush and before the implementation of Obamacare.
Quote from: crazy canuck on September 25, 2013, 03:50:14 PM
And what has made it less attractive? Higher cost for you? Less benefits?
Yes and yes.
Quote from: crazy canuck on September 25, 2013, 03:50:14 PM
And what has made it less attractive? Higher cost for you? Less benefits?
The biggest problem is rising costs, combined with a steep rise (from $1500 to $3000 in three years) in the amount I pay out of my HSA before the system kicks in to pay 100% of costs.
I don't think there will be any effect on me. The only place I have to go is down though, since I don't pay a cent of premiums myself and have a pretty good plan. I saw some gobbledygook in the union propaganda letter about the multi-employer trust fund not getting an exemption for something that something got for something or another but I didn't really look into it.
EDIT: I have a pretty sweet flexible spending plan too. I get a dollar/ dollar and a half per hour in my fund and I don't lose it and the end of the year, so I can hoard up as much money in it as I can.
I wish the HSA/high deductible plan option was available when I first started working. I would have accumulated a nice little cushion in the 10 years or so before we had kids.
Quote from: grumbler on September 25, 2013, 03:53:57 PMThe health care system(s) the country had under George W. Bush and before the implementation of Obamacare.
Gotcha. Thanks :)
It's what I thought, but sometimes you can be tricky...
I live in a Romney-care state.
Quote from: grumbler on September 25, 2013, 03:56:21 PM
Quote from: crazy canuck on September 25, 2013, 03:50:14 PM
And what has made it less attractive? Higher cost for you? Less benefits?
The biggest problem is rising costs, combined with a steep rise (from $1500 to $3000 in three years) in the amount I pay out of my HSA before the system kicks in to pay 100% of costs.
Yikes. With that kind of a deductable I would assume people would be reluctant to seek health care.
Quote from: crazy canuck on September 25, 2013, 04:38:44 PM
Quote from: grumbler on September 25, 2013, 03:56:21 PM
Quote from: crazy canuck on September 25, 2013, 03:50:14 PM
And what has made it less attractive? Higher cost for you? Less benefits?
The biggest problem is rising costs, combined with a steep rise (from $1500 to $3000 in three years) in the amount I pay out of my HSA before the system kicks in to pay 100% of costs.
Yikes. With that kind of a deductable I would assume people would be reluctant to seek health care.
It actually makes you think twice before having a wasteful visit to the doctor for the sniffles. Which is a good aspect of it.
Quote from: derspiess on September 25, 2013, 04:40:22 PM
Quote from: crazy canuck on September 25, 2013, 04:38:44 PM
Quote from: grumbler on September 25, 2013, 03:56:21 PM
Quote from: crazy canuck on September 25, 2013, 03:50:14 PM
And what has made it less attractive? Higher cost for you? Less benefits?
The biggest problem is rising costs, combined with a steep rise (from $1500 to $3000 in three years) in the amount I pay out of my HSA before the system kicks in to pay 100% of costs.
Yikes. With that kind of a deductable I would assume people would be reluctant to seek health care.
It actually makes you think twice before having a wasteful visit to the doctor for the sniffles. Which is a good aspect of it.
Not really, that cuts out a lot of preventative medicine which results in greater costs and poor health outcomes in the long run.
Quote from: crazy canuck on September 25, 2013, 04:41:37 PM
Not really, that cuts out a lot of preventative medicine which results in greater costs and poor health outcomes in the long run.
Not really. Preventative visits and screening procedures are usually covered by high deductible plans at 100% and do not require you to meet your deductible first.
The stuff that would increase premiums for employer plans are primarily the changes in coverage requirements necessary to make the employer plan compliant with PPACA. Namely this meant the plans had to cover preventive care without requiring a copay or meeting a deductible first (so the plans basically cannot require any out of pocket expense for preventive care), and the plans could have no lifetime limit.
Depending on what coverage your employer offered, changing to comply with those two standards could mean higher premiums. I've always gone with the Kaiser HMO plan available to Federal employees in this area, and as an HMO it didn't have the whole deductible/lifetime maximum scheme in the first place so I basically so no change. However, you can choose between a large number of plans as a Federal employee. My understanding is the other plans, some of which had the lifetime maximum coverage and that required copays for things like physicals had to be changed to comply with the PPACA to stay on the list of plans available to Federal employees, and those did have modest premium increases after that.
This is the first place I've heard that all private employers are required to participate in exchanges. I've seen that many employers are choosing to participate in private exchanges, which are different from the PPACA exchanges, because it gives employees more choice and creates large risk pools that can lower the employer's costs.
Quote from: crazy canuck on September 25, 2013, 04:41:37 PMNot really, that cuts out a lot of preventative medicine which results in greater costs and poor health outcomes in the long run.
A lot of the HDHPs were not so great when they and HSAs first went en vogue, but there have always been good ones that covered preventive care completely. With the PPACA, to even be recognized as a compliant PPACA plan these plans have to cover preventive care. If they are employer offered plans and they were not modified to be compliant, then for the PPACA purposes it's akin to the employer not offering insurance so they have to pay the per-employee penalty (iirc $4,000/year per employee) if they wanted to continue to offer a HD plan like that.
Quote from: derspiess on September 25, 2013, 04:43:30 PM
Quote from: crazy canuck on September 25, 2013, 04:41:37 PM
Not really, that cuts out a lot of preventative medicine which results in greater costs and poor health outcomes in the long run.
Not really. Preventative visits and screening procedures are usually covered by high deductible plans at 100% and do not require you to meet your deductible first.
prevention isnt about just screening. Its going to the doctor when you have an issue. It might be minor but it might also be major. Thats why we have doctors who are trained to make that call.
Out of curiosity, does Medicare have deductibles?
Quote from: derspiess on September 25, 2013, 04:40:22 PM
It actually makes you think twice before having a wasteful visit to the doctor for the sniffles. Which is a good aspect of it.
For those living paycheck-to-paycheck, it makes you think twice, thrice, and then some before going in for necessary treatments, too. I know it does for me.
My brother in law is constantly giving ambulance rides to lonely old people who just want a free meal and somebody to talk to...
Quote from: MadImmortalMan on September 25, 2013, 04:50:09 PM
Out of curiosity, does Medicare have deductibles?
I believe there is a copay for doctor visits.
And as everyone with a TV knows, it only covers 80% of hospital stays.
Quote from: MadImmortalMan on September 25, 2013, 04:50:09 PM
Out of curiosity, does Medicare have deductibles?
It depends on the plan that you have. There are a number of plan options, some of which require a deductible while others do not.
Did Obamacare make any changes to the Medicare setup or was it always like that?
Quote from: MadImmortalMan on September 25, 2013, 04:53:46 PM
Did Obamacare make any changes to the Medicare setup or was it always like that?
I believe that it's been that way for the past five years or so, but I'm not 100% sure when MedAdvantage kicked in.
Quote from: MadImmortalMan on September 25, 2013, 04:50:09 PM
Out of curiosity, does Medicare have deductibles?
In Canada it does not. Or do you mean the US program for seniors?
I have no idea what I'm supposed to do. I've been given no guidance. Am I supposed to sign up for something or what?
Quote from: derspiess on September 25, 2013, 04:43:30 PM
Not really. Preventative visits and screening procedures are usually covered by high deductible plans at 100% and do not require you to meet your deductible first.
Correct.
Quote from: Ideologue on September 25, 2013, 05:32:33 PM
I have no idea what I'm supposed to do. I've been given no guidance. Am I supposed to sign up for something or what?
What state are you again? North Carolina?
Quote from: merithyn on September 25, 2013, 06:41:37 PM
Quote from: Ideologue on September 25, 2013, 05:32:33 PM
I have no idea what I'm supposed to do. I've been given no guidance. Am I supposed to sign up for something or what?
What state are you again? North Carolina?
SC
Quote from: Ideologue on September 25, 2013, 05:32:33 PM
I have no idea what I'm supposed to do. I've been given no guidance. Am I supposed to sign up for something or what?
I got an email from the Writers' Guild of America, and from that I surmise the following:
- On Oct. 1st you'll get a note from your employer about the health care market places and that you will be required to have health insurance by Jan 1st.
- If you are not employed (or say, if the information is not given to you because things are different where you are compared to California), you will still have to obtain coverage by Jan 1st.
- If you do not have a state run exchange, you'll have to use the federal one.
Here's a blog post (http://www.forbes.com/sites/carolynmcclanahan/2013/09/25/health-insurance-rates-are-out-for-the-obamacare-exchanges-is-it-good-news/) that seems to have some decent information. It includes links to a rate calculator (http://kff.org/interactive/subsidy-calculator/#state=sc&zip=&income-type=dollars&income=50000&employer-coverage=0&people=2&adult-count=2&adults%5B0%5D%5Bage%5D=21&adults%5B0%5D%5Btobacco%5D=1&adults%5B1%5D%5Bage%5D=21&adults%5B1%5D%5Btobacco%5D=0&child-count=0&child-tobacco=0) for federal exchanges from one insurance provider, as well as a map of states with no state exchanges (http://kff.org/health-reform/state-indicator/health-insurance-exchanges/#map).
And here's the relevant bits from the letter I got:
Quote from: excerpt from letter from the WGA re: health insuranceBeginning January 1, 2014, the Affordable Care Act (ACA, often called "Obamacare") requires individuals to maintain health insurance for themselves and their dependants. If you and your dependants are covered by the Writers' Guild-Industry Health Fund ("WGA Health Fund"), that coverage satisfies the requirement. If, however, you do not have coverage under the WGA Health Fund and do not otherwise have health insurance, you will need to obtain coverage.
Around October 1, writers who are currently employed will be receiving a notice from their employer(s) informing them of the existence of health care "marketplaces" (also called "exchanges"). A marketplace is simply an online venue where you can purchase health coverage that meets the requirements of the ACA. In California, the state-run marketplace is called "Covered California." Other states will either run their own marketplace or rely on the federal government to set up the marketplace for their residents.
Writers who are not currently employed probably will not receive a notice in October but are still required by the ACA to have appropriate health care coverage effective January 1, 2014. In addition, any writer who falls out of WGA coverage in the future will have the opportunity to continue WGA coverage under the COBRA program or obtain ACA-compliant health coverage from the marketplace (or independently).
South Carolina doesn't have a state exchange, so they have to go to the federal exchange.
Yeah, I was just trying to find that.
Apparently we are opposing it? Surprise.
This (http://aspe.hhs.gov/health/reports/2013/MarketplacePremiums/ib_premiumslandscape.pdf) seems like it may have the answers to most of your questions re: the Federal Exchange Ide.
Conveniently(?) they use a 27 year old for calculating example rates (on p.10 or so). How old are you again?
Quote from: Jacob on September 25, 2013, 12:59:55 PM
Americans of Languish, the Obamacare deadline is almost upon you.
From what I've read, the impact is going to vary greatly between states that are working hard to implement it and make it work, and those that have rejected it completely.
In California (http://www.forbes.com/sites/rickungar/2013/05/24/unexpected-health-insurance-rate-shock-california-obamacare-insurance-exchange-announces-premium-rates/2/) it seems that the costs are even lower than predicted ($275/month vs predictions $450/month and $5200/year), and will be even lower for those who get subsidies.
Conversely (and I can't find the link right now), in states where they're actively working against the implementation people - especially poor people - are apparently set to have their costs increase.
So I'm curious, how is it likely to play out for you personally?
Fed worker, Retired Army. Dont know, dont care, I'll deal with it "if" it comes. Expecting the worst, so anything better than that is "Rainbows and Unicorns".
Quote from: Ideologue on September 25, 2013, 07:01:35 PM
Yeah, I was just trying to find that.
Apparently we are opposing it? Surprise.
It doesn't open until next week to apply and insurance won't start until Jan 1, so you have time.
Wow, New Jersey doesn't have one either? :wacko: I guess Christie really wants the presidency.
Quote from: 11B4V on September 25, 2013, 07:05:09 PMFed worker, Retired Army. Dont know, dont care, I'll deal with it "if" it comes. Expecting the worst, so anything better than that is "Rainbows and Unicorns".
Cool. I'll check back with you in six to twelve months or so.
Quote from: Jacob on September 25, 2013, 07:03:58 PM
This (http://aspe.hhs.gov/health/reports/2013/MarketplacePremiums/ib_premiumslandscape.pdf) seems like it may have the answers to most of your questions re: the Federal Exchange Ide.
Conveniently(?) they use a 27 year old for calculating example rates (on p.10 or so). How old are you again?
NOT TWENTY-SEVEN. <_<
:P
Thanks.
Quote from: Jacob on September 25, 2013, 07:06:39 PM
Quote from: 11B4V on September 25, 2013, 07:05:09 PMFed worker, Retired Army. Dont know, dont care, I'll deal with it "if" it comes. Expecting the worst, so anything better than that is "Rainbows and Unicorns".
Cool. I'll check back with you in six to twelve months or so.
I'll be glad to opine. :)
Quote from: DGuller on September 25, 2013, 07:05:43 PM
Wow, New Jersey doesn't have one either? :wacko: I guess Christie really wants the presidency.
Some of them didn't do it due to fiscal problems. NJ may be one of those.
So turns out Obamacare has nothing to do with dental coverage. That's fucking lame. What good is it? I don't have cancer, and if I did I could just die. But I have teeth that need to be fixed.
And, yes, obviously, I have not been following the ACA. It wasn't single payer so I didn't care.
That sucks. Dental coverage is one of those things were $100 saved today could cost you $2000 a year later. Then again, it's also a kind of coverage that is most vulnerable to adverse selection, precisely because you can really stockpile the problems in your mouth until you get insurance.
Quote from: Caliga on September 25, 2013, 01:03:51 PM
Believe it or not given who represents us in the Senate, Kentucky is cooperating. No idea what it'll do to my (already outstanding) coverage, but from what I'm hearing from the HR people (OF WHICH I AM NOT ONE), it's probably not going to impact our premiums in any way.
Denial is a terrible thing. :console:
Quote from: DGuller on September 25, 2013, 09:13:05 PM
That sucks. Dental coverage is one of those things were $100 saved today could cost you $2000 a year later. Then again, it's also a kind of coverage that is most vulnerable to adverse selection, precisely because you can really stockpile the problems in your mouth until you get insurance.
Would you say that presidential penis is a problem?
Quote from: The Brain on September 25, 2013, 11:20:18 PM
Quote from: DGuller on September 25, 2013, 09:13:05 PM
That sucks. Dental coverage is one of those things were $100 saved today could cost you $2000 a year later. Then again, it's also a kind of coverage that is most vulnerable to adverse selection, precisely because you can really stockpile the problems in your mouth until you get insurance.
Would you say that presidential penis is a problem?
It's an opportunity.
I work for a health care corp and I use their own plan which is administered by Tufts insurance. That keeps costs down for premiums and costs down for me. I generally need to stay within the health care medical service my deductible and costs are low, usually no deductible. But I can go elsewhere if my doctor advises it and I pay a deductible for that plus I may have to pay some of the costs of treatment. That works for me since all my doctors are in the system with one hospital in my hometown also. I have no idea if we'll see any cost changes, and I haven't seen anything about it from the company so I'm assuming I won't see much change.
I live in Massachusetts which already had its own plan (AKA Romney Care) so I assume the exchanges are pretty much aready setup. The Governor tried to get a waiver from parts of the ACA since the state already had its plan but that failed. Some legislators have been urging the Governor to try again as the Federal ACA could have some negative impacts on the MA plan.
Because of Obamacare, I am having my blue-collar parents (in their 50's) stop working so that their income drops to a level (using reported rental income) where their health premiums are 95% subsidized.
If I can get them qualified for Social Security disability payments (not counted as income under Obamacare), then our family will become wealthier from my parents not working.
Great system.
We've all seen how you read graphs and such. Maybe someone else should look at it.
Quote from: Phillip V on September 26, 2013, 10:35:22 PM
Because of Obamacare, I am having my blue-collar parents (in their 50's) stop working so that their income drops to a level (using reported rental income) where their health premiums are 95% subsidized.
If I can get them qualified for Social Security disability payments (not counted as income under Obamacare), then our family will become wealthier from my parents not working.
Great system.
Saboteurs will be shot.
Quote from: Razgovory on September 26, 2013, 10:43:43 PM
We've all seen how you read graphs and such. Maybe someone else should look at it.
:pinch:
Quote from: Phillip V on September 26, 2013, 10:35:22 PM
Because of Obamacare, I am having my blue-collar parents (in their 50's) stop working so that their income drops to a level (using reported rental income) where their health premiums are 95% subsidized.
If I can get them qualified for Social Security disability payments (not counted as income under Obamacare), then our family will become wealthier from my parents not working.
Great system.
:w00t: :w00t:
But I thought Clinton ended welfare as we knew it? :hmm:
Quote from: Caliga on September 27, 2013, 09:18:22 AM
But I thought Clinton ended welfare as we knew it? :hmm:
Some loopholes were left in. And disability is becoming the new welfare.
Quote from: derspiess on September 27, 2013, 09:19:48 AM
Some loopholes were left in. And disability is becoming the new welfare.
:huh:
Do you have any idea how hard it is to qualify for disability? It took my dad five years, two appeals, and dozens of home visits before he qualified, and he had COPD and congestive heart failure. He couldn't walk across the house without stopping for a breath.
That's a total joke to call it the "new welfare". There's a massive difference between the two.
I have a former co-worker who is on disability who is most definitely not disabled. She has "back pain". I don't know how hard it was for her to get that, and that's the only ancedotal example I've got. :hmm:
Quote from: Caliga on September 27, 2013, 09:29:28 AM
I have a former co-worker who is on disability who is most definitely not disabled. She has "back pain". I don't know how hard it was for her to get that, and that's the only ancedotal example I've got. :hmm:
How do you know that she's "most definitely not disabled"? Chronic "back pain" can absolutely make it impossible to work. Ask anyone who suffers from it.
I'm saying that if someone is getting disability, it's because they've jumped through a hell of a lot of hoops to get it, and one can guess that they are pretty messed up if they qualify.
What happens if they're too big to fit through the hoops? :hmm:
Quote from: Peter Wiggin on September 27, 2013, 09:45:22 AM
What happens if they're too big to fit through the hoops? :hmm:
That may be an automatic pass, but I'm not sure. :sleep:
Quote from: merithyn on September 27, 2013, 09:26:36 AM
That's a total joke to call it the "new welfare". There's a massive difference between the two.
Then what reason would you give for skyrocketing disability claims?
People ain't as tough as we used to be.
Quote from: Caliga on September 27, 2013, 09:18:22 AM
But I thought Clinton ended welfare as we knew it? :hmm:
His goal was to end welfare as we knew it, not to end welfare, poors-hater.
MAH GAG MISFIRE
Quote from: derspiess on September 27, 2013, 09:56:33 AM
Then what reason would you give for skyrocketing disability claims?
Jeez, where does one start?
People don't take care of themselves like they used to, fast food is more prevelant, obesity, sit-down jobs, more people in the 55-65 range than ever before, etc, etc, etc.
Oh and Meri your beloved NPR seems to agree:
http://apps.npr.org/unfit-for-work/
QuoteBut disability has also become a de facto welfare program for people without a lot of education or job skills. But it wasn't supposed to serve this purpose; it's not a retraining program designed to get people back onto their feet. Once people go onto disability, they almost never go back to work. Fewer than 1 percent of those who were on the federal program for disabled workers at the beginning of 2011 have returned to the workforce since then, one economist told me.
Quote from: derspiess on September 27, 2013, 09:56:33 AM
Then what reason would you give for skyrocketing disability claims?
Doctors that diagnose it, and the lawyers that argue it.
Quote from: derspiess on September 27, 2013, 10:07:42 AM
Once people go onto disability, they almost never go back to work.
Yeah, little rat bastards should be growing back those vertebrae on their own.
You can easily make $7500 a month at home by answering surveys, so how disabled do you have to be to be unable to work? Veggie-chick disabled?
Quote from: merithyn on September 27, 2013, 09:32:31 AM
How do you know that she's "most definitely not disabled"? Chronic "back pain" can absolutely make it impossible to work. Ask anyone who suffers from it.
She used to come in to work walking all slow and hunched over, all dramatic-like, but when she was in hot water for nonstop absenteeism related to this, one of our HR dudes caught her at Kroger walking normally, lifting her groceries into her SUV with no problems, etc. She also slipped a couple of times and mentioned how she had spent the weekend before waterskiing. Trust me, it's an act.
Quote from: derspiess on September 27, 2013, 10:07:42 AM
Oh and Meri your beloved NPR seems to agree:
:huh:
My "beloved" NPR? I listen to NPR because it's convenient and the least biased newsource in the area. That doesn't make it infallible.
Quote
http://apps.npr.org/unfit-for-work/
QuoteBut disability has also become a de facto welfare program for people without a lot of education or job skills. But it wasn't supposed to serve this purpose; it's not a retraining program designed to get people back onto their feet. Once people go onto disability, they almost never go back to work. Fewer than 1 percent of those who were on the federal program for disabled workers at the beginning of 2011 have returned to the workforce since then, one economist told me.
That's a ridiculous statement. Disability means that they are incapabe of working. How are they supposed to go back to work? If someone has congestive heart failure, they don't, generally, get better. If someone has missing or fused vertebrae in their back, it doesn't regrow. Lost limbs and eyesight from diabetes doesn't magically get better.
It doesn't make any sense to compare the two. Welfare is supposed to be a leg-up during tough times. Disability is supposed to help take care of people who are no longer able to work, but who haven't yet made it to retirement age.
Those aren't the only cases where disability is claimed. Quite a few are temporary conditions.
These people apparently got better:
https://www.youtube.com/watch?v=CNbhrvXHzuc
Quote from: derspiess on September 27, 2013, 10:34:41 AM
Those aren't the only cases where disability is claimed. Quite a few are temporary conditions.
These people apparently got better:
https://www.youtube.com/watch?v=CNbhrvXHzuc
How odd. This is what it says on the Social Security Online Benefits website:
QuoteWhat We Mean By "Disability"
Social Security's definition of disability is different than that of other programs. We pay only for total disability we do not pay for partial disability or for short-term disability.
Social Security's disability definition is based on your inability to work. We consider you disabled under Social Security rules if:
•you cannot do work that you did before,
•we decide that you cannot adjust to other work because of your medical condition(s), and
•your disability lasts or is expected to last for at least one year or to result in death.
Here is the list of allowed diagnoses: http://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm
Quote from: derspiess on September 27, 2013, 09:19:48 AM
Quote from: Caliga on September 27, 2013, 09:18:22 AM
But I thought Clinton ended welfare as we knew it? :hmm:
Some loopholes were left in. And disability is becoming the new welfare.
Do you understand how draconian that makes your society sound?
Quote from: crazy canuck on September 27, 2013, 10:52:57 AM
Do you understand how draconian that makes your society sound?
:o No :(
Quote from: crazy canuck on September 27, 2013, 10:52:57 AM
Do you understand how draconian that makes your society sound?
Yes, I do.
I can't speak for spiess, but I personally recognize the value of welfare. Every society has some people that cannot or will not work for whatever reason, and you can't just let these people starve to death in the streets.
I think it's ok to question people when it appears they may be abusing the system, though.
I actually believe in having something of a safety net. BUT NOT A SAFETY HAMMOCK OH SNAP :D
Quote from: Caliga on September 27, 2013, 10:56:57 AM
I can't speak for spiess, but I personally recognize the value of welfare. Every society has some people that cannot or will not work for whatever reason, and you can't just let these people starve to death in the streets.
I think it's ok to question people when it appears they may be abusing the system, though.
Absolutely. I agree on all points.
I was only saying that it's sometimes very hard to know if someone is faking it. There are an awful lot of illnesses out there that aren't obvious, like Crohn's, for instance.
I agree, and in the example I gave, I am 100% certain she is faking it. To give you another example, she used to claim her back hurt so bad that she just laid in bed all night and weekend, which is odd since she used to bug me nonstop on Facebook about going out on my boat. :hmm:
I found this video about the current state of the U.S. health care system interesting, an he offers a few points on why the costs in the U.S. are so much higher than elsewhere int he world (with not much additional benefit):
http://www.youtube.com/watch?v=qSjGouBmo0M
Can anyone with more knowledge on the issue advise whether he's broadly correct or if he's just a nut?
Quote from: Syt on September 27, 2013, 11:03:38 AM
I found this video about the current state of the U.S. health care system interesting, an he offers a few points on why the costs in the U.S. are so much higher than elsewhere int he world (with not much additional benefit):
http://www.youtube.com/watch?v=qSjGouBmo0M
Can anyone with more knowledge on the issue advise whether he's broadly correct or if he's just a nut?
That's pretty much my understanding of the situation, too.
Then without watching the video I'll vote "nut".
Just kidding, Meri :hug:
I agree with whoever said we should keep the streets clean.
Quote from: The Brain on September 27, 2013, 11:33:09 AM
I agree with whoever said we should keep the streets clean.
:hug:
Quote from: derspiess on September 27, 2013, 11:30:37 AM
Then without watching the video I'll vote "nut".
Basically, he says that health care in the U.S. is too expensive (other countries have equal or very similar level at much reduced costs) and that a number of factors contribute to it, not just one monolithic item (and that some things touted as cost drivers are almost negligible). Also, that reform will be long and hard.
lol
Quote from: CountDeMoney on September 27, 2013, 10:08:02 AM
Quote from: derspiess on September 27, 2013, 09:56:33 AM
Then what reason would you give for skyrocketing disability claims?
Doctors that diagnose it, and the lawyers that argue it.
This.
Oh, and DIB benefits are not a welfare, SSI almost is, but not DIB.
Quote from: Syt on September 27, 2013, 11:38:51 AM
Basically, he says that health care in the U.S. is too expensive (other countries have equal or very similar level at much reduced costs) and that a number of factors contribute to it, not just one monolithic item (and that some things touted as cost drivers are almost negligible). Also, that reform will be long and hard.
I thought he undercut his thesis with his comments about lack of bargaining ability.
Quote from: Syt on September 27, 2013, 11:38:51 AM
Quote from: derspiess on September 27, 2013, 11:30:37 AM
Then without watching the video I'll vote "nut".
Basically, he says that health care in the U.S. is too expensive (other countries have equal or very similar level at much reduced costs) and that a number of factors contribute to it, not just one monolithic item (and that some things touted as cost drivers are almost negligible). Also, that reform will be long and hard.
Yes, but I think the big point he makes is that single payor systems are able to control costs much more efficiently as most people or entities in the US cannot negotiate for a competitive effective price on their own.
Quote from: Admiral Yi on September 27, 2013, 11:47:08 AM
Quote from: Syt on September 27, 2013, 11:38:51 AM
Basically, he says that health care in the U.S. is too expensive (other countries have equal or very similar level at much reduced costs) and that a number of factors contribute to it, not just one monolithic item (and that some things touted as cost drivers are almost negligible). Also, that reform will be long and hard.
I thought he undercut his thesis with his comments about lack of bargaining ability.
You disagree with that part? I thought that that was a gimme.
Quote from: merithyn on September 27, 2013, 12:01:52 PM
You disagree with that part? I thought that that was a gimme.
I think he undercut his thesis about the complexity of the problem, the many contributing factors, the hard work to fix it, etc., by the way he talked about bargaining.
Quote from: Caliga on September 27, 2013, 11:02:02 AM
I agree, and in the example I gave, I am 100% certain she is faking it. To give you another example, she used to claim her back hurt so bad that she just laid in bed all night and weekend, which is odd since she used to bug me nonstop on Facebook about going out on my boat. :hmm:
Ah, kentuckians and the so called 'crazy check'. They do love them some SSI checks.
West Virginians, too. See: http://movies.netflix.com/WiMovie/The_Wild_and_Wonderful_Whites_of_West_Virginia/70117032?sod=search-autocomplete
Quote from: derspiess on September 27, 2013, 12:23:54 PM
West Virginians, too. See: http://movies.netflix.com/WiMovie/The_Wild_and_Wonderful_Whites_of_West_Virginia/70117032?sod=search-autocomplete
I want a crazy check too. :(
*checks* Yup.
Quote from: Ed Anger on September 27, 2013, 12:27:17 PM
I want a crazy check too. :(
Not me. Even with the pittance that I make, that check isn't nearly enough to live on.
Quote from: merithyn on September 27, 2013, 12:35:51 PM
Quote from: Ed Anger on September 27, 2013, 12:27:17 PM
I want a crazy check too. :(
Not me. Even with the pittance that I make, that check isn't nearly enough to live on.
Then supplement your crazy check with re-selling prescription painkillers, like they do in Appalachia.
Quote from: merithyn on September 27, 2013, 12:35:51 PM
Quote from: Ed Anger on September 27, 2013, 12:27:17 PM
I want a crazy check too. :(
Not me. Even with the pittance that I make, that check isn't nearly enough to live on.
Your check would go to your husband. :rolleyes:
He's not crazy, just Canadian.
Quote from: Ed Anger on September 27, 2013, 03:53:36 PM
Quote from: merithyn on September 27, 2013, 12:35:51 PM
Quote from: Ed Anger on September 27, 2013, 12:27:17 PM
I want a crazy check too. :(
Not me. Even with the pittance that I make, that check isn't nearly enough to live on.
Your check would go to your husband. :rolleyes:
:lmfao:
They don't have time for your back talk down there.
Quote from: derspiess on September 27, 2013, 09:56:33 AM
Quote from: merithyn on September 27, 2013, 09:26:36 AM
That's a total joke to call it the "new welfare". There's a massive difference between the two.
Then what reason would you give for skyrocketing disability claims?
Technology and kinder society prevents the ordinary number of people from keeling over, dying.
Quote from: Ideologue on September 27, 2013, 05:22:11 PM
Technology and kinder society prevents the ordinary number of people from keeling over, dying.
Republicans are trying their best, though.
Quote from: Admiral Yi on September 27, 2013, 12:05:07 PM
I think he undercut his thesis about the complexity of the problem, the many contributing factors, the hard work to fix it, etc., by the way he talked about bargaining.
Given that the lack of bargaining power is a key factor in the differences in health care costs, I disagree. The presentation was obviously simplified, but I think he hit on the major points, and his cost estimates were probably about right.
So is this a valid criticism of the situation?
http://www.nationalreview.com/article/360342/obamacare-sickens-american-workers-deroy-murdock
QuoteObamacare Sickens American Workers
Companies across the country drop insurance coverage and dump workers onto exchanges.
By Deroy Murdock
Democrats landed on Earth to nurture working Americans. How ironic, then, that Obamacare is hammering U.S. laborers. From terminated coverage to truncated schedules, the Democrats' reputed constituency is paying dearly for Obama's massive, $2.6 trillion health-care "reform."
"If you like your health-care plan, you will be able to keep your health-care plan. Period," Obama infamously claimed while peddling the so-called Affordable Care Act (ACA). "No one will take it away. No matter what." These words will trail Obama for life, just as "Read my lips: No new taxes" will mock Daddy Bush forever.
Companies — major and minor — have dropped workers from their health plans and dumped them onto Obamacare's exchanges, which sputtered to life on Tuesday.
• As The Weekly Standard's Ben Schachter reports, the insurer for the American Federation of Television and Radio Artists, the Dramatists Guild, and the Graphic Arts Guild announced: "All individual and/or Sole Proprietor Health Insurance will terminate January 1, 2014."
• "Provisions of the federal Affordable Care Act are projected to add $7.3 million to the cost of the University [of Virginia] health plan in 2014 alone," UVA Today reported. "Starting Jan. 1, spouses who have access to coverage through their own employer will no longer be eligible for coverage under U.Va.'s plan."
• The 81-store Wegmans grocery chain will stop insuring employees who work between 20 and 30 hours per week.
• Trader Joe's CEO Dan Bane stated that employees who work fewer than 30 hours per week will receive a stipend and best wishes next year as they enter Obamacare's exchanges. "We believe that with the $500 from Trader Joe's and the tax credits available under the ACA," Bane wrote his staffers, "many of you should be able to obtain health care coverage at very little if any net cost to you."
• To save some $60 million annually, UPS will stop covering 15,000 spouses of non-union employees with access to insurance elsewhere. Higher medical expenses, "combined with the costs associated with the Affordable Care Act, have made it increasingly difficult to continue providing the same level of health care benefits to our employees at an affordable cost," a UPS memo explained.
In a Market Watch article titled "Why your boss is dumping your wife," Jen Wieczner observes: "Next year, 12 percent of employers plan to exclude spouses, up from 4 percent this year, according to a recent Towers Watson survey." Ball State University and pump-maker Flowserve are among those now hurling spouses overboard.
• Home Depot will subject some 20,000 part-timers to Obamacare. As spokesman Stephen Holmes told The Daily Caller, "Unfortunately, the ACA precludes us from offering the limited liability medical plan we've been offering the part-time associates."
"Obamacare is going to kill off small business," Home Depot founder Bernie Marcus warned last April. "Obamacare is the capper. That's the bullet to the temple."
• Securitas, America's largest supplier of security guards, will ditch its low-cost coverage and direct 55,000 of its employees into Obamacare.
• Roughly 160,000 Walgreens drug-store employees will be driven into private-insurance exchanges.
Just like the stereotype of a banker-loving, secretary-hating greedy Republican, Obama postponed the employer mandate until 2015 while leaving the individual mandate intact. This has been good news in corporate boardrooms and bad news in company lunchrooms. In the New York Post, Cato Institute senior fellow Michael Tanner captured the immoral absurdity of Obama's sop to the 1 percent: "Workers may now face a situation where they'll be legally required to buy their own insurance or pay a penalty because their employers take advantage of the delay and don't provide coverage."
"We are hearing from our members who are concerned about what is happening with their companies," Janna Pea of America's Retail, Wholesale and Department Store Union told The Guardian, London's leading left-wing daily. "Not only are they looking at having their health-care coverage cut, they are also looking at less hours."
Indeed, Investor's Business Daily's Jed Graham documents 313 employers who have cut workers' hours, outsourced their positions, or simply eliminated them outright. So far — because assigning staffers to 30 or fewer hours spares employers from new penalties for not providing insurance — at least 30,377 Americans are working shorter shifts (if any), thanks to Obamacare.
IBD's excellent coverage of this tragic trend, by definition, includes only cutbacks that generate headlines.
"No such list would be really 'complete,' because the information likely would have to be carried in the news for anyone to know about it," explains health-policy scholar Merrill Matthews of the Institute for Policy Innovation in Dallas. "For example, a teller at a local branch of Bank of America told me that she was looking for another job about a month ago. When I asked why, she said that all of the full-time tellers were being switched to part time. I said, 'Don't tell me; let me guess — to under 30 hours?'"
"'Yep,' she said. She was too old (over 50) to have to work two part-time jobs. And no one will know about that because it isn't in the news."
So, Obama's original lies notwithstanding, if you like your health plan, Obamacare can crush it. And if you like your full-time job, Obamacare can turn you into a part-timer — or just unemploy you.
Obamacare swiftly is becoming the biggest bait-and-switch in American history.
Quote from: jimmy olsen on October 06, 2013, 06:54:16 PM
So is this a valid criticism of the situation?
http://www.nationalreview.com/article/360342/obamacare-sickens-american-workers-deroy-murdock
QuoteObamacare Sickens American Workers
Companies across the country drop insurance coverage and dump workers onto exchanges.
By Deroy Murdock
Democrats landed on Earth to nurture working Americans. How ironic, then, that Obamacare is hammering U.S. laborers. From terminated coverage to truncated schedules, the Democrats' reputed constituency is paying dearly for Obama's massive, $2.6 trillion health-care "reform."
"If you like your health-care plan, you will be able to keep your health-care plan. Period," Obama infamously claimed while peddling the so-called Affordable Care Act (ACA). "No one will take it away. No matter what." These words will trail Obama for life, just as "Read my lips: No new taxes" will mock Daddy Bush forever.
......
.
Given the tone of the first three lines, I'm gonna say it's not an impartial assessment.
It doesn't have to be impartial, as long as the facts reported therein are true. That's what I want to know, are lots of corporations dumping their employees on to the exchanges?
Does it matter if they haunt him forever? Unlike Bush he's not running for reelection. That haunting had consequences :mellow:
Quote from: jimmy olsen on October 06, 2013, 07:08:34 PM
It doesn't have to be impartial, as long as the facts reported therein are true. That's what I want to know, are lots of corporations dumping their employees on to the exchanges?
Tim, the left wing liberaltards and their like, will downplay anything related to what you talk about.
Why wouldnt a company not shift it's people to Nobamacare? They are in business for the money. How much would they save, dumping 20,000 peoples healthcare?
Quote from: 11B4V on October 06, 2013, 07:19:04 PM
Quote from: jimmy olsen on October 06, 2013, 07:08:34 PM
It doesn't have to be impartial, as long as the facts reported therein are true. That's what I want to know, are lots of corporations dumping their employees on to the exchanges?
Tim, the left wing liberaltards and their like, will downplay anything related to what you talk about.
Why wouldnt a company not shift it's people to Nobamacare? They are in business for the money. How much would they save, dumping 20,000 peoples healthcare?
You notice how you make an ass of yourself in the first sentence? You probably shouldn't do that. Makes you harder to take seriously.
Quote from: Razgovory on October 06, 2013, 07:24:36 PM
You notice how you make an ass of yourself in the first sentence? You probably shouldn't do that. Makes you harder to take seriously.
There's been a gap for faux conservatism since Fate stopped hanging around here, so Bravo decided to step in(and more ambiguously I might add).
Quote from: Peter Wiggin on October 06, 2013, 07:29:44 PM
Quote from: Razgovory on October 06, 2013, 07:24:36 PM
You notice how you make an ass of yourself in the first sentence? You probably shouldn't do that. Makes you harder to take seriously.
There's been a gap for faux conservatism since Fate stopped hanging around here, so Bravo decided to step in(and more ambiguously I might add).
Someone has to play devil's advocate here. Christ, there wouldnt be a forum if all you liberaltards agreed. Just the Gaming Section, Ide's Movie Thread, and Off Topic Topic thread.
Quote from: Razgovory on October 06, 2013, 07:24:36 PM
Quote from: 11B4V on October 06, 2013, 07:19:04 PM
Quote from: jimmy olsen on October 06, 2013, 07:08:34 PM
It doesn't have to be impartial, as long as the facts reported therein are true. That's what I want to know, are lots of corporations dumping their employees on to the exchanges?
Tim, the left wing liberaltards and their like, will downplay anything related to what you talk about.
Why wouldnt a company not shift it's people to Nobamacare? They are in business for the money. How much would they save, dumping 20,000 peoples healthcare?
You notice how you make an ass of yourself in the first sentence? You probably shouldn't do that. Makes you harder to take seriously.
So, your saying businesses are not dumping their employee's healthcare and sending them to Nobamacare.
Quote from: 11B4V on October 06, 2013, 08:00:47 PM
Quote from: Peter Wiggin on October 06, 2013, 07:29:44 PM
Quote from: Razgovory on October 06, 2013, 07:24:36 PM
You notice how you make an ass of yourself in the first sentence? You probably shouldn't do that. Makes you harder to take seriously.
There's been a gap for faux conservatism since Fate stopped hanging around here, so Bravo decided to step in(and more ambiguously I might add).
Someone has to play devil's advocate here. Christ, there wouldnt be a forum if all you liberaltards agreed. Just the Gaming Section, Ide's Movie Thread, and Off Topic Topic thread.
We are one big happy fleet!
Those are the best parts of the forum. Languish debates have sucked since 2003.
Fuck you
nobamafuckingway
Quote from: jimmy olsen on October 06, 2013, 07:08:34 PM
It doesn't have to be impartial, as long as the facts reported therein are true. That's what I want to know, are lots of corporations dumping their employees on to the exchanges?
Some surely are, but Wegmans had already dumped coverage for employees with 20 hours or less, and is now dumping the ones working 20-30 hours. Would they have dumped these workers under Bushcare? Maybe. Not every change is for the better for every person affected by it.
I certainly wouldn't consider this articles "facts" to be anything to base an opinion on, however.
Quote from: 11B4V on October 06, 2013, 08:02:53 PM
So, your saying businesses are not dumping their employee's healthcare and sending them to Nobamacare.
Businesses have been dumping health care for years. Republitards thought it was great under Bushcare, but now that it is happening under Obamacare, they think it is worse than the Holocaust. It's hysterical for us moderates to watch. All you 'tards are so predictable.
Quote from: grumbler on October 06, 2013, 08:27:01 PM
Quote from: 11B4V on October 06, 2013, 08:02:53 PM
So, your saying businesses are not dumping their employee's healthcare and sending them to Nobamacare.
All you 'tards are so predictable.
As well as you flip floppers.
so, bronze cover 60%, silver 70, gold 80, and platinium 90?
what are the prices per?
Quote from: Siege on October 06, 2013, 09:22:24 PM
so, bronze cover 60%, silver 70, gold 80, and platinium 90?
what are the prices per?
and what are the deductibles.
Quote from: Siege on October 06, 2013, 09:22:24 PM
so, bronze cover 60%, silver 70, gold 80, and platinium 90?
what are the prices per?
They vary by state.
This is so bad is not even funny.
I hope Tricare doesnt get affected by this craziness.
Your healthcare system is insane.
I went on the site for shits and giggles. First page shows what looks to be a black/asian/mexican female. Second page was two asians female. Third page had a black female in a moo-moo. :lol: Talk about sterotyping.
A Vermont plan would cost me 650$/month for my family.
Is that alot?
Quote from: Grey Fox on October 06, 2013, 09:35:53 PM
A Vermont plan would cost me 650$/month for my family.
Is that alot?
IMO that's outragious
Quote from: Siege on October 06, 2013, 09:28:57 PM
I hope Tricare doesnt get affected by this craziness.
Tricare is already a big steaming pile of crap (for us non-dependents, anyway).
Quote from: 11B4V on October 06, 2013, 09:41:06 PM
Quote from: Grey Fox on October 06, 2013, 09:35:53 PM
A Vermont plan would cost me 650$/month for my family.
Is that alot?
IMO that's outragious
I'm pretty sure that your plan costs more than that. The difference is that your employer pays a portion, whereas, GF's plan is for personal.
Quote from: merithyn on October 06, 2013, 09:45:08 PM
I'm pretty sure that your plan costs more than that. The difference is that your employer pays a portion, whereas, GF's plan is for personal.
Before doesn't have any chilluns I don't think.
Quote from: Admiral Yi on October 06, 2013, 09:50:35 PM
Quote from: merithyn on October 06, 2013, 09:45:08 PM
I'm pretty sure that your plan costs more than that. The difference is that your employer pays a portion, whereas, GF's plan is for personal.
Before doesn't have any chilluns I don't think.
An 8 y/o and me. $500.00 a year or $42 a month.
Quote from: 11B4V on October 06, 2013, 09:54:35 PM
Quote from: Admiral Yi on October 06, 2013, 09:50:35 PM
Quote from: merithyn on October 06, 2013, 09:45:08 PM
I'm pretty sure that your plan costs more than that. The difference is that your employer pays a portion, whereas, GF's plan is for personal.
Before doesn't have any chilluns I don't think.
An 8 y/o and me. $500.00 a year or $42 a month.
Meri's point still applies.
Quote from: DGuller on October 06, 2013, 10:10:11 PM
Quote from: 11B4V on October 06, 2013, 09:54:35 PM
Quote from: Admiral Yi on October 06, 2013, 09:50:35 PM
Quote from: merithyn on October 06, 2013, 09:45:08 PM
I'm pretty sure that your plan costs more than that. The difference is that your employer pays a portion, whereas, GF's plan is for personal.
Before doesn't have any chilluns I don't think.
An 8 y/o and me. $500.00 a year or $42 a month.
Meri's point still applies.
So GF paying 640.00 a month or Seedy paying 300.00 (IIRC) out of his pocket for a Nobamacare plan, equates to me paying 42.00 a month outta mine. Gottcha.
Is that the math liberals do?
Don't be a doofus Before. Your insurance probably costs around that much, it's just you have an employer who's picking up the tab.
Quote from: Admiral Yi on October 06, 2013, 10:27:09 PM
Don't be a doofus Before. Your insurance probably costs around that much, it's just you have an employer who's picking up the tab.
Exactly. But that's not the point. My plan does not cost me 650.00/mo out of my pocket now does it?
Quote from: 11B4V on October 06, 2013, 10:30:55 PM
Exactly. But that's not the point. My plan does not cost me 650.00/mo out of my pocket now does it?
What's the point.
Quote from: Admiral Yi on October 06, 2013, 10:32:00 PM
Quote from: 11B4V on October 06, 2013, 10:30:55 PM
Exactly. But that's not the point. My plan does not cost me 650.00/mo out of my pocket now does it?
What's the point.
It doesnt cost me 650.00/mo outta my pocket. If GF has an employer lets say, and
doesnt cover him with healthcare, Nobamacare still costs him 650.00/mo outta pocket.
Quote from: 11B4V on October 06, 2013, 10:33:53 PMIt doesnt cost me 650.00/mo outta my pocket. If GF has an employer lets say, and doesnt cover him with healthcare, Nobamacare still costs him 650.00/mo.
If you ignore the tax credits and subsidy he'll get, of course. I'm pretty sure he qualifies for a fair bit.
Quote from: Jacob on October 06, 2013, 10:38:25 PM
Quote from: 11B4V on October 06, 2013, 10:33:53 PMIt doesnt cost me 650.00/mo outta my pocket. If GF has an employer lets say, and doesnt cover him with healthcare, Nobamacare still costs him 650.00/mo.
If you ignore the tax credits and subsidy he'll get, of course. I'm pretty sure he qualifies for a fair bit.
Then we need to know that number dont we. His final otta pocket.
I still don't see what the point is. We already knew how much you paid out of pocket and we already knew how much Brown Wolf would have to pay in Vermont.
Quote from: Admiral Yi on October 06, 2013, 10:42:13 PM
I still don't see what the point is. We already knew how much you paid out of pocket and we already knew how much Brown Wolf would have to pay in Vermont.
Apparently Meri doesnt.
tis so confusing.
I went to go see how much it would cost me if I suddenly wasn't covered by my employer anymore:
QuoteThe system is down at the moment.
:(
Before, you're really tiresome. You're other doing this trolling thing very wrong, or very right.
Quote from: DGuller on October 06, 2013, 11:06:44 PM
Before, you're really tiresome. You're other doing this trolling thing very wrong, or very right.
Someone explain how someone paying 650/mo to my 42/mo outta pocket is the same. Hell lets even drop it to 300/mo with help from the US Gov. It doesnt matter if my plan costs 10k/mo and my employer picks up 99.5% (or whatever percentage) of it. It still only costs
me 42/mo outta pocket. For sake of conversation, his employer doesnt offer healthcare insurance. Someone explain how!!!!!!!!
QuoteI'm pretty sure that your plan costs more than that. The difference is that your employer pays a portion, whereas, GF's plan is for personal.
Here is Meri's statement when I said it was outrageous. Her statement doesnt matter when were are talking about outta pocket.
:hmm:
It's not the same. :mellow:
Quote from: garbon on October 06, 2013, 11:18:05 PM
:hmm:
Not trolling here G-man. Someone explain the math.
Quote from: 11B4V on October 06, 2013, 08:00:47 PM
Quote from: Peter Wiggin on October 06, 2013, 07:29:44 PM
Quote from: Razgovory on October 06, 2013, 07:24:36 PM
You notice how you make an ass of yourself in the first sentence? You probably shouldn't do that. Makes you harder to take seriously.
There's been a gap for faux conservatism since Fate stopped hanging around here, so Bravo decided to step in(and more ambiguously I might add).
Someone has to play devil's advocate here. Christ, there wouldnt be a forum if all you liberaltards agreed. Just the Gaming Section, Ide's Movie Thread, and Off Topic Topic thread.
So you're saying it would be great?
Anyway, I think Obamacare sucks, I've always said so. I've got to start paying for insurance.
Now, I want insurance, but either 1)I want it to be a form of compensation on top of my crappy wage or 2)I just want someone else to pay for it.
Serious question: will IBR be adjusted in any way by the ACA? I'm paying (well, I was paying, before I went into temp roller coaster mode) $400 a month to my loan servicer. If I am forced to pay for health insurance, that's a de facto reduction in income, and I want my SL payments reduced commensurately. If not, and if I have to start paying $100-300 a month in health insurance (as I expect I will since I doubt at my rate, and going by last year's tax returns, I'm entitled to any subsidy), I'm afraid it'll bring me that much closer to destitution. I don't like destitution. I want to buy a new car and maybe, one day, a fucking house.
And I'm a permatemp. What happens to my premium when I'm laid off, as I am constantly?
Quote from: 11B4V on October 06, 2013, 11:14:13 PM
Quote from: DGuller on October 06, 2013, 11:06:44 PM
Before, you're really tiresome. You're other doing this trolling thing very wrong, or very right.
Someone explain how someone paying 650/mo to my 42/mo outta pocket is the same. Hell lets even drop it to 300/mo with help from the US Gov. It doesnt matter if my plan costs 10k/mo and my employer picks up 99.5% (or whatever percentage) of it. It still only costs me 42/mo outta pocket. For sake of conversation, his employer doesnt offer healthcare insurance. Someone explain how!!!!!!!!
QuoteI'm pretty sure that your plan costs more than that. The difference is that your employer pays a portion, whereas, GF's plan is for personal.
Here is Meri's statement when I said it was outrageous. Her statement doesnt matter when were are talking about outta pocket.
It's simple: even if your employer pays for some of your health insurance premium, ultimately you still pay for it. The cost of benefits is part of your compensation package.
Quote from: DGuller on October 06, 2013, 11:29:33 PM
Quote from: 11B4V on October 06, 2013, 11:14:13 PM
Quote from: DGuller on October 06, 2013, 11:06:44 PM
Before, you're really tiresome. You're other doing this trolling thing very wrong, or very right.
Someone explain how someone paying 650/mo to my 42/mo outta pocket is the same. Hell lets even drop it to 300/mo with help from the US Gov. It doesnt matter if my plan costs 10k/mo and my employer picks up 99.5% (or whatever percentage) of it. It still only costs me 42/mo outta pocket. For sake of conversation, his employer doesnt offer healthcare insurance. Someone explain how!!!!!!!!
QuoteI'm pretty sure that your plan costs more than that. The difference is that your employer pays a portion, whereas, GF's plan is for personal.
Here is Meri's statement when I said it was outrageous. Her statement doesnt matter when were are talking about outta pocket.
It's simple: even if your employer pays for some of your health insurance premium, ultimately you still pay for it. The cost of benefits is part of your compensation package.
The insurance went up 40.00 since 2004. My retired pay has increased by 400.00 in the same amount of time. Sorry still dont get it.
What do you not get? :huh:
On the plus side, if I do have to get insurance, I'm getting drugged up as fuck. Uppers, downers, screamers, laughers, hope, and change.
Quote from: 11B4V on October 06, 2013, 11:33:00 PM
The insurance went up 40.00 since 2004. My retired pay has increased by 400.00 in the same amount of time. Sorry still dont get it.
I don't think you want to get it, so I'll stop wasting my time.
Quote from: Admiral Yi on October 06, 2013, 11:34:47 PM
What do you not get? :huh:
How him paying 650/mo is the same as me paying 42/mo.
Quote from: DGuller on October 06, 2013, 11:37:10 PM
Quote from: 11B4V on October 06, 2013, 11:33:00 PM
The insurance went up 40.00 since 2004. My retired pay has increased by 400.00 in the same amount of time. Sorry still dont get it.
I don't think you want to get it, so I'll stop wasting my time.
There you are wrong.
Quote from: 11B4V on October 06, 2013, 11:37:38 PM
How him paying 650/mo is the same as me paying 42/mo.
It's not. I already said this. 42 is only two digits and begins with a 4. It's less than 650.
Thing is, the question is whether the act will increase or decrease the actual cost of health care. Not whether some employers will use it as an excuse to cut benefits.
I think there are a number of valid concerns.
Will the surge in demand significantly raise health care costs?
Will the employer mandate lead to more unemployment and/or further shifts from full time to part time employment?
Will it significantly increase the deficit?
I had an idea before was an idiot, nice to see it confirmed. :lol:
Quote from: sbr on October 07, 2013, 12:38:25 AM
I had an idea before was an idiot, nice to see it confirmed. :lol:
I'm not real sure the extent to which he's trolling. I'm not sure he knows either. :hmm:
Quote from: sbr on October 07, 2013, 12:38:25 AM
I had an idea before was an idiot, nice to see it confirmed. :lol:
Prove your statement then. Dont talk shit. Prove it.
Quote from: Peter Wiggin on October 07, 2013, 12:57:09 AM
Quote from: sbr on October 07, 2013, 12:38:25 AM
I had an idea before was an idiot, nice to see it confirmed. :lol:
I'm not real sure the extent to which he's trolling. I'm not sure he knows either. :hmm:
Someone explain in the extreme case of 650/mo vs. 42/mo and how it benefits GF. I'll even let you close the gap and add what I pay for dental which is 118/mo to my total.
How is this good for a up and coming lower middle class family for example.
No trolling here. The numbers a'int adding up to me.
Quote from: 11B4V on October 07, 2013, 01:14:42 AM
Someone explain in the extreme case of 650/mo vs. 42/mo and how it benefits GF. I'll even let you close the gap and add what I pay for dental which is 118/mo to my total.
How is this good for a up and coming lower middle class family for example.
No trolling here. The numbers a'int adding up to me.
GF benefits by living in Quebec and not having to pay 650/month. You benefit by having a job that pays most of your health care. The guy in Vermont who doesn't have a job like that is the one who's screwed.
Companies who cut benefits due to Obamacare will have the same drawbacks as companies who cut pay- some of their employees will find work elsewhere.
Quote from: Peter Wiggin on October 07, 2013, 01:25:30 AM
Quote from: 11B4V on October 07, 2013, 01:14:42 AM
Someone explain in the extreme case of 650/mo vs. 42/mo and how it benefits GF. I'll even let you close the gap and add what I pay for dental which is 118/mo to my total.
How is this good for a up and coming lower middle class family for example.
No trolling here. The numbers a'int adding up to me.
GF benefits by living in Quebec and not having to pay 650/month. You benefit by having a job that pays most of your health care. The guy in Vermont who doesn't have a job like that is the one who's screwed.
Companies who cut benefits due to Obamacare will have the same drawbacks as companies who cut pay- some of their employees will find work elsewhere.
Sorry didn't know GF was Canadian. But your statement on Vermont guy is what concerns me.
@11B Liberaltards think individual mandate healthcare system are insane but the US Liberaltards take what they can.
I'd probably qualify for some tax credits but there is no way to know since to find that out I have to filled a real application & I think they'll know I'm not an American.
To be fair the system also said that I could qualify for medicaid.
To me the difference between me paying an hypothetical 650/mo and your 42/mo is that before I couldn't get insurance because of pre-existing conditions or other such nonsense. Yeah, it's expensive but so is getting cancer care.
I have a 11 weeks old at home, what if he has type 1 diabetes? No insurance for him his entire life?
Quote from: 11B4V on October 07, 2013, 01:41:45 AM
Sorry didn't know GF was Canadian. But your statement on Vermont guy is what concerns me.
I don't understand how a Canadian is the same as a guy from Vermont. B4tard math doesn't add up for me.
Quote from: 11B4V on October 07, 2013, 01:05:15 AM
Quote from: sbr on October 07, 2013, 12:38:25 AM
I had an idea before was an idiot, nice to see it confirmed. :lol:
Prove your statement then. Dont talk shit. Prove it.
No need to prove it myself, you are doing a fine job yourself.
To spell it out a bit more (though I think Yi already mentioned this), the Vermont guy will have to pay $650/month out of pocket for his insurance because his employer isn't paying anything for his. The assumption is that his job will also pay him more in salary to make up for not offering insurance, so that they will entice good employees from other companies who do offer paid health insurance.
You, B4, are paying $40/month out of pocket. (And so we're clear, that's $20/paycheck? Or is it $40/paycheck? A lot of people get that confused.) However, a part of your monthly pay goes toward covering the rest of your insurance.
So, what your company pays for insurance is considered part of your salary. You may not be paying for it from your checking account, but you are paying for it from your wages. That has to be factored into it in order to compare apples to apples.
I thought Vermont was one of the States that had instituted state level single payer?
Quote from: OttoVonBismarck on October 07, 2013, 09:11:11 AM
I thought Vermont was one of the States that had instituted state level single payer?
They voted it in, yes. It hasn't been fully implemented yet, Obamacare is part of the process.
I found Vermont's subsidy calculator : http://info.healthconnect.vermont.gov/tax_credit_calculator
It takes my previous 650$/mo and takes it down to 215$/mo for a silverplan.
I'm sorry if I cause un necessary trolling, this is confusing to get acquainted with. I've never had an interest into that crazyness before.
Quote from: merithyn on October 07, 2013, 08:29:57 AM
To spell it out a bit more (though I think Yi already mentioned this), the Vermont guy will have to pay $650/month out of pocket for his insurance because his employer isn't paying anything for his. The assumption is that his job will also pay him more in salary to make up for not offering insurance, so that they will entice good employees from other companies who do offer paid health insurance.
You, B4, are paying $40/month out of pocket. (And so we're clear, that's $20/paycheck? Or is it $40/paycheck? A lot of people get that confused.) However, a part of your monthly pay goes toward covering the rest of your insurance.
So, what your company pays for insurance is considered part of your salary. You may not be paying for it from your checking account, but you are paying for it from your wages. That has to be factored into it in order to compare apples to apples.
Thank you
Quote from: grumbler on October 07, 2013, 06:18:28 AM
Quote from: 11B4V on October 07, 2013, 01:41:45 AM
Sorry didn't know GF was Canadian. But your statement on Vermont guy is what concerns me.
I don't understand how a Canadian is the same as a guy from Vermont. B4tard math doesn't add up for me.
Are you senile?
Quote from: sbr on October 07, 2013, 07:50:08 AM
Quote from: 11B4V on October 07, 2013, 01:05:15 AM
Quote from: sbr on October 07, 2013, 12:38:25 AM
I had an idea before was an idiot, nice to see it confirmed. :lol:
Prove your statement then. Dont talk shit. Prove it.
No need to prove it myself, you are doing a fine job yourself.
:rolleyes:
Dude, you are flailing around out there.
Quote from: Razgovory on October 07, 2013, 09:47:51 AM
Dude, you are flailing around out there.
Dude, Meri provided what I was asking to her credit.
Shouldnt you be spending time on the HC exchanges? Where's my $20 fucker?
Quote from: Admiral Yi on October 07, 2013, 12:14:54 AM
I think there are a number of valid concerns.
Will the surge in demand significantly raise health care costs?
Will the employer mandate lead to more unemployment and/or further shifts from full time to part time employment?
Will it significantly increase the deficit?
I agree with all of these concerns. The ACA isn't pretty. It has a LOT of issues. But it's a start toward getting healthcare coverage to everyone. You can't tell insurance companies that they have to insure even the most uninsurable without giving them some way to also make money on it. The mandates are meant to do that.
So long as we continue to use private insurance companies, there are going to be some issues to deal with. I still think that private insurance with government subsidies is the better option (like how Medicare works). But it's a work in progress, and it will take time to shake it into the best process for most people.
Quote from: 11B4V on October 07, 2013, 09:54:52 AM
Dude, Meri provided what I was asking to her credit.
Sorry it took so long. I was working on my C++ homework. :glare:
Quote from: 11B4V on October 07, 2013, 09:54:52 AM
Quote from: Razgovory on October 07, 2013, 09:47:51 AM
Dude, you are flailing around out there.
Dude, Meri provided what I was asking to her credit.
Shouldnt you be spending time on the HC exchanges? Where's my $20 fucker?
You need to send me your address before I can send you any money in the mail. I keep asking you about that. PM me.
Quote from: Razgovory on October 07, 2013, 10:02:01 AM
Quote from: 11B4V on October 07, 2013, 09:54:52 AM
Quote from: Razgovory on October 07, 2013, 09:47:51 AM
Dude, you are flailing around out there.
Dude, Meri provided what I was asking to her credit.
Shouldnt you be spending time on the HC exchanges? Where's my $20 fucker?
You need to send me your address before I can send you any money in the mail. I keep asking you about that. PM me.
Dont worry about it. You need it more than me.
Get a paypal account for Christ's sake. And I'm the one that gets called idiot. :rolleyes:
Quote from: merithyn on October 07, 2013, 10:01:33 AM
Quote from: 11B4V on October 07, 2013, 09:54:52 AM
Dude, Meri provided what I was asking to her credit.
Sorry it took so long. I was working on my C++ homework. :glare:
NP. I just wasn't seeing your point.
Quote from: jimmy olsen on October 06, 2013, 06:54:16 PM
So is this a valid criticism of the situation?
http://www.nationalreview.com/article/360342/obamacare-sickens-american-workers-deroy-murdock
The big flaw I see in this is the assumption that people moving from employer-based coverage to the exchanges is a bad thing.
I'm not sure the exchanges are a good idea, but I'm practically certain they are a better idea than employer-based.
Losing the employer's contribution to the premium is almost certainly a bad thing from the employee's POV.
Quote from: 11B4V on October 07, 2013, 09:43:00 AM
Quote from: grumbler on October 07, 2013, 06:18:28 AM
Quote from: 11B4V on October 07, 2013, 01:41:45 AM
Sorry didn't know GF was Canadian. But your statement on Vermont guy is what concerns me.
I don't understand how a Canadian is the same as a guy from Vermont. B4tard math doesn't add up for me.
Are you senile?
:lmfao: No, I was imitating a moronic post. Seems to have hit a nerve.
Quote from: Admiral Yi on October 07, 2013, 11:24:30 AM
Losing the employer's contribution to the premium is almost certainly a bad thing from the employee's POV.
In that case I suspect the employee's POV is flawed.
Not that that makes you wrong, but you'll notice I'm saying it is a positive, not that it will be positively viewed.
Quote from: Maximus on October 07, 2013, 11:29:57 AM
In that case I suspect the employee's POV is flawed.
You've lost me Max. How is a preference for paying $200 month vs. $400 a month indicative of a flawed perspective?
Quote from: Admiral Yi on October 07, 2013, 11:32:17 AM
Quote from: Maximus on October 07, 2013, 11:29:57 AM
In that case I suspect the employee's POV is flawed.
You've lost me Max. How is a preference for paying $200 month vs. $400 a month indicative of a flawed perspective?
Because they get to choose their own plans, which gives more flexibility in coverage plans, deductibles, physician groups, etc.
Depending on what plans are chosen, they may not have to pay more per month.
Quote from: Admiral Yi on October 07, 2013, 11:32:17 AM
Quote from: Maximus on October 07, 2013, 11:29:57 AM
In that case I suspect the employee's POV is flawed.
You've lost me Max. How is a preference for paying $200 month vs. $400 a month indicative of a flawed perspective?
The employer contribution is coming out of their other compensation. Granted many will not see it this way.
In the long term, removing employer contributions should cause other compensation to rise accordingly, but insurance costs will rise immediately, which makes it hard to see the positive. The positive being what Meri outlined.
Fair enough. :thumbsup:
Quote from: grumbler on October 07, 2013, 11:24:46 AM
Quote from: 11B4V on October 07, 2013, 09:43:00 AM
Quote from: grumbler on October 07, 2013, 06:18:28 AM
Quote from: 11B4V on October 07, 2013, 01:41:45 AM
Sorry didn't know GF was Canadian. But your statement on Vermont guy is what concerns me.
I don't understand how a Canadian is the same as a guy from Vermont. B4tard math doesn't add up for me.
Are you senile?
:lmfao: No, I was imitating a moronic post. Seems to have hit a nerve.
I'm sorry that you are never wrong
or will ever admit your wrong
Isn't that right "Little Boat" man.
Meri has more character than you could ever hope to have. :lol:
Quote from: Maximus on October 07, 2013, 11:43:20 AM
In the long term, removing employer contributions should cause other compensation to rise accordingly
Yeah. Sure it will.
And I'm not even making a Money-esque CURSE YOU SHAREHOLDER VALUE point, though I share the sentiments. Wage stickiness is an observable economic concept.
Quote from: 11B4V on October 07, 2013, 12:54:40 PM
I'm sorry that you are never wrong
or will ever admit your wrong
Isn't that right "Little Boat" man.
:lol: Emo much?
QuoteMeri has more character than you could ever hope to have. :lol:
And more brains or character than you can hope to have. :console:
Quote from: grumbler on October 07, 2013, 01:31:28 PM
Quote from: 11B4V on October 07, 2013, 12:54:40 PM
I'm sorry that you are never wrong
or will ever admit your wrong
Isn't that right "Little Boat" man.
:lol: Emo much?
QuoteMeri has more character than you could ever hope to have. :lol:
And more brains or character than you can hope to have. :console:
Awww. Isn't that special. ;)
I'm touched, both of you. I think. :unsure:
Quote from: merithyn on October 07, 2013, 01:39:34 PM
I'm touched, both of you. I think. :unsure:
:D Collateral undamage.
Quote from: Maximus on October 07, 2013, 11:43:20 AM
The employer contribution is coming out of their other compensation. Granted many will not see it this way.
In the long term, removing employer contributions should cause other compensation to rise accordingly, but insurance costs will rise immediately, which makes it hard to see the positive. The positive being what Meri outlined.
My cynical side sees moves like this as a backdoor pay cut, meaning employees affected by companies throwing them to the exchanges are not going to see other compensation rise accordingly. I don't see that as CdM-level shareholder value cynicism, either.
Quote from: Baron von Schtinkenbutt on October 07, 2013, 02:57:51 PM
My cynical side sees moves like this as a backdoor pay cut, meaning employees affected by companies throwing them to the exchanges are not going to see other compensation rise accordingly. I don't see that as CdM-level shareholder value cynicism, either.
That's a major concern, to be sure, and I think it's one that most people share.
Disagree Moldy.
"Do they have health insurance" is a fairly standard question for people job-seeking. Tossing people on exchanges will, in my estimation, decrease their supply and drive up cash compensation.
Quote from: Admiral Yi on October 07, 2013, 03:03:51 PM
Disagree Moldy.
"Do they have health insurance" is a fairly standard question for people job-seeking. Tossing people on exchanges will, in my estimation, decrease their supply and drive up cash compensation.
I agree. Companies might get away with shortchanging employees on compensation by failing to balance lack of health care with increased pay to allow the employee to afford it in the current economic climate, but in the long run that will cost them their good people.
Quote from: Admiral Yi on October 07, 2013, 03:03:51 PM
Disagree Moldy.
"Do they have health insurance" is a fairly standard question for people job-seeking. Tossing people on exchanges will, in my estimation, decrease their supply and drive up cash compensation.
I dunno. Maybe in the hard-to-fill positions, but not in your typical pay-by-the-hour jobs like I have. Plus, there's more to it than individual insurance. I expect companies to start pulling benefits from spouses and families, but not making adjustments for those.
Quote from: merithyn on October 07, 2013, 03:16:36 PM
I dunno. Maybe in the hard-to-fill positions, but not in your typical pay-by-the-hour jobs like I have. Plus, there's more to it than individual insurance. I expect companies to start pulling benefits from spouses and families, but not making adjustments for those.
Were you indifferent to the provision of employer-provided insurance when you applied for and accepted your job?
Unless the wages are very sticky, and are currently stuck in "way too high" territory, I don't see how a company can get away with just taking away health insurance without any compensation. There is a reason most employers pay more than bare minimum to their workers, even in the not-hard-to-fill positions, and it's not charity.
Quote from: Admiral Yi on October 07, 2013, 03:18:51 PM
Quote from: merithyn on October 07, 2013, 03:16:36 PM
I dunno. Maybe in the hard-to-fill positions, but not in your typical pay-by-the-hour jobs like I have. Plus, there's more to it than individual insurance. I expect companies to start pulling benefits from spouses and families, but not making adjustments for those.
Were you indifferent to the provision of employer-provided insurance when you applied for and accepted your job?
At the time that I got the job, it was more important that I have a paycheck than that I have insurance. It was a bonus, not the reason for taking it.
Quote from: Ideologue on October 07, 2013, 01:18:40 PMYeah. Sure it will.
And I'm not even making a Money-esque CURSE YOU SHAREHOLDER VALUE point, though I share the sentiments. Wage stickiness is an observable economic concept.
This, employer contributions are typically a decent chunk of change. Awhile back to convince us how great it was to work at the Federal government they put up a little app on the intranet showing your "total compensation." This was their derived value for your salary + health insurance benefit + derived present value of your pension + matching contributions to TSP. Anyway, the amount they put in as "their contribution" to my health insurance was something like $5,000 a year.
Now imagine I work for say, Grumman or Lockheed or something instead of the Feds. If the company announces they are discontinuing their health plans and we are welcome to go to the exchanges, I obviously am way out of subsidy range, do you expect the corporate employers to automatically increase my salary by $5,000? Actually, I do expect some to do that, for their higher skilled employees. But many will not, and that just means less money in your pocket at the end of the day.
If they don't increase your pay to compensate, then the implication is that they overpaid you to begin with. I doubt that corporations would be okay with overpaying their employees, considering that they're the biggest expense. Of course, there may be lots of other real-world factors at play that would poke holes in this simplistic Econ 101 thinking.
The whole issue of employer decision-making regarding health care just shows, IMO, the major flaw in Bushcare that Obamacare didn't even attempt to fix: employers shouldn't be in the health care business!
Well I was able to create an account, verified it, etc, but now it is saying they don't have an account that matches the information given to them, even after having a password reset link sent to the email associated with my username, etc. :hmm:
E: Yay it took it now! Boo "Unexpected error. Error ID <blank space>"
Quote from: DGuller on October 07, 2013, 07:13:44 PM
If they don't increase your pay to compensate, then the implication is that they overpaid you to begin with. I doubt that corporations would be okay with overpaying their employees, considering that they're the biggest expense. Of course, there may be lots of other real-world factors at play that would poke holes in this simplistic Econ 101 thinking.
I think the big one is that one's salary/wage is considered compensation, and benefits (of any type to some degree, but health insurance especially) are considered extras. You can't make house payments with your BCBS coverage.
Quote from: Ideologue on October 07, 2013, 07:19:20 PM
I think the big one is that one's salary/wage is considered compensation, and benefits (of any type to some degree, but health insurance especially) are considered extras. You can't make house payments with your BCBS coverage.
What's the difference to the employer?
It'll be interesting to see actually. There's no other country that's had healthcare primarily provided via employers so who knows what'll happen :mellow:
I disagree Ide, but i also think the issue will become moot once the individual mandate kicks in. Then people will know very clearly that either they get a job with insurance, buy it on an exchange, or pay 1% of income to Tio Samuel.
Quote from: Sheilbh on October 07, 2013, 07:21:24 PM
Quote from: Ideologue on October 07, 2013, 07:19:20 PM
I think the big one is that one's salary/wage is considered compensation, and benefits (of any type to some degree, but health insurance especially) are considered extras. You can't make house payments with your BCBS coverage.
What's the difference to the employer?
The difference is that they'll find they can start paying their employees (even) less.
I suspect/fear that it will very similar to what they found out after 2008. It turned out that there were a lot of employees that companies didn't really need. They may well slap their collective foreheads once compensation is cut, realizing that they could have been doing this all along. In a lot of ways, Obamacare may wind up unstickying wages that may be, at present, "artificially" high.
Of course, the countervailing pressures you and Yi describe are not figments. As you say, who knows how it will ultimately work out.
Quote from: Ideologue on October 07, 2013, 07:29:37 PM
The difference is that they'll find they can start paying their employees (even) less.
I look at it the other way. I wonder how much healthcare inflation, mostly borne by employers, is part of the stagnation of wages? Anyone have an idea?
Edit: And as I say it's a mystery how this'll turn out.
Quote from: Sheilbh on October 07, 2013, 07:34:19 PM
I look at it the other way. I wonder how much healthcare inflation, mostly borne by employers, is part of the stagnation of wages?
I've thought the same thing.
Quote from: DGuller on October 07, 2013, 07:13:44 PM
If they don't increase your pay to compensate, then the implication is that they overpaid you to begin with. I doubt that corporations would be okay with overpaying their employees, considering that they're the biggest expense. Of course, there may be lots of other real-world factors at play that would poke holes in this simplistic Econ 101 thinking.
Once the employer mandate is in effect they'll be paying a penalty for every employee they've dropped. IIRC it was like $4,000 a year, so in my example where they were previously paying $5,000/yr for my coverage (this is how much my employer has actually said my health insurance costs them), a private company would save the $5,000 from my compensation but then owe a $4,000 penalty. So they come out $1,000 ahead, even if they pass it on to me, it's only going to be $1,000--not the $5,000 they were paying me before. They would have to actually increase my total compensation to return $5,000 to me directly.
Quote from: OttoVonBismarck on October 07, 2013, 07:36:50 PM
Quote from: DGuller on October 07, 2013, 07:13:44 PM
If they don't increase your pay to compensate, then the implication is that they overpaid you to begin with. I doubt that corporations would be okay with overpaying their employees, considering that they're the biggest expense. Of course, there may be lots of other real-world factors at play that would poke holes in this simplistic Econ 101 thinking.
Once the employer mandate is in effect they'll be paying a penalty for every employee they've dropped. IIRC it was like $4,000 a year, so in my example where they were previously paying $5,000/yr for my coverage (this is how much my employer has actually said my health insurance costs them), a private company would save the $5,000 from my compensation but then owe a $4,000 penalty. So they come out $1,000 ahead, even if they pass it on to me, it's only going to be $1,000--not the $5,000 they were paying me before. They would have to actually increase my total compensation to return $5,000 to me directly.
Why would a company even go for such an arrangement? It is effectively making its employees pay $4000 to the government for absolutely no gain for itself.
Quote from: DGuller on October 07, 2013, 07:52:13 PMWhy would a company even go for such an arrangement? It is effectively making its employees pay $4000 to the government for absolutely no gain for itself.
I would speculate on several different reasons, some employers have already announced they are ending traditional health benefit plans and accepting the fact they will be paying the penalty once it is assessed. So obviously some portion of employers are indeed making these decisions.
Quote from: grumbler on October 07, 2013, 03:14:39 PM
Quote from: Admiral Yi on October 07, 2013, 03:03:51 PM
Disagree Moldy.
"Do they have health insurance" is a fairly standard question for people job-seeking. Tossing people on exchanges will, in my estimation, decrease their supply and drive up cash compensation.
I agree. Companies might get away with shortchanging employees on compensation by failing to balance lack of health care with increased pay to allow the employee to afford it in the current economic climate, but in the long run that will cost them their good people.
LOL, "cost them their good people"...Their "good people" will stay and fucking take what they're given, all the way up the ass. What are they going to do? Leave in this job market? Maybe the Senior Associate Vice President of Human Resources or the Senior Director of IT Support - Applications, but that's about it.
But the rest of the worker bees will take the elimination of employer contributions to healthcare plans and get tossed to the exchanges without the equivalent increase in wages, and they'll fucking eat it and smile, as usual.
Quote from: OttoVonBismarck on October 07, 2013, 08:24:49 PM
Quote from: DGuller on October 07, 2013, 07:52:13 PMWhy would a company even go for such an arrangement? It is effectively making its employees pay $4000 to the government for absolutely no gain for itself.
I would speculate on several different reasons, some employers have already announced they are ending traditional health benefit plans and accepting the fact they will be paying the penalty once it is assessed. So obviously some portion of employers are indeed making these decisions.
They're making these decisions now, but there's no way to know how long they'll continue in that manner. The reality is that for the next 18 months to two years, a lot of things are going to change regarding employee compensation, benefits, and government intervention on both of those. Obamacare will not remain as it is, and companies will not stick to whatever high-handed ideologies they have at the moment.
Things will shake out in the wash in a way that can't be expected right now. I don't know if it will be for good or bad, but it will certainly change things dramatically.
Right now you've the most expensive system in the world that provides the least coverage. It's tough to see how it could get worse :mellow:
Quote from: Sheilbh on October 07, 2013, 09:28:14 PM
Right now you've the most expensive system in the world that provides the least coverage. It's tough to see how it could get worse :mellow:
Just wait. We're special in how we figure those kinds of things out. :)
Lulz, a stunning success!
QuoteMore than 300 Marylanders enroll in health plans in six days
By Andrea K. Walker and Meredith Cohn, The Baltimore Sun
9:38 PM EDT, October 7, 2013
Since it launched last week, the state's new health insurance exchange has been used by 326 Marylanders to enroll in plans, while thousands of others created accounts to start shopping, despite persistent technical problems.
A new report released Monday outlining the performance of Maryland Health Connection in its first six days showed steady interest from Marylanders looking for health insurance. But the report also acknowledged that the state must continue to improve the system to make it more accessible.
The website logged more than 174,000 unique visitors and more than 10,500 people telephoned its call center. About 13,500 created accounts that allow them to browse, compare and buy health plans. The initial count doesn't include paper applications, which are being processed.
"Through every channel we have had tremendous interest, and our challenge and goal is to meet that interest," said Maryland Health Secretary Dr. Joshua Sharfstein. "We are doing everything we can around the clock to improve the system so people can be successful in what they want to do."
Consumers are supposed to be able to visit Maryland Health Connection, create an individual account and browse a variety of health insurance plans before buying one, much as they would book an airline flight. The exchange was created as part of the national health reform to provide a place for Maryland's 800,000 uninsured to find health coverage.
The website crashed almost immediately after it launched Oct. 1 to begin taking applications. Technical problems inhibited people from creating accounts. Those who managed to create an account ran into frozen screens, error messages and other issues.
It's unclear how much those problems might have hindered enrollment. Officials had expected many people to window shop and buy later.
State officials warned before its start that there could be glitches with the system because it was such a complex launch. They blamed the problems on the high volume of people trying to access the exchange, but some analysts have said it appears the system wasn't built with enough capacity to handle the demand. Some suggested that requiring people to create accounts to access the exchange also might have overburdened the system.
Technicians in Maryland have since added server capacity, made technical adjustments and improved the ability for employees in the call center to help those interested in enrolling, the report said. There are plans for a software upgrade in the near future.
Improvements will continue. During upgrades, users won't be able to access certain parts of the site. The site also will be taken down every night in October between 11 p.m. and 5 a.m. to fix problems.
Because Maryland's exchange has been open for so little time, it's tough to assess how well it's doing compared with other states or even within its borders, said Brad Herring, a Johns Hopkins University health economist who has been following the health law's implementation.
"If there are 800,000 uninsured in Maryland, then these numbers, at least in terms of applications and enrollment, seem pretty low," said Herring, an associate professor of health economics at Hopkins' Bloomberg School of Public Health. "But on the other hand, it's really early and certainly there have been a lot of visitors" to the site.
Herring said most people would want to gather information at first about premiums and deductibles, think about their options and return later to sign up, so the small number of enrollees is not surprising. Consumers have several months before the policies would kick in. Consumers have until March to enroll, but they must sign up by mid-December for coverage starting Jan. 1.
Also, Maryland requires consumers to create an account before seeing specific information on policies, so many may not be ready to enter the formal process, Herring said. Some also may have been deterred from logging on or creating an account because of news of the system's glitches.
On the other hand, he said, the number of visitors to the site may be inflated by those who have insurance but are curious about the offerings, such as researchers and journalists.
Others said it's not surprising there is more interest than enrollees at this point.
"The number of website visits, calls and created accounts all demonstrate significant public interest in obtaining coverage through the Maryland Health Connection," said Karen Davenport, director of health policy at the National Women's Law Center. "Women and their families looking into coverage through this marketplace need time to sort through the wide variety of health insurance options — Maryland Health Connection offers more than 80 health and dental plans — to work out what works for their budgets and anticipated health needs."
The state is taking constant feedback from consumers as they use the site.
Sharfstein declined to talk in detail about the system's problems.
"We are tracking [problems] and knocking them off as we are able to," he said. "We are certainly aware the technical issues need to be addressed. We expect the experience for users to get substantially better as we continue to address the issues."
Exchanges across the country have dealt with similar problems as millions of people went searching for insurance under the Affordable Care Act, the landmark legislation meant to spread access to health coverage to most uninsured Americans.
Community groups in Maryland helping to enroll people have turned to paper applications until kinks in the system are worked out.
Evergreen Health, a co-op started by former Baltimore Health Commissioner Dr. Peter Beilenson, has delayed signing up people using the website until next week because of problems with the exchange.
Sharfstein said people have plenty of time to enroll and he doesn't think the problems with the system will discourage people who need coverage.
"We think that there will be plenty of opportunity as the system moves forward for people to come back to it," he said.
Quote from: CountDeMoney on October 07, 2013, 08:38:04 PM
Quote from: grumbler on October 07, 2013, 03:14:39 PM
Quote from: Admiral Yi on October 07, 2013, 03:03:51 PM
Disagree Moldy.
"Do they have health insurance" is a fairly standard question for people job-seeking. Tossing people on exchanges will, in my estimation, decrease their supply and drive up cash compensation.
I agree. Companies might get away with shortchanging employees on compensation by failing to balance lack of health care with increased pay to allow the employee to afford it in the current economic climate, but in the long run that will cost them their good people.
LOL, "cost them their good people"...Their "good people" will stay and fucking take what they're given, all the way up the ass. What are they going to do? Leave in this job market? Maybe the Senior Associate Vice President of Human Resources or the Senior Director of IT Support - Applications, but that's about it.
But the rest of the worker bees will take the elimination of employer contributions to healthcare plans and get tossed to the exchanges without the equivalent increase in wages, and they'll fucking eat it and smile, as usual.
I suppose my title does have a senior in it.
Quote from: CountDeMoney on October 07, 2013, 09:41:24 PM
Lulz, a stunning success!
QuoteMore than 300 Marylanders enroll in health plans in six days
By Andrea K. Walker and Meredith Cohn, The Baltimore Sun
9:38 PM EDT, October 7, 2013
Since it launched last week, the state's new health insurance exchange has been used by 326 Marylanders to enroll in plans, while thousands of others created accounts to start shopping, despite persistent technical problems.
A new report released Monday outlining the performance of Maryland Health Connection in its first six days showed steady interest from Marylanders looking for health insurance. But the report also acknowledged that the state must continue to improve the system to make it more accessible.
The website logged more than 174,000 unique visitors and more than 10,500 people telephoned its call center. About 13,500 created accounts that allow them to browse, compare and buy health plans. The initial count doesn't include paper applications, which are being processed.
"Through every channel we have had tremendous interest, and our challenge and goal is to meet that interest," said Maryland Health Secretary Dr. Joshua Sharfstein. "We are doing everything we can around the clock to improve the system so people can be successful in what they want to do."
Consumers are supposed to be able to visit Maryland Health Connection, create an individual account and browse a variety of health insurance plans before buying one, much as they would book an airline flight. The exchange was created as part of the national health reform to provide a place for Maryland's 800,000 uninsured to find health coverage.
The website crashed almost immediately after it launched Oct. 1 to begin taking applications. Technical problems inhibited people from creating accounts. Those who managed to create an account ran into frozen screens, error messages and other issues.
It's unclear how much those problems might have hindered enrollment. Officials had expected many people to window shop and buy later.
State officials warned before its start that there could be glitches with the system because it was such a complex launch. They blamed the problems on the high volume of people trying to access the exchange, but some analysts have said it appears the system wasn't built with enough capacity to handle the demand. Some suggested that requiring people to create accounts to access the exchange also might have overburdened the system.
Technicians in Maryland have since added server capacity, made technical adjustments and improved the ability for employees in the call center to help those interested in enrolling, the report said. There are plans for a software upgrade in the near future.
Improvements will continue. During upgrades, users won't be able to access certain parts of the site. The site also will be taken down every night in October between 11 p.m. and 5 a.m. to fix problems.
Because Maryland's exchange has been open for so little time, it's tough to assess how well it's doing compared with other states or even within its borders, said Brad Herring, a Johns Hopkins University health economist who has been following the health law's implementation.
"If there are 800,000 uninsured in Maryland, then these numbers, at least in terms of applications and enrollment, seem pretty low," said Herring, an associate professor of health economics at Hopkins' Bloomberg School of Public Health. "But on the other hand, it's really early and certainly there have been a lot of visitors" to the site.
Herring said most people would want to gather information at first about premiums and deductibles, think about their options and return later to sign up, so the small number of enrollees is not surprising. Consumers have several months before the policies would kick in. Consumers have until March to enroll, but they must sign up by mid-December for coverage starting Jan. 1.
Also, Maryland requires consumers to create an account before seeing specific information on policies, so many may not be ready to enter the formal process, Herring said. Some also may have been deterred from logging on or creating an account because of news of the system's glitches.
On the other hand, he said, the number of visitors to the site may be inflated by those who have insurance but are curious about the offerings, such as researchers and journalists.
Others said it's not surprising there is more interest than enrollees at this point.
"The number of website visits, calls and created accounts all demonstrate significant public interest in obtaining coverage through the Maryland Health Connection," said Karen Davenport, director of health policy at the National Women's Law Center. "Women and their families looking into coverage through this marketplace need time to sort through the wide variety of health insurance options — Maryland Health Connection offers more than 80 health and dental plans — to work out what works for their budgets and anticipated health needs."
The state is taking constant feedback from consumers as they use the site.
Sharfstein declined to talk in detail about the system's problems.
"We are tracking [problems] and knocking them off as we are able to," he said. "We are certainly aware the technical issues need to be addressed. We expect the experience for users to get substantially better as we continue to address the issues."
Exchanges across the country have dealt with similar problems as millions of people went searching for insurance under the Affordable Care Act, the landmark legislation meant to spread access to health coverage to most uninsured Americans.
Community groups in Maryland helping to enroll people have turned to paper applications until kinks in the system are worked out.
Evergreen Health, a co-op started by former Baltimore Health Commissioner Dr. Peter Beilenson, has delayed signing up people using the website until next week because of problems with the exchange.
Sharfstein said people have plenty of time to enroll and he doesn't think the problems with the system will discourage people who need coverage.
"We think that there will be plenty of opportunity as the system moves forward for people to come back to it," he said.
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?
Quote from: CountDeMoney on October 07, 2013, 08:38:04 PM
Quote from: grumbler on October 07, 2013, 03:14:39 PM
Quote from: Admiral Yi on October 07, 2013, 03:03:51 PM
Disagree Moldy.
"Do they have health insurance" is a fairly standard question for people job-seeking. Tossing people on exchanges will, in my estimation, decrease their supply and drive up cash compensation.
I agree. Companies might get away with shortchanging employees on compensation by failing to balance lack of health care with increased pay to allow the employee to afford it in the current economic climate, but in the long run that will cost them their good people.
LOL, "cost them their good people"...Their "good people" will stay and fucking take what they're given, all the way up the ass. What are they going to do? Leave in this job market? Maybe the Senior Associate Vice President of Human Resources or the Senior Director of IT Support - Applications, but that's about it.
But the rest of the worker bees will take the elimination of employer contributions to healthcare plans and get tossed to the exchanges without the equivalent increase in wages, and they'll fucking eat it and smile, as usual.
LOL, you are just repeating what I said, with mouth foam added.
Quote from: Sheilbh on October 07, 2013, 09:28:14 PM
Right now you've the most expensive system in the world that provides the least coverage. It's tough to see how it could get worse :mellow:
Things can always get worse.
Quote from: Sheilbh on October 07, 2013, 09:28:14 PM
Right now you've the most expensive system in the world that provides the least coverage. It's tough to see how it could get worse :mellow:
I could easily see it getting worse before it gets better. The PPACA was good in that it created a scheme by which everyone would have access to more affordable healthcare (some individuals will still face monthly premiums on the exchanges that they might conclude are too expensive), but it does little to control the rising costs of healthcare.
The OvBCare plan would take care of the cost side. It's a well known fact we spend often times twice the per capita amount of many other OECD countries for a system that doesn't even provide universal coverage. The reasons for that are varied, but the focus on health insurance companies have always been misplaced. They are just a pass-through entity, and while their profits represent some level of inefficiency for society they are not the drivers of cost increases.
I'm not sure what the long term plan is, I can only suspect that maybe when the Democrats were unable to get single payer they felt the system they crafted would at least make it so everyone was covered and then society collectively felt it had "skin in the game" about rising health care costs, in the hope that it would force some greater change down the road. Regardless, until we make structural changes to control costs things can and very well may get much worse here. With the tax subsidy scheme you could say one benefit of the PPACA is that as things get worse it will be the government's finances that take a direct hit instead of private citizens who would be unable to afford insurance, for example (which may be the mechanism that forces a serious look at controlling medical costs.)
Actually, Otto, the system the Democrats "crafted" was just the one they stole from Romneycare, with the necessary pork and corruption to get it through both chambers.
That quibble aside, i agree with you; things could get very much worse, indeed. Health insurance companies lack both the leverage and the motivation to get serious about negotiating costs, and that's where the savings in ROTW health care mostly comes from.
Quote from: merithyn on October 07, 2013, 09:25:33 PMThey're making these decisions now, but there's no way to know how long they'll continue in that manner. The reality is that for the next 18 months to two years, a lot of things are going to change regarding employee compensation, benefits, and government intervention on both of those. Obamacare will not remain as it is, and companies will not stick to whatever high-handed ideologies they have at the moment.
Things will shake out in the wash in a way that can't be expected right now. I don't know if it will be for good or bad, but it will certainly change things dramatically.
Removing employer provided health benefits reduces total compensation, I agree with the likes of Yi, Sheilbh and DGuller that this will ultimately have an upward pressure on take home wages as over time the market for labor will eventually price that in and you'll see an expectation of higher pay in absence of the expensive healthcare benefit. But these sort of economic changes can often take many years to play out, and it's not family's like mine that suffer during the transition. It is the family's where they live paycheck to paycheck on hourly pay jobs that get munched into mash by these sort of economic shifts.
There is no doubt that 90% of the problem with the American healthcare system is the cost of healthcare itself. Something will have to be done about it, though what, I have no idea. It's one of (if not THE) strongest lobbies in the country, and Congress seems perfectly happy bending over the table for them.
Quote from: grumbler on October 08, 2013, 06:56:38 AM
Actually, Otto, the system the Democrats "crafted" was just the one they stole from Romneycare, with the necessary pork and corruption to get it through both chambers.
That quibble aside, i agree with you; things could get very much worse, indeed. Health insurance companies lack both the leverage and the motivation to get serious about negotiating costs, and that's where the savings in ROTW health care mostly comes from.
It seems to me that is the critical weakness of Obamacare. Insurance companies control their costs by limiting coverage and denial of coverage not by controlling the cost of health care providers. For that to occur you would need to have a single payor system.
Quote from: crazy canuck on October 08, 2013, 11:37:09 AM
It seems to me that is the critical weakness of Obamacare. Insurance companies control their costs by limiting coverage and denial of coverage not by controlling the cost of health care providers. For that to occur you would need to have a single payor system.
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.
Quote from: Admiral Yi on October 08, 2013, 11:51:29 AM
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. That is what makes single payor systems very efficient at controlling health care costs.
As to your second point. I agree entirely. Which is also why a single payor system makes the most sense.
Quote from: Admiral Yi on October 08, 2013, 11:51:29 AM
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.
Yes, although in many cases hospitals and hospital networks are becoming so powerful that even the insurers no longer have the ability to negotiate very strong prices. The hospitals maintain a chargemaster (used to be a giant book, now it's anything from an Access DB to a DB on a mainframe etc), it has mostly insane and fictitious prices. This is where the infamous $45 for a pair of surgical gloves (bought for <$7 in 500 count boxes) and $120 for a single dose of ordinary Aspirin come from. Medicare ignores the chargemaster, instead its reimbursement rate is set based on the national average for the procedure/item. It does not care what the hospital claims its costs are. Insurers used to mostly throw out the chargemaster as well, negotiating directly to hit some sort of beneficial price. But where many hospitals have so much power in terms of demand/market share in their operating areas that now insurers are being forced to negotiate "discounts off the chargemaster" which result in much higher prices than when insurers can negotiate from a neutral position.
Quote from: grumbler on October 08, 2013, 06:18:29 AM
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.
Quote from: sbr on October 07, 2013, 11:06:46 PM
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". :lol:
It's bad, man.
Quote from: CountDeMoney on October 08, 2013, 12:45:51 PM
Quote from: sbr on October 07, 2013, 11:06:46 PM
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". :lol:
It's bad, man.
Ah ok.
Quote from: crazy canuck on October 08, 2013, 11:59:33 AM
Quote from: Admiral Yi on October 08, 2013, 11:51:29 AM
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.
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 :lol:.
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
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?
I'll give you a call sometime tomorrow about it.
Quote from: dps on October 08, 2013, 12:49:16 PM
Quote from: crazy canuck on October 08, 2013, 11:59:33 AM
Quote from: Admiral Yi on October 08, 2013, 11:51:29 AM
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.
Quote from: crazy canuck on October 08, 2013, 01:11:48 PM
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.
Quote from: Baron von Schtinkenbutt link=topic=10497.msg651009#msg651009Some 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).
Quote from: crazy canuck on October 08, 2013, 01:30:07 PM
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.
Quote from: Admiral Yi on October 08, 2013, 01:35:16 PM
Quote from: crazy canuck on October 08, 2013, 01:30:07 PM
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?
If it is covered and a liscenced doctor says you need it why would you need a gate keeper?
Quote from: Admiral Yi on October 08, 2013, 01:35:16 PM
Quote from: crazy canuck on October 08, 2013, 01:30:07 PM
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.
Quote from: Grey Fox on October 08, 2013, 01:42:54 PM
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.
:lol:
Quote from: Admiral Yi on October 08, 2013, 01:47:19 PM
Quote from: Grey Fox on October 08, 2013, 01:42:54 PM
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.
And in the Canadian system a doctor would assess the patient, make a medical judgment as to whether any further inquiry was necessary, make a diagnosis and determine whether any further treatment was necessary.
Which is why GF asked his question. Your system makes no sense to us.
FYI CC, the gatekeeper is an MD.
Quote from: Admiral Yi on October 08, 2013, 02:25:52 PM
FYI CC, the gatekeeper is an MD.
FYI there is a big difference between a medically trained person who is not the attending doctor acting as a gatekeeper and the attending doctor performing that function.
Everything I have read indicates that attending doctors in the US do not have the final decision as to the treatment their patient will recieve and who will provide that treatment as that is a question of the type of insurance coverage the patient has and the decisions of the "gatekeepers" to whom you refer.
I just found out that "self-funded" companies - ie health insurance companies - are exempt from the exchanges. :mad:
Fucking "exemptions". :glare:
Quote from: crazy canuck on October 08, 2013, 02:33:53 PM
FYI there is a big difference between a medically trained person who is not the attending doctor acting as a gatekeeper and the attending doctor performing that function.
Everything I have read indicates that attending doctors in the US do not have the final decision as to the treatment their patient will recieve and who will provide that treatment as that is a question of the type of insurance coverage the patient has and the decisions of the "gatekeepers" to whom you refer.
In an HMO, your primary care physician is your gatekeeper.
Meri: What does being "exempt from the exchanges" mean?
Quote from: merithyn on October 08, 2013, 02:34:57 PM
I just found out that "self-funded" companies - ie health insurance companies - are exempt from the exchanges. :mad:
Fucking "exemptions". :glare:
What does that mean?
Quote from: crazy canuck on October 08, 2013, 01:30:07 PMI 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.
I think the term single payer has always been awkward. I prefer the term "government payer system", because once you start using that it's understandable we're talking about something like providing for say roads or a military. Other services which are primarily provided by a system in which the government is the sole payer.
I agree with you that for healthcare a government payer system is most effective for many of the same reasons it is the most effective way to pay for roads and the military. However I must quibble, in a GP system the government does not regulate
cost, they regulate price/reimbursement rate.
It means that we're locked into whatever policy choices our company offers us.
Non-exempt company employees have the opportunity to seek out other companies and other plans.
Quote from: Admiral Yi on October 08, 2013, 02:36:28 PM
In an HMO, your primary care physician is your gatekeeper.
Based on what others have said you have to appoint someone to be that gatekeeper and if it turns out they are terrible then you have great difficulty moving to someone else. But more fundamentally, in the HMO model there is a terrible conflict of interest because "your" doctor can only make decisions within the limited options funded by the HMO.
Quote from: crazy canuck on October 08, 2013, 02:38:58 PM
Quote from: Admiral Yi on October 08, 2013, 02:36:28 PM
In an HMO, your primary care physician is your gatekeeper.
Based on what others have said you have to appoint someone to be that gatekeeper and if it turns out they are terrible then you have great difficulty moving to someone else. But more fundamentally, in the HMO model there is a terrible conflict of interest because "your" doctor can only make decisions within the limited options funded by the HMO.
It's pretty easy to change your primary. Usually it involves going on the insurance website and clicking a button.
And the doctor isn't tied to the HMO plan. She's just expected to do a once-over first to make sure that it's not something else before sending you on to a (much more expensive) specialist. I understood that that was common in Canada, as well.
Quote from: crazy canuck on October 08, 2013, 02:38:58 PM
Quote from: Admiral Yi on October 08, 2013, 02:36:28 PM
In an HMO, your primary care physician is your gatekeeper.
Based on what others have said you have to appoint someone to be that gatekeeper and if it turns out they are terrible then you have great difficulty moving to someone else. But more fundamentally, in the HMO model there is a terrible conflict of interest because "your" doctor can only make decisions within the limited options funded by the HMO.
I am listening to this conversation, so to speak, and cannot help but wonder if every single HMO I've ever had is vastly better than the supposed norm, or whether your view of what the norm is is just completely out of whack with the reality.
I suspect that your basic disconnect is "based on what others have said..." view of how healthcare works in the US has little in common with how it actually works for most people with middle income health insurance.
I've never once had any problem getting any health care I needed. The only debates have ever been around who is paying for what and whether it falls under my co-pay or deductible, and even that has been very minor. The idea you seem to have that there are "limited options funded by the HMO" might be semantically accurate (I suppose there are some things my HMO won't cover, so technically the options are limited, but in reality I've never had any problem at all getting 100% of the medical services me and my family has needed, and that even includes some relatively expensive and rare genetic testing, for example) but practically incorrect.
Quote from: crazy canuck on October 08, 2013, 02:33:53 PMFYI there is a big difference between a medically trained person who is not the attending doctor acting as a gatekeeper and the attending doctor performing that function.
Everything I have read indicates that attending doctors in the US do not have the final decision as to the treatment their patient will recieve and who will provide that treatment as that is a question of the type of insurance coverage the patient has and the decisions of the "gatekeepers" to whom you refer.
Yi is talking about HMOs. HMOs have various cost control mechanisms, and a properly run HMO in my opinion offers some of the best medical care in the world if they have a comprehensive and well managed organization of physicians. Kaiser Permanente to me, offers this level of care because they have thousands of doctors who actually work for them and they realize huge cost savings because there are no "provider referrals" and all this other business. Since everyone is a KP employee sending you to different practitioners is a breeze, it IMO realizes the best of all worlds in quality care, with none of the negatives you see in single payer systems. But it isn't perfect, it's still too expensive for the poor.
The "bad" HMOs, which is most of them, don't actually have everyone employed by the same organization. Instead there is a "virtual network" of providers who accept the HMO's coverage, and it tends to be a patchwork quilt of varying quality and painful restrictions and paper work to get anything covered.
But anyway, one of the ways in which HMOs save money is by having you pick a PCP--primary care physician. This is a person who is a "General Practitioner" or "Family Doctor" who serves as your starting point for all non-emergency care. Ex. under traditional American health insurance I find a cyst on my scalp, my first trip will probably be to a dermatologist who will look at it and diagnose it as most likely a benign cyst. He'll then schedule to either surgically remove it himself or refer me to a plastic surgeon depending on the location of the cyst and how tricky the removal will be.
Under an HMO, I would go to my PCP first, and would not be allowed to go straight to a specialist like a dermatologist. Then the PCP does a preliminary diagnosis and sends me to either a dermatologist or surgeon who can then look at it again and make their diagnosis, and who then will either remove it or schedule a removal with a third doctor. That sounds crazy, but where it saves money is when I think I might have a crazy heart/skin/brain/liver/etc problem and I rush to a specialist, and it ends up being mono or the flu, the PCP can stop the stupid train in the station. HMOs mostly do not work though, which must be understood.
I'm beginning to get the sneaking suspicion, based on CC's comments, that the entire Canadian system is a giant HMO.
Not that that's necessarily an evil thing.
Is the Keymaster an MD?
Quote from: OttoVonBismarck on October 08, 2013, 02:37:13 PM
I think the term single payer has always been awkward. I prefer the term "government payer system", because once you start using that it's understandable we're talking about something like providing for say roads or a military. Other services which are primarily provided by a system in which the government is the sole payer.
I agree with you that for healthcare a government payer system is most effective for many of the same reasons it is the most effective way to pay for roads and the military. However I must quibble, in a GP system the government does not regulate cost, they regulate price/reimbursement rate.
You may be right about the semantics.
Regarding regulating cost - they do that not just by regulated the tarrif by which physicians (and others) will be paid but they also have negotiating muscle with suppliers. For example, if someone wants to sell tongue depressors (not sure why that is the first thing that popped into my mind :D) they need to negotiate a price with the health authority. All the doctors in private practice then get to piggyback on that price. A doctor doesnt have to take advantage of the price. If they think they can get a better product or better price they are free to try to do so but since the purchase adds to their overhead they are more likely to take the good rate negotiated by the health authority. In this way you wont see the equivalent of a $500 screw driver in the Canadian system.
Another example is the cost of drugs and other medications. The health authorities in Canada have become very smart at negotiating with suppliers so that they get good bulk discounts. Something that would be impossible in a more fragmented marketplace.
The other significant way in which cost is controlled is through the direct funding model. This is the biggest area of conflict within our system. Health authorities prioritize where funding goes in order to try to keep in line with demands and attempt to keep costs in line with projected budgets. The biggest weakness of our system is that if inefficient funding decisions are made it can, and does, result in wait list for procedures because there could be operating room time which is available and doctors available to do the procedure but the operating room is only funded to operate x amount of time. If the problem gets too bad more funding is provided to clear up those backlogs. However, we recognize that we do not have unlimited resources and so some amount of waiting is required. But as I said, this is the #1 area of conflict in our system.
Quote from: OttoVonBismarck on October 08, 2013, 02:45:08 PM
But anyway, one of the ways in which HMOs save money is by having you pick a PCP--primary care physician. This is a person who is a "General Practitioner" or "Family Doctor" who serves as your starting point for all non-emergency care. Ex. under traditional American health insurance I find a cyst on my scalp, my first trip will probably be to a dermatologist who will look at it and diagnose it as most likely a benign cyst. He'll then schedule to either surgically remove it himself or refer me to a plastic surgeon depending on the location of the cyst and how tricky the removal will be.
Under an HMO, I would go to my PCP first, and would not be allowed to go straight to a specialist like a dermatologist. Then the PCP does a preliminary diagnosis and sends me to either a dermatologist or surgeon who can then look at it again and make their diagnosis, and who then will either remove it or schedule a removal with a third doctor. That sounds crazy, but where it saves money is when I think I might have a crazy heart/skin/brain/liver/etc problem and I rush to a specialist, and it ends up being mono or the flu, the PCP can stop the stupid train in the station. HMOs mostly do not work though, which must be understood.
Interesting. Under our system your first visit would be to your family doctor who would then assess what further treatment you require. If the doctor determines you need a specialist then you will be referred directly to that specialist and your doctors office will help make that appointment. Also the doctor would likely order some tests so that the specialist has the results for your visit. Sounds like our system is very much like a well run HMO.
But I am curious. What do you see as the downside to a single payor system?
Quote from: Admiral Yi on October 08, 2013, 02:45:52 PM
I'm beginning to get the sneaking suspicion, based on CC's comments, that the entire Canadian system is a giant HMO.
It is roughly equivalent to the very well run HMO he described. But even then there are some differences that would make me uncomfortable with the HMO model. I am not restricted to one access point to our system (the primary provider in an HMO model). If I dont like my family doctor I can go to whomever I wish. Or more likely, if I know that doctor X has a particular specialty as a primary care giver I can go to him for my treatment.
That is actually what I did with when diagnosed with my current condition. I made a number of inquires and found the family doctor who best fit my needs. As a result I have a different primary care doctor than the rest of my family who have another doctor who is best suited for their needs.
edit: another important factor is that my choice is not restricted to the employees of a particular HMO. I have the whole system to choose from.
Quote from: crazy canuck on October 08, 2013, 03:11:35 PM
It is roughly equivalent to the very well run HMO he described. But even then there are some differences that would make me uncomfortable with the HMO model. I am not restricted to one access point to our system (the primary provider in an HMO model). If I dont like my family doctor I can go to whomever I wish. Or more likely, if I know that doctor X has a particular specialty as a primary care giver I can go to him for my treatment.
That is actually what I did with when diagnosed with my current condition. I made a number of inquires and found the family doctor who best fit my needs. As a result I have a different primary care doctor than the rest of my family who have another doctor who is best suited for their needs.
Pretty much everything that you could do with an HMO.
Quote from: merithyn on October 08, 2013, 03:14:19 PM
Pretty much everything that you could do with an HMO.
I thought someone said that you need to go through some kind of approval process to change a primary care physician in an HMO?
In any event, even if you had complete freedom of choice in an HMO similar to what we have you are still restricted to the doctors employeed in the HMO. What if the doctor who is the best fit is employeed elsewhere?
Quote from: crazy canuck on October 08, 2013, 03:16:20 PM
Quote from: merithyn on October 08, 2013, 03:14:19 PM
Pretty much everything that you could do with an HMO.
I thought someone said that you need to go through some kind of approval process to change a primary care physician in an HMO?
In any event, even if you had complete freedom of choice in an HMO similar to what we have you are still restricted to the doctors employeed in the HMO. What if the doctor who is the best fit is employeed elsewhere?
The Canadian system allows for all doctors because it's a national program, and all doctors agree to a set charge. An HMO limits it to the doctors who sign a contract with them, agreeing to charge a specific charge.
Would your Canadian system cover a doctor in the US?
Quote from: merithyn on October 08, 2013, 03:19:03 PM
Quote from: crazy canuck on October 08, 2013, 03:16:20 PM
Quote from: merithyn on October 08, 2013, 03:14:19 PM
Pretty much everything that you could do with an HMO.
I thought someone said that you need to go through some kind of approval process to change a primary care physician in an HMO?
In any event, even if you had complete freedom of choice in an HMO similar to what we have you are still restricted to the doctors employeed in the HMO. What if the doctor who is the best fit is employeed elsewhere?
The Canadian system allows for all doctors because it's a national program, and all doctors agree to a set charge. An HMO limits it to the doctors who sign a contract with them, agreeing to charge a specific charge.
Yes, we are in agreement that I have a wider range to choose from.
Quote
Would your Canadian system cover a doctor in the US?
It doesnt. I have no idea what point you are making here. Why would a Canadian tax payor subsidize an American doctor who is not part of the cost controls I have been talking about?
Quote from: crazy canuck on October 08, 2013, 03:32:43 PM
It doesnt. I have no idea what point you are making here. Why would a Canadian tax payor subsidize an American doctor who is not part of the cost controls I have been talking about?
Why would an insurance company cover the costs of a doctor not in their system, who has not agreed to their cost controls?
Quote from: merithyn on October 08, 2013, 03:36:10 PM
Quote from: crazy canuck on October 08, 2013, 03:32:43 PM
It doesnt. I have no idea what point you are making here. Why would a Canadian tax payor subsidize an American doctor who is not part of the cost controls I have been talking about?
Why would an insurance company cover the costs of a doctor not in their system, who has not agreed to their cost controls?
You have lost me Meri. I made the point that I have more choice in doctors. You seem to be agreeing with me but in an odd passive aggressive manner.
Quote from: crazy canuck on October 08, 2013, 03:32:43 PM
Quote from: merithyn on October 08, 2013, 03:19:03 PM
Quote from: crazy canuck on October 08, 2013, 03:16:20 PM
Quote from: merithyn on October 08, 2013, 03:14:19 PM
Pretty much everything that you could do with an HMO.
I thought someone said that you need to go through some kind of approval process to change a primary care physician in an HMO?
In any event, even if you had complete freedom of choice in an HMO similar to what we have you are still restricted to the doctors employeed in the HMO. What if the doctor who is the best fit is employeed elsewhere?
The Canadian system allows for all doctors because it's a national program, and all doctors agree to a set charge. An HMO limits it to the doctors who sign a contract with them, agreeing to charge a specific charge.
Yes, we are in agreement that I have a wider range to choose from.
Quote
Would your Canadian system cover a doctor in the US?
It doesnt. I have no idea what point you are making here. Why would a Canadian tax payor subsidize an American doctor who is not part of the cost controls I have been talking about?
Her point is that you are making a distinction without a practical difference.
You don't really know if you have a wider range to choose from, since your choices are limited by more than simply what is available within the system. Factors like timing and geography enter into it as well, and if in the US the set of choices for a typical HMO encompass the bulk of the doctors in a particular area, then in fact the distinction becomes largely meaningless.
If in fact the Canadian system then creates a pool of less qualified doctors to begin with, the "greater choice" could actually be even less meaningful (I don't know if that is the case or not, of course).
Does it matter if I can choose between 1000 specialists and 2000? I don't think it really does, as long as there are excellent choices within each pool.
Quote from: Berkut on October 08, 2013, 03:39:18 PM
You don't really know if you have a wider range to choose from, since your choices are limited by more than simply what is available within the system. Factors like timing and geography enter into it as well, and if in the US the set of choices for a typical HMO encompass the bulk of the doctors in a particular area, then in fact the distinction becomes largely meaningless.
By definition "the bulk" of local doctors does not mean all local doctors. I can choose all local doctors and you cant. No big mystery.
QuoteDoes it matter if I can choose between 1000 specialists and 2000? I don't think it really does, as long as there are excellent choices within each pool.
Do all HMOs have such a large pool to choose from? If so why do I read posts complaining about lack of choice within HMOs? Why is it that there is a distinction between well run HMOs that give good choice and those that do not?
Quote from: Berkut on October 08, 2013, 03:39:18 PM
Her point is that you are making a distinction without a practical difference.
You don't really know if you have a wider range to choose from, since your choices are limited by more than simply what is available within the system. Factors like timing and geography enter into it as well, and if in the US the set of choices for a typical HMO encompass the bulk of the doctors in a particular area, then in fact the distinction becomes largely meaningless.
If in fact the Canadian system then creates a pool of less qualified doctors to begin with, the "greater choice" could actually be even less meaningful (I don't know if that is the case or not, of course).
Does it matter if I can choose between 1000 specialists and 2000? I don't think it really does, as long as there are excellent choices within each pool.
:yes:
It's the same thing that you're talking about, CC, except that we have far more physicians and specialists in a smaller geographical region than you do. You may have quite a few in Vancouver, but I'd probably have twice that number to choose from in Chicago.
HMO doctor lists are regionally located. If I want to go outside my region, I have to pay extra for the privilege. If the specialist that could help you was located in Seattle, you would have had to do the same.
Quote from: crazy canuck on October 08, 2013, 03:41:36 PM
Quote from: Berkut on October 08, 2013, 03:39:18 PM
You don't really know if you have a wider range to choose from, since your choices are limited by more than simply what is available within the system. Factors like timing and geography enter into it as well, and if in the US the set of choices for a typical HMO encompass the bulk of the doctors in a particular area, then in fact the distinction becomes largely meaningless.
By definition "the bulk" of local doctors does not mean all local doctors. I can choose all local doctors and you cant. No big mystery.
QuoteDoes it matter if I can choose between 1000 specialists and 2000? I don't think it really does, as long as there are excellent choices within each pool.
Do all HMOs have such a large pool to choose from? If so why do I read posts complaining about lack of choice within HMOs? Why is it that there is a distinction between well run HMOs that give good choice and those that do not?
It really seems like you're struggling to find some major flaw in the HMO system that just isn't a big deal, because you've found out that the Canadian system is the same thing.
Quote from: merithyn on October 08, 2013, 03:42:52 PM
Quote from: Berkut on October 08, 2013, 03:39:18 PM
Her point is that you are making a distinction without a practical difference.
You don't really know if you have a wider range to choose from, since your choices are limited by more than simply what is available within the system. Factors like timing and geography enter into it as well, and if in the US the set of choices for a typical HMO encompass the bulk of the doctors in a particular area, then in fact the distinction becomes largely meaningless.
If in fact the Canadian system then creates a pool of less qualified doctors to begin with, the "greater choice" could actually be even less meaningful (I don't know if that is the case or not, of course).
Does it matter if I can choose between 1000 specialists and 2000? I don't think it really does, as long as there are excellent choices within each pool.
:yes:
It's the same thing that you're talking about, CC, except that we have far more physicians and specialists in a smaller geographical region than you do. You may have quite a few in Vancouver, but I'd probably have twice that number to choose from in Chicago.
HMO doctor lists are regionally located. If I want to go outside my region, I have to pay extra for the privilege. If the specialist that could help you was located in Seattle, you would have had to do the same.
The point is I wouldnt have to go to Seattle....
Quote from: crazy canuck on October 08, 2013, 03:44:17 PM
The point is I wouldnt have to go to Seattle....
And I wouldn't have to go out of Chicago.
Quote from: merithyn on October 08, 2013, 03:44:52 PM
Quote from: crazy canuck on October 08, 2013, 03:44:17 PM
The point is I wouldnt have to go to Seattle....
And I wouldn't have to go out of Chicago.
On the one hand I have American posters stating that all but the expensive HMOs are restrictive and then I have you and Berkut making the case that all HMOs provide exactly the same quality of choice and care as I have. One of those versions of the American system is incorrect.
But assuming that all HMOs are as good as what I enjoy. What is the downside of creating a system that ensures that quality for all?
Quote from: Berkut on October 08, 2013, 03:39:18 PM
Quote from: crazy canuck on October 08, 2013, 03:32:43 PM
Quote from: merithyn on October 08, 2013, 03:19:03 PM
Quote from: crazy canuck on October 08, 2013, 03:16:20 PM
Quote from: merithyn on October 08, 2013, 03:14:19 PM
Pretty much everything that you could do with an HMO.
I thought someone said that you need to go through some kind of approval process to change a primary care physician in an HMO?
In any event, even if you had complete freedom of choice in an HMO similar to what we have you are still restricted to the doctors employeed in the HMO. What if the doctor who is the best fit is employeed elsewhere?
The Canadian system allows for all doctors because it's a national program, and all doctors agree to a set charge. An HMO limits it to the doctors who sign a contract with them, agreeing to charge a specific charge.
Yes, we are in agreement that I have a wider range to choose from.
Quote
Would your Canadian system cover a doctor in the US?
It doesnt. I have no idea what point you are making here. Why would a Canadian tax payor subsidize an American doctor who is not part of the cost controls I have been talking about?
Her point is that you are making a distinction without a practical difference.
You don't really know if you have a wider range to choose from, since your choices are limited by more than simply what is available within the system. Factors like timing and geography enter into it as well, and if in the US the set of choices for a typical HMO encompass the bulk of the doctors in a particular area, then in fact the distinction becomes largely meaningless.
If in fact the Canadian system then creates a pool of less qualified doctors to begin with, the "greater choice" could actually be even less meaningful (I don't know if that is the case or not, of course).
Does it matter if I can choose between 1000 specialists and 2000? I don't think it really does, as long as there are excellent choices within each pool.
I thought the issue was 'My HMO prevents me from seeing Dr. Blogs, my favorite guy, whom I would otherwise want to see'.
This issue doesn't arise in a nationally-based system, because other than with certain specialists for very severe conditions like Cancer, a patient doesn't usually travel outside of a major Western nation just to go to visit their favorite doctor. In fact, if you live in a major city like Toronto or Vancouver, you are unlikely to travel out of your city.
Quote from: crazy canuck on October 08, 2013, 03:41:36 PM
Quote from: Berkut on October 08, 2013, 03:39:18 PM
You don't really know if you have a wider range to choose from, since your choices are limited by more than simply what is available within the system. Factors like timing and geography enter into it as well, and if in the US the set of choices for a typical HMO encompass the bulk of the doctors in a particular area, then in fact the distinction becomes largely meaningless.
By definition "the bulk" of local doctors does not mean all local doctors. I can choose all local doctors and you cant. No big mystery.
I think I covered this. Distinction without a practical difference, at least, there is no reason to simply assume that there is a difference.
I would much rather choose from 20 great doctors than 40 crappy ones.
Or more to the point, my list of doctors for my HMO includes pretty much every single doctor I would consider anyway without such a list, and since I have no ability to distinguish qualitatively between them at a enough of a granular enough level that it matters, your extra "choice" is not useful to me.
QuoteDoes it matter if I can choose between 1000 specialists and 2000? I don't think it really does, as long as there are excellent choices within each pool.
Do all HMOs have such a large pool to choose from?
[/quote]
I don't know - do you?
I do know that whenever I've need to see a doctor, I've had zero trouble finding an excellent one in the variety of different HMOs I've been part of so far.
Quote
If so why do I read posts complaining about lack of choice within HMOs?
If not, why are you right now reading posts not complaining about the lack of choice in HMOs? Anecdotal evidence is not really all that useful. For exactly that reason.
Quote
Why is it that there is a distinction between well run HMOs that give good choice and those that do not?
Is there such a distinction? I suppose there could be - sound to me like the answer would be to get a different HMO. Of course, the real problem is never lack of choice, it is "I don't like my doctor". And the answer to that problem is "Find another one in your HMO - they almost certainly have a huge array of choices".
The real difference in my experience between well run HMOs and the shit ones are generally administrative. Crappy ones it seems we spend a ridiculous amount of time arguing with them about who pays for what, when, and how.
But that is just my experience, of course. Others may differ.
Quote from: merithyn on October 08, 2013, 03:44:11 PM
Quote from: crazy canuck on October 08, 2013, 03:41:36 PM
Quote from: Berkut on October 08, 2013, 03:39:18 PM
You don't really know if you have a wider range to choose from, since your choices are limited by more than simply what is available within the system. Factors like timing and geography enter into it as well, and if in the US the set of choices for a typical HMO encompass the bulk of the doctors in a particular area, then in fact the distinction becomes largely meaningless.
By definition "the bulk" of local doctors does not mean all local doctors. I can choose all local doctors and you cant. No big mystery.
QuoteDoes it matter if I can choose between 1000 specialists and 2000? I don't think it really does, as long as there are excellent choices within each pool.
Do all HMOs have such a large pool to choose from? If so why do I read posts complaining about lack of choice within HMOs? Why is it that there is a distinction between well run HMOs that give good choice and those that do not?
It really seems like you're struggling to find some major flaw in the HMO system that just isn't a big deal, because you've found out that the Canadian system is the same thing.
The issue is that we in Canada hear people in the US complain that if they go with certain HMOs, they can only use approved doctors, and so they can't use (say) their favorite guy, Dr. Blogs.
This complaint can of course be totally incorrect. I really have no idea.
Quote from: crazy canuck on October 08, 2013, 03:46:35 PM
Quote from: merithyn on October 08, 2013, 03:44:52 PM
Quote from: crazy canuck on October 08, 2013, 03:44:17 PM
The point is I wouldnt have to go to Seattle....
And I wouldn't have to go out of Chicago.
On the one hand I have American posters stating that all but the expensive HMOs are restrictive and then I have you and Berkut making the case that all HMOs provide exactly the same quality of choice and care as I have. One of those versions of the American system is incorrect.
My suspicion is that it is the strawman version.
Quote
But assuming that all HMOs are as good as what I enjoy. What is the downside of creating a system that ensures that quality for all?
I am not arguing that our system is great, far from it. Just pointing out that your caricature of our system is rather bizarrely out of whack with the actual system.
Quote from: Berkut on October 08, 2013, 03:51:08 PM
Is there such a distinction? I suppose there could be - sound to me like the answer would be to get a different HMO. Of course, the real problem is never lack of choice, it is "I don't like my doctor". And the answer to that problem is "Find another one in your HMO - they almost certainly have a huge array of choices".
The real difference in my experience between well run HMOs and the shit ones are generally administrative. Crappy ones it seems we spend a ridiculous amount of time arguing with them about who pays for what, when, and how.
But that is just my experience, of course. Others may differ.
I am just going by what I am learning from what Americans are posting in this thread. If you are asserting that all HMOs are created equal that runs contrary to what others have said and frankly seems rather unlikely. I find the position put forward earlier that the more expensive HMOs are run similar to the Canadian system while others can be a bit of a nightmare more pursuasive because I find it highly unlikely that the cheaper HMOs provide the same level of care as the expensive HMOs.
Quote from: Malthus on October 08, 2013, 03:49:06 PM
Quote from: Berkut on October 08, 2013, 03:39:18 PM
Quote from: crazy canuck on October 08, 2013, 03:32:43 PM
Quote from: merithyn on October 08, 2013, 03:19:03 PM
Quote from: crazy canuck on October 08, 2013, 03:16:20 PM
Quote from: merithyn on October 08, 2013, 03:14:19 PM
Pretty much everything that you could do with an HMO.
I thought someone said that you need to go through some kind of approval process to change a primary care physician in an HMO?
In any event, even if you had complete freedom of choice in an HMO similar to what we have you are still restricted to the doctors employeed in the HMO. What if the doctor who is the best fit is employeed elsewhere?
The Canadian system allows for all doctors because it's a national program, and all doctors agree to a set charge. An HMO limits it to the doctors who sign a contract with them, agreeing to charge a specific charge.
Yes, we are in agreement that I have a wider range to choose from.
Quote
Would your Canadian system cover a doctor in the US?
It doesnt. I have no idea what point you are making here. Why would a Canadian tax payor subsidize an American doctor who is not part of the cost controls I have been talking about?
Her point is that you are making a distinction without a practical difference.
You don't really know if you have a wider range to choose from, since your choices are limited by more than simply what is available within the system. Factors like timing and geography enter into it as well, and if in the US the set of choices for a typical HMO encompass the bulk of the doctors in a particular area, then in fact the distinction becomes largely meaningless.
If in fact the Canadian system then creates a pool of less qualified doctors to begin with, the "greater choice" could actually be even less meaningful (I don't know if that is the case or not, of course).
Does it matter if I can choose between 1000 specialists and 2000? I don't think it really does, as long as there are excellent choices within each pool.
I thought the issue was 'My HMO prevents me from seeing Dr. Blogs, my favorite guy, whom I would otherwise want to see'.
This issue doesn't arise in a nationally-based system, because other than with certain specialists for very severe conditions like Cancer, a patient doesn't usually travel outside of a major Western nation just to go to visit their favorite doctor. In fact, if you live in a major city like Toronto or Vancouver, you are unlikely to travel out of your city.
Yeah, but since I've lived in Rochester, I've had 5-6 different HMOs.
And the same doctor the entire time. Because it is in her interest to be signed up with all the local major HMOs, and it is in their interest to have her signed up, so in reality, most of the doctors are members of most of the HMOs. Hell, this is probably part of the problem with the system, is that everyone pretty much signs on for all the major providers, and there isn't any actual competition based on price or anything like that. I suspect most of the HMOs provide payment to the doctors based on some generic schedule as well, so there isn't even pressure on the doctors to not be part of any particular HMO.
Maybe it is different elsewhere, but in my experience the "choice" issue just isn't an issue at all.
Quote from: crazy canuck on October 08, 2013, 03:54:38 PM
Quote from: Berkut on October 08, 2013, 03:51:08 PM
The real difference in my experience between well run HMOs and the shit ones...
If you are asserting that all HMOs are created equal
<boggle>
Quote from: Berkut on October 08, 2013, 03:52:27 PM
I am not arguing that our system is great, far from it. Just pointing out that your caricature of our system is rather bizarrely out of whack with the actual system.
Its not mine. If you have a beef with the way OVB characterized it take it up with him.
QuoteThe "bad" HMOs, which is most of them, don't actually have everyone employed by the same organization. Instead there is a "virtual network" of providers who accept the HMO's coverage, and it tends to be a patchwork quilt of varying quality and painful restrictions and paper work to get anything covered.
Quote from: crazy canuck on October 08, 2013, 03:41:36 PM
Do all HMOs have such a large pool to choose from? If so why do I read posts complaining about lack of choice within HMOs? Why is it that there is a distinction between well run HMOs that give good choice and those that do not?
The distinction, I believe, is that you don't get to choose whether or not you have a good HMO. Your employer chooses your HMO, and the good ones are likely to be more expensive.
As a note, I don't have an HMO, so I might not understand the issues as fully as those who do.
Quote from: crazy canuck on October 08, 2013, 02:58:59 PMInteresting. Under our system your first visit would be to your family doctor who would then assess what further treatment you require. If the doctor determines you need a specialist then you will be referred directly to that specialist and your doctors office will help make that appointment. Also the doctor would likely order some tests so that the specialist has the results for your visit. Sounds like our system is very much like a well run HMO.
But I am curious. What do you see as the downside to a single payor system?
My perception at least is there is a speed differential in receiving services and in terms of having to wait a long time in between your doctor deciding you need a procedure and when a time slot opens for you to receive said procedure. Kaiser Permanente (KP) is a well oiled machine in this regard. Within the 9m member KP network I think probably the single greatest negative compared to single payer or "Government Payer" is simply that it would not work for the entire country since a large portion have preexisting conditions, a large portion could not afford the coverage, a large portion are old and wouldn't be wanted in the system (if Medicare didn't already exist.) I think SP/GP is superior from a societal perspective because it is "almost as good" in every other area as a well run HMO like KP, and it provides universal access--which is a substantial positive.
I should mention even in terms of access, where KP is available it is often more affordable than other HMOs or traditional health insurance because their "complete control" model gives them extremely strong cost controls. It's almost like a SP/GP system even with outside suppliers because as a huge organization with almost 9m patients they have significant bargaining power over suppliers. Part of how KP achieves this is their "tripod" system, they have a "Health Plan" division, a "Medical Group" division, and a "hospital" division. The health plan division basically does traditional insurance type activities, they provide access to the KP system and set rates, coverage rules etc. Most HMOs don't have the deductible model of insurance, but they do have copays and obviously have monthly premiums. The health plan is almost exclusively where the revenue for the Medical Group and Hospital division comes from.
When you're a KP customer, if you need to get services from a GP you go to a doctor that works for one of the Medical Groups. The Medical Group employs GPs and lots of other specialists who hold regular office hours. If you need surgery or hospitalization, you ideally go to a KP hospital. (There is coverage for emergencies, which obviously don't as easily go through a KP hospital based on where you are when the emergency happens.) The interesting thing about all of this is, every physician working for the medical group or the hospitals is salaried. Their pay is the same whether they have you take 10 tests or 2, or whether they see 25 patients or 5 patients in a day. It removes a lot of the bad incentives that doctors have under traditional insurance to push through as many patients a day as possible.
But yes, in a sense I think the few well run managed care organizations are very similar to SP/GP systems in terms of results and even cost savings. However since the ultimate revenue stream comes from individual consumers, it misses out on the universal access benefits of true SP/GP.
Quote from: Berkut on October 08, 2013, 03:57:41 PM
Quote from: crazy canuck on October 08, 2013, 03:54:38 PM
Quote from: Berkut on October 08, 2013, 03:51:08 PM
The real difference in my experience between well run HMOs and the shit ones...
If you are asserting that all HMOs are created equal
<boggle>
Ok, you werent the one that said care was the same its just the paperwork that separates them?
Quote from: grumbler on October 08, 2013, 03:58:28 PM
Quote from: crazy canuck on October 08, 2013, 03:41:36 PM
Do all HMOs have such a large pool to choose from? If so why do I read posts complaining about lack of choice within HMOs? Why is it that there is a distinction between well run HMOs that give good choice and those that do not?
The distinction, I believe, is that you don't get to choose whether or not you have a good HMO. Your employer chooses your HMO, and the good ones are likely to be more expensive.
As a note, I don't have an HMO, so I might not understand the issues as fully as those who do.
Yeah, that is a good point and is consistent with OVB's observation of good vs not so good HMOs.
Quote from: OttoVonBismarck on October 08, 2013, 03:58:32 PM
Quote from: crazy canuck on October 08, 2013, 02:58:59 PMInteresting. Under our system your first visit would be to your family doctor who would then assess what further treatment you require. If the doctor determines you need a specialist then you will be referred directly to that specialist and your doctors office will help make that appointment. Also the doctor would likely order some tests so that the specialist has the results for your visit. Sounds like our system is very much like a well run HMO.
But I am curious. What do you see as the downside to a single payor system?
My perception at least is there is a speed differential in receiving services and in terms of having to wait a long time in between your doctor deciding you need a procedure and when a time slot opens for you to receive said procedure. Kaiser Permanente (KP) is a well oiled machine in this regard. Within the 9m member KP network I think probably the single greatest negative compared to single payer or "Government Payer" is simply that it would not work for the entire country since a large portion have preexisting conditions, a large portion could not afford the coverage, a large portion are old and wouldn't be wanted in the system (if Medicare didn't already exist.) I think SP/GP is superior from a societal perspective because it is "almost as good" in every other area as a well run HMO like KP, and it provides universal access--which is a substantial positive.
I should mention even in terms of access, where KP is available it is often more affordable than other HMOs or traditional health insurance because their "complete control" model gives them extremely strong cost controls. It's almost like a SP/GP system even with outside suppliers because as a huge organization with almost 9m patients they have significant bargaining power over suppliers. Part of how KP achieves this is their "tripod" system, they have a "Health Plan" division, a "Medical Group" division, and a "hospital" division. The health plan division basically does traditional insurance type activities, they provide access to the KP system and set rates, coverage rules etc. Most HMOs don't have the deductible model of insurance, but they do have copays and obviously have monthly premiums. The health plan is almost exclusively where the revenue for the Medical Group and Hospital division comes from.
When you're a KP customer, if you need to get services from a GP you go to a doctor that works for one of the Medical Groups. The Medical Group employs GPs and lots of other specialists who hold regular office hours. If you need surgery or hospitalization, you ideally go to a KP hospital. (There is coverage for emergencies, which obviously don't as easily go through a KP hospital based on where you are when the emergency happens.) The interesting thing about all of this is, every physician working for the medical group or the hospitals is salaried. Their pay is the same whether they have you take 10 tests or 2, or whether they see 25 patients or 5 patients in a day. It removes a lot of the bad incentives that doctors have under traditional insurance to push through as many patients a day as possible.
But yes, in a sense I think the few well run managed care organizations are very similar to SP/GP systems in terms of results and even cost savings. However since the ultimate revenue stream comes from individual consumers, it misses out on the universal access benefits of true SP/GP.
Yeah, I agree with that criticism of the Canadian system. We attempt to move toward the kinds of efficiency your HMO has but with a system this size it is hard to achieve. The upside is our system is provided to all at a lesser cost. So there are definitely tradeoffs involved.
I would say the number one issue people have with HMOs by far is "I can't visit the doctor I want." As a Federal employee we have a wide range of options, KP is not the only HMO, and each year during open enrollment we got bombarded with advertising from many other HMOs available to Federal employees. Probably the #1 advertising point all of them like to tout is "all of the doctors in our network."
However KP is the only true managed care organization in the list. The rest may be structured as an HMO, but they do not actually directly employ doctors. Instead they operate a "network" of physicians that accept the HMO rate for specific services. Really it's very, very similar to traditional insurance. Which means it's fine in terms of coverage as long as your employer is subsidizing the premium, but it's bad in terms of cost control because unless you have all the actors on salary and all/most of the services within the same organization you lose much of the ability to control cost that comes with true managed care.
A genuine managed care organization does not have an expansive selection of doctors, so if you are part of such an organization and it doesn't have your region very well covered, it's bad for you if the doctors they do have are not to your liking. The more "virtual" HMO model, where the practitioners are still in business for themselves, typically have the same options locally as "regular" health insurance. The only difference is that instead of the doctor billing your insurance "full price" and then "accepting" the "pre-approved negotiated price", with an HMO the doctor just bills the HMO for "one unit" of x service at "x rate." A virtual HMO so to speak is really just a different type of billing from the physician's perspective. Real managed care the doctors work for the managed care organization itself, and when those sort of organizations are poorly run or maybe just poorly staffed in the area you live, they don't provide great care and they provide very poor coverage outside of the network.
In Ontario at least there is the theoretical "safety valve" for speed, that if the Ontario medical system can't provide a treatment in a reasonable time to prevent death or injury, you can go elsewhere - such as the US - and get that treatment, and the Ontario public insurer will pay for it.
However, getting the government to pay up may be a major task.
Also, I believe the reason many plans that are really just traditional U.S. style health insurance are "organized" as HMOs is because of the tax code. I think traditional health insurance plans have to operate or typically do operate as for-profit companies which has tax implications. Organized as an HMO you're tax exempt, so a lot of plans that aren't really managed care but just regular health insurance, are organized as HMOs.
Quote from: OttoVonBismarck on October 08, 2013, 04:06:14 PM
I would say the number one issue people have with HMOs by far is "I can't visit the doctor I want." As a Federal employee we have a wide range of options, KP is not the only HMO, and each year during open enrollment we got bombarded with advertising from many other HMOs available to Federal employees. Probably the #1 advertising point all of them like to tout is "all of the doctors in our network."
However KP is the only true managed care organization in the list. The rest may be structured as an HMO, but they do not actually directly employ doctors. Instead they operate a "network" of physicians that accept the HMO rate for specific services. Really it's very, very similar to traditional insurance. Which means it's fine in terms of coverage as long as your employer is subsidizing the premium, but it's bad in terms of cost control because unless you have all the actors on salary and all/most of the services within the same organization you lose much of the ability to control cost that comes with true managed care.
A genuine managed care organization does not have an expansive selection of doctors, so if you are part of such an organization and it doesn't have your region very well covered, it's bad for you if the doctors they do have are not to your liking. The more "virtual" HMO model, where the practitioners are still in business for themselves, typically have the same options locally as "regular" health insurance. The only difference is that instead of the doctor billing your insurance "full price" and then "accepting" the "pre-approved negotiated price", with an HMO the doctor just bills the HMO for "one unit" of x service at "x rate." A virtual HMO so to speak is really just a different type of billing from the physician's perspective. Real managed care the doctors work for the managed care organization itself, and when those sort of organizations are poorly run or maybe just poorly staffed in the area you live, they don't provide great care and they provide very poor coverage outside of the network.
Berkut and Meri just told us quite forcefully that physician choice isn't a problem in the US at all.
Colour me confused. Is physician choice a problem in the US, or is it not?
Berkut said in his experience this wasn't the problem that CC says it is, and that CC may not have good information.
Berkut also said several times that he was relating HIS PERSONAL EXPERIENCE.
Quote from: Malthus on October 08, 2013, 03:52:07 PM
The issue is that we in Canada hear people in the US complain that if they go with certain HMOs, they can only use approved doctors, and so they can't use (say) their favorite guy, Dr. Blogs.
This complaint can of course be totally incorrect. I really have no idea.
That's true of any insurance plan down here, to an extent. Even Medicare is limiting in which doctors that they can go to. We don't have an HMO, and yet we cannot see the doctor of our choice, since he's not contracted with our insurance company.
In our case, it's a pretty small pool because I work for a health insurance company that's owned by a hospital and physicians' services group. Ergo, I'm required to go to one of the doctors from that group and/or the hospital to see the full payment of benefits. That's a problem.
Also, my big issue with the whole HMO system is that I dislike having to go pay a $20 co-pay when I'm having issues with my asthma before I can go to the specialist, who will then charge me another $40 co-pay. Then, of course, I have to pay for my prescription, too. I have asthma. I've had asthma for 20+ years. I know when I need to see the specialist, and I don't see a need to go to my PCP first. It's a waste of everyone's time and my money.
I think that would grate against me if I lived in Canada, too. :P
Quote from: Malthus on October 08, 2013, 04:13:25 PM
Berkut and Meri just told us quite forcefully that physician choice isn't a problem in the US at all.
Colour me confused. Is physician choice a problem in the US, or is it not?
Sounds like a matter of having enough doctors to choose from vs having every doctor to choose from. There's always gonna be someone who opts out.
Quote from: Berkut on October 08, 2013, 04:18:32 PM
Berkut said in his experience this wasn't the problem that CC says it is, and that CC may not have good information.
Berkut also said several times that he was relating HIS PERSONAL EXPERIENCE.
That Berkut guy. Always saying things.
Physician choice can be a problem for people who are in real managed care organizations that have bad service coverage, people who have Medicaid, or people who have "sub prime" insurance.
Medicaid is hated by physicians because the reimbursement rates are horrible and the patients themselves are usually not great to deal with and anything they end up owing on their end has a high chance of going to collections, so many physicians refuse to accept Medicaid. Sub prime plans, are basically "bad" health insurance plans that many employers offer in very low income/low skill industries to their employees. Many have described these plans as "not insurance at all" but just a relatively meager fixed benefit costs quite a lot for doing very little. Those plans have bad reimbursement schedules and many doctors will not accept them.
Finally, I tried to distinguish between "genuine managed care" and "health insurance organized as an HMO", genuine managed care has cost savings and other benefits, but if it's a small HMO you have a very limited selection of doctors. True managed care organizations simply will not cover services you get at a doctor outside the organization, meaning you don't visit that physician or you pay the full price. With say KP, that doesn't matter because the organization has 9m patients and like 14,000 physicians, it's basically like a Scandinavian country in scope, and where it offers membership it has more than enough service facilities. With smaller plans, for example I knew awhile back that employees of the State of WV had an option to be in a true managed care local to WV and the Ohio Valley region of Ohio. I think in the capital of the State, it had like 4 family doctors that worked for it, so if you were in that plan you probably waited a 1-3 months to get an appointment and if you didn't like that doctor you only had a few others to choose from.
If you have traditional insurance, through a PPO network or one of the "pseudo-HMOs" you basically will be served by any doctor around. Most doctors accept all the decent insurance plans as it is to their benefit to accept as many as possible (if they aren't Medicaid/some garbage bin insurance plan.)
Quote from: merithyn on October 08, 2013, 04:19:28 PMThat's true of any insurance plan down here, to an extent. Even Medicare is limiting in which doctors that they can go to. We don't have an HMO, and yet we cannot see the doctor of our choice, since he's not contracted with our insurance company.
In our case, it's a pretty small pool because I work for a health insurance company that's owned by a hospital and physicians' services group. Ergo, I'm required to go to one of the doctors from that group and/or the hospital to see the full payment of benefits. That's a problem.
Also, my big issue with the whole HMO system is that I dislike having to go pay a $20 co-pay when I'm having issues with my asthma before I can go to the specialist, who will then charge me another $40 co-pay. Then, of course, I have to pay for my prescription, too. I have asthma. I've had asthma for 20+ years. I know when I need to see the specialist, and I don't see a need to go to my PCP first. It's a waste of everyone's time and my money.
I think that would grate against me if I lived in Canada, too. :P
It's not really that onerous with KP, because everyone works for the same company so when you get schedule for a specialist KP does it for you. They basically say "okay, your GP has said you need to go here, this is your appointment date/time at this facility and you'll be seen by this doctor that day." You do have to pay various copays, but that's the tradeoff with many HMOs, you pay (IMO) small copays here and there but there isn't the deductible scheme like with traditional insurance. You don't have to worry about paying a deductible or out of pocket maximum before your full benefits come in.
Quote from: OttoVonBismarck on October 08, 2013, 04:06:14 PM
I would say the number one issue people have with HMOs privatized insurance in the US by far is "I can't visit the doctor I want."
FYP
Quote from: Berkut on October 08, 2013, 04:18:32 PM
Berkut said in his experience this wasn't the problem that CC says it is, and that CC may not have good information.
Berkut also said several times that he was relating HIS PERSONAL EXPERIENCE.
Stop putting words in Berkut's mouth.
How much is Kaiser paying you to shill for them Biscuit?
Quote from: Berkut on October 08, 2013, 04:18:32 PM
Berkut said in his experience this wasn't the problem that CC says it is, and that CC may not have good information.
Berkut also said several times that he was relating HIS PERSONAL EXPERIENCE.
Aside from whatever CC has or hasn't said, is it fair to say that under the US system physician choice issue
is an issue for
some, while physician choice
isn't an issue in Canada for
any?
Quote from: Admiral Yi on October 08, 2013, 04:27:22 PM
How much is Kaiser paying you to shill for them Biscuit?
Isn't his wife an MD? :hmm:
Quote from: merithyn on October 08, 2013, 04:23:30 PM
Quote from: OttoVonBismarck on October 08, 2013, 04:06:14 PM
I would say the number one issue people have with HMOs privatized insurance in the US by far is "I can't visit the doctor I want."
FYP
Under a PPO, is that as big an issue?
Check out the big brain on the Wigger. :cheers:
Yes, PPO are the best choices. A typical scheme would be 80% coinsurance at PPO doctors, but if you choose to go out of the preferred providers it's only a 60% coinsurance. (Up to your OOP max obviously.) So you can go just about anywhere and get some level of service coverage.
Quote from: Peter Wiggin on October 08, 2013, 04:35:03 PM
Quote from: Admiral Yi on October 08, 2013, 04:27:22 PM
How much is Kaiser paying you to shill for them Biscuit?
Isn't his wife an MD? :hmm:
Kaiser provided him with a
wife? :blink:
Quote from: Malthus on October 08, 2013, 04:28:50 PM
Quote from: Berkut on October 08, 2013, 04:18:32 PM
Berkut said in his experience this wasn't the problem that CC says it is, and that CC may not have good information.
Berkut also said several times that he was relating HIS PERSONAL EXPERIENCE.
Aside from whatever CC has or hasn't said, is it fair to say that under the US system physician choice issue is an issue for some, while physician choice isn't an issue in Canada for any?
Can everyone in Canada sign up to have the same GP? :unsure:
Quote from: garbon on October 08, 2013, 04:38:13 PMCan everyone in Canada sign up to have the same GP? :unsure:
Much like Kaiser, Canadian health care provides you with a wife who's a GP or specialist if you so desire.
Quote from: garbon on October 08, 2013, 04:38:13 PM
Quote from: Malthus on October 08, 2013, 04:28:50 PM
Quote from: Berkut on October 08, 2013, 04:18:32 PM
Berkut said in his experience this wasn't the problem that CC says it is, and that CC may not have good information.
Berkut also said several times that he was relating HIS PERSONAL EXPERIENCE.
Aside from whatever CC has or hasn't said, is it fair to say that under the US system physician choice issue is an issue for some, while physician choice isn't an issue in Canada for any?
Can everyone in Canada sign up to have the same GP? :unsure:
Indeed. The biggest problem my wife has had hasn't been that the doctor she wants (she seems to change a lot more than I do) isn't available under our HMO, it is that they are not accepting new patients.
Quote from: garbon on October 08, 2013, 04:38:13 PM
Quote from: Malthus on October 08, 2013, 04:28:50 PM
Quote from: Berkut on October 08, 2013, 04:18:32 PM
Berkut said in his experience this wasn't the problem that CC says it is, and that CC may not have good information.
Berkut also said several times that he was relating HIS PERSONAL EXPERIENCE.
Aside from whatever CC has or hasn't said, is it fair to say that under the US system physician choice issue is an issue for some, while physician choice isn't an issue in Canada for any?
Can everyone in Canada sign up to have the same GP? :unsure:
He'd be pretty busy. :hmm:
But yeah, there is a genuine issue in Canada with physician availability. Particularly in rural places.
But even in cities, there are certain classes of care facing shortages - mostly, family physicians, but also some specialties.
One of the big critiques of a one-payor socialized system is that in many ways it replaces "money" with "connections" as the limiting factor for good care. Of course, those with connections are often the same as those with money ...
Quote from: Berkut on October 08, 2013, 04:41:58 PMIndeed. The biggest problem my wife has had hasn't been that the doctor she wants (she seems to change a lot more than I do) isn't available under our HMO, it is that they are not accepting new patients.
Yeah, that's the same here.
Quote from: Jacob on October 08, 2013, 04:40:33 PM
Quote from: garbon on October 08, 2013, 04:38:13 PMCan everyone in Canada sign up to have the same GP? :unsure:
Much like Kaiser, Canadian health care provides you with a wife who's a GP or specialist if you so desire.
Garbon with a wife? :hmm:
Quote from: Admiral Yi on October 08, 2013, 01:35:16 PM
The purpose of the gatekeeper is to regulate usage, not to price shop.
Maybe. But also medicine is an area that requires knowledge, skill and expertise. As much as regulating usage it's about stopping people being stupid based on what they've read in the health pages of Woman's Own. You've no more right to demand tests than you do to self-prescribe.
Quote from: Sheilbh on October 08, 2013, 04:54:20 PM
Maybe. But also medicine is an area that requires knowledge, skill and expertise. As much as regulating usage it's about stopping people being stupid based on what they've read in the health pages of Woman's Own. You've no more right to demand tests than you do to self-prescribe.
:huh: You just described regulating usage.
Quote from: Admiral Yi on October 08, 2013, 04:59:07 PM
:huh: You just described regulating usage.
Ok. That sounds very negative to me, which it isn't.
Quote from: Sheilbh on October 08, 2013, 05:08:17 PM
Ok. That sounds very negative to me, which it isn't.
Maybe you confused it with rationing.
Quote from: Admiral Yi on October 08, 2013, 05:09:15 PM
Maybe you confused it with rationing.
Nothing wrong with rationing - as an idea or the word :P
Quote from: Jacob on October 08, 2013, 04:40:33 PM
Quote from: garbon on October 08, 2013, 04:38:13 PMCan everyone in Canada sign up to have the same GP? :unsure:
Much like Kaiser, Canadian health care provides you with a wife who's a GP or specialist if you so desire.
:lol:
Talking GP, I might have found one.
Quote from: Malthus on October 08, 2013, 04:45:32 PM
Quote from: Jacob on October 08, 2013, 04:40:33 PM
Quote from: garbon on October 08, 2013, 04:38:13 PMCan everyone in Canada sign up to have the same GP? :unsure:
Much like Kaiser, Canadian health care provides you with a wife who's a GP or specialist if you so desire.
Garbon with a wife? :hmm:
Sure, don't be so gender-centric.
Quote from: garbon on October 08, 2013, 04:36:15 PM
Quote from: merithyn on October 08, 2013, 04:23:30 PM
Quote from: OttoVonBismarck on October 08, 2013, 04:06:14 PM
I would say the number one issue people have with HMOs privatized insurance in the US by far is "I can't visit the doctor I want."
FYP
Under a PPO, is that as big an issue?
Even in a PPO, there can be tiers of coverage. So, you can see a Tier I doctor for a $20 co-pay and 100% coverage, a Tier II doctor for 75% coverage, or a Tier III doctor for 50% coverage. If you see a Tier II or Tier III doctor, what you pay doesn't usually apply toward your family deductible.
So yeah, it can be a big issue.
Quote from: garbon on October 08, 2013, 09:10:13 PM
Quote from: Malthus on October 08, 2013, 04:45:32 PM
Quote from: Jacob on October 08, 2013, 04:40:33 PM
Quote from: garbon on October 08, 2013, 04:38:13 PMCan everyone in Canada sign up to have the same GP? :unsure:
Much like Kaiser, Canadian health care provides you with a wife who's a GP or specialist if you so desire.
Garbon with a wife? :hmm:
Sure, don't be so gender-centric.
Garbon with a husband? :hmm:
Quote from: Malthus on October 09, 2013, 10:26:24 AM
Quote from: garbon on October 08, 2013, 09:10:13 PM
Quote from: Malthus on October 08, 2013, 04:45:32 PM
Quote from: Jacob on October 08, 2013, 04:40:33 PM
Quote from: garbon on October 08, 2013, 04:38:13 PMCan everyone in Canada sign up to have the same GP? :unsure:
Much like Kaiser, Canadian health care provides you with a wife who's a GP or specialist if you so desire.
Garbon with a wife? :hmm:
Sure, don't be so gender-centric.
Garbon with a husband? :hmm:
Who else is going to pay for my fabulous lifestyle?
Quote from: garbon on October 09, 2013, 10:34:55 AM
Who else is going to pay for my fabulous lifestyle?
Face harsh facts - at your age and occupation, you are from now on going to be *doing* the sugar-daddying. :P
Ouch.
Quote from: Malthus on October 09, 2013, 11:04:45 AM
Quote from: garbon on October 09, 2013, 10:34:55 AM
Who else is going to pay for my fabulous lifestyle?
Face harsh facts - at your age and occupation, you are from now on going to be *doing* the sugar-daddying. :P
Very rude!
Also, unlikely as my tastes don't extend younger.
Quote from: garbon on October 09, 2013, 11:24:09 AM
Quote from: Malthus on October 09, 2013, 11:04:45 AM
Quote from: garbon on October 09, 2013, 10:34:55 AM
Who else is going to pay for my fabulous lifestyle?
Face harsh facts - at your age and occupation, you are from now on going to be *doing* the sugar-daddying. :P
Very rude!
Also, unlikely as my tastes don't extend younger.
If Malthus is correct you may begin to experience long periods of celebacy.
Quote from: crazy canuck on October 09, 2013, 11:35:51 AM
Quote from: garbon on October 09, 2013, 11:24:09 AM
Quote from: Malthus on October 09, 2013, 11:04:45 AM
Quote from: garbon on October 09, 2013, 10:34:55 AM
Who else is going to pay for my fabulous lifestyle?
Face harsh facts - at your age and occupation, you are from now on going to be *doing* the sugar-daddying. :P
Very rude!
Also, unlikely as my tastes don't extend younger.
If Malthus is correct you may begin to experience long periods of celebacy.
Yeah but I'm not sure what assumptions he is using (or not using) beyond age and occupation.
It would appear the free stuff is popular.
Quote
Medicaid enrollment spike a threat to Obamacare structure?
(CBS News) The disastrous rollout of HealthCare.gov may have another serious problem: A CBS News analysis shows that in many of the 15 state-based health insurance exchanges more people are enrolling in Medicaid rather than buying private health insurance. And if that trend continues, there's concern there won't be enough healthy people buying health insurance for the system to work.
As the Obamacare website struggles, the administration is emphasizing state-level success. President Obama said Monday, "There's great demand at the state level as well. Because there are a bunch of states running their own marketplaces."
But left unsaid in the president's remarks: the newly insured in some of those states are overwhelmingly low-income people signing up for Medicaid at no cost to them.
Matt Salo, executive director of the National Association of Medicaid Directors, said, "We're seeing a huge spike in terms of Medicaid enrollments."
He says the numbers have surprised him and state officials.
CBS News has confirmed that in Washington, of the more than 35,000 people newly enrolled, 87 percent signed up for Medicaid. In Kentucky, out of 26,000 new enrollments, 82 percent are in Medicaid. And in New York, of 37,000 enrollments, Medicaid accounts for 64 percent. And there are similar stories across the country in nearly half of the states that run their own exchanges.
Medicaid experts say they're not sure why they're seeing the lopsided enrollment numbers, but point out it's easier to enroll in Medicaid than private insurance.
An administration spokeswoman says coverage provided by the new law offers "a range of options so consumers can pick a plan that best meets their needs ... and their budget."
But Gail Wilensky, a former Medicaid director, said the numbers are causing concern in the insurance industry, which needs healthy adults to buy private insurance in large numbers for the system to work.
"Either the private insurance enrollments come up somewhere around the expected amount or there's going to be a problem. ... You need a volume and you need a mix of people that are healthy as well as high users in private insurance, in order to have it be sustainable," she said.
The Obama administration says they expected these high enrollment numbers in Medicaid because the law expands the number of low-income people who can get Medicaid, CBS News' Jan Crawford reported on "CBS This Morning." Supporters say this shows demand. But industry sources say that if we do not see some real turnaround soon, there could be big problems for the entire system.
http://www.cbsnews.com/8301-505267_162-57609254/medicaid-enrollment-spike-a-threat-to-obamacare-structure/
Free stuff is pretty popular when you can't afford real stuff in the first place.
:lol:
QuoteIf 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.
Quote
Arrival of Obamacare forcing insurers to drop customers with low coverage
The Affordable Care Act was signed by President Obama in 2010 and since then he has repeated one reassuring phrase: "If you like your insurance plan you will keep it. No one will be able to take that away from you. It hasn't happened yet. It won't happen in the future."
But it is happening. The president's health care law raises the standards for insurance policies, which many consider to be a good thing. But hundreds of thousands of Americans whose policies don't meet the new standards are being told that their health plans are being cancelled.
Natalie Willes is a sleep consultant who helps parents in Los Angeles train their newborns to sleep. She buys her own health insurance.
Natalie Willes
/ CBS News
"I was completely happy with the insurance I had before," Willes said.
So she was surprised when she tried to renew her policy. What did she find out?
"That my insurance was going to be completely different, and they were going to be replaced with 10 new plans that were going to fall under the regulations of the Affordable Care Act," she said.
Her insurer, Kaiser Permanente, is terminating policies for 160,000 people in California and presenting them with new plans that comply with the healthcare law.
"Before I had a plan that I had a $1,500 deductible," she said. "I paid $199 dollars a month. The most similar plan that I would have available to me would be $278 a month. My deductible would be $6,500 dollars, and all of my care after that point would only be covered 70 percent."
Vaccines are now required
/ CBS News
Gerry Kominski, director of public health policy at UCLA said: "About half of the 14 million people who buy insurance on their own are not going to be able to keep the policies that they had previously."
He says higher premiums help insurers pay for new requirements including accepting patients with pre-existing conditions and providing preventative care like check-ups and vaccines.
Gerry Kominski
/ CBS News
"You're paying more for a better product and for more protection -- and you won't understand the value of that until you need it," he said.
But many can't get past the sticker shock.
"Now I'm being forced to choose from a bunch of new plans that I don't want to choose from that are all more expensive," Willes said.
New plan prices vary depending on age and location. But we're told younger people who currently have with high deductible plans will likely pay higher premiums and people with health problems will pay lower premiums.
http://www.cbsnews.com/8301-18563_162-57609224/arrival-of-obamacare-forcing-insurers-to-drop-customers-with-low-coverage/
Shit happens.
QuotePolicy cancellations, higher premiums add to frustration over Obamacare
(CBS News) Nearly five weeks into the launch of HealthCare.gov, the management expert brought in to turn around the website says its issues are fixable. But it's going to take weeks, not days. That comes as some Americans are being surprised, not only that they are being booted off their current plans, but at how much they're being asked to pay for new ones.
Special section: Health care in America
For many, their introduction to the Affordable Care Act has been negative: a broken website, and now cancellation notices from insurance companies followed by sticker shock over higher prices for the new plans. It's directly at odds with repeated assurances from the president, who has said "if you like your insurance plan, you will keep it. No one will be able to take that away from you."
But people across the country are finding out they're losing their existing insurance plans under Obamacare because requirements in the law, such as prenatal and prescription drug coverage, mean their old plans aren't comprehensive enough.
In California, Kaiser Permanente terminated policies for 160,000 people. In Florida, at least 300,000 people are losing coverage.
That includes 56-year-old Dianne Barrette. Last month, she received a letter from Blue Cross Blue Shield informing her as of January 2014, she would lose her current plan. Barrette pays $54 a month. The new plan she's being offered would run $591 a month -- 10 times more than what she currently pays.
Barrette said, "What I have right now is what I am happy with and I just want to know why I can't keep what I have. Why do I have to be forced into something else?"
According to HealthCare.gov, Barrette is eligible for some subsidies, CBS News' Jan Crawford pointed out on "CBS This Morning." But Barrette told CBS News she has no idea what those subsidies would be because she cannot log on to the website -- an issue U.S. Health and Human Services Secretary Kathleen Sebelius is sure to be asked about when she testifies on Capitol Hill Wednesday.
Technical problems continued through the weekend, as Americans trying to sign up were blocked from the website on Sunday. The administration blames technical problems at a Verizon data center for shutting down HealthCare.gov. The Obama administration says it needs until the end of November to make HealthCare.gov work -- two months after the launch.
What average Americans have been saying for weeks has now become the conventional wisdom in Washington -- "the rollout has been a disaster," as Sen. Jeanne Shaheen, D-N.H., remarked Sunday on "Face the Nation."
Shaheen said Sunday of the November deadline, "I hope that's accurate. We're hearing from lots of constituents in New Hampshire, that they want to enroll in health insurance -- that they can't because of the problems with the website."
http://www.cbsnews.com/8301-505263_162-57609534/policy-cancellations-higher-premiums-add-to-frustration-over-obamacare/
Quote from: CountDeMoney on October 28, 2013, 12:30:53 PM
Free stuff is pretty popular when you can't afford real stuff in the first place.
Then you admit obamacare is unaffordable.
Quote from: 11B4V on October 28, 2013, 12:36:16 PM
Quote from: CountDeMoney on October 28, 2013, 12:30:53 PM
Free stuff is pretty popular when you can't afford real stuff in the first place.
Then you admit obamacare is unaffordable.
:huh: Your technique needs work.
Quote from: 11B4V on October 28, 2013, 12:36:16 PM
Quote from: CountDeMoney on October 28, 2013, 12:30:53 PM
Free stuff is pretty popular when you can't afford real stuff in the first place.
Then you admit obamacare is unaffordable.
The ACA only works in combination with the federal sub, not without.
Medicaid experts say they're not sure why they're seeing the lopsided enrollment numbers, but point out it's easier to enroll in Medicaid than private insurance.
The Obama administration says they expected these high enrollment numbers in Medicaid because the law expands the number of low-income people who can get Medicaid, CBS News' Jan Crawford reported on "CBS This Morning." Supporters say this shows demand. But industry sources say that if we do not see some real turnaround soon, there could be big problems for the entire system.
Really? The Medicaid "experts" couldn't see this likely possibility? If someone is low income and qualifies for free Medicaid, why and why should they, sign up for a plan under the ACA. Makes perfect sense.
The ACA plan needs young people to sign up but with the expansion of Medicaid plus covering young'uns on their parent's insurance up to age 26 that all would seem to cut into the numbers of those in the needed younger ages who will sign up for the new ACA plans.
There was a 0% chance of a website of that scale, complexity, and load would roll out in the manner they designed without massive problems.
This should have been a graduated release, scaling up over time with a carefully managed release schedule driven by the technical requirements. Of course, that was politically impossible, so what we have is completely predictable and inevitable.
Quote from: 11B4V on October 28, 2013, 12:36:16 PM
Quote from: CountDeMoney on October 28, 2013, 12:30:53 PM
Free stuff is pretty popular when you can't afford real stuff in the first place.
Then you admit obamacare is unaffordable.
No, dumbass. Private insurance is unaffordable to the indigent, which is why you see people who couldn't afford private providers before suddenly enrolling in expanded Medicaid.
So sorry, 11B, but you just may see more black people with Medicaid in the future. Sucks to be you.
Quote from: KRonn on October 28, 2013, 12:39:17 PM
Medicaid experts say they're not sure why they're seeing the lopsided enrollment numbers, but point out it's easier to enroll in Medicaid than private insurance.
The Obama administration says they expected these high enrollment numbers in Medicaid because the law expands the number of low-income people who can get Medicaid, CBS News' Jan Crawford reported on "CBS This Morning." Supporters say this shows demand. But industry sources say that if we do not see some real turnaround soon, there could be big problems for the entire system.
Really? The Medicaid "experts" couldn't see this likely possibility? If someone is low income and qualifies for free Medicaid, why and why should they, sign up for a plan under the ACA. Makes perfect sense.
The ACA plan needs young people to sign up but with the expansion of Medicaid plus covering young'uns on their parent's insurance up to age 26 that all would seem to cut into the numbers of those in the needed younger ages who will sign up for the new ACA plans.
:yes:
It needs the young folks or it will implode making premiums through the roof.
Quote from: 11B4V on October 28, 2013, 12:44:14 PM
Quote from: KRonn on October 28, 2013, 12:39:17 PM
The ACA plan needs young people to sign up but with the expansion of Medicaid plus covering young'uns on their parent's insurance up to age 26 that all would seem to cut into the numbers of those in the needed younger ages who will sign up for the new ACA plans.
:yes:
It needs the young folks or it will implode making premiums through the roof.
Hell, it certainly doesn't need old people. The company covering my father's healthcare policy through his retirement package sent the notice they're terminating his policy last week.
Effective January 1, they're sending him and my mother cash instead.
Quote from: CountDeMoney on October 28, 2013, 12:43:11 PM
Quote from: 11B4V on October 28, 2013, 12:36:16 PM
Quote from: CountDeMoney on October 28, 2013, 12:30:53 PM
Free stuff is pretty popular when you can't afford real stuff in the first place.
Then you admit obamacare is unaffordable.
No, dumbass. Private insurance is unaffordable to the indigent, which is why you see people who couldn't afford private providers before suddenly enrolling in expanded Medicaid.
So this benefits the Obamacare plan how???? So this helps the overall scheme of Obamacare???
QuoteSo sorry, 11B, but you just may see more black people with Medicaid in the future. Sucks to be you.
Your statement just reinforces the stigma of the "Fourty Seven Percenters".
Keep spouting the party line Sparky
Quote from: CountDeMoney on October 28, 2013, 12:46:26 PM
Quote from: 11B4V on October 28, 2013, 12:44:14 PM
Quote from: KRonn on October 28, 2013, 12:39:17 PM
The ACA plan needs young people to sign up but with the expansion of Medicaid plus covering young'uns on their parent's insurance up to age 26 that all would seem to cut into the numbers of those in the needed younger ages who will sign up for the new ACA plans.
:yes:
It needs the young folks or it will implode making premiums through the roof.
Hell, it certainly doesn't need old people. The company covering my father's healthcare policy through his retirement package sent the notice they're terminating his policy last week.
Effective January 1, they're sending him and my mother cash instead.
So, you admit Obama lied.
QuoteIf 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.
:lol:
11Bravo's going off the rails today. :lol:
Must still be pissy they moved Megyn Kelly off days, so he misses her when he's working. :P
Quote from: Berkut on October 28, 2013, 12:41:22 PM
There was a 0% chance of a website of that scale, complexity, and load would roll out in the manner they designed without massive problems.
This should have been a graduated release, scaling up over time with a carefully managed release schedule driven by the technical requirements. Of course, that was politically impossible, so what we have is completely predictable and inevitable.
Seems like that could have been a good plan.
It often makes me wonder how these high paid government officials cant come up with a common sense plan like you just submitted.
Quote from: 11B4V on October 28, 2013, 12:48:54 PM
Your statement just reinforces the stigma of the "Fourty Seven Percenters".
Keep spouting the party line Sparky
Pretty funny coming from the very model of institutionalized welfare, a United States Government employee. You're sucking it up from the deepest trough, piggie.
You should take your "small government" philosophy to heart, save the US taxpayer from that bloated deficit you hate so much, and resign. :P
Quote from: CountDeMoney on October 28, 2013, 12:53:53 PM
11Bravo's going off the rails today. :lol:
Must still be pissy they moved Megyn Kelly off days, so he misses her when he's working. :P
He's always had difficulty making logical connections.
Quote from: CountDeMoney on October 28, 2013, 12:53:53 PM
11Bravo's going off the rails today. :lol:
Certainly not. Just reveling in the Signature Turd of your boy. :lmfao:
The debacle of Obamacare has just begun. Should measure nicely in the 2014 mid-terms. It will be a treat to watch Dems waffle and start think about they're own skins and re elections in their districts.
Any bets on a delay to the individual mandate?
Quote from: 11B4V on October 28, 2013, 01:01:07 PM
Certainly not. Just reveling in the Signature Turd of your boy.
So racist. You should go back to your code words.
Quote from: 11B4V on October 28, 2013, 12:55:11 PM
Quote from: Berkut on October 28, 2013, 12:41:22 PM
There was a 0% chance of a website of that scale, complexity, and load would roll out in the manner they designed without massive problems.
This should have been a graduated release, scaling up over time with a carefully managed release schedule driven by the technical requirements. Of course, that was politically impossible, so what we have is completely predictable and inevitable.
Seems like that could have been a good plan.
It often makes me wonder how these high paid government officials cant come up with a common sense plan like you just submitted.
Because the highly paid government officials are usually ignored in the final round of political horse-trading when the bill finally takes shape.
Quote from: CountDeMoney on October 28, 2013, 12:57:29 PM
Quote from: 11B4V on October 28, 2013, 12:48:54 PM
Your statement just reinforces the stigma of the "Fourty Seven Percenters".
Keep spouting the party line Sparky
You should take your "small government" philosophy to heart, save the US taxpayer from that bloated deficit you hate so much, and resign. :P
Civil Service believes in big Govmint. That's the reason I voted for Obama.
Get it right
QuotePretty funny coming from the very model of institutionalized welfare, a United States Government employee. You're sucking it up from the deepest trough, piggie.
Dont hate the player. Hate the game. ;) :lol:
Quote from: Barrister on October 28, 2013, 01:03:37 PM
Quote from: 11B4V on October 28, 2013, 12:55:11 PM
Quote from: Berkut on October 28, 2013, 12:41:22 PM
There was a 0% chance of a website of that scale, complexity, and load would roll out in the manner they designed without massive problems.
This should have been a graduated release, scaling up over time with a carefully managed release schedule driven by the technical requirements. Of course, that was politically impossible, so what we have is completely predictable and inevitable.
Seems like that could have been a good plan.
It often makes me wonder how these high paid government officials cant come up with a common sense plan like you just submitted.
Because the highly paid government officials are usually ignored in the final round of political horse-trading when the bill finally takes shape.
Sadly
Quote from: Razgovory on October 28, 2013, 12:59:23 PM
Quote from: CountDeMoney on October 28, 2013, 12:53:53 PM
11Bravo's going off the rails today. :lol:
Must still be pissy they moved Megyn Kelly off days, so he misses her when he's working. :P
He's always had difficulty making logical connections.
Nice try. You sign up yet for the free medicaid?
Quote from: 11B4V on October 28, 2013, 01:04:32 PM
Quote from: Barrister on October 28, 2013, 01:03:37 PM
Quote from: 11B4V on October 28, 2013, 12:55:11 PM
Quote from: Berkut on October 28, 2013, 12:41:22 PM
There was a 0% chance of a website of that scale, complexity, and load would roll out in the manner they designed without massive problems.
This should have been a graduated release, scaling up over time with a carefully managed release schedule driven by the technical requirements. Of course, that was politically impossible, so what we have is completely predictable and inevitable.
Seems like that could have been a good plan.
It often makes me wonder how these high paid government officials cant come up with a common sense plan like you just submitted.
Because the highly paid government officials are usually ignored in the final round of political horse-trading when the bill finally takes shape.
Sadly
Now I'm hardly in the policy branch, but I am inside the government, so it's always interesting to see what changes the two levels of government make that impact us in prosecutions.
Sometimes the people in policy put forward a proposal and the government follows it, and it's tremendously successful. The system works.
Sometimes we get these odd proposals that nobody really asked for, but we thank them, we guess.
And sometimes we get changes that are horrifically awful because some genius in the minister's office thought it would be a good idea, but nobody ever thought to ask the experts. In the spring budget for Alberta one of the lines was that the government 'would save money by cutting all funding for weekend jail sentences'. It horrified everyone involved, because weekend sentences are in the criminal code and they HAVE to allow them, plus since weekend prisoners cost less than full-time prisoners the move would actually cost the government more. Thankfully they quickly backtracked on that one.
Quote from: 11B4V on October 28, 2013, 01:05:59 PM
Quote from: Razgovory on October 28, 2013, 12:59:23 PM
Quote from: CountDeMoney on October 28, 2013, 12:53:53 PM
11Bravo's going off the rails today. :lol:
Must still be pissy they moved Megyn Kelly off days, so he misses her when he's working. :P
He's always had difficulty making logical connections.
Nice try. You sign up yet for the free medicaid?
Long, long ago.
Quote from: 11B4V on October 28, 2013, 01:01:07 PM
Quote from: CountDeMoney on October 28, 2013, 12:53:53 PM
11Bravo's going off the rails today. :lol:
Certainly not. Just reveling in the Signature Turd of your boy. :lmfao:
The debacle of Obamacare has just begun. Should measure nicely in the 2014 mid-terms. It will be a treat to watch Dems waffle and start think about they're own skins and re elections in their districts.
Any bets on a delay to the individual mandate?
Yes, you go ahead in revel in turds.
Quote from: CountDeMoney on October 28, 2013, 01:02:55 PM
Quote from: 11B4V on October 28, 2013, 01:01:07 PM
Certainly not. Just reveling in the Signature Turd of your boy.
So racist. You should go back to your code words.
QuoteCiting website problems, Sen. Jeanne Shaheen, D-N.H., advocates extending the open enrollment period for the health care law's insurance exchanges.
http://www.cbsnews.com/8301-250_162-57609507/healthcare.gov-glitches-congress-is-demanding-answers/
Quote from: Razgovory on October 28, 2013, 01:14:33 PM
Quote from: 11B4V on October 28, 2013, 01:01:07 PM
Quote from: CountDeMoney on October 28, 2013, 12:53:53 PM
11Bravo's going off the rails today. :lol:
Certainly not. Just reveling in the Signature Turd of your boy. :lmfao:
The debacle of Obamacare has just begun. Should measure nicely in the 2014 mid-terms. It will be a treat to watch Dems waffle and start think about they're own skins and re elections in their districts.
Any bets on a delay to the individual mandate?
Yes, you go ahead in revel in turds.
2014
Okay.
Hey 11, what is it you hate about the ACA?
Quote from: 11B4V on October 28, 2013, 01:03:51 PM
Civil Service believes in big Govmint.
Not always.
(https://languish.org/forums/proxy.php?request=http%3A%2F%2Fdailycaller.com%2Fwp-content%2Fuploads%2F2013%2F10%2Fron-swanson-waste.jpg&hash=e01e77f5ece43202a293b7bb190512f9c94f3613)
:lol:
Somehow I doubt the GOP will be picking up a bunch of seats in 2014.
Quote from: Razgovory on October 28, 2013, 01:48:07 PM
Somehow I doubt the GOP will be picking up a bunch of seats in 2014.
Who knows. Lots could happen in the next year.
Quote from: derspiess on October 28, 2013, 01:48:51 PM
Quote from: Grey Fox on October 28, 2013, 01:46:51 PM
Quote from: 11B4V on October 28, 2013, 01:25:46 PM
Quote from: Grey Fox on October 28, 2013, 01:22:28 PM
Hey 11, what is it you hate about the ACA?
I dont.
You sure?
He likes poking fun at both sides, as he's a centrist.
Damn it DS. I didnt want Seedy to know that. :mad: :P
More about Hannity than anything else, but....
http://www.salon.com/2013/10/18/inside_the_fox_news_lie_machine_i_fact_checked_sean_hannity_on_obamacare/
Quote from: derspiess on October 28, 2013, 01:49:44 PM
Quote from: Razgovory on October 28, 2013, 01:48:07 PM
Somehow I doubt the GOP will be picking up a bunch of seats in 2014.
Who knows. Lots could happen in the next year.
Well, they already have a strong majority in the house so you can't pick up a great deal there. I imagine the Senate will remain the close. I expect the GOP to pick up maybe a few seats in the House and maybe one in Senate (the party not holding Presidency tends to do so in the midterms), but beyond that I don't see any big shifts.
Quote from: derspiess on October 28, 2013, 01:48:51 PM
Quote from: Grey Fox on October 28, 2013, 01:46:51 PM
Quote from: 11B4V on October 28, 2013, 01:25:46 PM
Quote from: Grey Fox on October 28, 2013, 01:22:28 PM
Hey 11, what is it you hate about the ACA?
I dont.
You sure?
He likes poking fun at both sides, as he's a centrist.
That's a polite way to put it.
QuoteSome health insurance gets pricier as Obamacare rolls out
Many middle-class Californians with individual health plans are surprised they need policies that cover more — and cost more.
Thousands of Californians are discovering what Obamacare will cost them — and many don't like what they see.
These middle-class consumers are staring at hefty increases on their insurance bills as the overhaul remakes the healthcare market. Their rates are rising in large part to help offset the higher costs of covering sicker, poorer people who have been shut out of the system for years.
Although recent criticism of the healthcare law has focused on website glitches and early enrollment snags, experts say sharp price increases for individual policies have the greatest potential to erode public support for President Obama's signature legislation.
PHOTOS: The battle over Obamacare
"This is when the actual sticker shock comes into play for people," said Gerald Kominski, director of the UCLA Center for Health Policy Research. "There are winners and losers under the Affordable Care Act."
Fullerton resident Jennifer Harris thought she had a great deal, paying $98 a month for an individual plan through Health Net Inc. She got a rude surprise this month when the company said it would cancel her policy at the end of this year. Her current plan does not conform with the new federal rules, which require more generous levels of coverage.
Now Harris, a self-employed lawyer, must shop for replacement insurance. The cheapest plan she has found will cost her $238 a month. She and her husband don't qualify for federal premium subsidies because they earn too much money, about $80,000 a year combined.
"It doesn't seem right to make the middle class pay so much more in order to give health insurance to everybody else," said Harris, who is three months pregnant. "This increase is simply not affordable."
On balance, many Americans will benefit from the healthcare expansion. They are guaranteed coverage regardless of their medical history. And lower-income families will gain access to comprehensive coverage at little or no cost.
The federal government picks up much of the tab through an expansion of Medicaid and subsidies to people earning up to four times the federal poverty level. That's up to $46,000 for an individual or $94,000 for a family of four.
But middle-income consumers face an estimated 30% rate increase, on average, in California due to several factors tied to the healthcare law.
Some may elect to go without coverage if they feel prices are too high. Penalties for opting out are very small initially. Defections could cause rates to skyrocket if a diverse mix of people don't sign up for health insurance.
Pam Kehaly, president of Anthem Blue Cross in California, said she received a recent letter from a young woman complaining about a 50% rate hike related to the healthcare law.
"She said, 'I was all for Obamacare until I found out I was paying for it,'" Kehaly said.
Nearly 2 million Californians have individual insurance, and several hundred thousand of them are losing their health plans in a matter of weeks.
Blue Shield of California sent termination letters to 119,000 customers last month whose plans don't meet the new federal requirements. About two-thirds of those people will experience a rate increase from switching to a new health plan, according to the company.
HMO giant Kaiser Permanente is canceling coverage for about half of its individual customers, or 160,000 people, and offering to automatically enroll them in the most comparable health plan available.
The 16 million Californians who get health insurance through their employers aren't affected. Neither are individuals who have "grandfathered" policies bought before March 2010, when the healthcare law was enacted. It's estimated that about half of policyholders in the individual market have those older plans.
Obamacare: News and analysis
All these cancellations were prompted by a requirement from Covered California, the state's new insurance exchange. The state didn't want to give insurance companies the opportunity to hold on to the healthiest patients for up to a year, keeping them out of the larger risk pool that will influence future rates.
Peter Lee, executive director of Covered California, said the state and insurers agreed that clearing the decks by Jan. 1 was best for consumers in the long run despite the initial disruption. Lee has heard the complaints — even from his sister-in-law, who recently groused about her 50% rate increase.
"People could have kept their cheaper, bad coverage, and those people wouldn't have been part of the common risk pool," Lee said. "We are better off all being in this together. We are transforming the individual market and making it better."
Lee said consumers need to consider all their options. They don't have to stick with their current company, and higher premiums are only part of the cost equation. Lee said some of these rate hikes will be partially offset by smaller deductibles and lower limits on out-of-pocket medical expenses in the new plans.
More legal trouble for Affordable Care Act More legal trouble for Affordable Care Act
Sean Hannity to Obamacare worker: Sorry I got you fired. Here's $25k. Sean Hannity to Obamacare worker: Sorry I got you fired. Here's $25k.
Obamacare's next hurdle McManus: Obamacare's next hurdle
The battle over the Affordable Care Act Photos: The battle over the Affordable Care Act
Saving Obamacare from the website disaster: A smart proposal Hiltzik: Saving Obamacare from the website disaster: A smart proposal
Still, many are frustrated at being forced to give up the plans they have now. They frequently cite assurances given by Obama that Americans could hold on to their health insurance despite the massive overhaul.
"All we've been hearing the last three years is if you like your policy you can keep it," said Deborah Cavallaro, a real estate agent in Westchester. "I'm infuriated because I was lied to."
Supporters of the healthcare law say Obama was referring to people who are insured through their employers or through government programs such as Medicare. Still, they acknowledge the confusion and anger from individual policyholders who are being forced to change.
Cavallaro received her cancellation notice from Anthem Blue Cross this month. The company said a comparable Bronze plan would cost her 65% more, or $484 a month. She doubts she'll qualify for much in premium subsidies, if any. Regardless, she resents losing the ability to pick and choose the benefits she wants to pay for.
"I just won't have health insurance because I can't pay this increase," she said.
Most Americans are required to have health coverage starting next year or pay a fine of $95 per adult or 1% of their income, whichever is greater. The fines increase over time.
A number of factors are driving up rates. In a report this year, consultants hired by the state said the influx of sicker patients as a result of guaranteed coverage was the biggest single reason for higher premiums. Bob Cosway, a principal and consulting actuary at Milliman Inc. in San Diego, estimated that the average individual premium in 2014 will rise 27% because of that difference alone.
Individual policies must also cover a higher percentage of overall medical costs and include 10 "essential health benefits," such as prescription drugs and mental health services. The aim is to fill gaps in coverage and provide consumers more peace of mind. But those expanded benefits have to be paid for with higher premiums.
The federal law also adjusts how rates are set by age, a change that gives older consumers a break and shifts more costs to younger people. Rates by age can vary by only 3 to 1 starting next year as opposed to 6 to 1 in some cases now in California. People in their 20s just starting their careers may earn so little they qualify for subsidies. But that might not be the case for consumers who are slightly older and earning more.
"It has the effect of benefiting people in their 50s and 60s and shifting costs to people in their 20s and 30s," said Patrick Johnston, president of the California Assn. of Health Plans. "Benefits are being increased for all, but it's not government subsidies for all. Some will pay more."
Rates would be going up regardless of changes from the healthcare expansion. The average individual premium will climb 9% next year because of rising healthcare costs and increases in medical provider reimbursement, according to Milliman's estimates.
Some consumer groups have questioned whether insurers are inflating their rates under the guise of the healthcare law changes.
"We believe the prices are higher than they should be," said Jamie Court, president of Consumer Watchdog, a Santa Monica advocacy group. "This is giving a bad name to the Affordable Care Act."
State regulators checked the insurance companies' math and underlying cost projections for next year, but they don't have the authority to deny increases. Under federal rules, insurers can be ordered to issue rebates if they don't spend a minimum amount of every premium dollar on customers' medical care.
"The rates aren't going up because insurance companies are pocketing more money," Lee said. "That is what it takes to pay the claims and deliver the healthcare."
Javier Lopez, 38 and a self-employed aerospace engineer in Huntington Beach, pays about $750 a month for an Anthem Blue Cross plan for his family of four. His premiums may rise nearly 20% next year for a new policy because his current plan is being phased out.
Lopez says he's willing to absorb that one-year jump if it means the government can rein in future rate hikes.
"I'm hoping with this reform," Lopez said, "we won't see big increases year after year."
11Bravo doesn't hate the ACA. He just hates the people that need it. THERES A DIFFERENCE
Hitler learns of the Obamacare problems:
http://www.youtube.com/watch?v=e3-RKS0_NKk (http://www.youtube.com/watch?v=e3-RKS0_NKk)
(https://languish.org/forums/proxy.php?request=http%3A%2F%2Fwww.zerohedge.com%2Fsites%2Fdefault%2Ffiles%2Fimages%2Fuser3303%2Fimageroot%2F2013%2F10%2F20131027_obama1.jpg&hash=0f2394c67e9384b974428e35daee7b08dab70688)
Quote from: CountDeMoney on October 28, 2013, 02:00:33 PM
11Bravo doesn't hate the ACA. He just hates the people that need it. THERES A DIFFERENCE
I dont hate you. :(
The face of Obamacare.
(https://languish.org/forums/proxy.php?request=http%3A%2F%2Fwww.humanevents.com%2Fwp-content%2Fuploads%2F2013%2F06%2FKathleen-Sebelius.jpg&hash=a87e4f3167ad49123648f7fa0008ed82af8d521f)
Quote from: 11B4V on October 28, 2013, 02:06:07 PM
Quote from: CountDeMoney on October 28, 2013, 02:00:33 PM
11Bravo doesn't hate the ACA. He just hates the people that need it. THERES A DIFFERENCE
I dont hate you. :(
You just don't want me to have access to affordable health insurance, that's all. Nothing personal, I can dig it.
Quote from: citizen k on October 28, 2013, 02:04:58 PM
Hitler learns of the Obamacare problems:
http://www.youtube.com/watch?v=e3-RKS0_NKk (http://www.youtube.com/watch?v=e3-RKS0_NKk)
(https://languish.org/forums/proxy.php?request=http%3A%2F%2Fwww.zerohedge.com%2Fsites%2Fdefault%2Ffiles%2Fimages%2Fuser3303%2Fimageroot%2F2013%2F10%2F20131027_obama1.jpg&hash=0f2394c67e9384b974428e35daee7b08dab70688)
QuoteFord has sold more Pintos than have enrolled in Obamacare, after people learned they were death traps.
:lmfao: I 'bout fell out of my chair.
Quote from: citizen k on October 28, 2013, 02:04:58 PM
Hitler learns of the Obamacare problems:
http://www.youtube.com/watch?v=e3-RKS0_NKk (http://www.youtube.com/watch?v=e3-RKS0_NKk)
(https://languish.org/forums/proxy.php?request=http%3A%2F%2Fwww.zerohedge.com%2Fsites%2Fdefault%2Ffiles%2Fimages%2Fuser3303%2Fimageroot%2F2013%2F10%2F20131027_obama1.jpg&hash=0f2394c67e9384b974428e35daee7b08dab70688)
That was pretty good :lol: Thank you.
It was only a matter of time for a Downfall meme.
"He didn't know you still drive a Pinto, Sandra."
I liked SNL's coverage woes. I'd like to sign up for the Trollish plan and eagerly await my copy of Encarta'95 and 1000 free hours of AOL.
I received my Open Enrollment package in the mail today. It included this note: "I am very pleased to share with you that rates for this coverage have stayed the save for 2014 - no increase in premium costs to employees."
Quote from: 11B4V on October 28, 2013, 12:36:16 PM
Quote from: CountDeMoney on October 28, 2013, 12:30:53 PM
Free stuff is pretty popular when you can't afford real stuff in the first place.
Then you admit obamacare is unaffordable.
So is Bushcare. That was the point of reform.
The US will discover that it isn't magical, and that single-payer (even with opt-out provisions like Germany) will be necessary, just as all of the other industrialized nations have discovered. I really don't understand why healthcare reform had to go down this obviously non-viable path. Even the right-wingers have to see that health care simply doesn't respond to market forces.
Under Bushcare the cheapest option was $0.
The computer glitch is what it is, a fuck up that can be fixed. For those who weren't aware, it's all the fault of the Canadians anyway.
What I believe will be a bigger issue is when the great unwashed masses become aware for the first time that they will have to buy insurance for the first time or pay a fine.
Quote from: Admiral Yi on October 28, 2013, 07:36:40 PM
For those who weren't aware, it's all the fault of the Canadians anyway.
Bastards probably used the metric system in the code.
Quote from: Admiral Yi on October 28, 2013, 07:36:40 PM
Under Bushcare the cheapest option was $0.
And it was a great option, because you got coverage as a free rider. That option was $0 to the participant, but not the system.
QuoteThe computer glitch is what it is, a fuck up that can be fixed.
Yeah, the angst over the rollout glitches seems to be motivated by stupidity, politics, or stupid politicians.
QuoteWhat I believe will be a bigger issue is when the great unwashed masses become aware for the first time that they will have to buy insurance for the first time or pay a fine.
Yeah, the free riders will squeal. They always do.
MSNBC? The honeymoon is finally ended between these two???? :(
QuoteObama admin. knew millions could not keep their health insurance
http://investigations.nbcnews.com/_news/2013/10/28/21213547-obama-admin-knew-millions-could-not-keep-their-health-insurance?lite
Quote from: Admiral Yi on October 28, 2013, 07:36:40 PM
Under Bushcare the cheapest option was $0.
The computer glitch is what it is, a fuck up that can be fixed. For those who weren't aware, it's all the fault of the Canadians anyway.
What I believe will be a bigger issue is when the great unwashed masses become aware for the first time that they will have to buy insurance for the first time or pay a fine.
It's your own fault to give a contract to CGI.
Quote from: grumbler on October 28, 2013, 07:29:04 PM
Quote from: 11B4V on October 28, 2013, 12:36:16 PM
Quote from: CountDeMoney on October 28, 2013, 12:30:53 PM
Free stuff is pretty popular when you can't afford real stuff in the first place.
Then you admit obamacare is unaffordable.
So is Bushcare. That was the point of reform.
The US will discover that it isn't magical, and that single-payer (even with opt-out provisions like Germany) will be necessary, just as all of the other industrialized nations have discovered. I really don't understand why healthcare reform had to go down this obviously non-viable path. Even the right-wingers have to see that health care simply doesn't respond to market forces.
:rolleyes: Germany doesn't have single payer. The UK does, and it is known as the worst health care system in the western world.
Quote from: Hansmeister on October 29, 2013, 07:16:45 PM
:rolleyes: Germany doesn't have single payer. The UK does, and it is known as the worst health care system in the western world.
That's not fair.
I've always thought it's a curse that the US and UK know about each other. In both countries we can be good examples against reform. In the US you don't want a system like the NHS, here even the slightest hint of moving to a (European) social insurance system invokes fears of an American system.
The NHS isn't, as we like to tell ourselves, the best system in the world. But it is relatively cheap and efficient, and universal. Different countries and societies will have different priorities but I think that moderate results for moderate spending is about where Britain is on healthcare policy. The other virtue the system has is that while it's extremely labyrinthine it's all internal, so for a patient it's really very simple which, I think, is why in international polls the UK tends to be most satisfied with effectiveness and cost. For a socialist system we don't have to fill in any forms.
Quote from: Hansmeister on October 29, 2013, 07:16:45 PM
:rolleyes: Germany doesn't have single payer. The UK does, and it is known as the worst health care system in the western world.
Spain is mostly single payer and the overwhelming majority of services are public, and the results are pretty good.
Though I'll admit much of that success might be attributable to lifestyle factors -- all Med Euro countries are placed very high in WHO rankings.
Quote from: Hansmeister on October 29, 2013, 07:16:45 PM
:rolleyes: Germany doesn't have single payer. The UK does, and it is known as the worst health care system in the western world.
:rolleyes: Of course Germany has (effectively) single-payer. The Gesetzliche Krankenversicherung have traditionally been collected/paid by non-profit government-established organizations at rates set by the state (Lander), with optout provisions for those who want to (and can) pay for their own insurance). Everyone has to have coverage, by law, and the government provides it for those who cannot contribute through the normal non-profits.
The British system has its problems, but I don't think anyone with a pulse would rate it worse than Bushcare (which provids no coverage at all for about 1/6 of the legal population).
The ability to opt out or supplement is consistent with the concept of single payer.
The UK is both single payer (government is primary and universal payer) and single provider (government in primary provider of health care resources). It is the single provider provisions of the UK system that typically are highlighted for criticism.
CNN showed quite a bit of footage of the Sibelius hearing. She was excellent I thought.
Quote from: Admiral Yi on October 30, 2013, 12:00:02 PM
CNN showed quite a bit of footage of the Sibelius hearing. She was excellent I thought.
Of course, she's a civil service executive. They excel at bullshit.
I didn't hear any bullshit from her. :mellow:
Quote from: Admiral Yi on October 30, 2013, 12:00:02 PM
CNN showed quite a bit of footage of the Sibelius hearing. She was excellent I thought.
In what respect? (Did not see)
Quote from: The Minsky Moment on October 30, 2013, 04:11:45 PM
In what respect? (Did not see)
Calm, cool, informative, responsive. Apologetic but not sock-sucking. Accepted ultimate responsibility. Resisted the temptation to bus under-throw.
She did blurt out the name of the underling (contractor?) in charge of the program at one point, but rode right over it and emphasized right after that she bore responsibility.
and she should be fired...err moved as they call it.
Just heard on CNN that the favorable rating for Obamacare actually edged up during Glitchgate.
To 44%. :huh:
Which makes me suspect that the oft-repeated refrain about the overwhelming popularity of Obamacare was bunkum.
Quote from: Admiral Yi on October 30, 2013, 05:41:58 PM
Which makes me suspect that the oft-repeated refrain about the overwhelming popularity of Obamacare was bunkum.
:blink: Who has ever said it's overwhelmingly popular?
QuoteJust heard on CNN that the favorable rating for Obamacare actually edged up during Glitchgate.
It climbed to the low-40s during the shutdown - which was another sign of how counter-productive that was for Republicans.
Quote from: Admiral Yi on October 30, 2013, 05:41:58 PM
Just heard on CNN that the favorable rating for Obamacare actually edged up during Glitchgate.
To 44%. :huh:
Which makes me suspect that the oft-repeated refrain about the overwhelming popularity of Obamacare was bunkum.
Whereas NBC/WSJ have him at a low.
http://firstread.nbcnews.com/_news/2013/10/30/21252250-nbcwsj-poll-obama-approval-sinks-to-new-low?lite
Quote from: Sheilbh on October 30, 2013, 05:47:30 PM
:blink: Who has ever said it's overwhelmingly popular?
I can't think of a Democrat who has *not* talked about its popularity.
Quote from: Admiral Yi on October 30, 2013, 05:41:58 PM
Just heard on CNN that the favorable rating for Obamacare actually edged up during Glitchgate.
To 44%. :huh:
Which makes me suspect that the oft-repeated refrain about the overwhelming popularity of Obamacare was bunkum.
I'd be curious to see how these poll questions are phrased. There is a lot of gray area with things like "I'm happy that I can finally get insurance to treat my diabetes, lung cancer, and cardiac arrest, but I don't think there should be an individual mandate".
Quote from: Admiral Yi on October 30, 2013, 05:52:43 PM
Quote from: Sheilbh on October 30, 2013, 05:47:30 PM
:blink: Who has ever said it's overwhelmingly popular?
I can't think of a Democrat who has *not* talked about its popularity.
I can't really recall those claims, and they would fly in the face of known reality long before you caught that CNN poll. What I do recall is claims that majority of Americans want to move on, and not keep trying to repeal Obamacare.
Quote from: Admiral Yi on October 30, 2013, 05:52:43 PM
Quote from: Sheilbh on October 30, 2013, 05:47:30 PM
:blink: Who has ever said it's overwhelmingly popular?
I can't think of a Democrat who has *not* talked about its popularity.
Can you get some examples because that's madness if they are. Politicians are sometimes panglossian but they're rarely that stupid in their spin.
I can think of three things -
1 - The ideas in Obamacare are overwhelmingly popular. If you poll them individually everyone likes them (with the exception of the mandate). Less people like 'Obamacare'.
2 - The name 'Obamacare' is unpopular. If you poll people on the 'Affordable Care Act' then popularity shoots up.
3 - Most lefties, I think, assume Obamacare will become popular once its fully effective.
Quote from: DGuller on October 30, 2013, 05:53:54 PM
I'd be curious to see how these poll questions are phrased. There is a lot of gray area with things like "I'm happy that I can finally get insurance to treat my diabetes, lung cancer, and cardiac arrest, but I don't think there should be an individual mandate".
That's more or less what I've always suspected, that the talking point was based on a push poll about "would you like your pre-existing condition to be covered etc etc."
Seedy you were one of the six??? :lol:
Quote
Six enrolled on health site on Day 1
Only six people enrolled in health insurance via the Obamacare exchanges on the website's first day, newly released documents reveal.
"War room notes" released by the House Oversight and Government Reform Committee from the morning of Oct. 2, the day after the exchange site opened, show that amid ongoing problems with the site, just six people had completed enrollment as of that morning.
http://www.politico.com/story/2013/11/obamacare-enrollment-website-glitches-99213.html
Only 6? I could believe only 60, but 6?! :lol:
Quote from: Sheilbh on October 30, 2013, 05:56:33 PM
3 - Most lefties, I think, assume Obamacare will become popular once its fully effective.
Actually the righties believe this as well, at least the top does. An recording of a conversation between Petreaus and an envoy from Fox News said as much.
Quote from: 11B4V on November 01, 2013, 11:11:04 AM
Seedy you were one of the six??? :lol:
I wasnt aware that morning was the deadline, 11DanIssa.
Quote from: CountDeMoney on November 01, 2013, 12:15:21 PM
Quote from: 11B4V on November 01, 2013, 11:11:04 AM
Seedy you were one of the six??? :lol:
I wasnt aware that morning was the deadline, 11DanIssa.
So people had muted excitement about the change?
Quote from: 11B4V on November 01, 2013, 11:11:04 AM
Seedy you were one of the six??? :lol:
Quote
Six enrolled on health site on Day 1
Only six people enrolled in health insurance via the Obamacare exchanges on the website's first day, newly released documents reveal.
"War room notes" released by the House Oversight and Government Reform Committee from the morning of Oct. 2, the day after the exchange site opened, show that amid ongoing problems with the site, just six people had completed enrollment as of that morning.
http://www.politico.com/story/2013/11/obamacare-enrollment-website-glitches-99213.html
That's also the number that Saturday Night Live used during their spoof on Sebelius and the website. I wonder how they got the real number first! ;)
Quote from: garbon on November 01, 2013, 12:17:40 PM
So people had muted excitement about the change?
I dunno.
El Caballo would never have allowed such shenanigans from an opposition party. :cigar: :beard:
Then again, what the GOP's managed to do as the minority opposition party would impress even him, right before having them all shot.
QuotePolitico.com
The Obamacare sabotage campaign
By: Todd S. Purdum
November 1, 2013 05:04 AM EST
To the undisputed reasons for Obamacare's rocky rollout — a balky website, muddied White House messaging and sudden sticker shock for individuals forced to buy more expensive health insurance — add a less acknowledged cause: calculated sabotage by Republicans at every step.
That may sound like a left-wing conspiracy theory — and the Obama administration itself is so busy defending the indefensible early failings of its signature program that it has barely tried to make this case. But there is a strong factual basis for such a charge.
From the moment the bill was introduced, Republican leaders in both houses of Congress announced their intention to kill it. Republican troops pressed this cause all the way to the Supreme Court — which upheld the law, but weakened a key part of it by giving states the option to reject an expansion of Medicaid. The GOP faithful then kept up their crusade past the president's reelection, in a pattern of "massive resistance" not seen since the Southern states' defiance of the Supreme Court's Brown v. Board of Education decision in 1954.
The opposition was strategic from the start: Derail President Barack Obama's biggest ambition, and derail Obama himself. Party leaders enforced discipline, withholding any support for the new law — which passed with only Democratic votes, thus undermining its acceptance. Partisan divisions also meant that Democrats could not pass legislation smoothing out some rough language in the draft bill that passed the Senate. That left the administration forced to fill far more gaps through regulation than it otherwise would have had to do, because attempts — usually routine — to re-open the bill for small changes could have led to wholesale debate in the Senate all over again.
But the bitter fight over passage was only the beginning of the war to stop Obamacare. Most Republican governors declined to create their own state insurance exchanges — an option inserted in the bill in the Senate to appeal to the classic conservative preference for local control — forcing the federal government to take at least partial responsibility for creating marketplaces serving 36 states — far more than ever intended.
]Then congressional Republicans refused repeatedly to appropriate dedicated funds to do all that extra work, leaving the Health and Human Services Department and other agencies to cobble together HealthCare.gov by redirecting funds from existing programs. On top of that, nearly half of the states declined to expand their Medicaid programs using federal funds, as the law envisioned.
Then, in the months leading up to the program's debut, some states refused to do anything at all to educate the public about the law. And congressional Republicans sent so many burdensome queries to local hospitals and nonprofits gearing up to help consumers navigate the new system face-to-face that at least two such groups returned their federal grants and gave up the effort. When the White House let it be known last summer that it was in talks with the National Football League to enlist star athletes to help promote the law, the Senate's top two Republicans sent the league an ominous letter wondering why it would "risk damaging its inclusive and apolitical brand." The NFL backed off.
The drama culminated on the eve of the open enrollment date of Oct. 1. Congressional Republicans shut down the government, disrupting last-minute planning and limiting the administration's political ability to prepare the public for the likelihood of potential problems, because it was in a last-ditch fight to defend the president's biggest legislative accomplishment.
"I think my Republican colleagues forget that a lot of people are enrolling through state exchanges, rather than the federal exchange," Rep. Frank Pallone (D-N.J.) noted last week. "And if it wasn't for the fact that many Republican governors, including my own," failed to set up state exchanges, "then we wouldn't be putting so much burden on the federal system."
In fact, putting an excessive burden on the federal government was the explicit aim of the law's opponents. "Congress authorized no funds for federal 'fallback' exchanges," the Tea Party Patriots website noted as long ago as last December. "So Washington may not be able to impose exchanges on states at all." The group went on to suggest that since Washington was not equipped to handle so many state exchanges, "both financially and otherwise — this means the entire law could implode on itself."
That same month, the conservative pollster and pundit Dick Morris urged visitors to his website to sign petitions asking their states to refuse to establish exchanges. "If states assume the responsibility for administering this nightmare," he warned, "the blame will not land on the president's doorstep."
In congressional testimony this week, HHS Secretary Kathleen Sebelius declined to blame the paucity of state exchanges for the system's problems. "We should have anticipated, we should have planned better, we should have tested better," she said.
But just last week, Rush Limbaugh advised his listeners that they could avoid penalties for failing to buy mandated insurance by arranging to avoid federal income tax refunds, since the IRS can only levy fines by withholding refunds, not by liens or criminal sanctions.
The conservative battle against the Affordable Care Act continues on multiple fronts — including, again, in the courts. A federal district court judge in Washington last week denied the government's motion to dismiss a lawsuit filed by individuals and businesses from six states. The suit, coordinated by the Washington-based Competitive Enterprise Institute, challenges an IRS ruling that people can get tax credits to subsidize insurance in the federal-run exchanges, not just the state-based ones. Knocking out those subsidies would be a huge blow to the heart of Obamacare's coverage expansion. Similar cases are pending in other states.
Meantime, Darrell Issa, chairman of the House Committee on Oversight and Government Reform, sent letters last week to Google, Microsoft, Verizon, Oracle and Expedia, demanding to know if they were among the Silicon Valley experts enlisted by the Obama administration to help fix the sputtering health care website. He asked them to "provide all documents and communications referring or relating to any contact" they may have had with the administration or contractors working on the problem since Oct. 1.
And a health expert at the libertarian Cato Institute has drawn up an action plan on how to keep fighting the law in the states.
For months, the White House has hoped that every politician's instinct to render effective constituent service would trump political resistance to the law among Republicans. Even that has proved doubtful. Rep. Tim Huelskamp (R-Kan.) said last summer that his office would not provide assistance in signing up for the law. "Given that we come from Kansas," he said, "it's much easier to say, 'Call your former governor," meaning Sebelius. "You say, 'She's the one. She's responsible.'''
Obama himself has occasionally expressed frustration at the GOP's implacable resistance to even the smallest gestures of cooperation on the law.
"In a normal political environment, it would have been easier for me to simply call up the speaker and say, 'You know what, this is a tweak that doesn't go to the essence of the law.' It has to do with, for example, are we able to simplify the attestation of employers as to whether they're already providing health insurance or not. 'It looks like there may be some better ways to do this. Let's make a technical change to the law.'
"That would be the normal thing that I would prefer to do," the president said. "But we're not in a normal atmosphere around here when it comes to Obamacare.''
And the problem is?
It's all the fault of Republicans? :lol:
No, numbnuts: it's a superlative example of oppositional non-government. I mean, can you really think of any other examples other than the '94 shutdown where the minority opposition truly achieved its policy goals?
Maybe crashing the Robert Bork nomination, but that's a really distant bronze medal.
What we're seeing from the GOP and the Tea Party, from Benghazi to Obamacare, is a series of political masterpieces on how to win from the minority side on a number of fronts, from PR to concrete policy objectives. It's true politics.
I mean, I thought our generation missed out on not witnessing Watergate in live time, but this is actually even more fascinating.
Doesn't it just show how weak the Dems are. Perhaps we should avoid them. :)
Quote from: CountDeMoney on November 03, 2013, 10:23:58 AM
No, numbnuts: it's a superlative example of oppositional non-government. I mean, can you really think of any other examples other than the '94 shutdown where the minority opposition truly achieved its policy goals?
Maybe crashing the Robert Bork nomination, but that's a really distant bronze medal.
What we're seeing from the GOP and the Tea Party, from Benghazi to Obamacare, is a series of political masterpieces on how to win from the minority side on a number of fronts, from PR to concrete policy objectives. It's true politics.
I mean, I thought our generation missed out on not witnessing Watergate in live time, but this is actually even more fascinating.
I read Frank Rich's column in the NYT every week, so I can appreciate the technical mastery required to assign blame without stating a single testable thesis. :lol:
I wouldn't say weak as much as fractured, and they're pulling in different directions.
LOL, but no, I'd rather not see today's GOP with a two-house Congressional majority with Ted Cruz in the White House. And we thought Mitt Romney's first 90 day blueprint would've eliminated government? Sheesh.
Clinton-O'Malley* '16 will steady the waters. With their combined strength, they can end this destructive conflict and bring order to the galaxy.
*Maybe even Clinton-Castro '16. No, that would be Julian, unfortunately.
Quote from: Admiral Yi on November 03, 2013, 10:48:51 AM
I read Frank Rich's column in the NYT every week, so I can appreciate the technical mastery required to assign blame without stating a single testable thesis. :lol:
So you're saying all this is mere coincidence, and not the results of a well-organized, ideologically-unified and well-motivated and driven opposition?
Quote from: CountDeMoney on November 03, 2013, 10:57:01 AM
So you're saying all this is mere coincidence, and not the results of a well-organized, ideologically-unified and well-motivated and driven opposition?
So you're trying to make the incendiary, earth shattering point that the GOP
opposes Obamacare, and to help you make this revelatory point you linked to an article that's trying to argue that the problems of Obamacare are due to Republican sabotoge? :lol:
I felt it summed up the salient GOP efforts that directly affected an altered its course.
Nigga can't even give props when props is due. Damn.
Quote from: CountDeMoney on November 03, 2013, 10:23:58 AM
No, numbnuts: it's a superlative example of oppositional non-government.
Whereas Obama is a shining example of Presidential non-government. Nothing is ever his fault-- it's always someone else to blame. I bet Bush is somehow to blame for the Obamacare website fiasco.
Quote from: CountDeMoney on November 03, 2013, 11:07:51 AM
I felt it summed up the salient GOP efforts that directly affected an altered its course.
I felt it was a valiant effort to spin the computer fuckup and the mandate sticker shock as the fault of Republicans.
Quote from: derspiess on November 03, 2013, 01:31:56 PM
Whereas Obama is a shining example of Presidential non-government. Nothing is ever his fault-- it's always someone else to blame. I bet Bush is somehow to blame for the Obamacare website fiasco.
To be fair, Obama is no different from Bush in that regard. Dubya and the shrubbery always blamed the Democrats for their own blunders, just as Democrats now blame Republicans.
Bush senior was probably the last president to stop the buck. Clinton probably lacked the moral courage to do it, but we won't know because the psychotic episode the Republican leadership suffered when Clinton was elected made it impossible for Clinton to accept much responsibility; had he done so, he would have been impeached in his second day, not his second term.
Quote from: derspiess on November 03, 2013, 01:31:56 PM
Quote from: CountDeMoney on November 03, 2013, 10:23:58 AM
No, numbnuts: it's a superlative example of oppositional non-government.
Whereas Obama is a shining example of Presidential non-government. Nothing is ever his fault-- it's always someone else to blame. I bet Bush is somehow to blame for the Obamacare website fiasco.
Being professorial and deliberate to the point of paralysis while failing to react to the nuances of the news cycle doesn't mean it's somebody else's fault. Silly Teabagger.
Quote from: grumbler on November 03, 2013, 01:42:53 PM
To be fair, Obama is no different from Bush in that regard. Dubya and the shrubbery always blamed the Democrats for their own blunders, just as Democrats now blame Republicans.
Meh, with Dubya's administration, there was always the insinuation that any Democratic resistance to policy was unpatriotic, and that the terrorists would win.
You know, given the depth of Republican sentiment on Obamacare, sabotage really isn't that unthinkable. They shut down the government over it and there were a significant portion of their troops who seemed to favour destroying the modern economies over it.
Dude, no way shutting down the government and sending home all the Fed IT people right at rollout time for over two weeks would ever impact a project of that scale, and to think it was nothing more than mere coincidence is feeding into the paranoia.
Most of the Tea Party caucus doesn't really strike me as "big picture", thinkers.
Quote from: CountDeMoney on November 03, 2013, 02:29:37 PM
Dude, no way shutting down the government and sending home all the Fed IT people right at rollout time for over two weeks would ever impact a project of that scale, and to think it was nothing more than mere coincidence is feeding into the paranoia.
To think it was anything more than coincidence right after bruising hearings during which the Secretary of Health and Human Services had all the opportunity in the world to inform Congress that the problem was due, even in part, to the government shutdown but chose instead to say she had been informed by her team that it was all ready to go, is a desperate attempt to deflect criticism and reassign blame.
Wouldn't it make sense to assign the blame in the first place to Republicans, who have stabbed America in the back?
If by make sense you mean it would be coocoo, then yes.
I don't think it's that crazy. Evil people will do evil things.
So the vote from my extended family is in. My one uncle loves it as his healthcare costs have gone down. Everyone else in my family hates as they have seen their healthcare costs increase.
Quote from: Admiral Yi on November 03, 2013, 04:16:25 PM
Quote from: CountDeMoney on November 03, 2013, 02:29:37 PM
Dude, no way shutting down the government and sending home all the Fed IT people right at rollout time for over two weeks would ever impact a project of that scale, and to think it was nothing more than mere coincidence is feeding into the paranoia.
To think it was anything more than coincidence right after bruising hearings during which the Secretary of Health and Human Services had all the opportunity in the world to inform Congress that the problem was due, even in part, to the government shutdown but chose instead to say she had been informed by her team that it was all ready to go, is a desperate attempt to deflect criticism and reassign blame.
That's too rational.
Quote from: garbon on November 03, 2013, 10:44:06 AM
Doesn't it just show how weak the Dems are. Perhaps we should avoid them. :)
The Dems are totally worthless. But this has been true for probably 20 years now.
The sad part is the Republicans might just be worse.
Quote from: CountDeMoney on November 03, 2013, 02:19:49 PM
Quote from: grumbler on November 03, 2013, 01:42:53 PM
To be fair, Obama is no different from Bush in that regard. Dubya and the shrubbery always blamed the Democrats for their own blunders, just as Democrats now blame Republicans.
Meh, with Dubya's administration, there was always the insinuation that any Democratic resistance to policy was unpatriotic, and that the terrorists would win.
The difference is this actually worked and often the Democrats would cave.
I got Tricare.
How much of a deductible do you pay for those bedsheets you stick your dick through?
Quote from: Valmy on November 03, 2013, 08:50:36 PM
Quote from: garbon on November 03, 2013, 10:44:06 AM
Doesn't it just show how weak the Dems are. Perhaps we should avoid them. :)
The Dems are totally worthless. But this has been true for probably 20 years now.
The sad part is the Republicans might just be worse.
:bleeding: Yep, you can't ever just criticize the Dems without also slamming the GOP, can you?
Quote from: derspiess on November 03, 2013, 10:15:34 PM
:bleeding: Yep, you can't ever just criticize the Dems without also slamming the GOP, can you?
Any particular reason I should be showing the GOP any deference? What have they done to earn it?
Quote from: Valmy on November 03, 2013, 10:22:04 PM
Quote from: derspiess on November 03, 2013, 10:15:34 PM
:bleeding: Yep, you can't ever just criticize the Dems without also slamming the GOP, can you?
Any particular reason I should be showing the GOP any deference? What have they done to earn it?
Not at all. Just seems like on the other hand you're okay criticizing the GOP without feeling a need to slam the Dems. It's okay if you're left of center-- just own up to it.
Quote from: derspiess on November 03, 2013, 10:30:31 PM
It's okay if you're left of center-- just own up to it.
:hmm:
Quote from: derspiess on November 03, 2013, 10:30:31 PM
Not at all. Just seems like on the other hand you're okay criticizing the GOP without feeling a need to slam the Dems. It's okay if you're left of center-- just own up to it.
The Republicans have been acting worse, at least since Obama's been in power. Probably an integral part of being the opposition.
Anyway you should wait until he actually praises the Dems for something. :P
Quote from: derspiess on November 03, 2013, 10:30:31 PM
Quote from: Valmy on November 03, 2013, 10:22:04 PM
Quote from: derspiess on November 03, 2013, 10:15:34 PM
:bleeding: Yep, you can't ever just criticize the Dems without also slamming the GOP, can you?
Any particular reason I should be showing the GOP any deference? What have they done to earn it?
Not at all. Just seems like on the other hand you're okay criticizing the GOP without feeling a need to slam the Dems. It's okay if you're left of center-- just own up to it.
I think your center is off.
Quote from: Peter Wiggin on November 03, 2013, 11:01:21 PM
Anyway you should wait until he actually praises the Dems for something. :P
Ah, but that's not the Languish Way. Dems aren't overtly praised so much-- the GOP just gets demonized no matter what it does.
Quote from: derspiess on November 03, 2013, 11:07:59 PM
Quote from: Peter Wiggin on November 03, 2013, 11:01:21 PM
Anyway you should wait until he actually praises the Dems for something. :P
Ah, but that's not the Languish Way. Dems aren't overtly praised so much-- the GOP just gets demonized no matter what it does.
Maybe it should try to do different things.
Like what, Raz, out-Dem the Dems? Yeah that would be ossum.
Quote from: derspiess on November 03, 2013, 11:07:59 PM
Quote from: Peter Wiggin on November 03, 2013, 11:01:21 PM
Anyway you should wait until he actually praises the Dems for something. :P
Ah, but that's not the Languish Way. Dems aren't overtly praised so much-- the GOP just gets demonized no matter what it does.
It didn't used to be this way. The GOP used to be riding high around these parts. Sure, the social conservatism often rubbed a lot of people here the wrong way, but they were given a fair bit of respect back in the early and mid 2000s. But the crash did some damage and their disgraceful behavior since Obama was elected has damaged the brand.
Yeah, this forum would be a good case study of where the Republicans lost ground. They picked up Garbon but lost a lot of others.
I like to think that the NSDAP gained posters, not that the GOP lost them. :)
Quote from: The Brain on November 04, 2013, 12:52:55 PM
I like to think that the NSDAP gained posters, not that the GOP lost them. :)
:pinch:
Quote from: The Brain on November 04, 2013, 12:52:55 PM
I like to think that the NSDAP gained posters, not that the GOP lost them. :)
:huh: I don't think stock car racing gained that many posters from here.
Quote from: derspiess on November 03, 2013, 11:10:40 PM
Like what, Raz, out-Dem the Dems? Yeah that would be ossum.
Heh, the Dems essentially out GOPed the GOP in the 1990's. The GOP has chosen to be a right wing party and the dems have chosen to be a centrist party. In fact, in their efforts to demonize and distance themselves from the Democrats the Republicans force themselves further and further right. Now while this may suit you, you will have to understand that as you push further and further right you are going to lose more and more support from the center.
Democrats are a centrist party? :lol:
Quote from: derspiess on November 04, 2013, 02:27:03 PM
Democrats are a centrist party? :lol:
Outside of the Conservative echo chamber, most Dems aren't actually socialists conspiring to bring down the country. The rest are pretty much one guy in South Carolina who wants to start a nuclear war.
Quote from: derspiess on November 04, 2013, 02:27:03 PM
Democrats are a centrist party? :lol:
What in your opinion does a centrist party look like?
Quote from: derspiess on November 04, 2013, 02:27:03 PM
Democrats are a centrist party? :lol:
Compared to the Republicans? Of course they are.
Quote from: crazy canuck on November 04, 2013, 02:32:27 PM
Quote from: derspiess on November 04, 2013, 02:27:03 PM
Democrats are a centrist party? :lol:
What in your opinion does a centrist party look like?
One that's not decisively on the right or left.
Quote from: Berkut on November 04, 2013, 02:32:45 PM
Quote from: derspiess on November 04, 2013, 02:27:03 PM
Democrats are a centrist party? :lol:
Compared to the Republicans? Of course they are.
So says the admitted socialist.
Quote from: derspiess on November 04, 2013, 02:42:25 PM
Quote from: crazy canuck on November 04, 2013, 02:32:27 PM
Quote from: derspiess on November 04, 2013, 02:27:03 PM
Democrats are a centrist party? :lol:
What in your opinion does a centrist party look like?
One that's not decisively on the right or left.
What exactly do you consider "left"?
A centrist party to me suggests one that overlaps the center on both sides. To me that does not describe the Democratic Party. They are center-left, with a left wing that makes noise and must be appeased, usually through rhetoric rather than policy.
Quote from: Admiral Yi on November 04, 2013, 02:44:53 PM
A centrist party to me suggests one that overlaps the center on both sides. To me that does not describe the Democratic Party. They are center-left, with a left wing that makes noise and must be appeased, usually through rhetoric rather than policy.
But the context of this discussion is how the parties appeal to centrists, and on that scale, the Dems right now are solid centrist while the Republicans are out in right field crazy land somewhere.
Quote from: Admiral Yi on November 04, 2013, 02:44:53 PM
A centrist party to me suggests one that overlaps the center on both sides. To me that does not describe the Democratic Party. They are center-left, with a left wing that makes noise and must be appeased, usually through rhetoric rather than policy.
I seem to recall quite a few conservative Dems.
Didn't DGuller and Friends have all the Blue Dogs put down?
Quote from: Razgovory on November 04, 2013, 02:47:24 PM
I seem to recall quite a few conservative Dems.
All the Blue Dogs got pushed to the curb in the first midterm.
Quote from: Admiral Yi on November 04, 2013, 02:49:44 PM
Quote from: Razgovory on November 04, 2013, 02:47:24 PM
I seem to recall quite a few conservative Dems.
All the Blue Dogs got pushed to the curb in the first midterm.
All?
Quote from: Berkut on November 04, 2013, 02:48:16 PM
Didn't DGuller and Friends have all the Blue Dogs put down?
Back to that bullshit? In any case, the Blue Dogs weren't primaried, they just lost to Republicans.
Quote from: Admiral Yi on November 04, 2013, 02:52:07 PM
Quote from: Razgovory on November 04, 2013, 02:50:47 PM
All?
You win Raz.
You shouldn't overreach.
To demonstrate my point (about Democratic centrism not Yi), take Barack Obama's health care bill. He modeled it on Mitt Romney's Healthcare law, Romney and many of the Republicans had to repudiate the ideas they had supported only a few years previous. Part of the problem is that Republican seen Democrats as intrinsically liberal and leftist. So if Dems take a position it automatically becomes suspect and Republicans have to distance themselves. Republicans often put as much distance between themselves and Democrats simply to show how radical the dems are.
Quote from: derspiess on November 04, 2013, 02:42:25 PM
One that's not decisively on the right or left.
Then I am not sure what your complaint is. The US has no parties that are "decisively" on the left. All of your parties are on the right of the spectrum compared to the politics of other countries. The Democrats are just less right than the Republicans and therefore by definition the more centrist of the two parties.
:hmm: I think we need to ban derspiess from using the " :lol: " smiley. They're so obnoxious when abused so frequently in such a way.
Quote from: DGuller on November 04, 2013, 03:03:48 PM
:hmm: I think we need to ban derspiess from using the " :lol: " smiley. They're so obnoxious when abused so frequently in such a way.
Hans would do the same thing except he used the :lmfao: one.
I do hope Hans some more on politics, I saved a few of his predictions and have been waiting for the right time to use them.
Quote from: DGuller on November 04, 2013, 03:03:48 PM
:hmm: I think we need to ban derspiess from using the " :lol: " smiley. They're so obnoxious when abused so frequently in such a way.
It just doesn't mean what he thinks it means.
Quote from: crazy canuck on November 04, 2013, 03:03:42 PM
Quote from: derspiess on November 04, 2013, 02:42:25 PM
One that's not decisively on the right or left.
Then I am not sure what your complaint is. The US has no parties that are "decisively" on the left. All of your parties are on the right of the spectrum compared to the politics of other countries. The Democrates are just less right than the Republicans and therefore by definition the more centrist of the two parties.
Democrats are center-left and the GOP is center-right.
Quote from: DGuller on November 04, 2013, 03:03:48 PM
:hmm: I think we need to ban derspiess from using the " :lol: " smiley. They're so obnoxious when abused so frequently in such a way.
You know that only encourages me, right?
The Young Avoid New Health Plans
'Insurers say the early buyers of health coverage on the nation's troubled new websites are older than expected so far, raising early concerns about the economics of the insurance marketplaces.
If the trend continues, an older, more expensive set of customers could drive up prices for everyone, the insurers say, by forcing them to spread their costs around. "We need a broad range of people to make this work, and we're not seeing that right now," said Heather Thiltgen of Medical Mutual of Ohio, the state's largest insurer by individual customers. "We're seeing the population skewing older."
...
The law bars insurers from charging sicker customers higher rates, and limits the amount they can charge older people compared with younger ones. It offers new subsidies to help cover premiums available to many lower-income applicants. Insurers are relying on a steady stream of younger, healthier enrollees to offset medical bills of older, sicker customers.'
http://online.wsj.com/news/articles/SB10001424052702303661404579178231174626314 (http://online.wsj.com/news/articles/SB10001424052702303661404579178231174626314)
(https://languish.org/forums/proxy.php?request=http%3A%2F%2Fi2.cdn.turner.com%2Fmoney%2F2012%2F06%2F28%2Fpf%2Fhealth-care-young-adults%2Fobamacare-women.gi.top.jpg&hash=a10bfa6d35684728a1e92e9b7149b6ae44b5a04e)
It would probably help if young people had any means to pay for health insurance, like, you know, jobs.
Quote from: Ideologue on November 04, 2013, 11:19:13 PM
It would probably help if young people had any means to pay for health insurance, like, you know, jobs.
They should all start their own businesses.
Quote from: Ideologue on November 04, 2013, 11:19:13 PM
It would probably help if young people had any means to pay for health insurance, like, you know, jobs.
They're not looking hard enough. They could probably sign up for two or three jobs at fast food joints.
Quote from: Syt on November 05, 2013, 12:34:57 AM
Quote from: Ideologue on November 04, 2013, 11:19:13 PM
It would probably help if young people had any means to pay for health insurance, like, you know, jobs.
They're not looking hard enough. They could probably sign up for two or three jobs at fast food joints.
You say that like it is some kind of rhetorical slam dunk.
But you are in fact exactly right. If you have a job that doesn't pay you enough, getting a second one is probably a good idea. Why is that such a difficult concept?
Of course, me and my silver spoon have no idea what we are talking about.
Working in a fast food restaurant full time, let alone 60 hours a week, generates less utility than death, so why not commit suicide? Then you don't need health insurance.
Quote from: Admiral Yi on November 04, 2013, 02:44:53 PM
A centrist party to me suggests one that overlaps the center on both sides. To me that does not describe the Democratic Party. They are center-left, with a left wing that makes noise and must be appeased, usually through rhetoric rather than policy.
I think because less and less people care about certain social issues, like the gays, it's easier to see the pro-business, corporatey wing of the Democrats as pretty centre-right. What the centre right's disagreement be with Cuomo, Quinn (and perhaps Clinton) really disagree? Maybe, occasionally, rhetoric at most?
QuoteAll the Blue Dogs got pushed to the curb in the first midterm.
Isn't that just a nature of the centre changing? My understanding of Blue Dog would be fiscally conservative, but also hawkish in foreign policy and socially conservative. I'd suggest that since the end of the Cold War the public's moved a long way on the last two. Does a constellation of views from Southern Democrats thirty years ago really describe the centre now?
By contrast there's 50 'New Democrats' (a la New Labour) who are associated with the DLC and broadly identify as fiscally conservative, pro-business but normally quite liberal on social issues, like the gays. I'd argue that's a better reflection of the centre now than the blue dogs.
Quote from: Berkut on November 05, 2013, 01:48:33 AM
But you are in fact exactly right. If you have a job that doesn't pay you enough, getting a second one is probably a good idea. Why is that such a difficult concept?
I don't disagree. I just don't find this to be an ideal situation - in the past, low qualified people (and little prospects of educating themselves due to lack of ability or talent) could e.g. find decent jobs in manufacturing or construction that would allow them a modest existence. With a lot of these jobs either requiring better education/training or being moved offshore, these people slip even further down the pole.
Unfortunately I don't see a magic bullet solution to improving their situation.
Open enrollment starting in a few weeks.
Employee contribution towards our health care plan at work for myself+family is going from $250/month for 2013 to $171/month for 2014.
Question for DGuller:
I was thinking about state level competition, and the barriers to entry created by the cost of submitting plans to insurance commisionaers for approval.
Any chance of that disappearing now due to Obamacare?
Quote from: Syt on November 05, 2013, 12:34:57 AM
Quote from: Ideologue on November 04, 2013, 11:19:13 PM
It would probably help if young people had any means to pay for health insurance, like, you know, jobs.
They're not looking hard enough. They could probably sign up for two or three jobs at fast food joints.
That is not so easy in some parts of the country. My cousin in College was trying to find a job like that, working at a fast food joint or waiting tables or something and that took her awhile. Getting two or three might be challenging depending upon where you live.
Quote from: Admiral Yi on November 06, 2013, 02:36:36 PM
Question for DGuller:
I was thinking about state level competition, and the barriers to entry created by the cost of submitting plans to insurance commisionaers for approval.
Any chance of that disappearing now due to Obamacare?
Your guess is as good as mine. State-based insurance regulation seems to be a bit of an anachronism these days, but it has a lot of powerful supporters, and some debatable advantages. I'm not at all confident about predicting the future of regulation for property/casualty insurance that I specialize in, much less health insurance.
Nobody cares about the impact of Obamacare on me?
Quote from: Berkut on November 06, 2013, 02:34:25 PM
Open enrollment starting in a few weeks.
Employee contribution towards our health care plan at work for myself+family is going from $250/month for 2013 to $171/month for 2014.
Sounds like a win :cheers:
Quote from: Berkut on November 06, 2013, 04:42:28 PM
Nobody cares about the impact of Obamacare on me?
You're rich.
Quote from: Jacob on November 06, 2013, 04:58:15 PM
Quote from: Berkut on November 06, 2013, 02:34:25 PM
Open enrollment starting in a few weeks.
Employee contribution towards our health care plan at work for myself+family is going from $250/month for 2013 to $171/month for 2014.
Sounds like a win :cheers:
They actually said that this was the first year in a long time when the cost of the health care plan was successfully held steady, so they passed some of the savings against their expected increase back to the employees.
Crazy Euro companies.
They also stated that if we choose to forgo health insurance, they would refund some of the savings back to us. If I give up my Family health care plan, in addition to saving $3000 or so a year that I kick in towards the cost, they would refund me an additional $6000/year.
I think my wife needs to go find a job with health care...
Quote from: Berkut on November 06, 2013, 05:03:04 PM
They also stated that if we choose to forgo health insurance, they would refund some of the savings back to us. If I give up my Family health care plan, in addition to saving $3000 or so a year that I kick in towards the cost, they would refund me an additional $6000/year.
I wonder how that jibes with the employer mandate.
Unless after the $6,000 and the fine they're still coming out ahead. :hmm:
Quote from: Admiral Yi on November 06, 2013, 05:04:35 PM
Quote from: Berkut on November 06, 2013, 05:03:04 PM
They also stated that if we choose to forgo health insurance, they would refund some of the savings back to us. If I give up my Family health care plan, in addition to saving $3000 or so a year that I kick in towards the cost, they would refund me an additional $6000/year.
I wonder how that jibes with the employer mandate.
Unless after the $6,000 and the fine they're still coming out ahead. :hmm:
I don't think they would be in any trouble in that case - they are basically saying that if I don't need healthcare from them (say my wife has coverage from her employer) then they would share in that savings with me.
They are still offering health care.
Quote from: Admiral Yi on November 06, 2013, 05:04:35 PM
Quote from: Berkut on November 06, 2013, 05:03:04 PM
They also stated that if we choose to forgo health insurance, they would refund some of the savings back to us. If I give up my Family health care plan, in addition to saving $3000 or so a year that I kick in towards the cost, they would refund me an additional $6000/year.
I wonder how that jibes with the employer mandate.
Unless after the $6,000 and the fine they're still coming out ahead. :hmm:
I think Berkut's right. They're not going to be fined if you choose not to take their healthcare plan. The mandate is to offer one.
Hmmm.
Quote from: Admiral Yi on November 06, 2013, 05:30:24 PM
Hmmm.
It'd be perverse to have a penalty on companies who offer health insurance but are turned down by their employees - for whatever reason.
Apparently there's two employer penalties. There's a heavy one which is levied on companies that don't offer any plan. There's then a lighter penalty on companies who offer insurance that isn't 'affordable' - so broadly which pays for 60% costs and that charges less than 10% of employee's household income.
Health Site Sign-Ups Fall Far Short Of Obama Target
'Fewer than 50,000 people successfully navigated the troubled federal health-care website to enroll in private health-insurance plans as of last week.
...
The administration had estimated that nearly 500,000 people would enroll in October. An estimated seven million were expected to gain private coverage by the end of March, when the open-enrollment period is set to end.'
http://online.wsj.com/news/articles/SB10001424052702303460004579192190709762378
(https://languish.org/forums/proxy.php?request=http%3A%2F%2Fs.wsj.net%2Fpublic%2Fresources%2Fimages%2FBN-AI913_111113_D_20131111164952.jpg&hash=84cfe4fc303540597e1d95e65a58540481da8469)
Then lots of cool usernames should still be available. :w00t:
DickLong12
Quote from: Phillip V on November 11, 2013, 06:29:37 PM
Health Site Sign-Ups Fall Far Short Of Obama Target
'Fewer than 50,000 people successfully navigated the troubled federal health-care website to enroll in private health-insurance plans as of last week.
That's just the Federal website, for people stuck in Dumbfuckistan states that don't have exchanges. Do we know what the total numbers are, including state exchanges?
They said that won't be released till later in the week.
Bill Clinton Attacks Obamacare
'Former President Bill Clinton joined the intensifying criticism of the botched health care rollout, urging President Obama to allow all Americans to keep their current health insurance plan.'
http://www.nytimes.com/2013/11/13/us/bill-clinton-urges-obama-to-yield-on-health-law.html
(https://languish.org/forums/proxy.php?request=http%3A%2F%2Fs.wsj.net%2Fpublic%2Fresources%2Fimages%2FOB-UL341_0905rn_G_20120906001544.jpg&hash=fd43e2c568ea68b1e2070b7784dfa07a8363a970)
:thumbsdown:
Up to now Bubba has been quite good about not Monday Morning Quarterbacking the presidency.
Quote from: Admiral Yi on November 12, 2013, 08:25:19 PM
:thumbsdown:
Up to now Bubba has been quite good about not Monday Morning Quarterbacking the presidency.
But he's one hell of a surrogate.
Yeah, that was pretty bad form, and a pretty bad policy. The reason some are losing their individual coverage is because it was substandard. Does Bill want to force insurers to provide better coverage for the same price, or dispense with the basic standards for health insurance?
'Bout time Bill. Right on point.
Substandard how?
That a 65 y/o woman doesnt think she needs, maternity and newborn care, and pediatric services, with oral and vision. But Obamacare mandates it. What a fucking joke.
Quote from: 11B4V on November 12, 2013, 08:36:43 PM
'Bout time Bill. Right on point.
Substandard how?
That a 65 y/o woman doesnt think she needs, maternity and newborn care, and pediatric services, with oral and vision. But Obamacare mandates it. What a fucking joke.
I might knock her up.
Et tu, Bubba?
Meh, it's all positioning now for Hillarypalooza 2016, anyway. That man wants to be in the White House again so bad, he can taste it.
Quote from: DGuller on November 12, 2013, 08:29:04 PM
Yeah, that was pretty bad form, and a pretty bad policy. The reason some are losing their individual coverage is because it was substandard. Does Bill want to force insurers to provide better coverage for the same price, or dispense with the basic standards for health insurance?
Actually I don't think it's quite as bad policy as you make out. Employer provided and individually purchased plans that existed before Obamacare was signed into law were grandfathered in. By the same logic those individual plans bought after the law was enacted could be grandfathered.
Quote from: 11B4V on November 12, 2013, 08:36:43 PM
Substandard how?
Deductibles too big, annual/lifetime caps, not enough whore pills. Things like that.
Quote from: Ed Anger on November 12, 2013, 08:38:08 PM
Quote from: 11B4V on November 12, 2013, 08:36:43 PM
'Bout time Bill. Right on point.
Substandard how?
That a 65 y/o woman doesnt think she needs, maternity and newborn care, and pediatric services, with oral and vision. But Obamacare mandates it. What a fucking joke.
I might knock her up.
:P
Quote from: 11B4V on November 12, 2013, 08:36:43 PM
That a 65 y/o woman doesnt think she needs, maternity and newborn care, and pediatric services, with oral and vision. But Obamacare mandates it. What a fucking joke.
That a 65 year old woman thinks she still needs to buy for-profit insurance with those mandated coverages when she already qualifies for Medicare, she deserves to pay more anyway. :P
Quote from: CountDeMoney on November 12, 2013, 08:46:16 PM
Quote from: 11B4V on November 12, 2013, 08:36:43 PM
That a 65 y/o woman doesnt think she needs, maternity and newborn care, and pediatric services, with oral and vision. But Obamacare mandates it. What a fucking joke.
That a 65 year old woman thinks she still needs to buy for-profit insurance with those mandated coverages when she already qualifies for Medicare, she deserves to pay more anyway. :P
True. How dare she not suckle on the gov't teat! :angry:
Quote from: CountDeMoney on November 12, 2013, 08:46:16 PM
Quote from: 11B4V on November 12, 2013, 08:36:43 PM
That a 65 y/o woman doesnt think she needs, maternity and newborn care, and pediatric services, with oral and vision. But Obamacare mandates it. What a fucking joke.
That a 65 year old woman thinks she still needs to buy for-profit insurance with those mandated coverages when she already qualifies for Medicare, she deserves to pay more anyway. :P
You get the point. Why cant you choose? Your boy lied Seedy, LIED.
I'll laugh my ass off if Hillary gets in there and overhauls it for the better.
Quote from: garbon on November 12, 2013, 08:48:38 PM
Quote from: CountDeMoney on November 12, 2013, 08:46:16 PM
Quote from: 11B4V on November 12, 2013, 08:36:43 PM
That a 65 y/o woman doesnt think she needs, maternity and newborn care, and pediatric services, with oral and vision. But Obamacare mandates it. What a fucking joke.
That a 65 year old woman thinks she still needs to buy for-profit insurance with those mandated coverages when she already qualifies for Medicare, she deserves to pay more anyway. :P
True. How dare she not suckle on the gov't teat! :angry:
Go with past child bearing years then.
Quote from: garbon on November 12, 2013, 08:48:38 PM
True. How dare she not suckle on the gov't teat! :angry:
Shit, they've got no problem clawing your eyes out for that discount at the movies or the IHOP, they're damned well gonna git whatfer's owed to 'em for fighting in Vietnam.
Quote from: garbon on November 12, 2013, 08:48:38 PM
Quote from: CountDeMoney on November 12, 2013, 08:46:16 PM
Quote from: 11B4V on November 12, 2013, 08:36:43 PM
That a 65 y/o woman doesnt think she needs, maternity and newborn care, and pediatric services, with oral and vision. But Obamacare mandates it. What a fucking joke.
That a 65 year old woman thinks she still needs to buy for-profit insurance with those mandated coverages when she already qualifies for Medicare, she deserves to pay more anyway. :P
True. How dare she not suckle on the gov't teat! :angry:
Who's teat do you suck?
Quote from: 11B4V on November 12, 2013, 08:51:12 PM
Quote from: CountDeMoney on November 12, 2013, 08:46:16 PM
Quote from: 11B4V on November 12, 2013, 08:36:43 PM
That a 65 y/o woman doesnt think she needs, maternity and newborn care, and pediatric services, with oral and vision. But Obamacare mandates it. What a fucking joke.
That a 65 year old woman thinks she still needs to buy for-profit insurance with those mandated coverages when she already qualifies for Medicare, she deserves to pay more anyway. :P
You get the point. Why cant you choose? Your boy lied Seedy, LIED.
I'll laugh my ass off if Hillary gets in there and overhauls it for the better.
Seriously, dude? Of all the shit that's bouncing off your echo chamber of a FOX media bubble,
this example is the one you're going to go with?
Quote from: CountDeMoney on November 12, 2013, 08:55:22 PM
Quote from: 11B4V on November 12, 2013, 08:51:12 PM
Quote from: CountDeMoney on November 12, 2013, 08:46:16 PM
Quote from: 11B4V on November 12, 2013, 08:36:43 PM
That a 65 y/o woman doesnt think she needs, maternity and newborn care, and pediatric services, with oral and vision. But Obamacare mandates it. What a fucking joke.
That a 65 year old woman thinks she still needs to buy for-profit insurance with those mandated coverages when she already qualifies for Medicare, she deserves to pay more anyway. :P
You get the point. Why cant you choose? Your boy lied Seedy, LIED.
I'll laugh my ass off if Hillary gets in there and overhauls it for the better.
Seriously, dude? Of all the shit that's bouncing off your echo chamber of a FOX media bubble, this example is the one you're going to go with?
That the Prez lied? You bet, because he did. You Obama worshipers cant spin that. :lol:
We'll see what 2014 mid-terms bring, Sparky.
Quote from: Razgovory on November 12, 2013, 08:55:16 PM
Quote from: garbon on November 12, 2013, 08:48:38 PM
Quote from: CountDeMoney on November 12, 2013, 08:46:16 PM
Quote from: 11B4V on November 12, 2013, 08:36:43 PM
That a 65 y/o woman doesnt think she needs, maternity and newborn care, and pediatric services, with oral and vision. But Obamacare mandates it. What a fucking joke.
That a 65 year old woman thinks she still needs to buy for-profit insurance with those mandated coverages when she already qualifies for Medicare, she deserves to pay more anyway. :P
True. How dare she not suckle on the gov't teat! :angry:
Who's teat do you suck?
I wish I had a teat. :(
Quote from: 11B4V on November 12, 2013, 08:58:54 PM
That the Prez lied? You bet, because he did. You Obama worshipers cant spin that. :lol:
We'll see what 2014 mid-terms bring, Sparky.
No, Muttski; your example of some 65 year old women forced to buy coverage with mandated neo-natal care when she's already qualified for Medicare. I mean, if that's the sort of "choice" example you're going with, that's a poor one.
Simply bleating OBAMA LIED PIPPLE DIED over and over again in this thread doesn't make any points, other than the one on the top of your head.
Quote from: CountDeMoney on November 12, 2013, 09:02:32 PM
No, Muttski; your example of some 65 year old women forced to buy coverage with mandated neo-natal care when she's already qualified for Medicare. I mean, if that's the sort of "choice" example you're going with, that's a poor one.
Granted, change that to what I posted above. That shitholes your argument. I'll put a 20 spot that
1. They will pass something that allows people to keep their current plans if they want.
2. Allow the plan to be tailor made to the individual. (IOW, if you dont need the pediatric shit you can dump it.)
Care to make that bet????
Quote
Simply bleating OBAMA LIED PIPPLE DIED over and over again in this thread doesn't make any points, other than the one on the top of your head.
Argue that he didnt. ;)
When he says he has never traded arms for hostages' healthcare coverage, I believe him.
Quote from: CountDeMoney on November 12, 2013, 09:21:42 PM
When he says he has never traded arms for hostages' healthcare coverage, I believe him.
Take the bet.
Quote from: 11B4V on November 12, 2013, 08:51:12 PM
I'll laugh my ass off if Hillary gets in there and overhauls it for the better.
How will she manage that with the House owned by the Republicans, and little chance of that changing due to gerry-mandering? They're the reason the ACA looks the way it does right now, and it's not because of Obama.
Quote from: 11B4V on November 12, 2013, 09:08:49 PM
Granted, change that to what I posted above. That shitholes your argument. I'll put a 20 spot that
1. They will pass something that allows people to keep their current plans if they want.
2. Allow the plan to be tailor made to the individual. (IOW, if you dont need the pediatric shit you can dump it.)
Care to make that bet????
They can't. There's no way that it will be affordable for anyone if it's piece-mealed like that.
Quote from: merithyn on November 12, 2013, 11:54:46 PM
Quote from: 11B4V on November 12, 2013, 08:51:12 PM
I'll laugh my ass off if Hillary gets in there and overhauls it for the better.
How will she manage that with the House owned by the Republicans, and little chance of that changing due to gerry-mandering? They're the reason the ACA looks the way it does right now, and it's not because of Obama.
Bullshit
Quote from: merithyn on November 12, 2013, 11:56:34 PM
Quote from: 11B4V on November 12, 2013, 09:08:49 PM
Granted, change that to what I posted above. That shitholes your argument. I'll put a 20 spot that
1. They will pass something that allows people to keep their current plans if they want.
2. Allow the plan to be tailor made to the individual. (IOW, if you dont need the pediatric shit you can dump it.)
Care to make that bet????
They can't. There's no way that it will be affordable for anyone if it's piece-mealed like that.
Affordable????
Quote from: 11B4V on November 13, 2013, 12:02:16 AM
Quote from: merithyn on November 12, 2013, 11:54:46 PM
How will she manage that with the House owned by the Republicans, and little chance of that changing due to gerry-mandering? They're the reason the ACA looks the way it does right now, and it's not because of Obama.
Bullshit
Not really. And you're not answering the other questions.
Quote from: 11B4V on November 13, 2013, 12:02:57 AM
Quote from: merithyn on November 12, 2013, 11:56:34 PM
They can't. There's no way that it will be affordable for anyone if it's piece-mealed like that.
Affordable????
Yes, affordable. The reality is that most people won't have to pay more for insurance under the ACA. If people were allowed to only select via the a la cart method, it wouldn't be at all.
Quote from: 11B4V on November 12, 2013, 08:51:12 PM
I'll laugh my ass off if Hillary gets in there and overhauls it for the better.
Yeah, that'd show him :P
It would seem that the ACA relies on many people losing their health care and going into the Federal exchanges in order to pay for it all. Administration info being released recently shows that they expect 90 million people to lose coverage and other estimates are higher. I think that's when the employer mandate kicks in and employer plans are lost, or what ever else causes that. The admin knew this as early as 2010, from internal memos/documents.
The Dems are panicked over this so you know there are huge problems, and I think this is only the tip of the iceberg.
I didn't think it would be this messed up but the reports coming out now look bad and the future outlook seems even worse.
As for the low enrollment so far, ACA detractors keep touting the low numbers but that will change over time. It's too early but I think the Obama admin was expecting more to sign up by now, even if the web site worked. I think that was over zealous thinking. Takes time.
That number sounds suspiciously similar to the total number of uninsured people in America K.
Quote from: Admiral Yi on November 13, 2013, 11:05:48 AM
That number sounds suspiciously similar to the total number of uninsured people in America K.
Numbers of uninsured I've seen is 30-40 million? And how many uninsured are young adults, 18-30 who don't feel they need insurance so don't buy it? They rarely go to a doctor and if they have to they pay for it. Many are working, some could pay for insurance, others would get subsidies.
Quote from: KRonn on November 13, 2013, 11:39:53 AM
Numbers of uninsured I've seen is 30-40 million?
Kay. But I'm still deeply skeptical of 90 million losing their coverage because of Obamacare.
QuoteAnd how many uninsured are young adults, 18-30 who don't feel they need insurance so don't buy it? They rarely go to a doctor and if they have to they pay for it.
Sure, that's the whole point of the individual mandate: young healthy people subsidizing folks with pre-existing conditions and such.
Quote from: Admiral Yi on November 13, 2013, 11:45:30 AM
QuoteAnd how many uninsured are young adults, 18-30 who don't feel they need insurance so don't buy it? They rarely go to a doctor and if they have to they pay for it.
Sure, that's the whole point of the individual mandate: young healthy people subsidizing folks with pre-existing conditions and such.
Yeah but we are only really getting the 26-30 of that range. The others will be rather cheaply on their parents coverage.
Quote from: garbon on November 13, 2013, 12:10:26 PM
Yeah but we are only really getting the 26-30 of that range. The others will be rather cheaply on their parents coverage.
You're assuming that the 26 year old mandate had no effect on family plan rates.
Quote from: Admiral Yi on November 13, 2013, 12:12:41 PM
Quote from: garbon on November 13, 2013, 12:10:26 PM
Yeah but we are only really getting the 26-30 of that range. The others will be rather cheaply on their parents coverage.
You're assuming that the 26 year old mandate had no effect on family plan rates.
You're right, I am mistakenly making that assumption. -_-
Though it would be pretty shitty, if understandable, if plans go up for kids being covered.
I want to point out that I haven't been given a raise in order to buy health insurance. <_<
Quote from: Admiral Yi on November 13, 2013, 11:45:30 AM
Quote from: KRonn on November 13, 2013, 11:39:53 AM
Numbers of uninsured I've seen is 30-40 million?
Kay. But I'm still deeply skeptical of 90 million losing their coverage because of Obamacare.
QuoteAnd how many uninsured are young adults, 18-30 who don't feel they need insurance so don't buy it? They rarely go to a doctor and if they have to they pay for it.
Sure, that's the whole point of the individual mandate: young healthy people subsidizing folks with pre-existing conditions and such.
I'm skeptical also about the 90+ million but we'll see as next year rolls in and the employer mandate kicks in. We have seen some companies drop employees down to under 30 hours or not hire above a certain number (50 I think) to avoid the ACA rules. Besides, those figures are supposedly from the govt.
As for the youngsters buying coverage, I hope they do but my point was that many didn't have coverage because they chose not to and they're still counted as among the uninsured, not that the ACA was needed to give them coverage. They can still choose to get health care insurance, or not. And the fines for not buying insurance apparently can't go up very high to compel them to buy else it stops being a tax as the SJC ruled and it becomes a fine or penalty, which may then be seen as unconstitutional. Lol, I was wondering why the damn fines were so low. They get larger in later years but IMO the fines for not buying insurance could be more than buying it, thereby more incentive to get the insurance.
The cost of the ACA plans may still be higher than private plans were on the individual market unless people qualify for subsidies. And I don't think it's true that all the indie plans were lousy. That's just a canard being floated. Yeah, I'm sure some were but many or even most probably not. Many people like me if I wasn't working would just want a plan to cover the big stuff like hospitalization. In fact, to defray some of the high costs of the ACA plans the Obama admin wants to push a bill to subsidize people who lost insurance and have to pay more on the exchanges. That's kind of ass backwards as it takes people who were paying their own insurance and has the govt instead subsidising them.
Quote from: KRonn on November 13, 2013, 01:09:35 PM
We have seen some companies drop employees down to under 30 hours or not hire above a certain number (50 I think) to avoid the ACA rules.
That's entirely predictable. But the only way this mechanism could cause someone to lose coverage is if their employer were previously providing insurance, and the new requirements were just enough to make those employers no longer want to provide insurance.
It's going to be much more common that companies that didn't provide insurance drop their employees to part time to avoid the mandate. Which means their employees don't lose insurance because of Obamacare.
Quote from: Admiral Yi on November 13, 2013, 01:17:42 PM
Quote from: KRonn on November 13, 2013, 01:09:35 PM
We have seen some companies drop employees down to under 30 hours or not hire above a certain number (50 I think) to avoid the ACA rules.
That's entirely predictable. But the only way this mechanism could cause someone to lose coverage is if their employer were previously providing insurance, and the new requirements were just enough to make those employers no longer want to provide insurance.
It's going to be much more common that companies that didn't provide insurance drop their employees to part time to avoid the mandate. Which means their employees don't lose insurance because of Obamacare.
And in fact, those same people will now be in a position to get insurance, which they couldn't do before. This is the exact opposite of what KRonn is claiming.
I don't see how they couldn't get it before. Yes, some people will now get free money, but you seem to be suggesting something more widespread.
Quote from: merithyn on November 13, 2013, 01:36:21 PM
Quote from: Admiral Yi on November 13, 2013, 01:17:42 PM
Quote from: KRonn on November 13, 2013, 01:09:35 PM
We have seen some companies drop employees down to under 30 hours or not hire above a certain number (50 I think) to avoid the ACA rules.
That's entirely predictable. But the only way this mechanism could cause someone to lose coverage is if their employer were previously providing insurance, and the new requirements were just enough to make those employers no longer want to provide insurance.
It's going to be much more common that companies that didn't provide insurance drop their employees to part time to avoid the mandate. Which means their employees don't lose insurance because of Obamacare.
And in fact, those same people will now be in a position to get insurance, which they couldn't do before. This is the exact opposite of what KRonn is claiming.
Some will have more of an option for insurance, true, mainly those with low incomes and unable to afford before. They'll get subsidized insurance and before they should have been able to get Medicaid. Not sure about that but Medicaid has been expanded and will now cover more people. But many could have afforded their own insurance and chose not to and will pay for their own on the ACA plans. The ACA may or may not be cheaper than buying on the individual market, that market is now going away for the most part anyway. And it wasn't just lousy insurance as is what is trying to be said, it was insurance of all kinds and for many people quite affordable.
You're both ignoring the pre-existing condition clause that was in affect prior to ACA. My company alone insured over 5000 people in Illinois who qualified for the Pre-Ex federal policy that was in affect for the last few years.
I'm not ignoring it Meri. Those people are a minority. Your previous statement was more general than that. It suggested that the antecedent for "they" was those working people who had not previously had employer provided insurance.
Quote from: Admiral Yi on November 13, 2013, 04:22:41 PM
I'm not ignoring it Meri. Those people are a minority. Your previous statement was more general than that. It suggested that the antecedent for "they" was those working people who had not previously had employer provided insurance.
I was referring to everyone who couldn't have insurance before, most notably those who didn't qualify no matter the cost.
This might be a good data point for the theory that computer skills and verbal communication add to a constant then. :P
Quote from: Admiral Yi on November 13, 2013, 04:41:57 PM
This might be a good data point for the theory that computer skills and verbal communication add to a constant then. :P
:P
Not my fault that you can't read my mind. I knew what I meant. :D
Quote from: CountDeMoney on November 11, 2013, 09:46:37 PM
Quote from: Phillip V on November 11, 2013, 06:29:37 PM
Health Site Sign-Ups Fall Far Short Of Obama Target
'Fewer than 50,000 people successfully navigated the troubled federal health-care website to enroll in private health-insurance plans as of last week.
That's just the Federal website, for people stuck in Dumbfuckistan states that don't have exchanges. Do we know what the total numbers are, including state exchanges?
100,000, apparently: http://www.forbes.com/sites/theapothecary/2013/11/12/the-obamacare-exchange-scorecard-around-100000-enrollees-and-five-million-cancellations/
Mission Accomplished?
Democrats Threaten to Abandon Obama on Health Law Provision
'Anxious congressional Democrats are threatening to abandon President Obama on a central element of his signature health care law, voicing increasing support for proposals that would allow Americans to retain the health insurance coverage they are losing because of the Affordable Care Act.
The dissent comes as the Obama administration released enrollment figures Wednesday that fell far short of expectations.'
http://www.nytimes.com/2013/11/14/us/politics/democrats-threaten-to-abandon-obama-on-health-law-provision.html
(https://languish.org/forums/proxy.php?request=http%3A%2F%2Fgraphics8.nytimes.com%2Fimages%2F2013%2F11%2F14%2Fus%2Fhealthweb%2Fhealthweb-articleLarge.jpg&hash=49ee6a4531bdceeadc7ae7bc516903b1349a9681)
Sigh. Idiots.
Quote from: Phillip V on November 13, 2013, 06:07:42 PM
Democrats Threaten to Abandon Obama on Health Law Provision
'Anxious congressional Democrats are threatening to abandon President Obama on a central element of his signature health care law, voicing increasing support for proposals that would allow Americans to retain the health insurance coverage they are losing because of the Affordable Care Act.
The dissent comes as the Obama administration released enrollment figures Wednesday that fell far short of expectations.'
http://www.nytimes.com/2013/11/14/us/politics/democrats-threaten-to-abandon-obama-on-health-law-provision.html
(https://languish.org/forums/proxy.php?request=http%3A%2F%2Fgraphics8.nytimes.com%2Fimages%2F2013%2F11%2F14%2Fus%2Fhealthweb%2Fhealthweb-articleLarge.jpg&hash=49ee6a4531bdceeadc7ae7bc516903b1349a9681)
Hahahaha. It will pass too. They are worried about their jobs.
It's disgusting how so many Americans are cheering for failure, and hoping for changes that they know would make Obamacare more likely to fail. Who needs external enemies with patriots like that?
Quote from: 11B4V on November 13, 2013, 06:52:27 PM
Hahahaha. It will pass too. They are worried about their jobs.
Do you mean pass in the House? That doesn't sound very tough with a Republican majority. :huh:
Quote from: Baron von Schtinkenbutt on November 13, 2013, 04:51:39 PM
Quote from: CountDeMoney on November 11, 2013, 09:46:37 PM
Quote from: Phillip V on November 11, 2013, 06:29:37 PM
Health Site Sign-Ups Fall Far Short Of Obama Target
'Fewer than 50,000 people successfully navigated the troubled federal health-care website to enroll in private health-insurance plans as of last week.
That's just the Federal website, for people stuck in Dumbfuckistan states that don't have exchanges. Do we know what the total numbers are, including state exchanges?
100,000, apparently: http://www.forbes.com/sites/theapothecary/2013/11/12/the-obamacare-exchange-scorecard-around-100000-enrollees-and-five-million-cancellations/
Does that include those enrolled into Medicaid in the respective states?
Quote from: DGuller on November 13, 2013, 07:00:26 PM
It's disgusting how so many Americans are cheering for failure, and hoping for changes that they know would make Obamacare more likely to fail. Who needs external enemies with patriots like that?
Not to fail. To live up to what was promised.
QuoteIf 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. No one will take it away. No matter what.....Lower Premiums by $2,500 a Year.
The Prez made a promise. If he cant deliver, the rest of the party needs to.
Quote from: Admiral Yi on November 13, 2013, 07:07:46 PM
Quote from: 11B4V on November 13, 2013, 06:52:27 PM
Hahahaha. It will pass too. They are worried about their jobs.
Do you mean pass in the House? That doesn't sound very tough with a Republican majority. :huh:
No, overall.
Quote from: DGuller on November 13, 2013, 07:00:26 PM
It's disgusting how so many Americans are cheering for failure, and hoping for changes that they know would make Obamacare more likely to fail. Who needs external enemies with patriots like that?
Awwwwwwwwww :(
Quote from: derspiess on November 13, 2013, 08:50:02 PM
Quote from: DGuller on November 13, 2013, 07:00:26 PM
It's disgusting how so many Americans are cheering for failure, and hoping for changes that they know would make Obamacare more likely to fail. Who needs external enemies with patriots like that?
Awwwwwwwwww :(
They're mad because their boyz signature legislation is a clusterfuck. Oh, and they have no arguement for his lies to the American people.
Quote from: 11B4V on November 13, 2013, 09:23:05 PM
Name terms.
The Burton Amendment grandfathering individual insurance that does not meet the standard of the ACA gets passed in both the House and Senate.
Even money, $20 American.
Keep a balance going until someone gets to $50 bucks, then pay. Saves on the wear and tear and postage.
Quote from: DGuller on November 13, 2013, 06:14:31 PM
Sigh. Idiots.
It really depends on what they pass.
If they pass a law grandfathering in only those specific programs that were in place when Obamacare passed, the grandfathering becomes void once terms change, and no new entrants are allowed into the plans, is that really so bad? How long can the plans endure under those conditions?
Quote from: Admiral Yi on November 13, 2013, 09:26:09 PM
Quote from: 11B4V on November 13, 2013, 09:23:05 PM
Name terms.
The Burton Amendment grandfathering individual insurance that does not meet the standard of the ACA gets passed in both the House and Senate.
Any amendment to ACA which, "grandfathers individual insurance that does not meet the standard of the ACA gets passed in both the House and Senate"
Agreed?
QuoteEven money, $20 American.
Keep a balance going until someone gets to $50 bucks, then pay. Saves on the wear and tear and postage.
Sounds good. Postage??? You dont have paypal??
Any amendment which does that, has to pass both houses by 12/31/13.
No paypal.
Quote from: 11B4V on November 13, 2013, 09:21:28 PM
They're mad because their boyz signature legislation is a clusterfuck. Oh, and they have no arguement for his lies to the American people.
Yeah, but as Meri says, it's not really his fault. I guess that means it's the GOP's fault somehow.
Quote from: Admiral Yi on November 13, 2013, 10:06:47 PM
Any amendment which does that, has to pass both houses by 12/31/13.
No paypal.
Need to extend the date to 04/15/14???????
Quote from: derspiess on November 13, 2013, 10:16:19 PM
Quote from: 11B4V on November 13, 2013, 09:21:28 PM
They're mad because their boyz signature legislation is a clusterfuck. Oh, and they have no arguement for his lies to the American people.
Yeah, but as Meri says, it's not really his fault. I guess that means it's the GOP's fault somehow.
The lies are all him. The legislation, however, is a Congress-made clusterfuck. Something had to be done, however, so Obama signed it. Better to have shit than nothing. It can be fixed later.
Wow.
Btw, I hear leftists and "independents" all the time saying "keep Obamacare but fix all the stuff that's wrong with it". Yet you never hear much about what they propose to fix. What is it you think should be fixed, Meri?
Quote from: derspiess on November 13, 2013, 10:39:05 PM
Wow.
There something to be said for that if you think it is at least better than what we have currently. Rome not built in a day and all that.
Quote from: garbon on November 13, 2013, 10:41:05 PM
Quote from: derspiess on November 13, 2013, 10:39:05 PM
Wow.
There something to be said for that if you think it is at least better than what we have currently. Rome not built in a day and all that.
I don't think it's better than what we had. Plus, why the urgency to stack all that shit at that particular moment in time? Oh, yeah-- there was a healthcare "crisis" or somesuch.
Yeah, I never understood that either. The whole healthcare 'crisis' thing seemed to come out of nowhere. First the economy was a big crisis (which I think was entirely accurate to say), but then out of left field it was all OMG HEALTHCARE IS BROKEN WE NEED TO FIX IT NOWNOWNOW!!!!!!!!!!!!!!!!! Before like 2008 nobody really talked about healthcare being so broken since Bill and Hillary's first term when they had tried to fix it. :hmm:
Quote from: derspiess on November 13, 2013, 10:43:42 PM
Quote from: garbon on November 13, 2013, 10:41:05 PM
Quote from: derspiess on November 13, 2013, 10:39:05 PM
Wow.
There something to be said for that if you think it is at least better than what we have currently. Rome not built in a day and all that.
I don't think it's better than what we had. Plus, why the urgency to stack all that shit at that particular moment in time? Oh, yeah-- there was a healthcare "crisis" or somesuch.
I don't know that it is worse and I guess people being forced to have it might gear us up for a more sensible system. I think I said before though that I don't know enough to say whether or not it is an okay basis.
I would think probably Obama's legacy was why it was suddenly important.
Quote from: garbon on November 13, 2013, 10:50:20 PM
I don't know that it is worse and I guess people being forced to have it might gear us up for a more sensible system. I think I said before though that I don't know enough to say whether or not it is an okay basis.
I would think probably Obama's legacy was why it was suddenly important.
This, pretty much, although I think it's is many times better than what we had.
Quote from: garbon on November 13, 2013, 10:50:20 PM
I don't know that it is worse and I guess people being forced to have it might gear us up for a more sensible system. I think I said before though that I don't know enough to say whether or not it is an okay basis.
I accept that I may have a very skewed view of all of this since I work in the health/healthcare insurance field. On top of that, I went 18 months without insurance, and I'm still paying off the $10,000 that cost me. (I couldn't get private insurance since I have a history of high blood pressure.) Making healthcare available to everyone has been very important to me for a lot of reasons.
QuoteI would think probably Obama's legacy was why it was suddenly important.
Yeah, I'd go along with that. I'm not sure what the crisis was either, but I thought it was pretty important, so I'm willing to accept what came from the "crisis."
I think the crisis was well known and long term....we spend far more than almost every other countries on healthcare, seem to lack better outcomes than other industrialized countries, and fail to provide a large segment of our population access to healthcare.
The urgency of working on it right away was that Republicans were going to be dead set against significant reform, and Obama needed to take advantage of majorities in both houses (and at least for a while a supermajority in the senate) plus his post election popularity. Even with those factors it barely passed.
Quote from: alfred russel on November 13, 2013, 11:50:56 PM
I think the crisis was well known and long term....we spend far more than almost every other countries on healthcare, seem to lack better outcomes than other industrialized countries, and fail to provide a large segment of our population access to healthcare.
Yeah but that wasn't something new or suddenly pressing.
Quote from: alfred russel on November 13, 2013, 11:50:56 PM
The urgency of working on it right away was that Republicans were going to be dead set against significant reform, and Obama needed to take advantage of majorities in both houses (and at least for a while a supermajority in the senate) plus his post election popularity. Even with those factors it barely passed.
I don't. I almost wonder if Obama was one of our least auspicious presidents to have work on such an important venture.
Quote from: alfred russel on November 13, 2013, 11:50:56 PM
The urgency of working on it right away was that Republicans were going to be dead set against significant reform, and Obama needed to take advantage of majorities in both houses (and at least for a while a supermajority in the senate) plus his post election popularity. Even with those factors it barely passed.
Yeah. He had a mandate to do something and he was handed a majority to do it. And it was a complete failure.
Quote from: Caliga on November 13, 2013, 10:47:03 PM
Yeah, I never understood that either. The whole healthcare 'crisis' thing seemed to come out of nowhere. First the economy was a big crisis (which I think was entirely accurate to say), but then out of left field it was all OMG HEALTHCARE IS BROKEN WE NEED TO FIX IT NOWNOWNOW!!!!!!!!!!!!!!!!! Before like 2008 nobody really talked about healthcare being so broken since Bill and Hillary's first term when they had tried to fix it. :hmm:
:mellow: except the system has been recognized as a failure for a long time. Before the economy fell apart Barack Obama and Hilary Clinton were debating how to fix it during their primary. The deficiencies of the current system caused George W. Bush to try patch it with Medicare part D.
Quote from: garbon on November 14, 2013, 12:01:40 AM
Quote from: alfred russel on November 13, 2013, 11:50:56 PM
I think the crisis was well known and long term....we spend far more than almost every other countries on healthcare, seem to lack better outcomes than other industrialized countries, and fail to provide a large segment of our population access to healthcare.
Yeah but that wasn't something new or suddenly pressing.
Quote from: alfred russel on November 13, 2013, 11:50:56 PM
The urgency of working on it right away was that Republicans were going to be dead set against significant reform, and Obama needed to take advantage of majorities in both houses (and at least for a while a supermajority in the senate) plus his post election popularity. Even with those factors it barely passed.
I don't. I almost wonder if Obama was one of our least auspicious presidents to have work on such an important venture.
What would make it pressing in your book garbon?
Quote from: Razgovory on November 14, 2013, 12:20:52 AM
Quote from: Caliga on November 13, 2013, 10:47:03 PM
Yeah, I never understood that either. The whole healthcare 'crisis' thing seemed to come out of nowhere. First the economy was a big crisis (which I think was entirely accurate to say), but then out of left field it was all OMG HEALTHCARE IS BROKEN WE NEED TO FIX IT NOWNOWNOW!!!!!!!!!!!!!!!!! Before like 2008 nobody really talked about healthcare being so broken since Bill and Hillary's first term when they had tried to fix it. :hmm:
:mellow: except the system has been recognized as a failure for a long time. Before the economy fell apart Barack Obama and Hilary Clinton were debating how to fix it during their primary. The deficiencies of the current system caused George W. Bush to try patch it with Medicare part D.
Yeah I am not sure where Cal got that from. The system is dangerously broken and could tank the entire economy and ruin the Federal budget. It needed reform.
Quote from: 11B4V on November 13, 2013, 09:21:28 PM
They're mad because their boyz signature legislation is a clusterfuck. Oh, and they have no arguement for his lies to the American people.
It was a clusterfuck the minute it was past. If the clusterfuck is the website thing...well I am not sure how that is a big deal big rollouts like this are almost always minor disasters. Something huge like this was going to have a rough start no matter what, even if it was genius legislation.
As for the lies...well I guess I am somewhat happy people actually care about that. The guy lied his ass off in 2008 and nobody really gave a flip. Obama is pretty worthless as a President. I am shocked about how badly he has done, not even in my wildest 2009 nightmares did I think he would be this putrid.
Quote from: Valmy on November 14, 2013, 12:40:06 AM
The system is dangerously broken and could tank the entire economy and ruin the Federal budget. It needed reform.
And instead we got the ACA which does next to nothing in slowing down the upward trajectory of healthcare costs.
Quote from: citizen k on November 14, 2013, 12:50:33 AM
Quote from: Valmy on November 14, 2013, 12:40:06 AM
The system is dangerously broken and could tank the entire economy and ruin the Federal budget. It needed reform.
And instead we got the ACA which does next to nothing in slowing down the upward trajectory of healthcare costs.
To say the Democrats fucked that up would be a massive understatement. They could have done anything they wanted. It just boggles the mind.
Quote from: DGuller on November 13, 2013, 07:00:26 PM
It's disgusting how so many Americans are cheering for failure, and hoping for changes that they know would make Obamacare more likely to fail. Who needs external enemies with patriots like that?
Indeed. It is as bad as some of the Dems trying to sabotage the Iraq War, with threats to pull funding, trying to pass resolutions forcing withdrawal, etc., etc.
Of course, the difference is that the crazies in the Dem Party never managed to actually get the rest of the party to go along with it, for the most part (at least in any actual practical sense). But the disgust is still just as disgusting, even if they were not as successful.
The Democrats are more moderate and less vulnerable to populist crusades....for now anyway. Radicalism seems to be growing in strength on both sides. Probably not unexplected given the failures of the establishment.
Quote from: Valmy on November 14, 2013, 12:54:03 AM
Quote from: citizen k on November 14, 2013, 12:50:33 AM
Quote from: Valmy on November 14, 2013, 12:40:06 AM
The system is dangerously broken and could tank the entire economy and ruin the Federal budget. It needed reform.
And instead we got the ACA which does next to nothing in slowing down the upward trajectory of healthcare costs.
To say the Democrats fucked that up would be a massive understatement. They could have done anything they wanted. It just boggles the mind.
Except in reality they could not. To get any bill passed they needed get pass obstuctionists in the house and Senate and the sheer hatred that Republicans had for the President and all his works took them by surprise so a lot of Dems were afraid to vote for any bill. Not that it helped them much, the Dems that opposed it tended to get beaten in 2010 if they voted for ACA or not.
Quote from: 11B4V on November 13, 2013, 09:21:28 PM
They're mad because their boyz signature legislation is a clusterfuck. Oh, and they have no arguement for his lies to the American people.
It is so cute to see you repeat, over and over again, the fact that a politician lied, as though your boyz aren't liars as well. Doesn't matter which party they are in, if they are a politician or an officer in the NRA, they are a liar. The sooner you stopped being shocked by that fact, the sooner you will stop sounding like a repetitive drone.
And, yes, Obamacare is as fucked up as Bushcare was, though for different reasons. The difference is that Bushcare offered no hope of improvement, while Obamacare offers a small hope of improvement.
Quote from: Valmy on November 14, 2013, 12:40:06 AM
Yeah I am not sure where Cal got that from. The system is dangerously broken and could tank the entire economy and ruin the Federal budget. It needed reform.
I'm not disputing that. What I am saying is that prior to ~2008 I don't recall politicians and the media bleating on about healthcare being broken and needing fixing, but all the sudden there was a firestorm of that around the time of the election and then immediately afterward, especially after the focus on the economy/banking crisis started to subside.
Quote from: Caliga on November 13, 2013, 10:47:03 PM
Yeah, I never understood that either. The whole healthcare 'crisis' thing seemed to come out of nowhere. First the economy was a big crisis (which I think was entirely accurate to say), but then out of left field it was all OMG HEALTHCARE IS BROKEN WE NEED TO FIX IT NOWNOWNOW!!!!!!!!!!!!!!!!! Before like 2008 nobody really talked about healthcare being so broken since Bill and Hillary's first term when they had tried to fix it. :hmm:
I must admit that this post forces me to ask: how old were you in 2008, that you missed all the angst over 13%/year increases in health care costs (or whatever increase in that range was the real number)? I sure remember it. Now, the disaster that befell the Clinton administration when it tried to implement health care reform made most politicians afraid to do anything about the disaster unfolding before their eyes, but I think most adult Americans were aware that the system was seriously broken.
Quote from: merithyn on November 13, 2013, 04:39:31 PM
Quote from: Admiral Yi on November 13, 2013, 04:22:41 PM
I'm not ignoring it Meri. Those people are a minority. Your previous statement was more general than that. It suggested that the antecedent for "they" was those working people who had not previously had employer provided insurance.
I was referring to everyone who couldn't have insurance before, most notably those who didn't qualify no matter the cost.
No doubt the existing system needed reform. It wasn't right that existing conditions prevented some from getting health insurance or had to pay an exorbitant amount, and that so many couldn't get insurance at all unless poor enough to qualify for existing Medicaid programs. So that left out many lower paid workers. Some of those type reforms are useful and long past time to put in place. That could have been done separately outside of a massive health care change. An increase to Medicaid eligibility was included in the ACA and many people are signing up, probably many on existing State systems, so I would think some of that could have been done with or without the ACA.
Quote from: Phillip V on November 13, 2013, 06:07:42 PM
Democrats Threaten to Abandon Obama on Health Law Provision
'Anxious congressional Democrats are threatening to abandon President Obama on a central element of his signature health care law, voicing increasing support for proposals that would allow Americans to retain the health insurance coverage they are losing because of the Affordable Care Act.
The dissent comes as the Obama administration released enrollment figures Wednesday that fell far short of expectations.'
http://www.nytimes.com/2013/11/14/us/politics/democrats-threaten-to-abandon-obama-on-health-law-provision.html
(https://languish.org/forums/proxy.php?request=http%3A%2F%2Fgraphics8.nytimes.com%2Fimages%2F2013%2F11%2F14%2Fus%2Fhealthweb%2Fhealthweb-articleLarge.jpg&hash=49ee6a4531bdceeadc7ae7bc516903b1349a9681)
This probably sounds good and will probably be popular but it may not pass as it could severely hamper the ACA as it needs those same people to sign up under the ACA plan. The ACA plans need people to sign up else I would think the insurance plans will be too expensive and/or the ACA program doesn't have the funds needed to make it work.
They need to make some serious fixes, obviously, should have done so before the ACA was fully implemented as it seems apparent that many analysts forecast-ed these problems. Hopefully the Feds will, they need to anyway given the severity of the problems that we seem to be hearing about every day now.
I just look at the ACA as "foot-in-the-door" politics. Once established, it will be hard to get rid of it. The only option is to then fix it to make it work. I'm okay with that. Something needed to be done, and something was done. It may hurt for a few years while Congress decides to actually do something that works, but if the long-term is better, less expensive healthcare for the entire population, I'm okay with that.
1. Yes the President fibbed. His pants are on fire. Point made. Either impeach him for it or move on with life.
2. Clearly the implementation has been piss-poor. That also lies with the WH because that is where the buck stops. The proper response to poor implementation is improve implementation. Anything else - from either side - is hot air.
3. It is too early to tell whether Obamacare "works" or what fixes if any need to be made.
4. Returning to the status quo ante is not a viable option.
5. If the GOP or wavering Democrats or any other critic of Obamacare wants to be taken seriously, they need to articulate a viable alternative that would be an improvement. So far there is radio silence on the front from where I sit. I wouldn't expect to hear much from the GOP-affiliated health experts, because Obamacare was their plan to begin with. But I would be very happy to be pleasantly surprised.
Quote from: The Minsky Moment on November 14, 2013, 10:01:26 AM
5. If the GOP or wavering Democrats or any other critic of Obamacare wants to be taken seriously, they need to articulate a viable alternative that would be an improvement. So far there is radio silence on the front from where I sit. I wouldn't expect to hear much from the GOP-affiliated health experts, because Obamacare was their plan to begin with. But I would be very happy to be pleasantly surprised.
That would be nice, but don't hold your breath. Doing that would require a great political risk, courage, leadership, and devotion to country Opposing Obamacare, on the other hand, requires no effort at all just playing to the populist masses.
Saw on CNN that health care reform has 55% disapproval.
:nelson:
Quote from: derspiess on November 14, 2013, 10:15:27 AM
:nelson:
VICTORY!!!111
Of course nothing has changed and we still need health care reform.
Quote from: derspiess on November 14, 2013, 10:15:27 AM
:nelson:
To set aside the typical crap you throw out there, what would you like to see moving forward? Are you hoping to completely repeal the ACA? What would you do to replace it? Were you legitimately okay with the status quo?
There's so much vitriol thrown out about the ACA, but like Minsky said, few of those same people are offering solid alternatives. And I have to say that those who think that there was nothing wrong with what was going on before lived in a bubble.
Quote from: derspiess on November 14, 2013, 10:15:27 AM
:nelson:
This is an example of the problem with the country; people rejoice when their political opponents' plans fail, even though such a failure leaves everyone worse off. To :nelson: the ACA failures is like going :nelson: when hearing about American military failures in Iraq or Afghanistan because one reflexively opposed Bush.
You guys make trolling easy.
Quote from: grumbler on November 14, 2013, 07:45:01 AM
It is so cute to see you repeat, over and over again, the fact that a politician lied, as though your boyz aren't liars as well. Doesn't matter which party they are in, if they are a politician or an officer in the NRA, they are a liar. The sooner you stopped being shocked by that fact, the sooner you will stop sounding like a repetitive drone.
11B has no boyz. He's in the middle & slings shit at both sides.
Quote from: merithyn on November 14, 2013, 10:56:39 AM
Quote from: derspiess on November 14, 2013, 10:15:27 AM
:nelson:
To set aside the typical crap you throw out there, what would you like to see moving forward? Are you hoping to completely repeal the ACA? What would you do to replace it? Were you legitimately okay with the status quo?
There's so much vitriol thrown out about the ACA, but like Minsky said, few of those same people are offering solid alternatives. And I have to say that those who think that there was nothing wrong with what was going on before lived in a bubble.
Tell me what you'd change about Obamacare and I might answer.
Quote from: derspiess on November 14, 2013, 11:19:49 AM
11B has no boyz. He's in the middle & slings shit at both sides.
Raz would say he lacks moral courage.
Quote from: Valmy on November 14, 2013, 12:10:33 AM
Quote from: alfred russel on November 13, 2013, 11:50:56 PM
The urgency of working on it right away was that Republicans were going to be dead set against significant reform, and Obama needed to take advantage of majorities in both houses (and at least for a while a supermajority in the senate) plus his post election popularity. Even with those factors it barely passed.
Yeah. He had a mandate to do something and he was handed a majority to do it. And it was a complete failure.
I really doubt it was a complete failure.
The website may have been a failure, but that is short term. People are losing health care plans that don't meet certain standards, but that was part of the plan.
I suspect the major issue in the near term is that the penalties for the individual mandate are way too low and will seriously jack up costs. But if that doesn't really derail the plan and we muddle through, then the penalties will increase and that problem will work itself out. I don't see any other issue that causes me to think that over the long term Obamacare will fail.
Quote from: alfred russel on November 14, 2013, 12:09:20 PM
I really doubt it was a complete failure.
Well ok not a complete failure, it does a few good things. I will call it...90% of a failure. This reform will not solve most of the problems it was supposed to fix. Prices will continue to rise and we will continue to be in crisis.
Quote from: Valmy on November 14, 2013, 11:36:26 AM
Quote from: derspiess on November 14, 2013, 11:19:49 AM
11B has no boyz. He's in the middle & slings shit at both sides.
Raz would say he lacks moral courage.
It's true, he does. He's not so much in the middle as being against everything. It's a safe position to take, you can look like someone who has an interest in politics without actually being for something. If you aren't for something, you can never be wrong. You never have to worry about the embarrassment or heart break that comes with being wrong. Politics is a bit like dating, you have to invest some of yourself and you'll likely get burned sometimes. The cynic that laughs at everyone else but stand for nothing is like a person who doesn't have the courage to get in a relationship because of fear of rejection. Instead he just goes home and jerks off. The cynic does the same thing, except instead of massaging his gentiles he massages his ego by laughing at others who were foolish enough to support an idea or person.
Quote from: alfred russel on November 14, 2013, 12:09:20 PM
I suspect the major issue in the near term is that the penalties for the individual mandate are way too low and will seriously jack up costs. But if that doesn't really derail the plan and we muddle through, then the penalties will increase and that problem will work itself out. I don't see any other issue that causes me to think that over the long term Obamacare will fail.
There is a chance that if penalties are raised enough, a popular backlash could develop against Obamacare.
I think it has helped Obamacare politically up to this point, and will hurt it going forward, that the targets of the individual mandate tend to be less politically aware. At least that is my impression.
Quote from: Valmy on November 14, 2013, 12:11:13 PM
Quote from: alfred russel on November 14, 2013, 12:09:20 PM
I really doubt it was a complete failure.
Well ok not a complete failure, it does a few good things. I will call it...90% of a failure. This reform will not solve most of the problems it was supposed to fix. Prices will continue to rise and we will continue to be in crisis.
Obamacare is a long term restructuring of health care and key parts that haven't been implemented yet. I'd give it time.
Quote from: Admiral Yi on November 14, 2013, 12:15:38 PM
There is a chance that if penalties are raised enough, a popular backlash could develop against Obamacare.
I think it has helped Obamacare politically up to this point, and will hurt it going forward, that the targets of the individual mandate tend to be less politically aware. At least that is my impression.
On the flip side, there are significant subsidies available to many people that people seem to be unaware of.
Quote from: alfred russel on November 14, 2013, 12:25:42 PM
Quote from: Valmy on November 14, 2013, 12:11:13 PM
Quote from: alfred russel on November 14, 2013, 12:09:20 PM
I really doubt it was a complete failure.
Well ok not a complete failure, it does a few good things. I will call it...90% of a failure. This reform will not solve most of the problems it was supposed to fix. Prices will continue to rise and we will continue to be in crisis.
Obamacare is a long term restructuring of health care and key parts that haven't been implemented yet. I'd give it time.
How much?
Quote from: alfred russel on November 14, 2013, 12:27:03 PM
On the flip side, there are significant subsidies available to many people that people seem to be unaware of.
Right, and that's a political question. Well lower income mandatees think "gee, I'm getting $2,000 worth of insurance for only $1,500," or will they think "that fucker is forcing me to spend $1,500 I could have spent on booze."
Quote from: alfred russel on November 14, 2013, 12:09:20 PM
Quote from: Valmy on November 14, 2013, 12:10:33 AM
Quote from: alfred russel on November 13, 2013, 11:50:56 PM
The urgency of working on it right away was that Republicans were going to be dead set against significant reform, and Obama needed to take advantage of majorities in both houses (and at least for a while a supermajority in the senate) plus his post election popularity. Even with those factors it barely passed.
Yeah. He had a mandate to do something and he was handed a majority to do it. And it was a complete failure.
I really doubt it was a complete failure.
The website may have been a failure, but that is short term. People are losing health care plans that don't meet certain standards, but that was part of the plan.
I suspect the major issue in the near term is that the penalties for the individual mandate are way too low and will seriously jack up costs. But if that doesn't really derail the plan and we muddle through, then the penalties will increase and that problem will work itself out. I don't see any other issue that causes me to think that over the long term Obamacare will fail.
Not related to your post, but we still want answers! :angry:
Quote from: derspiess on November 14, 2013, 12:30:03 PM
Quote from: alfred russel on November 14, 2013, 12:25:42 PM
Quote from: Valmy on November 14, 2013, 12:11:13 PM
Quote from: alfred russel on November 14, 2013, 12:09:20 PM
I really doubt it was a complete failure.
Well ok not a complete failure, it does a few good things. I will call it...90% of a failure. This reform will not solve most of the problems it was supposed to fix. Prices will continue to rise and we will continue to be in crisis.
Obamacare is a long term restructuring of health care and key parts that haven't been implemented yet. I'd give it time.
How much?
I'm not an expert on this at all, but from what I know I'd say 5 years. For Obamacare to really work you need functioning exchanges and significant mandates. There probably also needs to be some loss experience for actuaries to base rates off of, and some time for people to become familiar with their options. I don't think we will have significant mandates for another 4 years (I could be completely wrong on that).
Quote from: Razgovory on November 14, 2013, 12:11:56 PM
Quote from: Valmy on November 14, 2013, 11:36:26 AM
Quote from: derspiess on November 14, 2013, 11:19:49 AM
11B has no boyz. He's in the middle & slings shit at both sides.
Raz would say he lacks moral courage.
It's true, he does. He's not so much in the middle as being against everything. It's a safe position to take, you can look like someone who has an interest in politics without actually being for something. If you aren't for something, you can never be wrong. You never have to worry about the embarrassment or heart break that comes with being wrong. Politics is a bit like dating, you have to invest some of yourself and you'll likely get burned sometimes. The cynic that laughs at everyone else but stand for nothing is like a person who doesn't have the courage to get in a relationship because of fear of rejection. Instead he just goes home and jerks off. The cynic does the same thing, except instead of massaging his gentiles he massages his ego by laughing at others who were foolish enough to support an idea or person.
STFU basement boy.
Quote from: alfred russel on November 14, 2013, 12:38:41 PM
I'm not an expert on this at all, but from what I know I'd say 5 years. For Obamacare to really work you need functioning exchanges and significant mandates. There probably also needs to be some loss experience for actuaries to base rates off of, and some time for people to become familiar with their options. I don't think we will have significant mandates for another 4 years (I could be completely wrong on that).
Okay. What are the metrics, in general terms?
Quote from: grumbler on November 14, 2013, 07:45:01 AM
Quote from: 11B4V on November 13, 2013, 09:21:28 PM
They're mad because their boyz signature legislation is a clusterfuck. Oh, and they have no arguement for his lies to the American people.
It is so cute to see you repeat, over and over again, the fact that a politician lied, as though your boyz aren't liars as well. Doesn't matter which party they are in, if they are a politician or an officer in the NRA, they are a liar. The sooner you stopped being shocked by that fact, the sooner you will stop sounding like a repetitive drone.
The NRA are my boyz????? The Tea Party??? Who is it, since you think you know.
and when the NRA comes back in the news, does something stupid, which they will, I'll bash them.
Quote from: Razgovory on November 14, 2013, 12:11:56 PM
Quote from: Valmy on November 14, 2013, 11:36:26 AM
Quote from: derspiess on November 14, 2013, 11:19:49 AM
11B has no boyz. He's in the middle & slings shit at both sides.
Raz would say he lacks moral courage.
It's true, he does. He's not so much in the middle as being against everything. It's a safe position to take, you can look like someone who has an interest in politics without actually being for something. If you aren't for something, you can never be wrong. You never have to worry about the embarrassment or heart break that comes with being wrong. Politics is a bit like dating, you have to invest some of yourself and you'll likely get burned sometimes. The cynic that laughs at everyone else but stand for nothing is like a person who doesn't have the courage to get in a relationship because of fear of rejection. Instead he just goes home and jerks off. The cynic does the same thing, except instead of massaging his gentiles he massages his ego by laughing at others who were foolish enough to support an idea or person.
That was so poignant. :cry: Did you copy it from somewhere?
Quote from: Valmy on November 14, 2013, 11:36:26 AM
Quote from: derspiess on November 14, 2013, 11:19:49 AM
11B has no boyz. He's in the middle & slings shit at both sides.
Raz would say he lacks moral courage.
Doesnt take moral courage to be on one of those fucked up teams. Just laziness.
Quote from: Admiral Yi on November 14, 2013, 12:30:26 PM
Quote from: alfred russel on November 14, 2013, 12:27:03 PM
On the flip side, there are significant subsidies available to many people that people seem to be unaware of.
Right, and that's a political question. Well lower income mandatees think "gee, I'm getting $2,000 worth of insurance for only $1,500," or will they think "that fucker is forcing me to spend $1,500 I could have spent on booze."
My understanding is the subsidies can be much more generous than you mention. Also, some people are going to have the opportunity to get their families primary care for the first time.
Obamacare basically takes from the young, healthy, and rich to give to the old, sick, and poor. The people getting benefits will know what they are losing. The people paying in will get insurance, but many may not be aware they are paying in more than the actuarial cost of their benefit. See young healthy men who want insurance even though they have few assets and could sign up for insurance without regard to their medical history.
http://www.usatoday.com/story/news/politics/2013/11/14/obama-obamacare-white-house-announcement/3525383/
QuoteObama: Canceled plans can be kept for a year
President Obama said Thursday that Americans can keep canceled health insurance policies for a year as companies and consumers adjust to the new demands of the health care law.
In the coming weeks, insurance companies must also notify customers of what those policies lack, and of options consumers have for better coverage under the new law, Obama said in a statement at the White House."Americans whose plans have been canceled can choose to re-enroll," he said.
The president responded to criticism from lawmakers and Americans who have received cancellation notices since the Obamacare law came on line last month, a period also marred by a malfunctioning website.
"I think it's fair to say the rollout has been rough so far," Obama said. "This fix won't solve every problem, but it will help a lot of people."
Obama told reporters he knows he has to "win back some credibility" on the health care law."We fumbled the rollout," he said.
Administration officials have said policies have been canceled because they do not comply with new coverage requirements prescribed by Obamacare, and that the new system offers consumers better, higher quality options.
House Speaker John Boehner, R-Ohio, reacting to news reports of the extension, said that "I'm highly skeptical they can do this administratively," but he awaited the details.
Senate Minority Leader Mitch McConnell, R-Ky., said Obama's statement represented "the clearest acknowledgment yet that his oft-repeated pledge 'if you like your plan, you can keep it' was false all along."
President Obama indicated he would oppose a House Republican plan that would let people keep their plans for longer, saying it would undercut the structure of the Affordable Care Act.
Kaiser Family Foundation senior fellow Karen Pollitz says giving everyone another year to keep their plans and better understand their options is a "reasonable response" by President Obama.
"If people have the option to renew the policy for another year and if they're also informed about their new options and limitations of their current policies, they can decide their own timing for a transition," says Pollitz. "If they'll be better off moving this open season to ACA market (on Jan. 1) they can; if they decide it makes more sense to wait, they can do that too."
Obama and his signature health care law have come under sharp attack from lawmakers and people who have lost their insurance since the new law came on line last month.
A malfunctioning health care website has also drawn heavy criticism.
Fellow Democrats have been urging Obama to make changes, and a number of bills are making their way through Congress.
Obama's announcement comes a day after the administration announced that only 26,794 people have been able to enroll in Obamacare because of the balky website.
All told, there were some 106,000 sign-ups in October, including about 79,000 who enrolled in 14 states that have their have their own websites, all number lower than projected.
The health care problems appear to be taking a toll on Obama's popularity and approval ratings.
A Quinnipiac Poll this week said that "for the first time" a majority of Americans -- 52% to 44% -- say that Obama is not honest and trustworthy.
"His previous lowest marks on honesty were May 30, when 49% of voters said he was honest and 47% said he wasn't," Quinnipiac reported.
The health care law appears to be the root of Obama's current problem.
His ratings have fallen since the beginning of October and the unveiling of the malfunctioning web site.
Voters are also criticizing Obama for his long-ago pledge that people who like their existing insurance policies could keep them. Many Americans have received cancellation notices, though administration officials said that many of the affected policies do not meet new federal quality standards.
Administration officials, noting that Congress has an even lower approval rating, said voters are upset with all of Washington.
White House spokesman Jay Carney said the president is working to fix problems with the health care law, and other challenges facing Americans.
"We need to focus here on getting the work done that the American people sent us to do," he said. "And that means working together to fix problems when they arise, not to try to score political points, and it means taking ownership and responsibility for problems that happen on your watch."
President Obama isn't just facing lower approval ratings -- people are starting to question his honesty and trustworthiness.
A Quinnipiac Poll this week said that "for the first time" a majority of Americans -- 52% to 44% -- say that Obama is not honest and trustworthy.
His ratings have fallen since the beginning of October and a rollout of the health care law that has featured an infamously malfunctioning web site.
Voters are also on Obama for his long-ago pledge that people who like their existing insurance policies could keep them. Many Americans have received cancellation notices, though administration officials said that many of the affected policies do not meet new federal quality standards.
White House officials, noting that Congress has an even lower approval rating, said voters are upset with all of Washington. Spokesman Jay Carney said the president is working to fix problems with the health care law and other challenges facing Americans.
During his statement, Obama said: "We are going to solve those problems. We are going to get this rught, and the Affordable Care Act is going to work."
Quote from: derspiess on November 14, 2013, 12:43:07 PM
Quote from: alfred russel on November 14, 2013, 12:38:41 PM
I'm not an expert on this at all, but from what I know I'd say 5 years. For Obamacare to really work you need functioning exchanges and significant mandates. There probably also needs to be some loss experience for actuaries to base rates off of, and some time for people to become familiar with their options. I don't think we will have significant mandates for another 4 years (I could be completely wrong on that).
Okay. What are the metrics, in general terms?
Percentage of uninsured people
Affordability of health care
Aggregate health care spending
Changes in health care outcomes (I suspect this will not be easily measurable)
Changes in health care quality
Public perception of Obamacare
Quote from: garbon on November 14, 2013, 12:53:06 PM
http://www.usatoday.com/story/news/politics/2013/11/14/obama-obamacare-white-house-announcement/3525383/
QuoteObama: Canceled plans can be kept for a year
Well, well.
Looks like our bet is off Before.
Quote from: alfred russel on November 14, 2013, 12:55:51 PM
Percentage of uninsured people
Affordability of health care
Aggregate health care spending
Changes in health care outcomes (I suspect this will not be easily measurable)
Changes in health care quality
Public perception of Obamacare
Okay-- just wasn't sure if you were going for one thing alone. What is your expectation on spending & public perception 5 years from now?
QuoteDuring his statement, Obama said: "We are going to solve those problems. We are going to get this right, and the Affordable Care Act is going to work."
So many good things in that ACA bill. Pelosi was right-- they had to pass the bill before we could see it.
Quote from: alfred russel on November 14, 2013, 12:27:03 PM
My understanding is the subsidies can be much more generous than you mention. Also, some people are going to have the opportunity to get their families primary care for the first time.
This is the plus of the ACA
Quote
Obamacare basically takes from the young, healthy, and rich to give to the old, sick, and poor. The people getting benefits will know what they are losing. The people paying in will get insurance, but many may not be aware they are paying in more than the actuarial cost of their benefit. See young healthy men who want insurance even though they have few assets and could sign up for insurance without regard to their medical history.
How much did allowing a kids, till the age of 26, to stay on their parents plans, throw a possible wrench into the ACA? Seems like that is counter productive to the above statement. Seems a lot of revenue lost.
Quote from: derspiess on November 14, 2013, 01:03:33 PM
So many good things in that ACA bill. Pelosi was right-- they had to pass the bill before we could see it.
:D
Quote from: derspiess on November 14, 2013, 12:59:25 PM
Okay-- just wasn't sure if you were going for one thing alone. What is your expectation on spending & public perception 5 years from now?
I think the public perception will be positive. I think the act will generally work, but more than that I think that government programs that touch people's lives tend to be thought well of.
I don't think the ACA will be effective at reducing spending. I think that is the one place it is going to fail.
Quote from: 11B4V on November 14, 2013, 01:04:57 PM
How much did allowing a kids, till the age of 26, to stay on their parents plans, throw a possible wrench into the ACA? Seems like that is counter productive to the above statement. Seems a lot of revenue lost.
The revenue isn't lost. The cost of insuring a 25 year old will just be picked up by their parents' plan (which will become more expensive).
The key to making the health care law work is finding private sector pockets to pay for insurance for healthy people. Since young people tend to be healthy, getting them insured is important. That is why right now you see a bunch of ads trying to get young men to sign up for health care, but not so many for old people.
The problem is that in a world where you can sign up for insurance after you get sick, and don't have a bunch of assets that are at risk to an expensive emergency room visit, it doesn't make so much sense to sign up for healthcare. Hence pushing them onto their parents plan until 26, and putting an individual mandate on them.
CNN had on a prof from MIT who was involved in writing Romneycare and Obamacare. He explained Obama's statement about keeping the plan you have by saying they expected that people with those shitty plans would voluntarily switch once they got on the exchange and saw how much subsidy they would get. I think that's about as good of a job as one can do with Obama's promise.
On a related note, I think calling Romneycare Romneycare is dishonest agitprop.
Quote from: Admiral Yi on November 14, 2013, 01:29:59 PM
CNN had on a prof from MIT who was involved in writing Romneycare and Obamacare. He explained Obama's statement about keeping the plan you have by saying they expected that people with those shitty plans would voluntarily switch once they got on the exchange and saw how much subsidy they would get. I think that's about as good of a job as one can do with Obama's promise.
Yep, and I'm sure the Soviets figured the kulaks would voluntarily collectivize once they saw how awesome collectivization was.
Dude, that's nuts.
Yeah.
Quote from: DGuller on November 14, 2013, 12:47:43 PM
Quote from: Razgovory on November 14, 2013, 12:11:56 PM
Quote from: Valmy on November 14, 2013, 11:36:26 AM
Quote from: derspiess on November 14, 2013, 11:19:49 AM
11B has no boyz. He's in the middle & slings shit at both sides.
Raz would say he lacks moral courage.
It's true, he does. He's not so much in the middle as being against everything. It's a safe position to take, you can look like someone who has an interest in politics without actually being for something. If you aren't for something, you can never be wrong. You never have to worry about the embarrassment or heart break that comes with being wrong. Politics is a bit like dating, you have to invest some of yourself and you'll likely get burned sometimes. The cynic that laughs at everyone else but stand for nothing is like a person who doesn't have the courage to get in a relationship because of fear of rejection. Instead he just goes home and jerks off. The cynic does the same thing, except instead of massaging his gentiles he massages his ego by laughing at others who were foolish enough to support an idea or person.
That was so poignant. :cry: Did you copy it from somewhere?
I'm glad you liked it. I don't think 11B4 does though.
Quote from: 11B4V on November 14, 2013, 12:47:22 PM
The NRA are my boyz????? The Tea Party??? Who is it, since you think you know.
I'm not going down that B4 rathole. It doesn't matter who your boyz are, they are liars. I never said I knew who they were, just that they were liars.
Quoteand when the NRA comes back in the news, does something stupid, which they will, I'll bash them.
And when pigs fly, there will be pork in the treetops.
Quote from: Valmy on November 14, 2013, 12:11:13 PM
Well ok not a complete failure, it does a few good things. I will call it...90% of a failure. This reform will not solve most of the problems it was supposed to fix. Prices will continue to rise and we will continue to be in crisis.
i am not sure what you are arguing here. You say that it is 90% a failure because it hasn't solved things that will happen in the future, when it gets implemented? :huh:
I am not sure there is a logical construct that allows you to preemptively declare a future event a failure.
Quote from: grumbler on November 14, 2013, 02:00:50 PM
And when pigs fly, there will be pork in the treetops.
They fly here in Cincy :contract:
http://www.flyingpigmarathon.com/
Quote from: derspiess on November 14, 2013, 02:10:06 PM
Quote from: grumbler on November 14, 2013, 02:00:50 PM
And when pigs fly, there will be pork in the treetops.
They fly here in Cincy :contract:
http://www.flyingpigmarathon.com/
Nope. There's no pork in the treetops.
Well, there's goetta in the treetops anyway.
Quote from: 11B4V on November 14, 2013, 12:57:04 PM
Quote from: garbon on November 14, 2013, 12:53:06 PM
http://www.usatoday.com/story/news/politics/2013/11/14/obama-obamacare-white-house-announcement/3525383/
QuoteObama: Canceled plans can be kept for a year
Well, well.
Good idea for many people losing their plans but it may not be so easy to roll back. On the news it also showed the insurance companies have issued a statement that they aren't so easily able to comply, to reinstate the policies that they've been mandated to end and have been planning on doing for a while, with many ins comps deciding to leave the indidual market. Biggest thing is that by allowing these policies people like to remain that means the ACA policies aren't being purchased, which the companies have spent months putting together the plans, costs, and what ever else goes into such planning. Now the cost structure gets skewed, kind of turns things on its head, costs could go up.
And, can a President mandate like that, change the rules, given that a law is in place? Wouldn't that have to be legislated through Congress?
Quote from: derspiess on November 14, 2013, 11:23:16 AM
Tell me what you'd change about Obamacare and I might answer.
No, you won't. You never do.
Quote from: KRonn on November 14, 2013, 02:51:36 PM
Good idea for many people losing their plans but it may not be so easy to roll back. On the news it also showed the insurance companies have issued a statement that they aren't so easily able to comply, to reinstate the policies that they've been mandated to end and have been planning on doing for a while, with many ins comps deciding to leave the indidual market. Biggest thing is that by allowing these policies people like to remain that means the ACA policies aren't being purchased, which the companies have spent months putting together the plans, costs, and what ever else goes into such planning. Now the cost structure gets skewed, kind of turns things on its head, costs could go up.
I dunno. My company just sent out an email about that, and pretty much no one that I've seen is concerned. Change a few dates in the computer (from 12/31/2013 to 10/31/2014) for the old policy end dates and life goes on. I'm sure there's a bit more to it than that, but no one here seems overly concerned.
Quote from: grumbler on November 14, 2013, 02:00:50 PM
Quote from: 11B4V on November 14, 2013, 12:47:22 PM
The NRA are my boyz????? The Tea Party??? Who is it, since you think you know.
I'm not going down that B4 rathole. It doesn't matter who your boyz are, they are liars. I never said I knew who they were, just that they were liars.
Lame and way off form for you.
Quote from: KRonn on November 14, 2013, 02:51:36 PM
Quote from: 11B4V on November 14, 2013, 12:57:04 PM
Quote from: garbon on November 14, 2013, 12:53:06 PM
http://www.usatoday.com/story/news/politics/2013/11/14/obama-obamacare-white-house-announcement/3525383/
QuoteObama: Canceled plans can be kept for a year
Well, well.
Good idea for many people losing their plans but it may not be so easy to roll back. On the news it also showed the insurance companies have issued a statement that they aren't so easily able to comply, to reinstate the policies that they've been mandated to end and have been planning on doing for a while, with many ins comps deciding to leave the indidual market. Biggest thing is that by allowing these policies people like to remain that means the ACA policies aren't being purchased, which the companies have spent months putting together the plans, costs, and what ever else goes into such planning. Now the cost structure gets skewed, kind of turns things on its head, costs could go up.
And, can a President mandate like that, change the rules, given that a law is in place? Wouldn't that have to be legislated through Congress?
Apparently he think so. His law, guess he can change it at anytime he wants. ;)
Quote from: Razgovory on November 14, 2013, 01:57:37 PM
Quote from: DGuller on November 14, 2013, 12:47:43 PM
Quote from: Razgovory on November 14, 2013, 12:11:56 PM
Quote from: Valmy on November 14, 2013, 11:36:26 AM
Quote from: derspiess on November 14, 2013, 11:19:49 AM
11B has no boyz. He's in the middle & slings shit at both sides.
Raz would say he lacks moral courage.
It's true, he does. He's not so much in the middle as being against everything. It's a safe position to take, you can look like someone who has an interest in politics without actually being for something. If you aren't for something, you can never be wrong. You never have to worry about the embarrassment or heart break that comes with being wrong. Politics is a bit like dating, you have to invest some of yourself and you'll likely get burned sometimes. The cynic that laughs at everyone else but stand for nothing is like a person who doesn't have the courage to get in a relationship because of fear of rejection. Instead he just goes home and jerks off. The cynic does the same thing, except instead of massaging his gentiles he massages his ego by laughing at others who were foolish enough to support an idea or person.
That was so poignant. :cry: Did you copy it from somewhere?
I'm glad you liked it. I don't think 11B4 does though.
Never take anything you say seriously, unless it's in the Gaming Form.
Quote from: merithyn on November 14, 2013, 03:09:34 PM
Quote from: KRonn on November 14, 2013, 02:51:36 PM
Good idea for many people losing their plans but it may not be so easy to roll back. On the news it also showed the insurance companies have issued a statement that they aren't so easily able to comply, to reinstate the policies that they've been mandated to end and have been planning on doing for a while, with many ins comps deciding to leave the indidual market. Biggest thing is that by allowing these policies people like to remain that means the ACA policies aren't being purchased, which the companies have spent months putting together the plans, costs, and what ever else goes into such planning. Now the cost structure gets skewed, kind of turns things on its head, costs could go up.
I dunno. My company just sent out an email about that, and pretty much no one that I've seen is concerned. Change a few dates in the computer (from 12/31/2013 to 10/31/2014) for the old policy end dates and life goes on. I'm sure there's a bit more to it than that, but no one here seems overly concerned.
That's good, hope it can be done for people as much as needed. :)
Quote from: KRonn on November 14, 2013, 03:30:37 PM
That's good, hope it can be done for people as much as needed. :)
The bigger concern is the response when folks realize that they can have their old policies back, but not at the old prices.
Quote from: 11B4V on November 14, 2013, 03:24:00 PM
Quote from: Razgovory on November 14, 2013, 01:57:37 PM
Quote from: DGuller on November 14, 2013, 12:47:43 PM
Quote from: Razgovory on November 14, 2013, 12:11:56 PM
Quote from: Valmy on November 14, 2013, 11:36:26 AM
Quote from: derspiess on November 14, 2013, 11:19:49 AM
11B has no boyz. He's in the middle & slings shit at both sides.
Raz would say he lacks moral courage.
It's true, he does. He's not so much in the middle as being against everything. It's a safe position to take, you can look like someone who has an interest in politics without actually being for something. If you aren't for something, you can never be wrong. You never have to worry about the embarrassment or heart break that comes with being wrong. Politics is a bit like dating, you have to invest some of yourself and you'll likely get burned sometimes. The cynic that laughs at everyone else but stand for nothing is like a person who doesn't have the courage to get in a relationship because of fear of rejection. Instead he just goes home and jerks off. The cynic does the same thing, except instead of massaging his gentiles he massages his ego by laughing at others who were foolish enough to support an idea or person.
That was so poignant. :cry: Did you copy it from somewhere?
I'm glad you liked it. I don't think 11B4 does though.
Never take anything you say seriously, unless it's in the Gaming Form.
That's a shame. You might learn something.
Quote from: merithyn on November 14, 2013, 03:07:11 PM
Quote from: derspiess on November 14, 2013, 11:23:16 AM
Tell me what you'd change about Obamacare and I might answer.
No, you won't. You never do.
Yes, I will :pinkyswear:
Oh, man. Pinkyswearing is serious business. SHIT JUST GOT REAL
That's so butch.
Quote from: CountDeMoney on November 14, 2013, 04:11:35 PM
Oh, man. Pinkyswearing is serious business. SHIT JUST GOT REAL
If they break a pinky promise, you get to take their pinky. Or at least break the finger.
Quote from: Razgovory on November 14, 2013, 03:52:59 PM
Quote from: 11B4V on November 14, 2013, 03:24:00 PM
Quote from: Razgovory on November 14, 2013, 01:57:37 PM
Quote from: DGuller on November 14, 2013, 12:47:43 PM
Quote from: Razgovory on November 14, 2013, 12:11:56 PM
Quote from: Valmy on November 14, 2013, 11:36:26 AM
Quote from: derspiess on November 14, 2013, 11:19:49 AM
11B has no boyz. He's in the middle & slings shit at both sides.
Raz would say he lacks moral courage.
It's true, he does. He's not so much in the middle as being against everything. It's a safe position to take, you can look like someone who has an interest in politics without actually being for something. If you aren't for something, you can never be wrong. You never have to worry about the embarrassment or heart break that comes with being wrong. Politics is a bit like dating, you have to invest some of yourself and you'll likely get burned sometimes. The cynic that laughs at everyone else but stand for nothing is like a person who doesn't have the courage to get in a relationship because of fear of rejection. Instead he just goes home and jerks off. The cynic does the same thing, except instead of massaging his gentiles he massages his ego by laughing at others who were foolish enough to support an idea or person.
That was so poignant. :cry: Did you copy it from somewhere?
I'm glad you liked it. I don't think 11B4 does though.
Never take anything you say seriously, unless it's in the Gaming Form.
That's a shame. You might learn something.
Naw, you're to liberal.
:lol: Good old Nancy.
http://www.politico.com/story/2013/11/house-democrats-obamacare-promise-99899.html?hp=l6
QuoteHouse Minority Leader Nancy Pelosi (D-Calif.), who shepherded Obamacare through the House as speaker, said Obama was "very gracious" in making that apology but that the president's words – in the context of the law – were "absolutely" precise.
"There's nothing in the Affordable Care Act that says that your insurance company should cancel you," she told reporters. "That's not what the Affordable Care Act is about. It simply didn't happen."
:huh: Selective quoting? She can't be that stupid.
By all means, read the entire article.
Doing so did not answer my question.
Not much else I can do to help, then. Not sure what other possible context her remarks could have had, and it's not even the dumbest thing she's said.
I just enrolled in benefits for 2014. Cost is $58 per paycheck for coverage for Princesca and I, which is a 2.1% increase over last year. So basically no impact re: Obamacare.
Quote from: 11B4V on November 14, 2013, 04:45:12 PM
Naw, you're to liberal.
The word is "Liveral", and if you payed attention you might not have that opinion.
Quote from: Caliga on November 15, 2013, 03:04:53 PM
I just enrolled in benefits for 2014. Cost is $58 per paycheck for coverage for Princesca and I, which is a 2.1% increase over last year. So basically no impact re: Obamacare.
In details, what does it get you?
Hairy exploding ass cysts are 100% covered.
Medical, dental, vision, term life (1.5x my salary), STD, LTD.
Hopefully the STD treatment is included as well. :unsure:
Oh STD, how you served me well in 2010. -_-
Quote from: garbon on November 15, 2013, 04:32:32 PM
Oh STD, how you served me well in 2010. -_-
Did you get some insurance money too?
Quote from: Admiral Yi on November 15, 2013, 04:34:05 PM
Quote from: garbon on November 15, 2013, 04:32:32 PM
Oh STD, how you served me well in 2010. -_-
Did you get some insurance money too?
No. I don't think that's a battle I could have one if I am understanding correctly what you mean by insurance money.
Quote from: garbon on November 15, 2013, 04:43:55 PM
Quote from: Admiral Yi on November 15, 2013, 04:34:05 PM
Quote from: garbon on November 15, 2013, 04:32:32 PM
Oh STD, how you served me well in 2010. -_-
Did you get some insurance money too?
No. I don't think that's a battle I could have one if I am understanding correctly what you mean by insurance money.
Damn right you wouldn't have. :mad:
:huh:
(https://scontent-b-iad.xx.fbcdn.net/hphotos-ash4/1454837_10151990045468486_363027855_n.jpg)
More people in the US want to build a Death Star than "bought" health insurance?
Phil's not so good with numbers.
QuoteConsiderably more Americans signed a petition to have me deported, than enrolled for Obamacare. I'd start panicking, Mr President...
Piers Morgan
:XD:
Sounds like a complete clusterfuck.
http://www.politico.com/magazine/story/2013/11/the-obamacare-lie-that-cant-be-fixed-99843.html#ixzz2kxebGzWo
QuoteThe Obamacare Lie That Can't Be Fixed
Even Bill Clinton is lecturing Barack Obama on keeping his word.
By RICH LOWRY
November 14, 2013
Who knew that the day would come when Bill Clinton would be in a position to lecture President Barack Obama about honoring his word?
In an interview with Ozy.com, the former president addressed those millions of Americans getting cancellation notices from their insurance companies, even though Obama had infamously promised that they could keep their plans. "I personally believe," Clinton said, "even if it takes a change in the law, the president should honor the commitment the federal government made to these people and let them keep what they got."
Clinton has a black belt in verbal escape hatches and has never been one to let a strict adherence to truthfulness become an obstacle, so his statement hit with extra force. The words were barely out of his mouth before the speculation over his motives began. For the sake of argument, let's be overly credulous and literal and assume that he simply thinks it's wrong for a president to lie to people about whether they can keep their health insurance.
The problem with Clinton's advice is that Obama can't possibly take it.
Obama's promise on insurance wasn't just injudicious, it was completely impossible. It wasn't an incidental falsehood but ran counter to the central premise of his own health care law. People losing their current insurance isn't an unintended consequence of the law; it is an intended consequence without which much of the law doesn't work.
In short, Obama's lie runs so deep that perhaps even Clinton — who had his law license suspended for dissembling under oath — can't fathom all of its implications.
If Democrats were inclined to catch the falling flag of Obama's credibility, they might take a page from the 1990s and insist that "everyone lies about historic health care legislation." Almost by the hour, it becomes clearer that they aren't so inclined. They not only tied themselves to the law, they repeated Obama's false promise themselves, and evidently don't appreciate it one bit.
Maybe they genuinely didn't know better. Our representatives in Congress can't be expected to read or understand legislation they support to transform a major sector of the American economy. These are busy and important people. But at the very least, the president's policy staff could have let them in on the joke.
Some of them now support legislation, one way or another, to grandfather canceled insurance policies so people can really keep them if they like them. The bills are opposed by the White House, despite the president's prior promise, despite his semi-apology for misleading people, despite his stated desire to fix the problem.
The White House's posture, in other words, is that the president is sorry that he lied and all, and he really wants people to keep their coverage — but it just can't be done.
And, on its own terms, it is right. It is possible to let people keep their current insurance, but only by unraveling a key element of Obamacare. To make the law work, people in the individual insurance market content with their current coverage have to be forced out of their plans and onto the exchanges. That's the only way to ensure the exchanges aren't overwhelmed by older and less healthy consumers.
The president couldn't be honest about this at time of the law's passage and still can't be honest about it. The White House acts as though it is doing the people whose insurance is getting canceled a favor by protecting them from "substandard" policies, rather than admitting that it is asking them to make a sacrifice.
The great engine of the welfare state is the hidden cost. Usually, the costs of a new program or regulation are too diffuse or distant to matter much politically in comparison to the promise of a direct benefit. This time, the costs aren't hidden. They are immediate and concrete in the canceled policies and the higher premiums, and they are making the politics of Obamacare toxic.
The Obama administration clearly hopes it can brazen it out. It came up with a date for fixing the website, Nov. 30, so it could have a date to use to hold off the dogs, for now. It will come up with some sort of administrative "fix" to the problem of cancellations so it can have something it can call a fix and try to use to stop Democratic defections. Its strategy is always based, at bottom, on spin and muddling through. These are the same people who believe they possess the administrative mastery to run highly complex laws remaking swaths of the American economy.
You know it's a hell of a predicament, though, when Bill Clinton thinks keeping your word is the only way out.
Rich Lowry is editor of National Review.
http://www.examiner.com/article/right-wing-cyber-attacks-on-healthcare-gov-website-confirmed
Well, what do you know...
I don't know that I'd trust examiner.com. Isn't that just a hub of blogs?
Don't know. All good Republicans know that blogs are a much better source of information then the "lame stream media" anyway.
Quote from: garbon on November 17, 2013, 10:23:25 PM
I don't know that I'd trust examiner.com. Isn't that just a hub of blogs?
BloombergTV confirms it, though they pointed out that it's hard to take down a site that's already mostly down due to launch issues. :lol:
Quote from: merithyn on November 17, 2013, 10:26:57 PM
Quote from: garbon on November 17, 2013, 10:23:25 PM
I don't know that I'd trust examiner.com. Isn't that just a hub of blogs?
BloombergTV confirms it, though they pointed out that it's hard to take down a site that's already mostly down due to launch issues. :lol:
Got a link? Can't find anything beyond DailyKos and the like blaming rightwingers (not that it wouldn't make "sense" for people on that side to move against it).
It certainly sounds unbelievable that the Republican party wouldn't order cyberattacks against the Obamacare websites.
:mellow:
High-profile sites get attacked constantly. Part of the planning for any such site needs to take that into consideration.
Quote from: Caliga on November 18, 2013, 10:59:30 AM
:mellow:
High-profile sites get attacked constantly. Part of the planning for any such site needs to take that into consideration.
No kidding. Just another day at the internet.
Quote from: Caliga on November 18, 2013, 10:59:30 AM
:mellow:
High-profile sites get attacked constantly. Part of the planning for any such site needs to take that into consideration.
Site getting cyberattacks? non-story. If they could prove that the attacks were funded/sponsored by the Republican party or a direct affiliate that would be a story. I doubt that will happen.
Quote from: frunk on November 18, 2013, 11:42:51 AM
If they could prove that the attacks were funded/sponsored by the Republican party or a direct affiliate that would be a story. I doubt that will happen.
Even if it's just independent sympathizers, it's still a non-story. Shit happens to both sides during election years, where campaign sites get fucked with.
And it's a government website; regardless of content, they're fucked with all the time.
Quote from: CountDeMoney on November 18, 2013, 11:47:43 AM
Even if it's just independent sympathizers, it's still a non-story. Shit happens to both sides during election years, where campaign sites get fucked with.
And it's a government website; regardless of content, they're fucked with all the time.
I'd be surprised if either party supported an attack against a government website before. Do you know of a situation where that happened?
Hacktivism doesn't have to be supported by a party to be politically motivated; hell, look at Anonymous.
Quote from: 11B4V on November 16, 2013, 03:18:42 AM
QuoteConsiderably more Americans signed a petition to have me deported, than enrolled for Obamacare. I'd start panicking, Mr President...
Piers Morgan
:XD:
Well yeah, with an electorate that dumb the Tea Party has a real chance.
I see the makings of another Democratic fable similar to the California electricity/Enron fable.
LOL, the "Enron fable". Must be up there with the "Iraqi WMD fable".
Quote from: CountDeMoney on November 18, 2013, 11:59:18 AM
Hacktivism doesn't have to be supported by a party to be politically motivated; hell, look at Anonymous.
So? You don't think there's a difference between ideologically motivated hackers attacking a government website and political party backed hackers attacking a government website?
As far as I can tell these attacks are the former (non-story, who cares). If it was in any way the latter then this is an issue.
Quote from: frunk on November 18, 2013, 01:10:33 PM
Quote from: CountDeMoney on November 18, 2013, 11:59:18 AM
Hacktivism doesn't have to be supported by a party to be politically motivated; hell, look at Anonymous.
So? You don't think there's a difference between ideologically motivated hackers attacking a government website and political party backed hackers attacking a government website?
As far as I can tell these attacks are the former (non-story, who cares). If it was in any way the latter then this is an issue.
I sincerely doubt Rinse Grevious at the RNC is ordering hacker attacks upon all things Obamacare, if that's what you're asking. Happy now?
I can never spell that asshole's name correctly.
Quote from: CountDeMoney on November 18, 2013, 01:04:38 PM
LOL, the "Enron fable". Must be up there with the "Iraqi WMD fable".
Comparable to the Cheney/Haliburton fable.
Quote from: CountDeMoney on November 18, 2013, 01:13:55 PM
I sincerely doubt Rinse Grevious at the RNC is ordering hacker attacks upon all things Obamacare, if that's what you're asking. Happy now?
I agree, this is a non-story.
Quote from: CountDeMoney on November 18, 2013, 01:04:38 PM
LOL, the "Enron fable". Must be up there with the "Iraqi WMD fable".
All those Democratic fables. :D I like Yi's cognitive dissonance.
Quote from: Razgovory on November 18, 2013, 01:42:32 PM
All those Democratic fables. :D I like Yi's cognitive dissonance.
:face:
The hackers are probably from the NSA.... :ph34r:
Quote from: Admiral Yi on November 18, 2013, 02:00:03 PM
Quote from: Razgovory on November 18, 2013, 01:42:32 PM
All those Democratic fables. :D I like Yi's cognitive dissonance.
:face:
You really need to stop hitting your head like that.
http://thehill.com/blogs/healthwatch/health-reform-implementation/190844-obama-hits-new-low-with-dems-at-capitol
:(
http://www.reuters.com/article/2013/11/20/us-usa-healthcare-oregon-idUSBRE9AJ0ML20131120
What a cock-up.
QuoteOregon healthcare exchange website never worked, has no subscribers
Oregon, a state that fully embraced the Affordable Care Act, is enduring one of the rockiest rollouts of President Back Obama's signature health care law, with an inoperative online exchange that has yet to enroll a single subscriber, requiring thousands to apply on paper instead.
Unlike most other states, Oregon set an ambitious course to make its insurance exchange, dubbed Cover Oregon, an "all-in-one" website for every individual seeking health coverage, including those who are eligible for Medicaid.
But instead of serving as a national model, Oregon's experience has emerged as a cautionary tale, inviting comparisons to technical glitches that have plagued other state-run portals and the federal government's website for those states lacking exchanges of their own.
Oregon's online exchange has remained inaccessible to the public, requiring the state to sign up applicants the old-fashioned way, using paper forms. This has made comparison shopping more difficult for consumers and severely slowed the enrollment process.
"Oregonians have questions," said state Senate President Peter Courtney, a Democrat, in a written statement on Tuesday. "What went wrong with the rollout? How are they going to fix it? When are they going to get it right? Is the website contractor doing everything it can? Our people need to know."
Courtney urged state lawmakers to "ask the hard questions" of officials overseeing the state's healthcare exchange, and the Oregon Health Authority, at a pair of legislative hearings on the program scheduled for Wednesday.
With its online insurance marketplace out of commission and unavailable to the public indefinitely, the state has resorted to urging would-be subscribers to fill out applications that are between nine and 19 pages long by hand, said Michael Cox, a spokesman for Cover Oregon.
In the meantime, the program has hired about 400 temporary workers to help process those applications before January 1, when the new plans are due to take effect, Cox said.
As part of that effort, staff members from his office are fanning out to hotel conference rooms and other venues across the state over the next week to help prospective enrollees complete the forms, he said.
Nearly 25,000 individuals and families have so far submitted hard-copy applications, Cox said, with nearly two-thirds of those applicants eligible for Medicaid, a federal-state healthcare plan for the needy.
But none of those applicants has actually been enrolled, with manual processing of the paperwork slowing the process dramatically.
Separately, about 70,000 residents have signed up for Medicaid by responding to letters sent by the state to more than 200,000 people deemed eligible for the program by virtue of their receiving food stamps, Cox said.
By comparison, Oregon's neighbor to the south, California - with a population 10 times larger - enrolled about 31,000 people in an Affordable Care Act plan last month, and added 29,000 in the first 12 days of November.
California had much farther to go, with an estimated 7.3 million adults and children lacking insurance in 2011, compared with 560,000 counted as uninsured that year in Oregon.
Jesse Ellis O'Brien, a healthcare advocate with the Oregon State Public Interest Research Group, which pushed for the exchange, said he is "surprised and frustrated" by its ongoing woes but hopeful that they will be resolved within the next month or two.
"Once the website is functional it will provide a lot of valuable tools for consumers to make informed comparisons between plans," he said.
A spokesman for Oregon Governor John Kitzhaber, a Democrat and medical doctor who supported the Affordable Care Act, did not immediately return messages seeking comment.
Greg Leo, chairman of Oregon's Republican Party and an avowed foe of the 2010 healthcare reform law, said its troubled rollout in Oregon underscores his view that patients would be better served by a system managed by the private sector.
"I don't take any joy in this," he said. "This creates a lot of harm for citizens in Oregon and nationally. It's a tragedy, and it further erodes people's confidence in government."
Website failures, imagine that.
Of all the programs of all scopes and scales that I've seen, from onlining minor ODBC projects to standing up e911 centers, I've never seen "Day 1" actually become "Day 1".
I'd like to think that all of these rollout failures would educate people on the weaknesses of relying solely upon the word IT sachems and witchdoctors, on how simply expecting all this bullshit technology to magically work alone is naive, but it won't. The mindset is too ingrained.
Now if you'll excuse me, I have to patch a video game I just bought.
Quote from: CountDeMoney on November 20, 2013, 10:27:34 AM
Website failures, imagine that.
Of all the programs of all scopes and scales that I've seen, from onlining minor ODBC projects to standing up e911 centers, I've never seen "Day 1" actually become "Day 1".
I'd like to think that all of these rollout failures would educate people on the weaknesses of relying solely upon the word IT sachems and witchdoctors, on how simply expecting all this bullshit technology to magically work alone is naive, but it won't. The mindset is too ingrained.
Now if you'll excuse me, I have to patch a video game I just bought.
Weren't these sites supposedly going live at what is now almost 2 months ago?
I miss filling out forms with Carbon paper.
Quote from: garbon on November 20, 2013, 10:32:13 AM
Weren't these sites supposedly going live at what is now almost 2 months ago?
You seem to think governments work on the same clocks you and I do.
I think we need to claw back some money from bonehead contractors.
That would be a good first step, but the contractor model is too ingrained as well. Everybody's too busy gutting their internal workforces.
If you're suggesting federal agencies maintain in house capability, I don't see the point. HHS is not going to be creating an Obamacare.gov every year.
If HHS had enough in-house talent and infrastructure to build a project, I'm sure it would've done a better job than a wide disparate number of contractors independently developing their own pieces of the puzzle and trying to fit them all together. A lot easier to build something from the ground up and out than down and in.
Quote from: Ed Anger on November 20, 2013, 10:36:17 AM
I miss filling out forms with Carbon paper.
We do plea agreements that way. By the time you get to the 5th copy, for the defense attorney, it usually looks untouched by any writing implement whatsoever. :lol:
Quote from: CountDeMoney on November 20, 2013, 11:04:08 AM
If HHS had enough in-house talent and infrastructure to build a project, I'm sure it would've done a better job than a wide disparate number of contractors independently developing their own pieces of the puzzle and trying to fit them all together. A lot easier to build something from the ground up and out than down and in.
There is no way HHS would have the in-house talent or infrastructure to do something like this - what would those people be doing when they weren't building gigantic websites?
This is actually an example of where the contractor model makes perfect sense. The real problem here is simply one of scope and timing. As is always the case, the people who decide WHAT should be done have no appreciation for what CAN be done realistically given the time constraints.
So I am sure you had people making decisions about timing and content based on nothing more than political concerns, rather than approaching the issue from the proper technical perspective. I bet a billion fake internet dollars nobody went to the technical people and said something like "Given the resources available, what can we get done by this November 1st deadline?". No, they simply went and said "Hey, this has to be done by November 1st! And it has to have everything in it and working by then! Get to it!".
Time constraints? They've had five years.
Define "they"
Quote from: Berkut on November 20, 2013, 11:30:38 AM
So I am sure you had people making decisions about timing and content based on nothing more than political concerns, rather than approaching the issue from the proper technical perspective.
Of course that's what happened. That's what always happens, whether it's government or anywhere else; there's a level of expectation from the top that technology-driven projects are just like any other project, and that a website with such severe back end requirements can be created with the same deadline-oriented speed and efficiency of, say, an advertising campaign.
QuoteI bet a billion fake internet dollars nobody went to the technical people and said something like "Given the resources available, what can we get done by this November 1st deadline?". No, they simply went and said "Hey, this has to be done by November 1st! And it has to have everything in it and working by then! Get to it!".
And I'll bet another billyun fake internet dollars that the technical people (contractors) were too afraid to speak up and tell them, "no, it can't be done".
C'mon, you've been in those conversations; nobody in the room wants to tell the guy in the big chair at the end of the table that what he's asking for can't be done on time, in the way he wants it done, or at the price he wants it.
Quote from: Maximus on November 20, 2013, 11:34:29 AM
Define "they"
The people responsible for getting this going.
I understand your implicit point. I don't know when exactly the politicos green lit the project and starting the bidding and the work. However, that begs the question of how a contractor should respond when given an unrealistic work proposal.
"We need a website capable of processing insurance requests for ONE BILLION people, and you have 2 months to do it. What's your bid?"
If you accept the job you're telling the politicos the work can be performed in the time allotted and with the budget specified.
Quote from: CountDeMoney on November 20, 2013, 11:42:21 AM
C'mon, you've been in those conversations; nobody in the room wants to tell the guy in the big chair at the end of the table that what he's asking for can't be done on time, in the way he wants it done, or at the price he wants it.
The guy in the Big Chair doesn't want anything to threaten the checks rolling in when no one suspects the project is failing and, if people keep their mouths shut, won't figure that out for some time.
Quote from: Admiral Yi on November 20, 2013, 11:44:34 AM
Quote from: Maximus on November 20, 2013, 11:34:29 AM
Define "they"
The people responsible for getting this going.
I understand your implicit point. I don't know when exactly the politicos green lit the project and starting the bidding and the work. However, that begs the question of how a contractor should respond when given an unrealistic work proposal.
"We need a website capable of processing insurance requests for ONE BILLION people, and you have 2 months to do it. What's your bid?"
If you accept the job you're telling the politicos the work can be performed in the time allotted and with the budget specified.
Of course - and the people "accepting the job" know full well that it can't be done.
Quote from: alfred russel on November 20, 2013, 12:16:37 PM
Quote from: CountDeMoney on November 20, 2013, 11:42:21 AM
C'mon, you've been in those conversations; nobody in the room wants to tell the guy in the big chair at the end of the table that what he's asking for can't be done on time, in the way he wants it done, or at the price he wants it.
The guy in the Big Chair doesn't want anything to threaten the checks rolling in when no one suspects the project is failing and, if people keep their mouths shut, won't figure that out for some time.
:mellow:
I think we're talking about two different guys in two different chairs.
QuoteHowever, that begs the question of how a contractor should respond when given an unrealistic work proposal.
That depends - do you mean how should they respond in a perfect, honest world?
Or how should they respond in the actual world we live in where they want to actually get jobs?
Quote from: CountDeMoney on November 20, 2013, 12:52:02 PM
:mellow:
I think we're talking about two different guys in two different chairs.
Those readings sound pretty consistent...
Quote from: Peter Wiggin on November 20, 2013, 12:54:58 PM
Quote from: CountDeMoney on November 20, 2013, 12:52:02 PM
:mellow:
I think we're talking about two different guys in two different chairs.
Those readings sound pretty consistent...
I dunno...there's a difference between being the client boss, and the contractor boss. One is cutting the checks, the other is collecting them.
Quote from: Berkut on November 20, 2013, 12:53:54 PM
That depends - do you mean how should they respond in a perfect, honest world?
Or how should they respond in the actual world we live in where they want to actually get jobs?
Assuming there are reputational and/or financial penalties for failure to fulfill a contract, I would think the two worlds should produce similar results.
Quote from: Admiral Yi on November 20, 2013, 01:14:35 PM
Quote from: Berkut on November 20, 2013, 12:53:54 PM
That depends - do you mean how should they respond in a perfect, honest world?
Or how should they respond in the actual world we live in where they want to actually get jobs?
Assuming there are reputational and/or financial penalties for failure to fulfill a contract, I would think the two worlds should produce similar results.
It isn't a matter of "fulfilling a contract". Everyone always fulfills the contract eventually.
The question is what happens when stuff is not done on time, who pays?
The reality is that if you don't tell the customer that they can, in theory, get what they are asking for, they will simply ask another vendor who will tell that.
And of course, the reality is also that what they are asking for NOW is not in any way, shape or form going to be what they really want, or what they are going to be asking for before it is all said and done anyway.
It's not like someone went to vendors with a perfectly design spec for the obamacare site that was complete and written in stone and said "Hey, can you do all this?". No, they almost certianly went with a vague, poorly defined, and impossible specification that they then changed 46,543 times in the first six weeks, so who is really to say who is at fault that it didn't work? The contractor, who almost certainly agreed to provide something they knew could not be done? The government, who almost certianly asked for something THEY knew could not be done, and then changed what they wanted over the life of the project again and again anyway?
It just isn't as simple as you are making it out to be, and it never, ever is...or rather, maybe it is, but when it is that simple, we never hear about it anyway.
I can easily see how additional requirements could be built into the project. However, I think the right and proper thing to do is communicate to the client that these additional requirements could impact the delivery date. And then document these concerns to cover your ass.
Quote from: Admiral Yi on November 20, 2013, 01:45:06 PM
I can easily see how additional requirements could be built into the project. However, I think the right and proper thing to do is communicate to the client that these additional requirements could impact the delivery date. And then document these concerns to cover your ass.
It isn't jsut additional requirements, it is also changing requirements. And of course you build all that in to CYA. What makes you think that didn't happen here? Hell, this is a government project, I am sure the contractors ass is covered six ways from Sunday.
Quote from: Berkut on November 20, 2013, 02:06:19 PM
It isn't jsut additional requirements, it is also changing requirements. And of course you build all that in to CYA. What makes you think that didn't happen here? Hell, this is a government project, I am sure the contractors ass is covered six ways from Sunday.
I would appreciate it if you would share the information that is the basis of your conclusion with me, because at this point I have no idea if the politicos or the contractors muffed it.
Quote from: Admiral Yi on November 20, 2013, 02:13:30 PM
Quote from: Berkut on November 20, 2013, 02:06:19 PM
It isn't jsut additional requirements, it is also changing requirements. And of course you build all that in to CYA. What makes you think that didn't happen here? Hell, this is a government project, I am sure the contractors ass is covered six ways from Sunday.
I would appreciate it if you would share the information that is the basis of your conclusion with me, because at this point I have no idea if the politicos or the contractors muffed it.
I am saying that it is likely that they both muffed it, but did so in a 100% predictable manner, and they probably were perfectly aware all along that there was a 0% chance of the project being successful as designed.
And I have no specific information other than 15+ years working on projects just like these (although obviously not as large) and the last several years as a contractor working in professional services where it is my job to try to deliver on the projects sold by others to third parties.
I am not claiming any specific knowledge of this particular project.
Quote from: Berkut on November 20, 2013, 02:19:00 PM
I am saying that it is likely that they both muffed it, but did so in a 100% predictable manner, and they probably were perfectly aware all along that there was a 0% chance of the project being successful as designed.
Then either the flunky who told Sebilius it was good to go on 10/1 is on the hook, or the geek who told the flunky is on the hook.
Probably more like "my part will be ready, I don't know about anybody else" from all the flunkies at once.
Quote from: CountDeMoney on November 20, 2013, 02:23:35 PM
Probably more like "my part will be ready, I don't know about anybody else" from all the flunkies at once.
I bow before the collective geekerosity of the board, but surely there has to be a lead contractor who's overseeing the whole sheebang.
Yeah, one would think that there would be.
Of course there is.
And he is saying, IIRC, that there was never a system wide integrated test, nor was there time for one. So big surprise, it didn't work.
QuoteHealthCare.Gov Woes Highlight Government Hiring Of Old Contractors
Andy Sullivan, Reuters Nov. 19, 2013
WASHINGTON (Reuters) - One part of the Obama administration's technically flawed HealthCare.gov website is actually working as promised. Unfortunately, the company that built it does not intend to seek more government business.
Working out of a garage a few blocks north of the White House, a 12-person software shop called Development Seed built a customer interface praised for its elegance and stability, a bright spot in the rollout of a website that has been an embarrassment for President Barack Obama.
But chief executive Eric Gundersen said his company will not seek another slice of the $82 billion the U.S. government will spend on technology this year because of the paperwork and regulatory hurdles.
"We don't have proposal writers and lawyers. We have developers," Gundersen said.
The technical problems since the October 1 debut of the website have cast a harsh light on the federal government's tangled procurement process, a system that favors incumbents with long track records but leaves little room for innovation.
As a result, the government struggles to deliver the sophisticated digital services that tech-savvy consumers have come to expect.
Obama has apologized repeatedly for the performance of the website that is central to his health care overhaul. But he and other officials also have pointed fingers at the project's contractors, who have been paid at least $174 million for their work so far. Contractors say the administration is ultimately to blame.
The site has been plagued by timeouts, errors and slow responses, although an emergency effort to get the site running smoothly for most visitors has resulted in some improvements.
Fewer than 27,000 people signed up for private health insurance plans through the federal marketplace in October, a tiny fraction of the millions ultimately needed to make it financially viable.
Technology projects have never been easy for the federal government. One problem, say former administration officials, is that agencies too often rely on established contractors. Those contractors feel little pressure to innovate because there is no competition from cutting edge companies, which are deterred by government red tape.
More nimble tech firms such as Development Seed find it hard to overcome hurdles that surround competitive bidding or dealing with risk-averse bureaucrats. All but one of the 47 companies that worked on HealthCare.gov had done previous government work, according to the Sunlight Foundation, a watchdog group.
Obama himself says government too often gets it wrong.
"How we purchase technology in the federal government is cumbersome, complicated and outdated," he said last week.
"We might have done more to make sure that we were breaking the mold on how we were gonna be setting this up," he said. "But that doesn't help us now."
POOR RECORD
Government has a poor track record in tackling large technology projects. The Standish Group, a research firm, found that 40 percent of large federal, state and local tech projects are canceled or abandoned, while only 5 percent are completed on time and on budget. The research firm did not provide reasons.
Perhaps the only thing that makes HealthCare.gov exceptional is its high visibility.
"It's not an unusual screw-up," said Charlene Frizzera, a former acting head of the Centers for Medicare and Medicaid Services (CMS), the agency overseeing implementation of the Patient Protection and Affordable Care Act, which passed in 2010.
Even an effort to streamline the way the government buys goods and services came in years late, at twice the anticipated cost. That website, SAM.gov, crashed shortly after going live in 2012 and is still riddled with glitches.
The HealthCare.gov site illustrates the divide between companies specializing in government work and the freewheeling start-up culture that flourishes in Silicon Valley and other tech hubs.
Development Seed did not bid on the healthcare project. It was brought in as a subcontractor by a top official at the Department of Health and Human Services (HHS) who admired its emphasis on simplicity and "open source" design, the practice of releasing software code to the public so outsiders can spot flaws and suggest fixes.
"This is cutting edge, sort of where things are going," HHS chief technical officer Bryan Sivak said of Development Seed at a conference in March.
Development Seed reduced the number of computer servers involved in its part of the website from 32 to two, minimizing potential failure points, and finished work in June.
Gundersen said officials like Sivak, a former tech officer for the state of Maryland and the District of Columbia, ultimately had limited control.
"We've probably got one of the most visionary guys, that actually gets code, from a tech background, being the chief technology officer," Gundersen said of Sivak. "And still he can't turn the battleship?"
INSIDE TRACK
As Development Seed finished its work on the front page of HealthCare.gov this spring, a much larger company called CGI Federal scrambled to assemble the back end.
CGI Federal is a division of Montreal-based tech services provider CGI Group Inc, which globally employs 68,000 people. Roughly a quarter of its $1.3 billion revenue last fiscal year came from the U.S. government.
Like many large federal contractors, CGI spends handsomely to influence Washington. It spent $200,000 on lobbying last year, and its employees donated $128,500 in last year's election to federal candidates from both parties.
CGI ultimately could earn as much as $292 million under the HealthCare.gov contract, which it won over three other companies in 2011.
Even if it had wanted to, a small company like Development Seed would have been unable to bid on the main HealthCare.gov contract - CMS limited the competition to 16 companies already selected as primary technology providers under an open-ended contract in 2007.
CMS shaved months off the bidding process by limiting competition to those pre-screened companies. The website needed to be up and running by October 1, 2013.
A large company like CGI handles other complex projects for CMS, and it had the resources to build the site's complicated health exchange, said several people familiar with the process.
The company declined to comment for this story.
"Companies that compete for government business every day have to use the latest technologies to be successful," said contracting expert Larry Allen, who said CMS had ensured an adequate level of competition when awarding the contract.
But companies with the ability to bid for big government projects often rely on technology that is years out of date, several former Obama administration officials said.
"This is a stagnant community - they do not have to keep up with the latest technology," said Clay Johnson, a onetime Presidential Innovation Fellow who developed a tool that made it easier for small technology firms to bid on government work.
Merici Vinton, a former assistant to the chief information officer at the Consumer Financial Protection Bureau, said agency employees were better informed about technology than some vendors who competed to build its ConsumerFinance.gov site in 2010.
"I was shocked at the quality of the projects they were promising," Vinton said in an email.
COMPLEX TASK
With HealthCare.gov, CGI took on a task of enormous complexity.
An insurance applicant's identity and income must be verified through computer systems at the Social Security Administration, the Internal Revenue Service and the Department of Homeland Security. Then, the system checks databases from more than 170 insurance carriers to find the best plans.
The Obama administration has acknowledged it did not leave CGI and other contractors enough time to test the system before it went live.
But administration officials also have said CGI failed to meet certain development goals. A top CMS official, Henry Chao, worried three months before the site's launch that quality problems could "crash the plane at take-off," according to government documents obtained by Reuters.
CGI has blamed other contractors for site problems and the administration for last-minute design changes.
It is unclear whether the government would have gotten a better result if it had recruited more companies like Development Seed, rather than relying on established contractors like CGI.
Gundersen said his company lacks the scale to tackle such complex projects, and other contracting experts say it is often more cost-effective to go with a larger company that already has the engineers and other resources needed to tackle the job.
But the administration may have ended up with a better website if it had gone with a company that used some of the more current techniques now commonplace in companies that serve the private sector, former Obama administration officials say. Open source development, for example, could have enabled engineers to spot possible flaws sooner and keep the complexity of the site to a minimum.
"Government could benefit from that dynamic, but it has saddled itself with a procurement and contracting model that makes it off-limits," said Andrew McLaughlin, a former White House deputy chief technology officer.
Just saw this in an OECD report ... American exceptionalism:
(https://languish.org/forums/proxy.php?request=http%3A%2F%2Fi.imgur.com%2FCKrLdyE.png&hash=021dab2e01fd330d32565dc07ee70c49bb59a823)
It's our right as Americans to spend as much money as possible with a for-profit healthcare system and still die as early as possible, dammit.
If you socialists knew something about libertyness and freedomity, you people could learn a thing or two.
Quote from: CountDeMoney on November 20, 2013, 02:40:18 PM
QuoteHealthCare.Gov Woes Highlight Government Hiring Of Old Contractors
Andy Sullivan, Reuters Nov. 19, 2013
Unfortunately nothing new here. It wont change anytime soon.
Quote from: garbon on November 20, 2013, 09:59:33 AM
http://www.reuters.com/article/2013/11/20/us-usa-healthcare-oregon-idUSBRE9AJ0ML20131120
What a cock-up.
QuoteOregon healthcare exchange website never worked, has no subscribers
and a liberal state to boot.
Quote from: Berkut on November 20, 2013, 02:31:50 PM
Of course there is.
And he is saying, IIRC, that there was never a system wide integrated test, nor was there time for one. So big surprise, it didn't work.
That's what has been coming out in memos or other info, that the system was never fully tested. My view is that the end of November to have it even close to done is another pipe dream. It would take at least that long just to run a set of tests, functional then integrated tests of all the parts working together, then to fix any show stopping bugs.
Also I believe it's come out in the Congressional hearings or various memos that the security wasn't tight and that it would take a long time to get that right. That's pretty scary as people are putting very personal info in there and their info isn't secure.
Quote from: Zanza on November 20, 2013, 02:52:01 PM
Just saw this in an OECD report ... American exceptionalism:
(https://languish.org/forums/proxy.php?request=http%3A%2F%2Fi.imgur.com%2FCKrLdyE.png&hash=021dab2e01fd330d32565dc07ee70c49bb59a823)
I can't for the life of me understand what the hell are they spending all that money in.
It's obvious that we pay more for drugs than other countries.
I'm pretty sure our doctors are some of the highest paid in the world.
I suspect, but don't know, that we spend a lot more than other countries on "heroic" measures for dying patients.
Quote from: 11B4V on November 20, 2013, 03:04:41 PM
Quote from: CountDeMoney on November 20, 2013, 02:40:18 PM
QuoteHealthCare.Gov Woes Highlight Government Hiring Of Old Contractors
Andy Sullivan, Reuters Nov. 19, 2013
Unfortunately nothing new here. It wont change anytime soon.
I'm all for firing contractors.
Quote from: Razgovory on November 20, 2013, 04:30:56 PM
Quote from: 11B4V on November 20, 2013, 03:04:41 PM
Quote from: CountDeMoney on November 20, 2013, 02:40:18 PM
QuoteHealthCare.Gov Woes Highlight Government Hiring Of Old Contractors
Andy Sullivan, Reuters Nov. 19, 2013
Unfortunately nothing new here. It wont change anytime soon.
I'm all for firing contractors.
Same here.
Quote from: Admiral Yi on November 20, 2013, 04:30:14 PM
It's obvious that we pay more for drugs than other countries.
I'm pretty sure our doctors are some of the highest paid in the world.
I suspect, but don't know, that we spend a lot more than other countries on "heroic" measures for dying patients.
You forgot advertising. Because I just can't get enough of Kaiser Permanente's "Thrive" campaign starring the dulcet and comforting warmth of Allison Janney's voiceover.
Quote from: CountDeMoney on November 20, 2013, 04:44:35 PM
Quote from: Admiral Yi on November 20, 2013, 04:30:14 PM
It's obvious that we pay more for drugs than other countries.
I'm pretty sure our doctors are some of the highest paid in the world.
I suspect, but don't know, that we spend a lot more than other countries on "heroic" measures for dying patients.
You forgot advertising. Because I just can't get enough of Kaiser Permanente's "Thrive" campaign starring the dulcet and comforting warmth of Allison Janney's voiceover.
I really appreciate Abilify's (antipsychotic) commercials with cutsey animations that suggest you ask your doctor about using it for depression.
What's Thrive? Sounds like a drink for seniors.
The cost of drug advertising is already factored into drug prices.
Quote from: garbon on November 20, 2013, 04:47:47 PM
Quote from: CountDeMoney on November 20, 2013, 04:44:35 PM
Quote from: Admiral Yi on November 20, 2013, 04:30:14 PM
It's obvious that we pay more for drugs than other countries.
I'm pretty sure our doctors are some of the highest paid in the world.
I suspect, but don't know, that we spend a lot more than other countries on "heroic" measures for dying patients.
You forgot advertising. Because I just can't get enough of Kaiser Permanente's "Thrive" campaign starring the dulcet and comforting warmth of Allison Janney's voiceover.
I really appreciate Abilify's (antipsychotic) commercials with cutsey animations that suggest you ask your doctor about using it for depression.
I love the cute yellow pill and giant blue A helping that gal out.
Quote from: CountDeMoney on November 20, 2013, 04:44:35 PM
Quote from: Admiral Yi on November 20, 2013, 04:30:14 PM
It's obvious that we pay more for drugs than other countries.
I'm pretty sure our doctors are some of the highest paid in the world.
I suspect, but don't know, that we spend a lot more than other countries on "heroic" measures for dying patients.
You forgot advertising. Because I just can't get enough of Kaiser Permanente's "Thrive" campaign starring the dulcet and comforting warmth of Allison Janney's voiceover.
Let's not forget the nematodes in "Market Research".
Quote from: Razgovory on November 20, 2013, 05:05:20 PM
Quote from: CountDeMoney on November 20, 2013, 04:44:35 PM
Quote from: Admiral Yi on November 20, 2013, 04:30:14 PM
It's obvious that we pay more for drugs than other countries.
I'm pretty sure our doctors are some of the highest paid in the world.
I suspect, but don't know, that we spend a lot more than other countries on "heroic" measures for dying patients.
You forgot advertising. Because I just can't get enough of Kaiser Permanente's "Thrive" campaign starring the dulcet and comforting warmth of Allison Janney's voiceover.
Let's not forget the nematodes in "Market Research".
Nematodes. Heh.
Quote from: garbon on November 20, 2013, 04:47:47 PM
I really appreciate Abilify's (antipsychotic) commercials with cutsey animations that suggest you ask your doctor about using it for depression.
That doesn't sound like OTC medication. Is it possible to advertise prescription drugs in the US? :huh:
Quote from: Iormlund on November 20, 2013, 05:21:08 PM
Is it possible to advertise prescription drugs in the US? :huh:
Yes <_<, annoying as fuck.
Most of the time in those ads is telling you the multitude of reasons why you can't take that particular drug. :lol:
I'm flabbergasted. What possible benefit can such a thing have?
Quote from: Iormlund on November 20, 2013, 05:25:44 PM
I'm flabbergasted. What possible benefit can such a thing have?
Increased profits for drug companies.
Sell more drugs? $$$$$$$$$$$$$$$$$$$$$
Quote from: Iormlund on November 20, 2013, 05:25:44 PM
I'm flabbergasted. What possible benefit can such a thing have?
How else are you going to know what drugs you need to take? :huh:
On the upside, Viagra and Cialis commercials can have some nice looking older broads.
Quote from: Barrister on November 20, 2013, 05:12:16 PM
Quote from: Razgovory on November 20, 2013, 05:05:20 PM
Quote from: CountDeMoney on November 20, 2013, 04:44:35 PM
Quote from: Admiral Yi on November 20, 2013, 04:30:14 PM
It's obvious that we pay more for drugs than other countries.
I'm pretty sure our doctors are some of the highest paid in the world.
I suspect, but don't know, that we spend a lot more than other countries on "heroic" measures for dying patients.
You forgot advertising. Because I just can't get enough of Kaiser Permanente's "Thrive" campaign starring the dulcet and comforting warmth of Allison Janney's voiceover.
Let's not forget the nematodes in "Market Research".
Nematodes. Heh.
:angry:
Quote from: Iormlund on November 20, 2013, 05:25:44 PM
I'm flabbergasted. What possible benefit can such a thing have?
Patient awareness.
Quote from: Iormlund on November 20, 2013, 04:25:21 PM
I can't for the life of me understand what the hell are they spending all that money in.
We eat the worst foods, are the most obese, work the longest hours, and take the least vacation. It takes a lot of health care to keep our life spans as long as they are, even if they lag in international comparisons.
Quote from: Iormlund on November 20, 2013, 05:25:44 PM
I'm flabbergasted. What possible benefit can such a thing have?
The least cynical interpretation is that people watching the ad will become aware that there is a treatment available for their condition. Take Viagra for example: before it was invented no dude ever thought about going to the doctor to fix his limp willy.
Quote from: alfred russel on November 20, 2013, 05:36:56 PM
Quote from: Iormlund on November 20, 2013, 04:25:21 PM
I can't for the life of me understand what the hell are they spending all that money in.
We eat the worst foods, are the most obese, work the longest hours, and take the least vacation. It takes a lot of health care to keep our life spans as long as they are, even if they lag in international comparisons.
I am proud to report Mexico is now more obese than we are. USA! USA!
Quote from: Zanza on November 20, 2013, 02:52:01 PM
Just saw this in an OECD report ... American exceptionalism:
Question is: what happens when you adjust for the usually high level of deaths by accident and violence in the US?
These deaths tend to be uncorrelated or even reverse correlated from age and thus tend to hit life expectancy, but they aren't really addressable by the health care delivery system.
I have seen studies that suggest that the US health care system does a very good job of extending life span and quality among similarly situated people who have various kinds of significant ailments and conditions. OTOH some public health and extension of basic care across the population may lag behind the leaders.
Quote from: The Minsky Moment on November 20, 2013, 06:45:47 PM
Quote from: Zanza on November 20, 2013, 02:52:01 PM
Just saw this in an OECD report ... American exceptionalism:
Question is: what happens when you adjust for the usually high level of deaths by accident and violence in the US?
These deaths tend to be uncorrelated or even reverse correlated from age and thus tend to hit life expectancy, but they aren't really addressable by the health care delivery system.
I have seen studies that suggest that the US health care system does a very good job of extending life span and quality among similarly situated people who have various kinds of significant ailments and conditions. OTOH some public health and extension of basic care across the population may lag behind the leaders.
Higher level of deaths by violence then Israel?
Quote from: garbon on November 20, 2013, 04:47:47 PM
Quote from: CountDeMoney on November 20, 2013, 04:44:35 PM
Quote from: Admiral Yi on November 20, 2013, 04:30:14 PM
It's obvious that we pay more for drugs than other countries.
I'm pretty sure our doctors are some of the highest paid in the world.
I suspect, but don't know, that we spend a lot more than other countries on "heroic" measures for dying patients.
You forgot advertising. Because I just can't get enough of Kaiser Permanente's "Thrive" campaign starring the dulcet and comforting warmth of Allison Janney's voiceover.
I really appreciate Abilify's (antipsychotic) commercials with cutsey animations that suggest you ask your doctor about using it for depression.
I think we should ban advertising on all prescription drugs.
The idea is that your doctor is supposed to make an evidence-based diagnosis and create a prescription, not that Johnny Layman is supposed to go "hey, I'm a crazy fucker, maybe I should ask my doc about This Brand Name Anti-Crazy Pill."
Quote from: garbon on November 20, 2013, 05:35:15 PM
Quote from: Iormlund on November 20, 2013, 05:25:44 PM
I'm flabbergasted. What possible benefit can such a thing have?
Patient awareness.
They're supposed to get that from their physician. You know. The trained person.
Quote from: fhdz on November 20, 2013, 08:21:00 PM
Quote from: garbon on November 20, 2013, 05:35:15 PM
Quote from: Iormlund on November 20, 2013, 05:25:44 PM
I'm flabbergasted. What possible benefit can such a thing have?
Patient awareness.
They're supposed to get that from their physician. You know. The trained person.
Considering some of the quacks I've seen over the years, I want to know.
Quote from: Ed Anger on November 20, 2013, 08:21:54 PM
Quote from: fhdz on November 20, 2013, 08:21:00 PM
Quote from: garbon on November 20, 2013, 05:35:15 PM
Quote from: Iormlund on November 20, 2013, 05:25:44 PM
I'm flabbergasted. What possible benefit can such a thing have?
Patient awareness.
They're supposed to get that from their physician. You know. The trained person.
Considering some of the quacks I've seen over the years, I want to know.
But the ads don't tell you anything even mildly approaching the opinion of a professional. I've seen any number of prescription drug ads where they don't even tell you what the fucking thing is FOR.
Quote from: fhdz on November 20, 2013, 08:20:25 PM
I think we should ban advertising on all prescription drugs.
The idea is that your doctor is supposed to make an evidence-based diagnosis and create a prescription, not that Johnny Layman is supposed to go "hey, I'm a crazy fucker, maybe I should ask my doc about This Brand Name Anti-Crazy Pill."
I'm not sure I would go that far. Doctors can be pretty set in their ways when it comes to drugs, it takes way too much effort to get them to prescribe me antibiotics every single time I have a cold.
Quote from: DGuller on November 20, 2013, 08:23:38 PM
Quote from: fhdz on November 20, 2013, 08:20:25 PM
I think we should ban advertising on all prescription drugs.
The idea is that your doctor is supposed to make an evidence-based diagnosis and create a prescription, not that Johnny Layman is supposed to go "hey, I'm a crazy fucker, maybe I should ask my doc about This Brand Name Anti-Crazy Pill."
I'm not sure I would go that far. Doctors can be pretty set in their ways when it comes to drugs, it takes way too much effort to get them to prescribe me antibiotics every single time I have a cold.
:D
Quote from: fhdz on November 20, 2013, 08:23:18 PM
Quote from: Ed Anger on November 20, 2013, 08:21:54 PM
Quote from: fhdz on November 20, 2013, 08:21:00 PM
Quote from: garbon on November 20, 2013, 05:35:15 PM
Quote from: Iormlund on November 20, 2013, 05:25:44 PM
I'm flabbergasted. What possible benefit can such a thing have?
Patient awareness.
They're supposed to get that from their physician. You know. The trained person.
Considering some of the quacks I've seen over the years, I want to know.
But the ads don't tell you anything even mildly approaching the opinion of a professional. I've seen any number of prescription drug ads where they don't even tell you what the fucking thing is FOR.
But.... Viagra gives men horns.
Quote from: Ed Anger on November 20, 2013, 08:26:12 PM
Quote from: fhdz on November 20, 2013, 08:23:18 PM
Quote from: Ed Anger on November 20, 2013, 08:21:54 PM
Quote from: fhdz on November 20, 2013, 08:21:00 PM
Quote from: garbon on November 20, 2013, 05:35:15 PM
Quote from: Iormlund on November 20, 2013, 05:25:44 PM
I'm flabbergasted. What possible benefit can such a thing have?
Patient awareness.
They're supposed to get that from their physician. You know. The trained person.
Considering some of the quacks I've seen over the years, I want to know.
But the ads don't tell you anything even mildly approaching the opinion of a professional. I've seen any number of prescription drug ads where they don't even tell you what the fucking thing is FOR.
But.... Viagra gives men horns.
For erections lasting four hours or more, take advantage of that shit as much as you can in the limited time available to you.
Hey, a ban is win-win. Docs will be more likely to prescribe generics when those exist, they won't have to wade through as many kooky self-diagnoses, and the pharma companies can use the advertising budgets to create more neat drugs instead. Maybe it could even bring down the price of drugs a bit.
I would like to see a ban on whore pill commercials. I know I don't want to hear about women shit while I'm eating.
Quote from: Ed Anger on November 20, 2013, 08:30:46 PM
I would like to see a ban on whore pill commercials. I know I don't want to hear about women shit while I'm eating.
HAIL TO THE V
I don't think I've ever seen a whore pill commercial.
Quote from: Iormlund on November 20, 2013, 04:25:21 PM
I can't for the life of me understand what the hell are they spending all that money in.
Everything is more expensive:
(https://languish.org/forums/proxy.php?request=http%3A%2F%2Fwww.washingtonpost.com%2Fblogs%2Fwonkblog%2Ffiles%2F2013%2F03%2Fhigh-prices-health-care.jpg&hash=d0da4659155f7a7e66f440516c4a1639f58cc50e)
QuoteWe eat the worst foods, are the most obese, work the longest hours, and take the least vacation. It takes a lot of health care to keep our life spans as long as they are, even if they lag in international comparisons.
But you've also got way lower smoking rates than Europe and a younger population. Healthcare should be cheaper.
QuoteI'm pretty sure our doctors are some of the highest paid in the world.
Interesting that I believe the US has a below average number of doctors to population.
Quote from: Sheilbh on November 20, 2013, 08:58:06 PM
Interesting that I believe the US has a below average number of doctors to population.
Totally consistent with a monopoly (the AMA) limiting supply to keep prices firm.
Quote from: Admiral Yi on November 20, 2013, 09:01:40 PMTotally consistent with a monopoly (the AMA) limiting supply to keep prices firm.
How does the AMA limit supply? :mellow:
I'm assuming they work totally differently from the British doctors' union.
Quote from: Sheilbh on November 20, 2013, 09:06:04 PM
How does the AMA limit supply? :mellow:
They control the # of medical school spaces as well as licensing.
Interesting. Licensing and regulating medical schools in the UK is the responsibility of the General Medical Council. They're in effect the regulator of the medical profession. They regulate schools, but also license and revalidate doctors qualifications and you can also report a doctor to them and they've various disciplinary measures up to striking them off the register.
I'm not sure how the number of places at medical school are set (there's 8000) but I'd guess something to do with the schools, the GMC and the government negotiating.
The BMA are explicitly a doctors' union.
Quote from: Razgovory on November 20, 2013, 07:06:36 PM
[Higher level of deaths by violence then Israel?
Red-blooded gun-armed Americans are far better shots than some Hezbolloney clown with a Qassem rocket.
Plus Israel has an unfair advantage. They have all Jewish doctors.
Quote from: Admiral Yi on November 20, 2013, 08:31:56 PM
I don't think I've ever seen a whore pill commercial.
Never saw a Yaz commercial?
Wait, those are whore pills? :unsure:
Quote from: DGuller on November 20, 2013, 10:12:43 PM
Wait, those are whore pills? :unsure:
Well to be fair they also cause blood clots.
I knew I should've asked my doctor. :(
Quote from: Sheilbh on November 20, 2013, 08:58:06 PM
But you've also got way lower smoking rates than Europe and a younger population. Healthcare should be cheaper.
US healthcare has many many problems and cost is one of them. Please don't think I'm defending US healthcare vs. europe.
However, I think that after a certain minimum standard of care, life expectancy is much more of a function of lifestyle and genetics than the quality of healthcare. None of those factors are consistent when comparing Europe to the US, and I suspect healthcare is not the driver of our premature deaths.
Quote from: Admiral Yi on November 20, 2013, 09:01:40 PM
Quote from: Sheilbh on November 20, 2013, 08:58:06 PM
Interesting that I believe the US has a below average number of doctors to population.
Totally consistent with a monopoly (the AMA) limiting supply to keep prices firm.
No. The AMA's policy isn't to limit the supply of doctors. They've been lobbying to increase the numbers for the past two decades. In fact the AAMC has increased the number of medical student positions by 30% over the past decade.
The supply of doctors is limited by the amount of Graduated Medical Education funding from Medicare and thus the US Congress. They capped the number of residency training positions in 1997 with the Balanced Budget Act and it hasn't increased since then.
QuoteTo Cut Costs, ObamaCare Plans Drop Top Docs, Hospitals
(Newser) – If you have a health care provider you really like, look very carefully at any plan you buy on HealthCare.gov. To keep costs down—a top Obama administration priority—insurers on the government's health care exchange are offering smaller networks that cut out the country's most prestigious (and most expensive) hospitals and doctors, the Washington Post reports. In one much-watched case, the Seattle Children's Hospital has filed a lawsuit against Washington's insurance commissioner over all the plans excluding it. It's an especially expensive hospital, the region's top insurer explains; a pediatric appendectomy there costs $23,000, compared to $14,100 at another local hospital.
The Affordable Care Act requires plans to include enough providers to guarantee quality care, but offers no guidelines on what that entails. Some hospitals, such as the Cleveland Clinic, are pulling themselves off of plans, complaining that the reimbursement rates are too low. Some experts actually argue that these splits are good things—top-flight hospitals provide essential services, they explain, but routine care can be had elsewhere at a cheaper cost. But critics say these moves are producing a two-tiered system, and creating real dilemmas for families like Jeffrey Blank's; his daughter has a rare bone disorder, and is used to getting routine checkups from Seattle Children's.
http://www.newser.com/story/177974/to-cut-costs-obamacare-plans-drop-top-docs-hospitals.html?utm_source=part&utm_medium=united&utm_campaign=rss_top
QuoteGOP Plots All-Out War on ObamaCare
(Newser) – If it sounds like Republicans are reading from the same playbook in their ObamaCare offensive, it's because they are. A memo sent to House Republicans this week detailed an unusually focused attack plan, the New York Times explains. Republicans are to focus en masse on one of the program's failings, then swiftly pivot to the next as soon as that narrative gains traction, constantly keeping Democrats on their heels. First they focused on the website, then on dropped plans, and next they plan to shift to rate shocks.
"Yeah, there is a method being followed here," one rep says, "but really these stories are creating themselves." (This story, for example, must have been music to strategists' ears.) Democrats, meanwhile, have developed a counter-strategy: The Democratic Senatorial Campaign Committee is set to launch a campaign contrasting ObamaCare with "CruzCare," in hopes of highlighting how limited Republican policy alternatives are, the Washington Post reports. Ted Cruz is actually planning to roll out his own plan, but Democrats expect it to be the a potpourri of standard-issue Republican policies, rather than a credible ObamaCare alternative.
http://www.newser.com/story/177962/gop-plots-all-out-war-on-obamacare.html
So, high-priced suppliers are pricing themselves out of the market? Sounds great.
Republicans are playing politics with health care, just like Democrats? Color me shocked.
Overall, that works out to be good news. Thanks, B4.
http://www.politico.com/story/2013/11/cbs-poll-obamacare-record-lows-100115.html
QuoteThe president's signature health care law is also at a new low. Approval of Obamacare stands at 31 percent with disapproval at 61 percent, the worst figures for the law in CBS's polling.
Only one in three survey respondents said they believe the government will be able to fix the health care exchange website by the White House's end-of-the-month deadline, and just 7 percent said the Affordable Care Act should be left in place without any changes. Forty-eight percent said it needs some changes, and 43 percent want it repealed entirely.
:sadface:
So 55% think it should be kept in some form or another. Do those numbers come as a surprise?
Quote from: Berkut on November 21, 2013, 11:07:14 AM
So 55% think it should be kept in some form or another. Do those numbers come as a surprise?
Enough from you, Socialist.
31% approval is actually pretty high for a program that seems destined to become a classic case study on botched policy implementation.
Today's Metro said Obamacare is a failure.
Quote from: Berkut on November 21, 2013, 11:07:14 AM
So 55% think it should be kept in some form or another.
And it's not really damning that people want to see some changes made; I bet Obama has changes he would make at this point too.
Quote from: Kleves on November 21, 2013, 11:37:49 AM
Quote from: Berkut on November 21, 2013, 11:07:14 AM
So 55% think it should be kept in some form or another.
And it's not really damning that people want to see some changes made; I bet Obama has changes he would make at this point too.
Well, he does make changes. He pretty much does whatever he wants to with it. But I don't think they are changes most commoners would make.
(https://languish.org/forums/proxy.php?request=http%3A%2F%2Fimg.timeinc.net%2Ftime%2Fdaily%2F2013%2F1311%2F360_cover_1202.jpg&hash=5793e651e011cd78eb7b077f6a24852a46cd8111)
Quote from: The Minsky Moment on November 21, 2013, 11:36:43 AM
31% approval is actually pretty high for a program that seems destined to become a classic case study on botched policy implementation.
31% is painfully low for a nation that traditionally has valued wide consensus when imposing drastic changes.
Quote from: Admiral Yi on November 21, 2013, 03:58:09 PM
31% is painfully low for a nation that traditionally has valued wide consensus when imposing drastic changes.
There was wide consensus on civil rights? The New Deal? Reaganomics?
hard to think of historical drastic change in US history that had wide consensus.
Quote from: The Minsky Moment on November 21, 2013, 04:12:02 PM
There was wide consensus on civil rights? The New Deal? Reaganomics?
hard to think of historical drastic change in US history that had wide consensus.
I would say very much yes to the New Deal. Didn't FDR slaughter Adlai 3 times? Pretty much yes to Civil Rights. Only objectors were southern Democrats.
Not sure what you mean by Reagonomics.
Quote from: Admiral Yi on November 21, 2013, 04:17:21 PM
Quote from: The Minsky Moment on November 21, 2013, 04:12:02 PM
There was wide consensus on civil rights? The New Deal? Reaganomics?
hard to think of historical drastic change in US history that had wide consensus.
I would say very much yes to the New Deal. Didn't FDR slaughter Adlai 3 times? Pretty much yes to Civil Rights. Only objectors were southern Democrats.
Not sure what you mean by Reagonomics.
Oh Yi, such a kidder.
Yi looks like he got an Official Red Ryder Carbine-Action Two-Hundred-Shot Range Model Air Rifle.
Quote from: derspiess on November 21, 2013, 03:51:19 PM
(https://languish.org/forums/proxy.php?request=http%3A%2F%2Fimg.timeinc.net%2Ftime%2Fdaily%2F2013%2F1311%2F360_cover_1202.jpg&hash=5793e651e011cd78eb7b077f6a24852a46cd8111)
:) Now they need to fix it.
That is how my Maxide pills look after breaking them in half.
I can live with that.
QuoteI would say very much yes to the New Deal. Didn't FDR slaughter Adlai 3 times? Pretty much yes to Civil Rights. Only objectors were southern Democrats.
Not sure what you mean by Reagonomics.
See, I have no idea what you are on about with FDR slaughtering Adlai 3 times. "Only objectors were southern Democrats." is false and easily demonstrated to be so. I can point to lots of people who were not southern Democrats and were against civil rights. For instance, the John Birch society was against desegregation (they saw it as a communist plot.) As was William F. Buckley.
In fairness it's probably easier to list things the John Birchers didn't think were communist plots.
Quote from: Sheilbh on November 21, 2013, 07:31:59 PM
In fairness it's probably easier to list things the John Birchers didn't think were communist plots.
Well they are still around. In fact they were a cosponsor of CPAC the big conservative get together recently. You'd think they would gone away when the Soviet Union collapsed, but no they are still around.
Quote from: Razgovory on November 21, 2013, 07:26:00 PM
See, I have no idea what you are on about with FDR slaughtering Adlai 3 times. "Only objectors were southern Democrats." is false and easily demonstrated to be so. I can point to lots of people who were not southern Democrats and were against civil rights. For instance, the John Birch society was against desegregation (they saw it as a communist plot.) As was William F. Buckley.
You win Raz.
:XD:
Quote from: Admiral Yi on November 21, 2013, 08:29:32 PM
Quote from: Razgovory on November 21, 2013, 07:26:00 PM
See, I have no idea what you are on about with FDR slaughtering Adlai 3 times. "Only objectors were southern Democrats." is false and easily demonstrated to be so. I can point to lots of people who were not southern Democrats and were against civil rights. For instance, the John Birch society was against desegregation (they saw it as a communist plot.) As was William F. Buckley.
You win Raz.
Clearly not, since you continue to make such statements.
Quote from: Razgovory on November 21, 2013, 07:36:36 PM
Quote from: Sheilbh on November 21, 2013, 07:31:59 PM
In fairness it's probably easier to list things the John Birchers didn't think were communist plots.
Well they are still around. In fact they were a cosponsor of CPAC the big conservative get together recently.
Yes, I'm sure they scraped together $10 to put in the donation can.
I want to amend the list of smileys banned for certain posters, for their own good:
derspiess: :lol:
Admiral Yi: :face:
Good luck with that banning thing.
:lol:
:mad:
What is Fox News on about? Some emails about the rollout. Havent had a chance to look.
Quote from: 11B4V on November 22, 2013, 02:11:46 AM
What is Fox News on about? Some emails about the rollout. Havent had a chance to look.
Who cares? They are always off about nearly everything.
QuoteObama Pushes Back 2015 Health Care Enrollment
(Newser) – The Obama administration plans to push back the start of next year's ObamaCare enrollment period by a month, from Oct. 15, 2014 to Nov. 15—which would just happen to push it to after the midterm elections, Bloomberg reports. The idea, ostensibly, is to give insurers more time to evaluate the effects of the government-run exchanges, in the hope that doing so will prevent prices from spiking. Right now, the technical stink around the law has prevented it from attracting the kind of desirable enrollees who'll keep rates down.
Most of those young, healthy buyers, will probably start showing up in March—which is when the mandate deadline kicks in, and the uninsured will have to pay a fine, says one MIT economist who helped design the law. The administration wants to give insurers as much time as possible to absorb the impact of that influx, worrying that otherwise rates will spike in the program's second year. "It's in the nation's interest they get time to make those decisions," the economist says.
http://www.washingtonpost.com/blogs/post-politics/wp/2013/11/22/franken-open-to-individual-mandate-delay/
:(
Shit Happens
I can't speak for Ed, but the broken promise is what destroyed Obama's credibility in my eyes :(
http://www.realclearpolitics.com/articles/2013/11/27/obama_approval_hits_all-time_low_in_ohio_120797.html
I thought it was the fact that he was a Democrat?
So? My grandfather was a Democrat.
Quote from: derspiess on November 27, 2013, 09:55:08 AM
So? My grandfather was a Democrat.
:lol:
Or in 2012 dollars, he was a republican.
Quote from: Grey Fox on November 27, 2013, 10:14:53 AM
Or in 2012 dollars, he was a republican.
Oh, he was more conservative than me on everything but the subject of labor unions. And he was stuck in the early 1900s concept of unions at that.
Quote from: derspiess on November 27, 2013, 10:41:35 AM
Quote from: Grey Fox on November 27, 2013, 10:14:53 AM
Or in 2012 dollars, he was a republican.
Oh, he was more conservative than me on everything but the subject of labor unions. And he was stuck in the early 1900s concept of unions at that.
That just tells me you are an evil, evil man.
That I'm less conservative than my grandfather who was a Democrat?
Union hate.
Quote from: fhdz on November 20, 2013, 08:20:25 PM
I think we should ban advertising on all prescription drugs.
The idea is that your doctor is supposed to make an evidence-based diagnosis and create a prescription, not that Johnny Layman is supposed to go "hey, I'm a crazy fucker, maybe I should ask my doc about This Brand Name Anti-Crazy Pill."
Interesting and relevant: http://www.sciencebasedmedicine.org/low-t-the-triumph-of-marketing-over-science/
Quote from: derspiess on November 27, 2013, 09:35:08 AM
I can't speak for Ed, but the broken promise is what destroyed Obama's credibility in my eyes :(
http://www.realclearpolitics.com/articles/2013/11/27/obama_approval_hits_all-time_low_in_ohio_120797.html
Obama generally only gets a favorable rating from me on Drone striking brown shits. Otherwise, he is a huge disappointment.
Quote from: Ed Anger on November 27, 2013, 02:00:30 PM
Otherwise, he is a huge disappointment.
He's more or less lived up to my expectations, actually.
Quote from: derspiess on November 27, 2013, 02:05:54 PM
Quote from: Ed Anger on November 27, 2013, 02:00:30 PM
Otherwise, he is a huge disappointment.
He's more or less lived up to my expectations, actually.
Eh I doubt that. I seem to recall you actually thought he was a left winger of some sort rather than a complete non-entity who would barely shake the boat at all.
Quote from: Valmy on November 27, 2013, 02:23:31 PM
Eh I doubt that. I seem to recall you actually thought he was a left winger of some sort rather than a complete non-entity who would barely shake the boat at all.
He has been limited by a GOP controlled House since his first midterm. I think it's safe to say that had he been given a more accomodating congress he would have been more active.
Quote from: The Minsky Moment on November 20, 2013, 06:45:47 PM
Quote from: Zanza on November 20, 2013, 02:52:01 PM
Just saw this in an OECD report ... American exceptionalism:
Question is: what happens when you adjust for the usually high level of deaths by accident and violence in the US?
These deaths tend to be uncorrelated or even reverse correlated from age and thus tend to hit life expectancy, but they aren't really addressable by the health care delivery system.
I have seen studies that suggest that the US health care system does a very good job of extending life span and quality among similarly situated people who have various kinds of significant ailments and conditions. OTOH some public health and extension of basic care across the population may lag behind the leaders.
Health stats in the US by county. (http://www.healthmetricsandevaluation.org/tools/data-visualization/us-health-map#/overview/explore)
Baltimore males live 12 years less than those a few miles away in Howard County.
Only a handful counties manage to reach Spanish
average life expectancy, places like Marin County where income is several times higher than in Spain.
Quote from: derspiess on November 27, 2013, 11:06:37 AM
That I'm less conservative than my grandfather who was a Democrat?
Wallace voter?
The herder they come, the herder they fall, one and all.
Sheeple are nothing like the real thing.
Continuing the trend.
Quote
Obama Delays Health Care Site for Small Businesses
(Newser) – The long-promised small-business portal at HealthCare.gov will be launching in November—November 2014, that is. The Obama administration had promised that the site, which was originally slated to open back in October, would launch by the end of this month, but Health and Human Services officials today confirmed for the Washington Post and Wall Street Journal that it wouldn't be ready for a full year.
Small businesses will still be able to get coverage and apply for tax credits, and they'll be able to at least see rates on the site starting on Dec. 1. But to actually buy what they see, they'll have to buy it off-line the old fashioned way. It's the latest embarrassing digital setback for the health care rollout, and Republicans were quick to pounce. "If small firms failed to provide services this frequently, they would be fired," says one House Republican.
http://www.newser.com/story/178295/obama-delays-health-care-site-for-small-businesses.html
Quote from: Valmy on November 27, 2013, 02:23:31 PM
Eh I doubt that. I seem to recall you actually thought he was a left winger of some sort rather than a complete non-entity who would barely shake the boat at all.
He is a left-winger.
Quote
Obama Delays Health Care Site for Small Businesses
(Newser) – The long-promised small-business portal at HealthCare.gov will be launching in November—November 2014, that is. The Obama administration had promised that the site, which was originally slated to open back in October, would launch by the end of this month, but Health and Human Services officials today confirmed for the Washington Post and Wall Street Journal that it wouldn't be ready for a full year.
This is unbelievable. :huh:
No it isn't.
I'm a believer. :pope:
It's the Republicans' fault!!
Quote from: Admiral Yi on November 27, 2013, 03:57:20 PM
Quote
Obama Delays Health Care Site for Small Businesses
(Newser) – The long-promised small-business portal at HealthCare.gov will be launching in November—November 2014, that is. The Obama administration had promised that the site, which was originally slated to open back in October, would launch by the end of this month, but Health and Human Services officials today confirmed for the Washington Post and Wall Street Journal that it wouldn't be ready for a full year.
This is unbelievable. :huh:
Now all our Thanksgiving is ruined. :(
QuoteHP to replace Verizon as website provider
By Alexandra Jaffe- 11-27-13 18:33 PM EST
The Department of Health and Human Services is replacing Verizon with Hewlett-Packard as its web-hosting provider for the federal health insurance marketplace, according to multiple reports.
The website has suffered significant glitches since its rollout, prompting widespread criticism from Democrats and Republicans alike and complicating Americans' efforts to sign up for coverage under ObamaCare.
The data hub center, which Verizon has operated, has crashed multiple times over the past month, making it impossible for potential customers to sign up for insurance online while the site was down.
According to the Wall Street Journal, the switch to H-P had been in the works since the spring, when the government sought bids from competing providers for the same services.
Documents obtained by the Journal reveal the government rewarded the company's Enterprise Services group a $38 million contract over the summer, which a source told the paper was for the health insurance website.
The administration has set a Nov. 30 deadline for the Healthcare.gov website to run smoothly. However, a Wednesday New York Times report that the administration is delaying a planned ObamaCare marketing campaign because it's worried a crush of users could crash the system cast doubt on the ability of the administration to meet that deadline.
Quote from: Admiral Yi on November 27, 2013, 03:57:20 PM
Quote
Obama Delays Health Care Site for Small Businesses
(Newser) – The long-promised small-business portal at HealthCare.gov will be launching in November—November 2014, that is. The Obama administration had promised that the site, which was originally slated to open back in October, would launch by the end of this month, but Health and Human Services officials today confirmed for the Washington Post and Wall Street Journal that it wouldn't be ready for a full year.
This is unbelievable. :huh:
Why?
Quote from: Iormlund on November 29, 2013, 03:06:44 AM
Why?
:huh:
4 1/2 year lead time, Obama's signature legislative accomplishment, not a word from anyone prior to the launch date that there were problems. And now they need another whole year to get the small business exchange up and running.
They must have put a Brookings intern in charge of the whole thing.
Oh, I agree that someone has screwed up big time. I'm just not surprised at all. I've seen similar things happen in banking, telcom, industry or AAA videogames.
Quote from: Admiral Yi on November 29, 2013, 11:56:59 AM
Quote from: Iormlund on November 29, 2013, 03:06:44 AM
Why?
:huh:
4 1/2 year lead time, Obama's signature legislative accomplishment, not a word from anyone prior to the launch date that there were problems. And now they need another whole year to get the small business exchange up and running.
They must have put a Brookings intern in charge of the whole thing.
3 1/2 years since the legislation was passed, and most likely work on the website didn't get started for quite a while. The small business exchange is the least important of the exchanges, since they can file by paper or through the insurance brokers that many small businesses already have a relationship with.
Quote from: frunk on November 29, 2013, 03:04:47 PM
3 1/2 years since the legislation was passed, and most likely work on the website didn't get started for quite a while.
Because it would've been so much more awesomer using 3 1/2 year old HTML code.
So, what is it? One day to get that jalopy of a website up and running running?
Quote from: Iormlund on November 29, 2013, 02:02:03 PM
Oh, I agree that someone has screwed up big time. I'm just not surprised at all. I've seen similar things happen in banking, telcom, industry or AAA videogames.
Yeah. Every single government IT project here runs massively overbudget, is normally late and doesn't always work - see the government's signature welfare reform.
I always suspect part of the problem is that they always seem to use Capita, who always seem to fuck up :lol:
It's a bit like G4S, with their awful company song, providing 'security services' to the government:
http://www.buzzfeed.com/jimwaterson/g4s-has-been-charging-the-government-for-electronic-tags-on
Quote from: 11B4V on November 30, 2013, 02:16:02 AM
So, what is it? One day to get that jalopy of a website up and running running?
Health Site Likely to Miss Deadlinehttp://online.wsj.com/article/SB10001424052702303332904579228413800602836.html
Man, I bet someone's gonna lose her job over that.
Or not.
Quote from: Phillip V on November 30, 2013, 09:39:58 AM
Quote from: 11B4V on November 30, 2013, 02:16:02 AM
So, what is it? One day to get that jalopy of a website up and running running?
Health Site Likely to Miss Deadline
http://online.wsj.com/article/SB10001424052702303332904579228413800602836.html
But of course. What's the excuse this time.
(https://www.teaparty.org/wp-content/uploads/2013/09/obama_facepalm_wh_photo.jpg)
Quote from: 11B4V on November 30, 2013, 06:20:54 PM
But of course. What's the excuse this time.
:lol: what do you care? You're rooting for failure, regardless of the reason. Just be satisfied with what you get this holiday season, don't act so spoiled. :P
Quote from: CountDeMoney on November 30, 2013, 06:27:10 PM
Quote from: 11B4V on November 30, 2013, 06:20:54 PM
But of course. What's the excuse this time.
:lol: what do you care? You're rooting for failure, regardless of the reason. Just be satisfied with what you get this holiday season, don't act so spoiled. :P
:D
Theres where you are wrong. Too far into the process. It's too big to be allowed to fail now.
1. What I have is; no faith in the Federal Govmint abilities with something like this, without it turing into a clusterfuck. Overcost, missed deadlineds, bait and switch, no accoutability, etc.
2. The IRS' involvement in the process.
The government gave itself a passing grade even though it still doesn't work! :o
I'm shocked!
http://www.nytimes.com/2013/12/02/business/white-house-praises-gains-on-health-site.html?pagewanted=all&_r=1&
QuoteInsurers Claim Health Website Is Still Flawed
By ROBERT PEAR and REED ABELSON
Published: December 1, 2013
Weeks of frantic technical work appear to have made the government's health care website easier for consumers to use. But that does not mean everyone who signs up for insurance can enroll in a health plan.
The problem is that the systems that are supposed to deliver consumer information to insurers still have not been fixed. And with coverage for many people scheduled to begin in just 30 days, insurers are worried the repairs may not be completed in time.
"Until the enrollment process is working from end to end, many consumers will not be able to enroll in coverage," said Karen M. Ignagni, president of America's Health Insurance Plans, a trade group.
The issues are vexing and complex. Some insurers say they have been deluged with phone calls from people who believe they have signed up for a particular health plan, only to find that the company has no record of the enrollment. Others say information they received about new enrollees was inaccurate or incomplete, so they had to track down additional data — a laborious task that will not be feasible if data is missing for tens of thousands of consumers.
In still other cases, insurers said, they have not been told how much of a customer's premium will be subsidized by the government, so they do not know how much to charge the policyholder.
In trying to fix HealthCare.gov, President Obama has given top priority to the needs of consumers, assuming that arrangements with insurers can be worked out later.
The White House announced on Sunday that it had met its goal for improving HealthCare.gov so the website "will work smoothly for the vast majority of users."
In effect, the administration gave itself a passing grade. Because of hundreds of software fixes and hardware upgrades in the last month, it said, the website — the main channel for people to buy insurance under the 2010 health care law — is now working more than 90 percent of the time, up from 40 percent during some weeks in October.
Jeffrey D. Zients, the presidential adviser leading the repair effort, said he had shaken up management of the website so the team was now "working with the velocity and discipline of a high-performing private sector company."
Mr. Zients said 50,000 people could use the website at the same time and that the error rate, reflecting the failure of web pages to load properly, was consistently less than 1 percent, down from 6 percent before the overhaul.
Pages on the site generally load faster, in less than a second, compared with an average of eight seconds in late October, Mr. Zients said.
Whether Mr. Obama can fix his job approval ratings as well as the website is unclear. Public opinion polls suggest he may have done more political damage to himself in the last two months than Republican attacks on the health care law did in three years.
People who have tried to use the website in the last few days report a mixed experience, with some definitely noticing improvements.
"Every week, it's been getting better," said Lynne M. Thorp, who leads a team of counselors, or navigators, in southwestern Florida. "It's getting faster, and nobody's getting kicked out."
But neither Mr. Zients nor the Department of Health and Human Services indicated how many people were completing all the steps required to enroll in a health plan through the federal site, which serves residents of 36 states.
And unless enrollments are completed correctly, coverage may be in doubt.
For insurers the process is maddeningly inconsistent. Some people clearly are being enrolled. But insurers say they are still getting duplicate files and, more worrisome, sometimes not receiving information on every enrollment taking place.
"Health plans can't process enrollments they don't receive," said Robert Zirkelbach, a spokesman for America's Health Insurance Plans.
Despite talk from time to time of finding some sort of workaround, experts say insurers have little choice but to wait for the government to fix these problems. The insurers are in "an unenviable position," said Brett Graham, a managing director at Leavitt Partners, which has been advising states and others on the exchanges. "Although they don't have the responsibility or the capability to fix the system, they're reliant on it."
Insurers said they were alarmed when Henry Chao, the chief digital architect for the federal website, estimated that 30 to 40 percent of the federal insurance marketplace was still being built. He told Congress on Nov. 19 that the government was still developing "the back-office systems, the accounting systems, the payment systems" needed to pay insurers in January.
While insurers will start covering people who pay their share of the premium, many insurers worry that the government will be late on the payments they were expecting in mid-January for the first people covered.
"We want to be paid," said one executive, speaking frankly on the condition of anonymity. "If we want to pay claims, we need to get paid."
Insurers said they had received calls from consumers requesting insurance cards because they thought they had enrolled in a health plan through the federal website, but the insurers said they had not been notified.
"Somehow people are getting lost in the process," the insurance executive said. "If they go to a doctor or a hospital and we have no record of them, that will be very upsetting to consumers."
Thomas W. Rubino, a spokesman for Horizon Blue Cross Blue Shield of New Jersey, which says it has about 70 percent of the individual insurance market in the state, said the company had received "some but not a lot" of enrollments from the federal exchange.
Federal officials are encouraging insurers to let consumers sign up directly with them. But in the middle of this online enrollment process, consumers must be transferred to the federal website if they want to obtain tax credit subsidies to pay some or all of their premiums in 2014.
In a document describing problems with the federal website in late November, the administration said some consumers were "incorrectly determined to be ineligible for" tax credits. In some cases, it said, enrollment notices sent to insurers were missing the amount of the premium to be paid by a consumer, the amount of subsidies to be paid by the government and even the identification number for a subscriber.
In some cases, according to the document, government computers blocked the enrollment of people found eligible for subsidies that would pay the entire amount of their premiums. In other cases, the government system failed to retrieve information on a consumer's eligibility for financial assistance.
Mr. Zients said that software fixes installed on Saturday night should improve not only the consumer experience, but also the "the back end of the system," which consumers rarely see.
Ben Jumper, 29, of Dallas, said he had repeatedly been thwarted trying to use HealthCare.gov, most recently on Wednesday.
"I would get one or two steps further along, and then something else would be broken," Mr. Jumper said. "It is not very user-friendly. It is not very intuitive. Eventually, we just gave up."
But Urian Diaz Franco, a navigator with VNA Health Care in Aurora, Ill., said on Saturday, "We've seen nothing but improvements."
A week ago, he said, it often took 10 to 15 seconds for a page to load, but "now it's just boom, boom, boom — it comes up as soon as you click the button."
Jess Bidgood, Dan Frosch and Jennifer Preston contributed reporting.
Not shocking, but par for the course.
If 3 steps out of 5 work, isn't it still a passing grade?
3 out of 5 gets you first dibs on jobs in the UK.
Looks like enrollment is picking up speed
http://www.huffingtonpost.com/2013/12/11/obamacare-enrollment_n_4421797.html?1386770148
QuoteWASHINGTON -- More than two months after Obamacare's ugly debut, the number of Americans using the system is starting to grow: Nearly 1.2 million people are on track to have health coverage in place next year from the law's health insurance exchanges, the Department of Health and Human Services announced Wednesday.
From Oct. 1 through Nov. 30, almost 365,000 people enrolled into private health insurance via the federal and state marketplaces and more than 803,000 were deemed eligible for Medicaid or the Children's Health Insurance Program, according to the department.
The federally run exchanges in more than 30 states accounted for 137,000 of the enrollments in private coverage, and the remaining states signed up 227,000. About 1.9 million more people had been determined eligible for coverage through the marketplaces, but hadn't yet chosen a health plan. The new data don't include an apparent flurry of enrollments in the early days of December.
White House interns at it again:
https://twitter.com/WhiteHouse/status/411231710227857409/photo/1 (https://twitter.com/WhiteHouse/status/411231710227857409/photo/1)
(https://pbs.twimg.com/media/BbT9D8TCYAAF3nI.png)
Must be trying to appeal to the zombie demographic.
QuoteObama 'Wins' Lie of the Year
(Newser) – "If you like your health care plan, you can keep it." Barack Obama has been raked over the coals for that one in recent months, and now he's getting, umm, honored for it: PolitiFact has awarded the phrase its Lie of the Year Award, it announced on CNN last night. The editors' pick was backed up by an online poll that overwhelmingly agreed. It's the fourth year out of five that the top lie has been health care-related (see 2009, 2010, and 2011), and the three runners-up lies this year are all related to conservative attacks on the law.
When Obama first made the statement, back in 2009, PolitiFact rated it as "Half True." But when cancellations started pouring in, Obama dropped this whopper: "What we said was you can keep it if it hasn't changed since the law passed." That earned a "pants on fire" rating—Obama publicly made his promise, without any conditions, 37 times by PolitiFact's count. Besides, editor Angie Drobnic Holan explained on CNN, "the lie of the year is not the most wrong statement, it's the most significant impact."
http://www.newser.com/story/179149/obama-wins-lie-of-the-year.html
Quote
Lie of the Year: Readers' Poll results
By Angie Drobnic Holan
Published on Thursday, December 12th, 2013 at 3:59 p.m.
Share this article:
We offered readers 10 finalists for the Lie of the Year for 2013. It's the fifth year in a row we've asked readers to weigh in via an online poll. We received 14,278 votes this year, a record turnout.
First place among readers overwhelmingly went to President Barack Obama, for his repeated statement, "If you like your health care plan, you can keep it."
Here are the full results:
If you like your health care plan, you can keep it. Obama repeatedly made this claim in previous years; back then we rated it Half True. When people got cancellation notices in the individual market this year, Obama claimed, "What we said was, you can keep it if it hasn't changed since the law passed." That got a Pants on Fire.
59%
Congress is exempt from the health care law. Sen. Ted Cruz, R-Texas, said, "President Obama just granted all of Congress an exception" to Obamacare during an August speech in Iowa. False.
8%
The IRS will keep a database of health secrets. In May, Michele Bachmann gave a TV interview in which she claimed the IRS is going to be "in charge" of "a huge national database" on health care that will include Americans' "personal, intimate, most close-to-the-vest-secrets." Pants on Fire.
7%
No U.S.-trained doctors will accept Obamacare. In an October column, Ann Coulter wrote, "No doctors who went to an American medical school will be accepting Obamacare." Pants on Fire.
7%
The United Nations is coming for your guns. Chain emails repeatedly claimed that the United Nations has "adopted a proposed agenda" to enable member nations to "disarm civilians within their borders." False.
5%
The FISA Court is transparent. In a June interview, President Barack Obama defended the government's monitoring of telephone and Internet traffic by invoking the Foreign Intelligence Surveillance Court and saying the court "is transparent." Pants on Fire.
4%
The United States doesn't tolerate genocide. After Syria entered a civil war and many civilians were killed, U.S. Sen. Saxby Chambliss, R-Ga., said, "The United States has never stood by and seen innocent people slaughtered to the extent that's happening in Syria." History shows we have. Pants on Fire.
3%
Muslims are exempt from Obamacare. A chain email claimed the word "Dhimmitude" is on page 107 of the health care law and means "Muslims are specifically exempted from the government mandate to purchase insurance." Pants on Fire.
3%
Other (write-in votes)
3%
Obamacare means forced home inspections. Bloggers passed around a claim in August that a health care law provision will allow "forced home inspections" by government agents. Pants on Fire.
1%
Obamacare will question your sex life. Betsy McCaughey wrote an op-ed for the New York Post in September that said doctors will be required to ask about your sex life under Obamacare. Pants on Fire.
1%
http://www.politifact.com/truth-o-meter/article/2013/dec/12/lie-year-readers-poll-results-2013/
Preposterous :mad:
QuoteSick Find Key Drugs Missing From ObamaCare Plans
(Newser) – Thanks to the Affordable Care Act, heath insurers now can't turn away sick people. That's the good news. The bad news: They don't actually have to cover the drugs those patients need. Key drugs are missing from some plans, the Washington Post reports, in what patient advocates believe is a bid to drive sick customers away. Some plans omit certain medicines for HIV, cancer, multiple sclerosis, rheumatoid arthritis, and more altogether, or else require patients to pay as much as 50% out-of-pocket—which is often more than $1,000 a month.
Consumers might not realize, either; some plan don't detail their formulary (that's the list of covered drugs) until patients formally apply, the Wall Street Journal reports. And, as Scott Gottlieb at Forbes explains, if a drug isn't on the formulary, it won't even count toward your out-of-pocket cap ($12,700 for a family, $6,350 for an individual). The Obama administration says that if your plan doesn't cover a crucial drug, you should ask for an exception; the government is asking insurers to respond to these requests within three days.
http://www.newser.com/story/178943/sick-find-key-drugs-missing-from-obamacare-plans.html
Quote from: 11B4V on December 13, 2013, 10:49:12 AM
Preposterous :mad:
Obamacare's not exactly the out-of-control, full-blown communist locomotive that mowed everything and everybody down on its way to legality you panicky GOP retards thought it was, was it? Compromises were made with the healthcare industry. Imagine that.
Right, Seedy. It was some grade-A legislation :lol:
I imagine the insurance companies would have been perfectly satisfied with packing even more requirements onto the plans people are required to purchase.
Quote from: derspiess on December 13, 2013, 11:28:00 AM
Right, Seedy. It was some grade-A legislation :lol:
Legislation rarely is.
This new health scare plan just gets better and better.... :ph34r:
Quote from: CountDeMoney on December 13, 2013, 11:13:26 AMCompromises were made with the healthcare industry. Imagine that.
Compromises? The ACA was written for the healthcare industry.
California's Obamacare Exchange Releases Video Featuring A Rapping Barack Obama Impersonator To Try And Get People To Enroll: http://weaselzippers.us/2013/12/12/californias-obamacare-exchange-releases-video-featuring-a-rapping-barack-obama-impersonator-to-try-and-get-people-to-enroll/ (http://weaselzippers.us/2013/12/12/californias-obamacare-exchange-releases-video-featuring-a-rapping-barack-obama-impersonator-to-try-and-get-people-to-enroll/)
Love it!
Here's a bit more from a less sketchy site.
http://www.latimes.com/nation/politics/politicsnow/la-pn-obamacare-hollywood-new-social-media-campaign-20131212,0,2435151.story#axzz2nOFB16Wk
For Natural Allies of Affordable Care Act, a Rude Surprise
'Many in New York’s professional and cultural elite have long supported President Obama’s health care plan. But now, to their surprise, thousands of writers, opera singers, music teachers, photographers, doctors, lawyers and others are learning that their health insurance plans are being canceled and they may have to pay more to get comparable coverage, if they can find it.
...
It is not lost on many of the professionals that they are exactly the sort of people – liberal, concerned with social justice – who supported the Obama health plan in the first place. Ms. Meinwald, the lawyer, said she was a lifelong Democrat who still supported better health care for all, but had she known what was in store for her, she would have voted for Mitt Romney.
It is an uncomfortable position for many members of the creative classes to be in. “We are the Obama people,” said Camille Sweeney, a New York writer and member of the Authors Guild. Her insurance is being canceled, and she is dismayed that neither her pediatrician nor her general practitioner appears to be on the exchange plans. What to do has become a hot topic on Facebook and at dinner parties frequented by her fellow writers and artists.'
http://www.nytimes.com/2013/12/14/nyregion/with-affordable-care-act-canceled-policies-for-new-york-professionals.html
(https://languish.org/forums/proxy.php?request=http%3A%2F%2Fgraphics8.nytimes.com%2Fimages%2F2013%2F12%2F12%2Fnyregion%2F12GUILD%2F12GUILD-popup.jpg&hash=d03388e817856b707a160b7976527bbaf66822c7)
Oh noes! You can't just have the gravy train without feeling a pinch?
Quote
Sebelius Calls for HealthCare.gov Investigation
She thinks HHS needs to improve how it handles contracts
(Newser) – Many in Washington are calling for an investigation into HealthCare.gov's disastrous debut—and now, that includes the woman who was in charge of it. In a blog post today, Kathleen Sebelius announced that she has asked Health and Human Services' inspector general to look into the website's development, including issues related to how the contract was awarded, and how the program was managed. "The launch of HealthCare.gov was flawed and simply unacceptable," she wrote. "I strongly believe in the need for accountability."
Sebelius also announced the establishment of a new Chief Risk Officer position for Medicare and Medicaid. The announcement comes as Sebelius gets ready for another grilling before the House Energy and Commerce Committee today, the AP points out, adding that the "unusual" announcement "indicates that she realizes she has some explaining to do." But committee Republicans plan to focus less on the website, and more on the underlying program, the Washington Post reports.
http://www.newser.com/story/179015/sebelius-calls-for-healthcaregov-investigation.html
(https://languish.org/forums/proxy.php?request=http%3A%2F%2Fassets.nydailynews.com%2Fpolopoly_fs%2F1.1551347.1387388857%21%2Fimg%2FhttpImage%2Fimage.png_gen%2Fderivatives%2Flandscape_635%2Fpajama-boy.png&hash=cd776e2dbc50127a775206bf34c63a299c82eb94)
Not necessarily those particular pajamas.
I guess this guy's urology tests weren't covered. (http://www.cnn.com/2013/12/17/us/reno-hospital-shooting/)
Uninsured Disapprove Health Care Law
'Americans who lack coverage disapprove of the health law at roughly the same rate as the insured, according to the latest New York Times/CBS News poll.'
http://www.nytimes.com/2013/12/19/us/uninsured-americans-are-about-as-skeptical-of-health-care-law-as-the-insured-poll-finds.html
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Lol, is it true that Harry Reid, Senate Majority leader, is getting a subsidy on his health insurance from the ACA? :huh: I heard that reported, heard him asked if he would take the subsidy and he said yes. If he qualifies with his wealth and paycheck, then the rest of us should all get huge subsidies.
No way.
From what I heard, the subsidy was defined as an "employer contribution".
Quote from: derspiess on December 19, 2013, 04:50:30 PM
From what I heard, the subsidy was defined as an "employer contribution".
Well that makes sense then. Reid should have corrected it when asked the question about subsidies, tell what it was referring to. Sheesh....
Quote from: garbon on December 13, 2013, 06:25:58 PM
Oh noes! You can't just have the gravy train without feeling a pinch?
No shit.
Did they think they were somehow immune to the problems that come with the ACA just because they voted for Obama?
Quote from: merithyn on December 20, 2013, 01:07:06 PM
Quote from: garbon on December 13, 2013, 06:25:58 PM
Oh noes! You can't just have the gravy train without feeling a pinch?
No shit.
Did they think they were somehow immune to the problems that come with the ACA just because they voted for Obama?
Seems like some did.
Quote from: derspiess on December 18, 2013, 03:09:24 PM
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I basically agree with this. Now that the government has gotten involved in the insurance business, it's inevitable that it's role will continue to expand. I think it will take longer though then this guy expects.
http://www.newrepublic.com/article/116105/obamacare-will-lead-single-payer-michael-moore
QuoteHow Obamacare Actually Paves the Way Toward Single Payer
Last week the liberal documentary-maker Michael Moore prompted indigestion across the progressive wonk community by pronouncing Obamacare "awful." In a New York Times op-ed, he bemoaned the way the president's law preserved the health insurance industry rather than replacing it with a Medicare-for-all style single-payer system. The good news, Moore conceded, is that the previously uninsured (and often previously uninsurable) can get finally get coverage. The bad news is that their coverage will often be lousy and pose an enormous financial burden. He ended by calling for activists to lean on state politicians in an effort to beef the law up.
I happen to agree with Moore's basic sentiment. For-profit health insurance is on some level morally offensive—at least when it's practiced the way we Americans practice capitalism. With a few tantalizing but mostly unrepresentative exceptions, the longstanding aim of health insurers has been to weed out sick people, and to weasel out of paying for treatment if they somehow get insurance, so that the companies could boost their share price, lavish income on their executives, and plow money into annoyingly saccharine TV ads. To its everlasting credit, Obamacare genuinely tries to whip the insurers into shape—making it illegal to deny coverage to sick people, or to withdraw coverage when healthy people get sick, among other much-needed reforms. But you still have to be skeptical of middlemen who historically spent a mere 60 cents of every dollar individual policy-holders sent them on, you know, health care.1
And yet I'm still much more sympathetic to Obamacare than Moore. He thinks it's awful. I consider it a deceptively sneaky way to get the health care system both of us really want.
How? Allow me a brief digression: In 1991, Congress created the National Breast and Cervical Cancer Early Detection Program, which funded screenings for women who earn up to 250 percent of the poverty level. What Congress didn't do is provide money to pay for treatment if the tests came back positive. The policy seemed sadistically cruel: Suddenly thousands of women would discover they had a life-threatening illness while realizing they could do nothing about it. Both Moore and I would have surely denounced the law. But it soon proved to be a shrewd, if unintentional, opening move. "Almost from the moment it was implemented, there was pressure to take the next step," says Harold Pollack, a professor of social policy at the University of Chicago. "They constructed a sympathetic and organized constituency ... with an actionable grievance." Congress approved the money for treatment in 2000.
In some sense, Obamacare is the breast-and-cervical-cancer story writ large. In order to move the law through the Senate, the White House had to make all sorts of noxious compromises, like keeping the overall spending under $1 trillion, which limited the subsidies available to people buying insurance. Hence the kind of horror-stories Moore cites in his op-ed: A 60-year old couple with an annual income of $65,000 who could end up spending $25,000 on health care in a single year. And that's with Obamacare. (This is something of an outlier, but not that much of one.) But the flip side is that the law also created potentially millions of hard-working Americans who will have some health insurance; just maddeningly insufficient health insurance. What are the chances politicians stand up and take notice when these Americans complain?
In the heat of the political back-and-forth with Republicans bent on the program's destruction, this whole Obamacare adventure can feel a little hopeless. But when you look at the big picture, the underlying political logic is clearly toward more generous, more comprehensive coverage over time. Once the previously uninsured start getting insurance, the natural upshot of cataloguing the law's shortcomings isn't to give them less insurance, as my colleague Alec MacGillis pointed out last fall. It's to give them more. Republicans are in some sense playing into the trap Obamacare laid for them. And a few of them seem a bit concerned about it.2
Medicaid expansion is a case in point. Under Obamacare, uninsured people who earn up to 138 percent of the poverty level (just under $16,000 for a single person in 2013), can qualify for Medicaid, at least in states that opt into the law.3 This has a few key political consequences, as Pollack notes. First, it transforms the political constituency for the program. Historically, Medicaid has served extremely poor, frequently minority, patients who either don't vote or support Democrats when they do. That meant the GOP had no hang-ups about squeezing it. But there will likely be millions of white working-class voters on Medicaid in the coming years. (Even in some conservative states, like Arkansas, Kentucky, and West Virginia.) Once that happens, something tells me Republicans will become more charitably-disposed to the program.
Then there's the likelihood that, one day soon, especially if Medicaid becomes more generous, the working-class person who makes 175% of the poverty level will look at his working-class neighbor making 130% of the poverty level and think, wow, his health insurance seems a lot better than my private Obamacare plan. How long can it be before most people earning 175% or 200% of the poverty level are allowed to buy in, too?4
The same goes for Medicare. Many health-care reformers believe some version of Obamacare—government-subsidized private insurance—will eventually replace Medicare, something that will surely become more likely if voters feel warmly toward Obamacare and demand to keep it when they turn 65. But if private Obamacare plans stay stingy, the opposite may happen: As people age out of Obamacare and into that single-payer program we all love and support, their fondness for Medicare will only increase. Before long, their slightly younger friends and family members will be clamoring to join Medicare, too. How long before some opportunistic pol proposes that everyone on Obamacare who's 55-and-up can enroll in Medicare? Not very long, I'd guess. In wonk terms, progressives are likely to get their beloved public option one way or another, and probably not too far in the future.
The basic point is that, by pooling millions of people together in one institutional home—the exchanges where customers buy insurance under Obamacare—the Affordable Care Act is creating an organized constituency for additional reform. And since threadbare coverage is the only affordable option under Obamacare for many of these people, the law is giving them a whole set of grievances to get exercised about.
Granted, all this prophesizing assumes the exchanges will work, something Republicans seem determined to prevent. (For that matter, so did the Obama administration for a few months last year.) If the sick and old make up the overwhelming majority of enrollees, or if the back-end of HealthCare.gov never gets ironed out, the whole project could collapse. But if we do clear those thresholds in the next year or so—and the recent data points are encouraging—the relentless logic of the exchanges will be hard to stop. More and more people will be covered through the exchanges. (And not just the uninsured: The Congressional Budget Office estimates that three million people will move from employer-based coverage to the exchanges over the next five years.) Which means the constituency demanding better insurance will get bigger and more powerful each year.
In the end, I'll bet liberals like Moore develop a grudging respect for the administration on this front. (And believe me, I understand the tendency to second-guess.) Moore writes as though Obama created a complete dog of a program, then shrugged off any responsibility to improve it: "Obamacare can't be fixed by its namesake. It's up to us to make it happen." But flawed as Obamacare is, it has at least one great virtue: laying the groundwork for its own fixing.5 That's not bad for such an "awful" piece of legislation.
The government has been involved in the insurance business long before the ACA.
Quote from: jimmy olsen on January 06, 2014, 09:43:34 AM
I happen to agree with Moore's basic sentiment. For-profit health insurance is on some level morally offensive—at least when it's practiced the way we Americans practice capitalism. With a few tantalizing but mostly unrepresentative exceptions, the longstanding aim of health insurers has been to weed out sick people, and to weasel out of paying for treatment if they somehow get insurance, so that the companies could boost their share price, lavish income on their executives, and plow money into annoyingly saccharine TV ads. To its everlasting credit, Obamacare genuinely tries to whip the insurers into shape—making it illegal to deny coverage to sick people, or to withdraw coverage when healthy people get sick, among other much-needed reforms. But you still have to be skeptical of middlemen who historically spent a mere 60 cents of every dollar individual policy-holders sent them on, you know, health care.
:rolleyes: Last time we looked at the numbers here in the runup to the Obamacare vote we determined private insurers were marking up 6% on average and Medicaid was marking up 3%. The only way this kind of lying journalism is going to stop is if the people this crap is targeted at start demanding accuracy.
Fate: the government has been in the check writing business, not the insurance business.
Quote from: Admiral Yi on January 06, 2014, 09:52:39 PM
Quote from: jimmy olsen on January 06, 2014, 09:43:34 AM
I happen to agree with Moore's basic sentiment. For-profit health insurance is on some level morally offensive—at least when it's practiced the way we Americans practice capitalism. With a few tantalizing but mostly unrepresentative exceptions, the longstanding aim of health insurers has been to weed out sick people, and to weasel out of paying for treatment if they somehow get insurance, so that the companies could boost their share price, lavish income on their executives, and plow money into annoyingly saccharine TV ads. To its everlasting credit, Obamacare genuinely tries to whip the insurers into shape—making it illegal to deny coverage to sick people, or to withdraw coverage when healthy people get sick, among other much-needed reforms. But you still have to be skeptical of middlemen who historically spent a mere 60 cents of every dollar individual policy-holders sent them on, you know, health care.
:rolleyes: Last time we looked at the numbers here in the runup to the Obamacare vote we determined private insurers were marking up 6% on average and Medicaid was marking up 3%. The only way this kind of lying journalism is going to stop is if the people this crap is targeted at start demanding accuracy.
Are you saying that 94% of healthcare premiums were spent on medical care? :huh: That figure is almost impossible to believe.
Quote from: Admiral Yi on January 06, 2014, 09:52:39 PM
Quote from: jimmy olsen on January 06, 2014, 09:43:34 AM
I happen to agree with Moore's basic sentiment. For-profit health insurance is on some level morally offensive—at least when it's practiced the way we Americans practice capitalism. With a few tantalizing but mostly unrepresentative exceptions, the longstanding aim of health insurers has been to weed out sick people, and to weasel out of paying for treatment if they somehow get insurance, so that the companies could boost their share price, lavish income on their executives, and plow money into annoyingly saccharine TV ads. To its everlasting credit, Obamacare genuinely tries to whip the insurers into shape—making it illegal to deny coverage to sick people, or to withdraw coverage when healthy people get sick, among other much-needed reforms. But you still have to be skeptical of middlemen who historically spent a mere 60 cents of every dollar individual policy-holders sent them on, you know, health care.
:rolleyes: Last time we looked at the numbers here in the runup to the Obamacare vote we determined private insurers were marking up 6% on average and Medicaid was marking up 3%. The only way this kind of lying journalism is going to stop is if the people this crap is targeted at start demanding accuracy.
Fate: the government has been in the check writing business, not the insurance business.
Tricare, Medicare, Medicaid, county (indigent) insurance plans, CHIP - that's not the government involved in insurance business?
What would constitute the government being in the insurance business?
Quote from: DGuller on January 06, 2014, 10:07:11 PM
Are you saying that 94% of healthcare premiums were spent on medical care? :huh: That figure is almost impossible to believe.
That figure
is impossible to believe. Any 501(c)(3) organization can mark up 7-8%. You expect me to believe these guys are keeping from shuttering when they're making less money than a nonprofit?
Quote
http://www.examiner.com/article/washington-examiner-walmart-s-health-plans-are-better-than-obamacare
On Jan. 7, 2013, The Washington Examiner released the results of an investigation finding Walmart's employee health insurance is "significantly better" than Obamacare. Walmart has come under mega union labor union criticism as a retailer whose employees are both underpaid and mistreated. Like many insurance plans which have been canceled as a result of Obamacare benefit regulations, Walmart's health insurance has been called "substandard."
However after an in-depth comparison, the watch dog team of the Washington Examiner discovered employees of Walmart receive a better bang for the buck than Obamacare. In comparison to Obama care, it was discovered that Walmart plans were a whopping five to nine times less expensive. Full-service individual coverage in a Walmart HRA plan is available through a Blue Cross Blue Shield preferred provider organization for as little as $40 a month while family coverage averages $160 a month.
Some Walmart health insurance benefits for employees and their families include:
• no eligibility requirements
• age nor gender is a consideration
• a much larger doctor network
• a larger hospital network which includes some of the most renowned academic hospitals
• free heart surgery at four hospitals
• free spinal surgery at four hospitals
• free knee replacement at four hospitals
• free hip replacements at four hospitals
• free screenings for colorectal cancer, cervical cancer, chlamydia, diabetes, and depression
• free special counseling for diet and obesity
• free for children, more than 20 preventive services including but not limited to genetic disorders, autism and developmental problems to obesity, lead poisoning exposure and tuberculosis
• free for children, 12 vaccinations plus free hearing and vision testing
According to Business Insider, Walmart employs one percent of the nation's work force. Generally, the higher the number of potential insurees, the better leverage a company has negotiating a deal with insurance companies. Walmart's insurance negotiating leverage is certainly far less than that of the United States government who is hoping to insure seven million by March. It begs the question: How can Walmart get a better insurance deal, at better prices with better benefits than government?
Quote from: Fate on January 09, 2014, 11:14:50 PM
Tricare, Medicare, Medicaid, county (indigent) insurance plans, CHIP - that's not the government involved in insurance business?
What would constitute the government being in the insurance business?
I was trying to make a trivial and pedantic point about the difference between setting aside reserves to pay future claims and just writing checks to cover them.
Quote from: Admiral Yi on January 10, 2014, 08:46:34 AM
Quote from: Fate on January 09, 2014, 11:14:50 PM
Tricare, Medicare, Medicaid, county (indigent) insurance plans, CHIP - that's not the government involved in insurance business?
What would constitute the government being in the insurance business?
I was trying to make a trivial and pedantic point about the difference between setting aside reserves to pay future claims and just writing checks to cover them.
:huh: In the post Fate replied to?
Yes. :huh:
Oh, right, it had a second sentence. :Embarrass: I was so floored by the implied claim that 94% of premium dollars were used for medical care that I didn't read further.
Now that I read it, I would still disagree with you. The reason private insurance companies have to reserve is that their existence in the future is not guaranteed, and they also need to give an accurate account of their profitability, which can't be determined without reserving. Those reasons don't apply to the federal government, so it doesn't reserve. It's still in insurance business, if you go by the definition of insurance.
Quote from: DGuller on January 10, 2014, 09:10:02 AM
Oh, right, it had a second sentence. :Embarrass: I was so floored by the implied claim that 94% of premium dollars were used for medical care that I didn't read further.
Now that I read it, I would still disagree with you. The reason private insurance companies have to reserve is that their existence in the future is not guaranteed, and they also need to give an accurate account of their profitability, which can't be determined without reserving. Those reasons don't apply to the federal government, so it doesn't reserve. It's still in insurance business, if you go by the definition of insurance.
Yeah, I think Yi's point can only be that the government is not an insurance company. As he said, a trivial point to make.
TGI, one of the Obamacare.gov contractors, got shitcanned.
Quote from: Admiral Yi on January 10, 2014, 01:18:46 PM
TGI, one of the Obamacare.gov contractors, got shitcanned.
Heh, big surprise. But it may not even be the contractor fully at fault, depending on the specs they were given to work with and such.
Not Obamacare and me, but it is Obamacare and our family...
My sister in law is 49, and has 4 kids, all grown. She is a school cafeteria employee, and while she made a little to much to qualify for medicaid, she did not make enough to pay for the $300/month health insurance the school offered to their part time employees. At least she didn't think she could afford it, and mostly I believe her.
So a week before Christmas, she has what appeared to be a stroke. Collapsed, was taken to the hospital. Turns out it was actually a seizure, and a brain scan revealed a ping-pong ball sized tumor.
Once her doctors at the ER found out she was a smoker from the age of 16, they did a full body MRI, and the result was what we all had feared: stage 3 lung cancer that had metastasized to her brain.
She was originally in a Buffalo local, general type hospital but asked to be transferred to Roswell, which is a regional cancer center, and very, very good.
She had successful neurosurgery to remove the tumor on last Friday. Now she has to see a pulmonologist to figure out how to treat the lung cancer (due to the lesions location, it is almost certainly inoperable). We have not yet heard about what specific type of cancer it is (biopsy results are either not back or have been released).
What is interesting about all this from a health care/system perspective is that she has no insurance of any kind right now. Yet she was still immediately taken in at Roswell, and they scheduled semi-emergency neurosurgery, which I suspect is not cheap, while knowing that she had no real way to pay for it. She is going to meet with the cancer centers financial specialists this week, and I am sure they will get her set up with whatever assistance the state can provide and such.
But obviously her course of treatment is going to cost...well, a lot of money. I am sure the bill already is into six figures. I have no idea how this will or can be paid for.
So far her outcome, given the circumstances, has been pretty good. They think they got all the cancerous cells out of her brain, and the surgeon said the tumor was well contained.
That sucks Berkut. Good luck to your sister.
Kimmel's take on obamacare.
http://cnsnews.com/video/cnsnews/jimmy-kimmel-savages-obamacare-and-uninformed-young-people-who-support-it
Quote from: 11B4V on January 18, 2014, 08:54:37 PM
Kimmel's take on obamacare.
http://cnsnews.com/video/cnsnews/jimmy-kimmel-savages-obamacare-and-uninformed-young-people-who-support-it
It was a lot funnier when all the white people just bitched about having to pay for all teh blacks and teh poors and teh immigrants that stiffed society with their unpaid hospital ER visits instead.
You know, like you did before Obama stole the GOP's idea and turned it into the Most Evil Legislation Ever Invented(tm).
Berkut, tough news and at 49 she's still so young. Best of luck to your sister-in-law in fighting that disease.
Best of luck to your sister in law and your family, Berkut. This stuff is tough for everybody involved.
:(
Best wishes for your family Berkut. :console:
Thanks everyone. Things seem to be going about as well as can be hoped.
I am still wondering how all this gets paid for though...hence the point of sharing it in this particular thread.
She is getting treatment at one of the best cancer facilities in the area. Will there come some point where she may benefit from some treatment, but it is not available since she does not have insurance?
Hell, is she potentially actually better off for NOT having insurance, since the state will end up picking it up and it is likely or at least possible that the state will cover more than a traditional private insurer would?
Quote from: Berkut on January 11, 2014, 02:33:05 AM
Not Obamacare and me, but it is Obamacare and our family...
My sister in law is 49, and has 4 kids, all grown. She is a school cafeteria employee, and while she made a little to much to qualify for medicaid, she did not make enough to pay for the $300/month health insurance the school offered to their part time employees. At least she didn't think she could afford it, and mostly I believe her.
So a week before Christmas, she has what appeared to be a stroke. Collapsed, was taken to the hospital. Turns out it was actually a seizure, and a brain scan revealed a ping-pong ball sized tumor.
Once her doctors at the ER found out she was a smoker from the age of 16, they did a full body MRI, and the result was what we all had feared: stage 3 lung cancer that had metastasized to her brain.
She was originally in a Buffalo local, general type hospital but asked to be transferred to Roswell, which is a regional cancer center, and very, very good.
She had successful neurosurgery to remove the tumor on last Friday. Now she has to see a pulmonologist to figure out how to treat the lung cancer (due to the lesions location, it is almost certainly inoperable). We have not yet heard about what specific type of cancer it is (biopsy results are either not back or have been released).
What is interesting about all this from a health care/system perspective is that she has no insurance of any kind right now. Yet she was still immediately taken in at Roswell, and they scheduled semi-emergency neurosurgery, which I suspect is not cheap, while knowing that she had no real way to pay for it. She is going to meet with the cancer centers financial specialists this week, and I am sure they will get her set up with whatever assistance the state can provide and such.
But obviously her course of treatment is going to cost...well, a lot of money. I am sure the bill already is into six figures. I have no idea how this will or can be paid for.
So far her outcome, given the circumstances, has been pretty good. They think they got all the cancerous cells out of her brain, and the surgeon said the tumor was well contained.
She's likely getting immediate care via EMTALA (http://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act), America's unofficial single payer for the non-payers. If you have no insurance/no ability to pay, have an an emergency condition, and the hospital accepts ANY Medicare/Medicaid dollars, then they have to write her off as a loss.
She will probably qualify for Medicaid pretty soon via disability even if she made more than 133% of the poverty level for New York. Seizure disorder, brain tumor, lung cancer... I'd think that's a hard one to turn down.
I finally got my Medicaid card in the mail.
It's not even plastic. :mad:
You get those monthly paper ones?
I don't know if it's monthly, doesn't have a date on it other than my birth year. Laminated that bitch with my niece's Fisher-Price laminating machine, though.
Ohio, for some reason, sends its Medicaid peeps a paper card each month. Seems like a waste of postage.
Probably to make sure they always have one, since it's probably a right bitch to try to get a replacement.
I really want a WIC card, but alas. :mad: ALL THAT DISCOUNTED MILK
I'll send you a kid.
:lol:
First thing I'm going to do with it, I'm going to get me some methadone down at the clinic. First round's on derfetus.
Quote from: CountDeMoney on January 20, 2014, 08:41:40 PM
First thing I'm going to do with it, I'm going to get me some methadone down at the clinic. First round's on derfetus.
See you there, bruzz.
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Oooh, it still comes in cherry!
Public Sector Cuts Part-Time Shifts to Duck Insurance Law
'Cities, counties, public schools and community colleges around the country have limited or reduced the work hours of part-time employees to avoid having to provide them with health insurance under the Affordable Care Act.
...
Among those whose hours have been restricted in recent months are police dispatchers, prison guards, substitute teachers, bus drivers, athletic coaches, school custodians, cafeteria workers and part-time professors.
Mark D. Benigni, the superintendent of schools in Meriden, Connecticut, and a board member of the American Association of School Administrators, said in an interview that the new health care law was having “unintended consequences for school systems across the nation.”
http://www.nytimes.com/2014/02/21/us/public-sector-cuts-part-time-shifts-to-duck-insurance-law.html
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The Lyndon LaRouche fanboys are on campus today with ObamaHitler signs calling on us to impeach him. Man how come everybody we elect turns out to be Hitler? We are on a bad streak.
Quote from: Phillip V on February 20, 2014, 05:32:59 PM
Public Sector Cuts Part-Time Shifts to Duck Insurance Law
'Cities, counties, public schools and community colleges around the country have limited or reduced the work hours of part-time employees to avoid having to provide them with health insurance under the Affordable Care Act.
...
Among those whose hours have been restricted in recent months are police dispatchers, prison guards, substitute teachers, bus drivers, athletic coaches, school custodians, cafeteria workers and part-time professors.
Mark D. Benigni, the superintendent of schools in Meriden, Connecticut, and a board member of the American Association of School Administrators, said in an interview that the new health care law was having "unintended consequences for school systems across the nation."
http://www.nytimes.com/2014/02/21/us/public-sector-cuts-part-time-shifts-to-duck-insurance-law.html
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Damn those greedy corporations and their share-- oh, wait...
Quote"Are we supposed to lay off full-time teachers so that we can provide insurance coverage to part-time employees?" Mr. Benigni asked.
It's a child, not a choice.
Quote from: Valmy on February 20, 2014, 05:53:44 PM
Man how come everybody we elect turns out to be Hitler? We are on a bad streak.
Isn't that always the ultimate results of "democracy"?
Quote from: Valmy on February 20, 2014, 05:53:44 PM
The Lyndon LaRouche fanboys are on campus today with ObamaHitler signs calling on us to impeach him. Man how come everybody we elect turns out to be Hitler? We are on a bad streak.
And we still haven't gotten lebensraum; our Hitlers are just cheap imposters. :(
There was a gun show a couple weeks ago at the civic center here. As usual it was packed and as usual there were political fanatics in the parking lot. This time they had "Impeach Obama! Stop World War III!" placards. I'm still puzzled as to how making Biden president would make World War III less likely. He seems like he'd be willing to use nukes to keep kids off his lawn, given the opportunity.
Quote from: Savonarola on February 21, 2014, 03:11:53 PM
There was a gun show a couple weeks ago at the civic center here. As usual it was packed and as usual there were political fanatics in the parking lot. This time they had "Impeach Obama! Stop World War III!" placards. I'm still puzzled as to how making Biden president would make World War III less likely. He seems like he'd be willing to use nukes to keep kids off his lawn, given the opportunity.
Oh, it gets worse when you go inside.
Quote from: derspiess on February 21, 2014, 03:27:09 PM
Oh, it gets worse when you go inside.
I once met Randy Weaver at one.
Quote from: MadImmortalMan on February 21, 2014, 03:32:08 PM
Quote from: derspiess on February 21, 2014, 03:27:09 PM
Oh, it gets worse when you go inside.
I once met Randy Weaver at one.
I walked by his table, briefly made eye contact and kept on walking. Very creepy encounter.
Aryan nations types are creepy.
Quote from: Razgovory on February 21, 2014, 03:46:04 PM
Aryan nations types are creepy.
Yeah. Not sure he was totally one of them, though. But we've had that discussion before :sleep:
I saw this today, and I thought it might be of interest to Languish. It is just one person's experience with ACA, but it does show kind of the breakdown in costs for a relatively healthy person and how that will (and will not) affect their yearly costs.
QuoteMy Obamacare nightmare, concluded (http://economixcomix.com/2014/02/25/my-obamacare-nightmare-concluded/)
I posted a while back about my experience with Obamacare. To recap:
I was informed that my existing insurance plan (for which I was paying $7100 per year) would no longer operate;
I was offered other plans that looked to be better value for money.
I ended that post with:
So yes, Obamacare is a freaking Rube Goldberg machine, and single-payer would be simpler, more just, and cheaper. But at least in New York, at least for people like me, *it has nearly halved premiums.*
That ain't nothing.
But at that point I hadn't actually enrolled in a plan. Now I have. Here's what happened.
The plan I finally enrolled in, which was offered on the New York health exchange website, costs less than $3700 per year. That's almost exactly half of the premium I was paying. For me, Obamacare hasn't nearly halved premiums; it has halved them.
For that, I get a plan with a high deductible and, once that high deductible is met, a high copay. The plan just plain doesn't pay as much as my last plan did. So if I have, say, $8,000 in expenses in a year, I might wind up paying $5,500 of that, instead of maybe $1,600 with my old plan.
That sounds pretty bad. But there are two things mitigating that.
First off, preventive care–which is all I generally need anyway–is free (or maybe three visits are free. I'm not 100% clear here).
Much more important: Like all plans offered in all states through these exchanges, there's an out-of-pocket limit; this year it's $6350 for an individual.
That's right–I can't pay more than $6350, plus premiums, in a year (for covered charges; if a charge isn't covered at all, I'm on the hook for it, but all plans need to have broad coverage, by law).
So yes, if I have $8,000 in expenses, I'll have to pay more with my current plan. But if I have $80,000 in expenses, I'll pay $6350, rather than maybe $16,000. If I have $800,000 in expenses, I'll pay $6350 instead of $160,000.
For me, that's much better than my old plan. I wasn't paying $7100 per year in order to keep my medical costs down in ordinary years–I was paying it in case something really really bad happened that would otherwise ruin me. This plan actually protects me better (oh, and like all Obamacare plans, there's no annual or lifetime limit on benefits either).
And the extra I'll have to pay in years when my medical expenses are substantial but not ruinous? That can come out of the $3500 per year I'm saving in premiums.
Now: There are some caveats here.
One is that I live in New York, and New York is a special case. Essentially, New York made it illegal for insurers to exclude sick people (or to charge them so much that they were just pre-paying their medical expenses). BUT, this meant that they had to raise premiums on everyone else in order to cover those sick people, which meant that some young healthy people decided to drop their expensive insurance, which worsened the risk pool, leading to higher premiums, so more healthy people dropped insurance, and so on. This is called the "adverse selection death spiral," and New York was in the middle of one when Obamacare came along. By getting more people back into the risk pool, Obamacare seems to have broken that spiral, at least for now.
In other words, in New York Obamacare replaced poorly-thought-out regulation with better regulation. States that didn't have poorly-thought-out regulation to begin with will have different experiences. Although those states had other problems that Obamacare solves, like plans that excluded sick people or arbitrarily dropped them.
The other caveat is that my new plan has a narrow network, and my doctor isn't on it. But that's fine–I was never all that fond of my doctor. Still, that's exactly what Obama categorically said wouldn't happen, so score one for the critics there.
Of course, that sort of thing happened before Obamacare as well; I really liked my *previous* doctor, but I had to drop him when I originally enrolled in the plan I just switched from, and that was in the 1990s.
QuoteSo yes, if I have $8,000 in expenses, I'll have to pay more with my current plan. But if I have $80,000 in expenses, I'll pay $6350, rather than maybe $16,000. If I have $800,000 in expenses, I'll pay $6350 instead of $160,000.
This here is the problem when populism crosses Obamacare. The vast majority of people have less than $8,000 in medical expenses, so a significant number of them are seeing their overall care bills increase, and in many cases their premiums as well. The people who are truly crushed by medical expenses appear as just a handful of anecdotes in comparison. If the Democrats, Obama in particular, had not been so forceful with the bullshit that nothing would change for the vast majority and with trumpeting the "affordable" part of the bill, that populist argument would probably not work as well.
I would be very frustrated if I had to live with this
Quote from: Baron von Schtinkenbutt on February 25, 2014, 05:16:31 PM
QuoteSo yes, if I have $8,000 in expenses, I'll have to pay more with my current plan. But if I have $80,000 in expenses, I'll pay $6350, rather than maybe $16,000. If I have $800,000 in expenses, I'll pay $6350 instead of $160,000.
This here is the problem when populism crosses Obamacare. The vast majority of people have less than $8,000 in medical expenses, so a significant number of them are seeing their overall care bills increase, and in many cases their premiums as well. The people who are truly crushed by medical expenses appear as just a handful of anecdotes in comparison.
You think these people that have less than $8,000 in medical expenses would rather be in the kind of situation where they have more than $8.000? You want to deal with increased premiums as a healthy person, or would you rather be dealing with a colostomy and shitting in a sandwich baggie every day?
Healthy people bitching about their premiums really have nothing to bitch about. People with leukemia, now they have a gripe.
That's not the decision tree most people were confronting prior to Obamacare.
Tough shit. Time for everybody to jump on the team and come on in for the big win.
Seedy = Maduro
Quote from: Admiral Yi on February 25, 2014, 09:31:49 PM
That's not the decision tree most people were confronting prior to Obamacare.
I'm not sure I follow... seems to me that the logic in Meri's post is pretty sound.
Quote from: Jacob on February 25, 2014, 11:35:51 PM
I'm not sure I follow... seems to me that the logic in Meri's post is pretty sound.
My post was a reponse to Seedy's about preferring to pay $8,000 a year over shitting in a colostomy bag.
Quote from: derspiess on February 25, 2014, 09:54:58 PM
Seedy = Maduro
Because Venezuela is the only country into the world with universal health care.
Quote from: The Minsky Moment on February 26, 2014, 10:25:46 AM
Quote from: derspiess on February 25, 2014, 09:54:58 PM
Seedy = Maduro
Because Venezuela is the only country into the world with universal health care.
For somebody who places such a premium on feoteuosues, derspiess doesn't give a shit about their health.
Then again, maybe it's just certain feoteosuesoes, dependent on class and color.
Quote from: derspiess on February 25, 2014, 09:54:58 PM
Seedy = Maduro
:lol: You gotta give yourself some leeway DerFachist for the real socialist around here.
Quote from: The Minsky Moment on February 26, 2014, 10:25:46 AM
Quote from: derspiess on February 25, 2014, 09:54:58 PM
Seedy = Maduro
Because Venezuela is the only country into the world with universal health care.
No, just stating similarities between both guys. Seedy wants to be Castro, but sadly he's just a Maduro.
And derspiess wants to be Todd Akin. Oh wait, he already is.
Quote from: CountDeMoney on February 26, 2014, 10:41:57 AM
And derspiess wants to be Todd Akin. Oh wait, he already is.
Incorrect.
Der, you have an aversion for Obamacare. Do you have aversion for a real universal healthcare system?
Quote from: Grey Fox on February 26, 2014, 10:49:33 AM
Der, you have an aversion for Obamacare. Do you have aversion for a real universal healthcare system?
If you're talking about socialized healthcare, then yes. But even that would be a more efficient/workable system than Obamacare.
Quote from: derspiess on February 26, 2014, 10:54:21 AM
Quote from: Grey Fox on February 26, 2014, 10:49:33 AM
Der, you have an aversion for Obamacare. Do you have aversion for a real universal healthcare system?
If you're talking about socialized healthcare, then yes. But even that would be a more efficient/workable system than Obamacare.
Yes, your previous system is stupid, Obamacare is still stupid, there has been no improvement.
Why are you averse to a real universal healthcare system?
Quote from: derspiess on February 26, 2014, 10:44:47 AM
Quote from: CountDeMoney on February 26, 2014, 10:41:57 AM
And derspiess wants to be Todd Akin. Oh wait, he already is.
Incorrect.
Save it for your "traditional gender roles", babyfucker.
Quote from: derspiess on February 26, 2014, 10:54:21 AM
If you're talking about socialized healthcare, then yes. But even that would be a more efficient/workable system than Obamacare.
Obamacare like moved the goalposts one yard. It is only marginally less efficient and workable as it was before. So what is the alternative?
Quote from: Valmy on February 26, 2014, 11:25:27 AM
Obamacare like moved the goalposts one yard. It is only marginally less efficient and workable as it was before.
It's a lot more expensive and intrusive than it was before.
QuoteSo what is the alternative?
You wouldn't like it.
Quote from: derspiess on February 26, 2014, 11:28:44 AM
You wouldn't like it.
I will like whatever works. Well ok within reason, I suppose we can always just kill all humans.
QuoteIt's a lot more expensive and intrusive than it was before.
No it is not. It is incrementally more expensive and intrusive, and it was going that direction anyway.
Quote from: Valmy on February 26, 2014, 11:25:27 AM
Obamacare like moved the goalposts one yard. It is only marginally less efficient and workable as it was before. So what is the alternative?
Obamacare was never about efficiency, it was about "fairness" and compassion for those with bad luck. It's a very Rawlsian policy.
Massachusetts had a decent State run healthcare process, though it was getting extremely costly. The State could have, or should have, been able to get a waiver on implementing the ACA into the MA plan and website, but the Governor didn't push for it. Now the State website, which was built by the same company CGI that did the Federal site, is broken, a mess, lots of issues. No idea how much that all affects what was once a reasonably smooth running plan beyond the website. The MA plan wasn't great but seemed to do a good job, but as I said turned out being a lot more expensive than the initial plan, as more stuff was added.
Quote from: Valmy on February 26, 2014, 11:29:35 AM
Quote from: derspiess on February 26, 2014, 11:28:44 AM
You wouldn't like it.
I will like whatever works. Well ok within reason, I suppose we can always just kill all humans.
In very vague terms, here's SpiessCare:
Expand Medicare to provide bare-bones health coverage to the poors (I know Obamacare sort of does this). Encourage HSA participation, deregulate the hell out of private health insurance. Eliminate the individual mandate but make it difficult to get treatment unless you have health insurance or cash.
:hmm:
Quote from: derspiess on February 26, 2014, 11:44:04 AM
In very vague terms, here's SpiessCare:
Expand Medicare to provide bare-bones health coverage to the poors (I know Obamacare sort of does this). Encourage HSA participation, deregulate the hell out of private health insurance. Eliminate the individual mandate but make it difficult to get treatment unless you have health insurance or cash.
:blink:
I work for a health insurance company and I disagree with the bolded bit.
Quote from: merithyn on February 26, 2014, 11:53:56 AM
:blink:
I work for a health insurance company and I disagree with the bolded bit.
I'm sure you do.
Quote from: derspiess on February 26, 2014, 11:44:04 AM
Quote from: Valmy on February 26, 2014, 11:29:35 AM
Quote from: derspiess on February 26, 2014, 11:28:44 AM
You wouldn't like it.
I will like whatever works. Well ok within reason, I suppose we can always just kill all humans.
In very vague terms, here's SpiessCare:
Expand Medicare to provide bare-bones health coverage to the poors (I know Obamacare sort of does this). Encourage HSA participation, deregulate the hell out of private health insurance. Eliminate the individual mandate but make it difficult to get treatment unless you have health insurance or cash.
That doesn't really sound like it's going to work unless you really get serious about allowing people to die from lack of treatment.
Health care is one of those really tough public policy issues. Obamacare is flawed, but single payer has some serious flaws as well. I don't know if anyone has figured out a really good system that provides good care and keeps costs under control as well.
Quote from: derspiess on February 26, 2014, 11:44:04 AM
In very vague terms, here's SpiessCare:
Expand Medicare to provide bare-bones health coverage to the poors (I know Obamacare sort of does this). Encourage HSA participation, deregulate the hell out of private health insurance. Eliminate the individual mandate but make it difficult to get treatment unless you have health insurance or cash.
Man I don't know how they can encourage HSA's anymore than they already do. Those things are pretty sweet.
This would definitely get the costs under control I just question its political viability. The problem has always been: what happens when Bob McPennyless shows up in the emergency room suffering from a heart attack or something? The problem is the answer of 'tough cookies buddy' just doesn't seem to fly and that undermines most non-Commie solutions.
Quote from: derspiess on February 26, 2014, 11:54:48 AM
Quote from: merithyn on February 26, 2014, 11:53:56 AM
:blink:
I work for a health insurance company and I disagree with the bolded bit.
I'm sure you do.
Well yeah it is an industry that profits from NOT providing services. That can provide some pretty perverse outcomes.
I suppose the hospital could have some little bit of leeway to save Bob's life in that scenario.
Quote from: derspiess on February 26, 2014, 12:05:36 PM
I suppose the hospital could have some little bit of leeway to save Bob's life in that scenario.
Well, here you go. Now you're successfully back to square one.
The derspiess plan sounds like plenty of people will die from preventable causes and lots of issues will go un- or under-treated. The combination of deregulation (meaning people can be excluded from plans and the ignorant can be taken advantage of) and making it harder to get treatment unless yourbplan allows it or you have ready cash will lead to fewer people getting the healthcare they need.
Quote from: DGuller on February 26, 2014, 12:08:08 PM
Quote from: derspiess on February 26, 2014, 12:05:36 PM
I suppose the hospital could have some little bit of leeway to save Bob's life in that scenario.
Well, here you go. Now you're successfully back to square one.
I said make it difficult, not impossible.
Quote from: derspiess on February 26, 2014, 12:11:05 PM
Quote from: DGuller on February 26, 2014, 12:08:08 PM
Quote from: derspiess on February 26, 2014, 12:05:36 PM
I suppose the hospital could have some little bit of leeway to save Bob's life in that scenario.
Well, here you go. Now you're successfully back to square one.
I said make it difficult, not impossible.
From a systems point of view difficult simply means 2 in 10 will get what they need, while impossible means 0 in 10 will.
Quote from: Jacob on February 26, 2014, 12:10:22 PM
The derspiess plan sounds like plenty of people will die from preventable causes and lots of issues will go un- or under-treated. The combination of deregulation (meaning people can be excluded from plans and the ignorant can be taken advantage of) will lead to fewer people getting the healthcare they need.
But you understand what concern he has though - that under current systems people have fewer incentives to actually take care of their own health. You can be a smoker for 40 years, never have insurance, then be diagnosed with throat cancer and be guaranteed treatment.
Quote from: Jacob on February 26, 2014, 12:10:22 PM
The derspiess plan sounds like plenty of people will die from preventable causes and lots of issues will go un- or under-treated.
To be fair this is already a big problem. Dealing with doing any sort of medical thing, with all the bureaucracy and expense and nonsense, is something we all tend to avoid as much as we can.
Quote from: Jacob on February 26, 2014, 12:10:22 PM
The derspiess plan sounds like plenty of people will die from preventable causes and lots of issues will go un- or under-treated. The combination of deregulation (meaning people can be excluded from plans and the ignorant can be taken advantage of) and making it harder to get treatment unless yourbplan allows it or you have ready cash will lead to fewer people getting the healthcare they need.
Once as a society you decide that everybody should have healthcare, honestly a universal system is the best. Most countries in Europe (dunno about Canada, but I suspect it will happen there too), provide universal healthcare for a similar % of GNP (or even less) than the US devotes to their very limited public healthcare programs (pre-ACA).
Quote from: Barrister on February 26, 2014, 12:13:07 PM
Quote from: Jacob on February 26, 2014, 12:10:22 PM
The derspiess plan sounds like plenty of people will die from preventable causes and lots of issues will go un- or under-treated. The combination of deregulation (meaning people can be excluded from plans and the ignorant can be taken advantage of) will lead to fewer people getting the healthcare they need.
But you understand what concern he has though - that under current systems people have fewer incentives to actually take care of their own health. You can be a smoker for 40 years, never have insurance, then be diagnosed with throat cancer and be guaranteed treatment.
I think not dying of cancer is a fine incentive.
Quote from: Barrister on February 26, 2014, 12:13:07 PM
Quote from: Jacob on February 26, 2014, 12:10:22 PM
The derspiess plan sounds like plenty of people will die from preventable causes and lots of issues will go un- or under-treated. The combination of deregulation (meaning people can be excluded from plans and the ignorant can be taken advantage of) will lead to fewer people getting the healthcare they need.
But you understand what concern he has though - that under current systems people have fewer incentives to actually take care of their own health. You can be a smoker for 40 years, never have insurance, then be diagnosed with throat cancer and be guaranteed treatment.
So the desired outcome is that someone who has smoked for 40 years and has treatable throat cancer should be denied treatment if they don't have insurance?
Quote from: Jacob on February 26, 2014, 12:19:45 PM
So the desired outcome is that someone who has smoked for 40 years and has treatable throat cancer should be denied treatment if they don't have insurance?
The desired outcome is that treatment costs an insignificant amount so it is not anybody's business. We sort of have the opposite problem.
Quote from: Barrister on February 26, 2014, 12:13:07 PM
Quote from: Jacob on February 26, 2014, 12:10:22 PM
The derspiess plan sounds like plenty of people will die from preventable causes and lots of issues will go un- or under-treated. The combination of deregulation (meaning people can be excluded from plans and the ignorant can be taken advantage of) will lead to fewer people getting the healthcare they need.
But you understand what concern he has though - that under current systems people have fewer incentives to actually take care of their own health. You can be a smoker for 40 years, never have insurance, then be diagnosed with throat cancer and be guaranteed treatment.
:w00t: Ka-ching!
Quote from: Valmy on February 26, 2014, 12:24:11 PM
Quote from: Jacob on February 26, 2014, 12:19:45 PM
So the desired outcome is that someone who has smoked for 40 years and has treatable throat cancer should be denied treatment if they don't have insurance?
The desired outcome is that treatment costs an insignificant amount so it is not anybody's business. We sort of have the opposite problem.
Um, no. That's not the desired outcome, because then you have all the problems Canada has.
Our out-of-pocket expense for most health care is zero. But of course health care resources are limited. What it leads to is waiting lists. You need to see a doctor? Well you can go to a walk in clinic and wait for 4 hours, or they can schedule you an appointment for three months from now. You need an MRI for a serious but not life threatening condition? How does January 2015 work for you?
Quote from: celedhring on February 26, 2014, 12:18:17 PM
Once as a society you decide that everybody should have healthcare, honestly a universal system is the best. Most countries in Europe (dunno about Canada, but I suspect it will happen there too), provide universal healthcare for a similar % of GNP (or even less) than the US devotes to their very limited public healthcare programs (pre-ACA).
There are other factors that push up the cost of health care in the US apart from the insurance system, such as the cost of doctor training, the cost of patented medication, and malpractice insurance.
Quote from: celedhring on February 26, 2014, 12:18:17 PM
Quote from: Jacob on February 26, 2014, 12:10:22 PM
The derspiess plan sounds like plenty of people will die from preventable causes and lots of issues will go un- or under-treated. The combination of deregulation (meaning people can be excluded from plans and the ignorant can be taken advantage of) and making it harder to get treatment unless yourbplan allows it or you have ready cash will lead to fewer people getting the healthcare they need.
Once as a society you decide that everybody should have healthcare, honestly a universal system is the best. Most countries in Europe (dunno about Canada, but I suspect it will happen there too), provide universal healthcare for a similar % of GNP (or even less) than the US devotes to their very limited public healthcare programs (pre-ACA).
I don't think that's right. Western Europe and Canada spend about the same, or a little bit less, of our total GDP on health care as does the US. But that includes US public and private spending on health care.
In 2012 the US governments spent 19% of it's total budgets on healthcare.
In 2012 Canadian provinces spent 44.3% of it's budgets on healthcare.
In absolute number, it's consistent with the US having 10 times more population than Canada.
Quote from: Barrister on February 26, 2014, 12:37:42 PM
Quote from: celedhring on February 26, 2014, 12:18:17 PM
Quote from: Jacob on February 26, 2014, 12:10:22 PM
The derspiess plan sounds like plenty of people will die from preventable causes and lots of issues will go un- or under-treated. The combination of deregulation (meaning people can be excluded from plans and the ignorant can be taken advantage of) and making it harder to get treatment unless yourbplan allows it or you have ready cash will lead to fewer people getting the healthcare they need.
Once as a society you decide that everybody should have healthcare, honestly a universal system is the best. Most countries in Europe (dunno about Canada, but I suspect it will happen there too), provide universal healthcare for a similar % of GNP (or even less) than the US devotes to their very limited public healthcare programs (pre-ACA).
I don't think that's right. Western Europe and Canada spend about the same, or a little bit less, of our total GDP on health care as does the US. But that includes US public and private spending on health care.
Just rechecked, and I'm right. I haven't found a nice graph online for compared public budgets so I have crossed these two tables:
http://data.worldbank.org/indicator/SH.XPD.PUBL
For the total of health care spending as % of GNP
http://data.worldbank.org/indicator/SH.XPD.PUBL
For the weight of the public sector in health care spending.
So, doing a little math (results rounded to the nearest decimal)
US spends 17,9*45,9= 8,2% on public healthcare.
UK spends 9,3*82,7=7,7%
Canada spends 11,2*70,4= 7,9%
Spain spends 9,4*73,6 = 6,9%
Thing is the spending levels in the US are just absurd, and I don't think they yield better overall care than in most Western nations. Whatever the reason, the system is completely broken.
Quote from: Barrister on February 26, 2014, 12:37:42 PM
I don't think that's right. Western Europe and Canada spend about the same, or a little bit less, of our total GDP on health care as does the US. But that includes US public and private spending on health care.
It's unbelievable but correct. The government in America spends more on healthcare than the European average and certainly more than the NHS.
Quote from: Barrister on February 26, 2014, 12:30:05 PM
Our out-of-pocket expense for most health care is zero. But of course health care resources are limited. What it leads to is waiting lists. You need to see a doctor? Well you can go to a walk in clinic and wait for 4 hours, or they can schedule you an appointment for three months from now. You need an MRI for a serious but not life threatening condition? How does January 2015 work for you?
If you want to make a point you should try not to bend the facts to fit your argument so much that you venture into fantasy. If I picked up my phone now I would have an appointment with my doctor within the next 24 hours. Of course it might be that the medical system in Alberta is really messed up and I should cut you some slack.
When my lung issue was originally diagnosed they had an operating room wating for me depending on what the scan showed. If it was cancerous growth - as was first feared - they were going to wheel me directly from the scan to the operating room - this was 48 hours after I first saw a doctor about my symptoms. Thankfully it wasnt that and I saw another specialist 48 hours after the scan. In total, within one week I had full access.
When someone in my office was diagnosed with cancer she began her treatment within 24 hours. Her treatment continues to be prompt.
Please stick to facts when making your argument. Where we do have significant wait lists are for things that are more chronic in nature. Hip replacements for the elderly seem to top the lists most of the time. Now it would be nice to have those wait times reduced, and here in BC we have made some significant progress in that regard.
BC doctors are awesome.
Here it averages 3 days if you have a family doctor. Getting to see specialists is the hard part.
Maybe all the doctors and nurses in Alberta left to work in the tar sands.
Quote from: Admiral Yi on February 26, 2014, 12:33:09 PM
Quote from: celedhring on February 26, 2014, 12:18:17 PM
Once as a society you decide that everybody should have healthcare, honestly a universal system is the best. Most countries in Europe (dunno about Canada, but I suspect it will happen there too), provide universal healthcare for a similar % of GNP (or even less) than the US devotes to their very limited public healthcare programs (pre-ACA).
There are other factors that push up the cost of health care in the US apart from the insurance system, such as the cost of doctor training, the cost of patented medication, and malpractice insurance.
Well we do train our doctors too, at least I hope we do, and usage of patented meds is similar in Europe and in the US. Malpractice suits do happen over here too, although at least in Spain it is true that legislation is more restrictive on that regard than in the US.
The problem here is that the US misses out on all the massive savings of running your own hospital network and buying your meds from such a powerful bargaining position, and instead pays private hospitals to take care of patients, with all the accompanying increased costs. Now, the Federal or state governments aren't going to build their own hospital network anytime soon - that ship might have sailed for the US - but the current system is clearly not working.
Tons of counties have their own hospitals. I wonder how hard it would be for them to form some sort of buying alliance. Maybe they already did, I dunno.
Also even in the US medical malpractice accounts for 2.5% of health care expenditure. It's nothing.
Quote from: MadImmortalMan on February 26, 2014, 02:04:31 PM
Tons of counties have their own hospitals. I wonder how hard it would be for them to form some sort of buying alliance. Maybe they already did, I dunno.
There are two aspects to the "bargaining power" concept. One is economies of scale, which you're alluding to. The other aspect, the one that proponents of nationalized health care tend not to focus on, is the option to decline to provide a medication if the perceived cost/benefit is not favorable. Bargaining power does not mean the power to impose a price on a seller.
Quote from: Sheilbh on February 26, 2014, 02:04:42 PM
Also even in the US medical malpractice accounts for 2.5% of health care expenditure. It's nothing.
Malpractice insurance?
Docs are spending more than a hundred grand a year in premiums in many places, so the insurance has to be more significant than that.
Quote from: Admiral Yi on February 26, 2014, 02:09:34 PM
There are two aspects to the "bargaining power" concept. One is economies of scale, which you're alluding to. The other aspect, the one that proponents of nationalized health care tend not to focus on, is the option to decline to provide a medication if the perceived cost/benefit is not favorable. Bargaining power does not mean the power to impose a price on a seller.
Isn't that side just about drugs though? One of the major issues in the US is the cost of hospital treatments and visits to doctors:
http://hushp.harvard.edu/sites/default/files/downloadable_files/IFHP%202012%20Comparative%20Price%20Report.pdf
In the UK GPs for example are normally independent contractors, but the price they are allowed to charge the NHS is set by the government. And the NHS does set prices for primary care suppliers (hospitals and doctors) as part of a sort-of internal market:
http://www.monitor.gov.uk/nt
Also I think anyone would say that state provided care should have no limits on cost. There has to be cost/benefit analysis, it's no different than any other part of government.
Edit: Except for Nye Bevan and he lost that argument - though he was probably right on the facts.
Quote from: MadImmortalMan on February 26, 2014, 02:22:06 PM
Quote from: Sheilbh on February 26, 2014, 02:04:42 PM
Also even in the US medical malpractice accounts for 2.5% of health care expenditure. It's nothing.
Malpractice insurance?
Docs are spending more than a hundred grand a year in premiums in many places, so the insurance has to be more significant than that.
It includes malpractice insurance:
http://www.hsph.harvard.edu/news/press-releases/medical-liability-costs-us/
Wow. I guess if things were reasonable, then it would be an outrageous cost. But with things the way they are it's just one of many factors.
It's a big enough cost, but I think it's like the preventative care of the right. So it achieves this vast, almost silver bullet and entirely erroneous enormity.
Quote from: Grey Fox on February 26, 2014, 01:31:59 PM
BC doctors are awesome.
Here it averages 3 days if you have a family doctor. Getting to see specialists is the hard part.
Three days is a lot better than the three months BB suggested.
In Quebec, if you had a serious acute problem like cancer or a matter that required immediate surgery is there really an issue with waiting times? It seems to me our system is very good at dealing with things that are urgent. Where we get the waits is for things that can wait.
Quote from: crazy canuck on February 26, 2014, 02:54:37 PM
Quote from: Grey Fox on February 26, 2014, 01:31:59 PM
BC doctors are awesome.
Here it averages 3 days if you have a family doctor. Getting to see specialists is the hard part.
Three days is a lot better than the three months BB suggested.
In Quebec, if you had a serious acute problem like cancer or a matter that required immediate surgery is there really an issue with waiting times? It seems to me our system is very good at dealing with things that are urgent. Where we get the waits is for things that can wait.
Yes, which is, btw, what BB said too.
Quote from: Grey Fox on February 26, 2014, 02:56:23 PM
Yes, which is, btw, what BB said too.
It depends on what one considers "serious" I suppose. I had a serious but not "life threatening condition" and got immediate care.
The main problem with waiting lists is access to the first test/specialist visit in cases were time is an issue (eg. cancer). If your family physician does not consider such tests/visits urgent you might end up losing precious months.
In Spain - at least - there's an easy way out of this. The private sector can and does offer what the public cannot: comfort (single hospital rooms, etc) and prompt care for all circumstances (not just urgent cases). And they have to be aggressively competitive in price since their main rival costs nothing beyond taxes that you have to pay anyway.
Quote from: Iormlund on February 26, 2014, 06:27:33 PM
The main problem with waiting lists is access to the first test/specialist visit in cases were time is an issue (eg. cancer). If your family physician does not consider such tests/visits urgent you might end up losing precious months.
In Spain - at least - there's an easy way out of this. The private sector can and does offer what the public cannot: comfort (single hospital rooms, etc) and prompt care for all circumstances (not just urgent cases). And they have to be aggressively competitive in price since their main rival costs nothing beyond taxes that you have to pay anyway.
We have the same option.
Obama Gives Health Plans Added 2-Year Reprieve
'The action helps Democrats in tight midterm election races, because it avoids the cancellation of insurance policies at the height of the political campaign season.'
http://www.nytimes.com/2014/03/06/us/politics/obama-extends-renewal-period-for-noncompliant-insurance-policies.html
(https://languish.org/forums/proxy.php?request=http%3A%2F%2Fs.wsj.net%2Fpublic%2Fresources%2Fimages%2FBN-BU112_expert_C_20140305105434.jpg&hash=73d1bc78398832b55f641f11f2c0bf79de0774d8)
Quote from: Phillip V on March 05, 2014, 05:21:03 PM
Obama Gives Health Plans Added 2-Year Reprieve
'The action helps Democrats in tight midterm election races, because it avoids the cancellation of insurance policies at the height of the political campaign season.'
http://www.nytimes.com/2014/03/06/us/politics/obama-extends-renewal-period-for-noncompliant-insurance-policies.html
(https://languish.org/forums/proxy.php?request=http%3A%2F%2Fs.wsj.net%2Fpublic%2Fresources%2Fimages%2FBN-BU112_expert_C_20140305105434.jpg&hash=73d1bc78398832b55f641f11f2c0bf79de0774d8)
:lmfao:
What a mess. :(
The administration announced that the March 31 deadline won't be extended. Do all the Americans on this forum have some form of approved health insurance (or plans to get one by March 31)? Is anyone planning on taking the penalty?
Did any of us not have insurance? :unsure:
Quote from: garbon on March 12, 2014, 09:39:56 AM
Did any of us not have insurance? :unsure:
Seedy signed up. Not sure about Ide.
Hadn't Seeds been on Cobra before? (if so in my mind then not sure that counts as somewhat who hadn't had insurance)
COBRA runs out a year after getting shitcanned.
I think he did jump from COBRA to his silver or gold plan. But it was going to run out, so he would've been uninsured otherwise.
Quote from: Savonarola on March 12, 2014, 07:40:48 AM
The administration announced that the March 31 deadline won't be extended. Do all the Americans on this forum have some form of approved health insurance (or plans to get one by March 31)? Is anyone planning on taking the penalty?
I have good health insurance with my company, a health care provider. But I've been looking into new plans for myself as I'm seriously considering retiring sometime this or next year.
Quote from: garbon on March 05, 2014, 09:53:46 PM
What a mess. :(
:yes:
I'm embarrassed for my country. :blush:
Quote from: Savonarola on March 12, 2014, 07:40:48 AM
The administration announced that the March 31 deadline won't be extended. Do all the Americans on this forum have some form of approved health insurance (or plans to get one by March 31)? Is anyone planning on taking the penalty?
At this time, we have insurance. I'm looking into whether it would be cheaper to have my oldest two boys get insurance through the exchange than through me, however. They get to piggy back on my insurance until they're 26, but because they're young and healthy (other than Carter's asthma), they may get cheaper, better insurance elsewhere. With their income, they would be subsidized.
Quote from: merithyn on March 12, 2014, 11:14:58 AM
At this time, we have insurance. I'm looking into whether it would be cheaper to have my oldest two boys get insurance through the exchange than through me, however. They get to piggy back on my insurance until they're 26, but because they're young and healthy (other than Carter's asthma), they may get cheaper, better insurance elsewhere. With their income, they would be subsidized.
That's good; I don't know the specifics of your situation but I've also heard that if you claim an uninsured person as a dependent you assume their penalty (and, contrary to what's been widely reported, $95 is the minimum penalty. The actual penalty is 1% of taxable income or $95 whichever is greater.)
Here are some Cover Oregon advertisements:
Live long in Oregon:
http://www.youtube.com/watch?v=Xv2UUcXCo9g (http://www.youtube.com/watch?v=Xv2UUcXCo9g)
Fly with your own wings:
http://www.youtube.com/watch?v=SLpKDNVU9dA (http://www.youtube.com/watch?v=SLpKDNVU9dA)
Washington got Woody Guthrie songs for the Bonneville Power Administration. Oregon got these. Life is unfair in the Pacific northwest. :(
The monthly premiums of Bronze plans, the cheapest ones, in Massachusetts seem ok, though with high deductibles and copays. Most Bronze plans seem to have $2000 out of pocket per year before insurance pays, $1000 per hospital stay. So if I have that insurance I'd basically be paying for everything except if I had a hospital stay for many thousands of dollars. But that could be ok since what I most worry about is a hospital stay, given that I had nearly a week long hospital stay a year and a half ago. My insurance paid for all of that, I didn't see a bill.
I think that maybe Mass does better since the state had its own plan before the ACA kicked in, but the state didn't get a waiver from the ACA, though the Governor was urged to by legislators. I think he tried but didn't push the issue.
Then the Mass state website is apparently full of problems, huge back log, problems using the site. The same company did the state ACA changes that did the Federal site. I was able to get around ok but I didn't go so far as to sign up, didn't go too far, so it may have problems as I get further in. Another thing I worry about is the security which is said to be very poor on the Federal site. I'm hoping/thinking the Mass site is in much better shape for security since it's been up and running for years now. But the new stuff could have security holes, who knows.
Is there anything available with a higher deductible, like 5k? Does it lower the premiums significantly?
Quote from: MadImmortalMan on March 13, 2014, 11:53:57 AM
Is there anything available with a higher deductible, like 5k? Does it lower the premiums significantly?
Bronze are the lowest tier, ranging from in the three hundreds up to over 500. I didn't see anything with 5k deductibles and I would think those would be in the Bronze plans, the cheapest priced but you should pay more out of pocket.
Plans are Bronze, Silver, Gold, Platinum. I checked the Gold plans and they're two or three hundred more in monthly premiums (500 or more) and have half the yearly deductible ($1000) than the Bronze plans. Silver plans are in the middle, a bit cheaper premiums, but some still with $2000 deductibles. So I think that's about the breakdown. I could even go with a Gold or Silver plan I think. Premiums can vary a lot even within the same categories, up to a few hundred per month.
Quote from: MadImmortalMan on March 13, 2014, 11:53:57 AM
Is there anything available with a higher deductible, like 5k? Does it lower the premiums significantly?
This site (https://www.healthsherpa.com/) is good for finding basic info.
In Texas, the Bronze plans are in the $5k - $6k range. Seems to cut the premium roughly in half.
If qualified plans have 5k deductibles, it makes me wonder what in the hell those non-qualified plans were offering. :huh:
Quote from: Admiral Yi on March 13, 2014, 02:29:03 PM
If qualified plans have 5k deductibles, it makes me wonder what in the hell those non-qualified plans were offering. :huh:
Peace of mind while you're healthy? :hmm:
Quote from: DGuller on March 13, 2014, 02:33:48 PM
Peace of mind while you're healthy? :hmm:
Yeah. Insurance is supposed to kick in when there is a catastrophe. Something you don't expect to happen but want to hedge against. My car insurance doesn't pay for gas or oil changes. Most people can absorb a fairly significant one time hit if it means they can save much more in consistent planned costs.
Having to pay five grand or go into debt five grand is a small price to not have to pay the 300k your heart surgery might cost you.
It's a problem if you can't ever save up five grand because you're too busy trying to keep super-low deductibles. The opportunity cost of that is not reasonable.
How much of a deductible do you guys think you could handle without it wrecking your life? Assume you won't have to pay it more than say twice in your lifetime.
Oregon's Ardor for Health Exchange Meets Grim Reality
'The state, once one of the more ambitious in the federal health care overhaul, has among the most dysfunctional online insurance exchanges in the nation, only enrolling about 50,000 people so far.
...
In the most recent federal report, earlier this month, the state was tied at the bottom with West Virginia, with only 18 percent of eligible 18- to 34-year-olds.
...
More than $130 million has gone to California-based Oracle Corp., the main exchange IT vendor.'
http://www.nytimes.com/2014/03/21/us/health-care-exchange-in-oregon-not-meeting-high-hopes.html
(https://languish.org/forums/proxy.php?request=http%3A%2F%2Fstatic01.nyt.com%2Fimages%2F2014%2F03%2F21%2Fus%2FJJP-OREGON-2%2FJJP-OREGON-2-articleLarge.jpg&hash=76a30fb4cdcd55c7e656730cd5de0e1594ae2366)
I understand deductibles but no Copays.
What are Copays?
Look it up on Baron's Healthsherpa. I've got that on my drug insurance. 10$/prescription.
Quote from: Grey Fox on March 21, 2014, 10:26:39 AM
I understand deductibles but no Copays.
What are Copays?
Look it up on Baron's Healthsherpa. I've got that on my drug insurance. 10$/prescription.
After you have paid your deductible you still need to pay a copay every time you use your insurance.
Quote from: Phillip V on March 21, 2014, 10:19:11 AM
Oregon's Ardor for Health Exchange Meets Grim Reality
'The state, once one of the more ambitious in the federal health care overhaul, has among the most dysfunctional online insurance exchanges in the nation, only enrolling about 50,000 people so far.
...
In the most recent federal report, earlier this month, the state was tied at the bottom with West Virginia, with only 18 percent of eligible 18- to 34-year-olds.
...
It's all that damned dope they're spending all their money on.
Whelp, now that I'm getting a decent paycheck, I finally dumped the Medicaid and went with a platinum plan with Blue Cross. At least my specialist at Georgetown is in it, and all my scripts will be straightened out now.
Quote from: CountDeMoney on March 30, 2014, 09:30:00 PM
Whelp, now that I'm getting a decent paycheck, I finally dumped the Medicaid and went with a platinum plan with Blue Cross. At least my specialist at Georgetown is in it, and all my scripts will be straightened out now.
:cool:
Wait a minute, a specialist whose office can keep the scripts correct? A rare duck indeed.
Yes, ObamaCare was a success for me, both for the temporary Medicaid coverage and now for the plan I can afford, much to the chagrin of all the hateful Languishites that want me and millions of others dead. Lulz, fuck you guys.
Funny thing is, if I were a bona fide federal employee, I wouldn't be paid at the rate I am as a contractor. But I don't have health care coverage as a contractor, so it all sorta evens out, I guess.
Quote from: Ed Anger on March 30, 2014, 09:40:56 PM
Wait a minute, a specialist whose office can keep the scripts correct? A rare duck indeed.
I don't know how to put this, but he's kind of a big deal.
The nurses hot?
Alas, you can't have everything.
OBAMACARE FAILED
Quote from: Ed Anger on March 30, 2014, 09:46:14 PM
OBAMACARE FAILED
Hot nurses are getting harder and harder to find. Damn non-age discrimination laws!
Quote from: HVC on March 30, 2014, 09:55:26 PM
Quote from: Ed Anger on March 30, 2014, 09:46:14 PM
OBAMACARE FAILED
Hot nurses are getting harder and harder to find. Damn non-age discrimination laws!
Bullshit. The hospitals where I'm at are jam packed full of the 2 year nurse PCT's. 22 year old chicks fondling my junk while giving me a sponge bath?
WIN
Quote from: katmai on March 30, 2014, 10:02:08 PM
Quote from: CountDeMoney on March 30, 2014, 09:30:00 PM
Whelp, now that I'm getting a decent paycheck, I
:huh:
"Decent" as in, it's money for a change, especially now that I have checks rolling in from my renters.
Understood. Thought you hadn't been updating us about job prospects :P
What, you didn't know I've been a federal contractor for the last month?
Quote from: CountDeMoney on March 30, 2014, 10:09:37 PM
What, you didn't know I've been a federal contractor for the last month?
I forgot you took that job, yes :D
The commute is a fucking bitch, though.
Grats on the job Seeds. :cheers:
About time you got off your ass, stopped collecting that sweet, sweet free goberment money and went back to work.
Congrats on the job Seedy. Glad you got some decent priced health care. Hope the coverage is decent, and I assume you have a couple thousand deductible per year, plus other deductibles for any hospital stay? That's what I found when I was browsing the Massachusetts site, seeing what's out there for when I retire.
Congrats on finding a way to get some of my tax money, Seeds :cheers:
Quote from: KRonn on March 31, 2014, 07:41:12 AM
Congrats on the job Seedy. Glad you got some decent priced health care. Hope the coverage is decent, and I assume you have a couple thousand deductible per year, plus other deductibles for any hospital stay? That's what I found when I was browsing the Massachusetts site, seeing what's out there for when I retire.
No deductibles, that's why I went Platinum. Either you go cheap and deal with deductibles, or you go expensive so you dont have to deal with them at all.
Either way, they get you; it's just whether you want to deal with it now or deal with it later.
Quote from: derspiess on March 31, 2014, 08:21:11 AM
Congrats on finding a way to get some of my tax money, Seeds :cheers:
Shit, i burned through those peanuts a while ago. Thanks for nothing, cheapskate.
Quote from: CountDeMoney on March 31, 2014, 12:02:57 PM
Quote from: KRonn on March 31, 2014, 07:41:12 AM
Congrats on the job Seedy. Glad you got some decent priced health care. Hope the coverage is decent, and I assume you have a couple thousand deductible per year, plus other deductibles for any hospital stay? That's what I found when I was browsing the Massachusetts site, seeing what's out there for when I retire.
No deductibles, that's why I went Platinum. Either you go cheap and deal with deductibles, or you go expensive so you dont have to deal with them at all.
Either way, they get you; it's just whether you want to deal with it now or deal with it later.
True dat.... I have another option to continue my existing coverage from work but that's about a thousand a month if I were to pay it on my own. It doesn't cost that much now and it's part of the group plan with the health care system I work for. It will cost a lot more if I get it on my own but that coverage is good, like a platinum plan. I'd have to get more details if I want to go with it to see how much if any it would change if I go with it. But for a few years before Medicare kicks in automatically I may go with cheaper premiums but higher deductibles, more for catastrophic coverage.
Heard an NPR story about difficulties California is having signing up Hispanics.
Part of the problem is lack of trained and certified Spanish speaking navigators. Another part is most don't want to pay that much for coverage.
A number of people interviewed said they wanted to pay $100 a month. For a family.
Quote from: Admiral Yi on March 31, 2014, 01:20:52 PM
A number of people interviewed said they wanted to pay $100 a month. For a family.
Nothing wrong with wanting stuff, that's what motivates us.
Quote
Health Chief Sebelius Is Resigning
White House budget official Sylvia Burwell expected to replace her
(Newser) – ObamaCare may have rebounded from its disastrous start, but health secretary Kathleen Sebelius won't be around for the next phase, reports the Wall Street Journal. In fact, Sebelius already has submitted her resignation, and President Obama has accepted it, reports the New York Times. The move is expected to be announced tomorrow, along with the president's nomination of Sylvia Mathews Burwell, currently the White House budget director, as Sebelius' replacement.
http://www.newser.com/story/185160/health-chief-sebelius-is-resigning.html?utm_source=part&utm_medium=united&utm_campaign=rss_topnews
Anyone here not have health insurance and have to pay the fine?
I'm curious how it works. I expected to see a "prove you're insured" part of the tax form, but it wasn't there.
Quote from: Admiral Yi on April 10, 2014, 06:30:49 PM
Anyone here not have health insurance and have to pay the fine?
I'm curious how it works. I expected to see a "prove you're insured" part of the tax form, but it wasn't there.
Turbo Tax asked me if I had insurance. I clicked 'Yes' and it moved on to the next question.
:hmm:
Quote from: Berkut on January 11, 2014, 02:33:05 AM
Not Obamacare and me, but it is Obamacare and our family...
My sister in law is 49, and has 4 kids, all grown. She is a school cafeteria employee, and while she made a little to much to qualify for medicaid, she did not make enough to pay for the $300/month health insurance the school offered to their part time employees. At least she didn't think she could afford it, and mostly I believe her.
So a week before Christmas, she has what appeared to be a stroke. Collapsed, was taken to the hospital. Turns out it was actually a seizure, and a brain scan revealed a ping-pong ball sized tumor.
Once her doctors at the ER found out she was a smoker from the age of 16, they did a full body MRI, and the result was what we all had feared: stage 3 lung cancer that had metastasized to her brain.
She was originally in a Buffalo local, general type hospital but asked to be transferred to Roswell, which is a regional cancer center, and very, very good.
She had successful neurosurgery to remove the tumor on last Friday. Now she has to see a pulmonologist to figure out how to treat the lung cancer (due to the lesions location, it is almost certainly inoperable). We have not yet heard about what specific type of cancer it is (biopsy results are either not back or have been released).
What is interesting about all this from a health care/system perspective is that she has no insurance of any kind right now. Yet she was still immediately taken in at Roswell, and they scheduled semi-emergency neurosurgery, which I suspect is not cheap, while knowing that she had no real way to pay for it. She is going to meet with the cancer centers financial specialists this week, and I am sure they will get her set up with whatever assistance the state can provide and such.
But obviously her course of treatment is going to cost...well, a lot of money. I am sure the bill already is into six figures. I have no idea how this will or can be paid for.
So far her outcome, given the circumstances, has been pretty good. They think they got all the cancerous cells out of her brain, and the surgeon said the tumor was well contained.
Follow up:
So the brain tunour was successfully operated on, and follow up scans appear to show that they had gotten it all. So that was great news.
The lesion on her lung was almost certainly too large to operate, so they did the chemo thing. Which worked much better than expected, so they decided that since it had been reduced much more than they had hoped, surgery was now an option.
But the surgery in question would be to remove a lobe of her lung, which of course is pretty serious, but that is "good" news, compared to the alternative of not being able to operate at all.
Plan was to go in, and first check lymph nodes while they had her on the table - make sure no cancer had spread there. I guess if it had, they would close her back up, since there would be little point in operating on her lung cancer - once it spreads to the lymph nodes, it is going to spread eleswhere.
If they were clear, then they would remove the effected part of her lungs.
She went into surgery day before yesterday at Roswell. Lymph nodes looked perfectly fine, so they moved onto the lungs.
Once they got in there though...the tumour was actually, well, gone. The chemo had not just reduced it, it had apparently eliminated it, which is just...not expected. Not only are her lungs apparently cancer free, they decided they didn't even need to remove the lobe at all, and just did some minor excising around the previous lesions site and closed her back up. She should be home tomorrow.
The impression we are getting from her doctors is that they are a little baffled. That kind of cancer was the more treatable kind, but generally not THAT treatable. This was a result well beyond any "best case" scenario envisioned.
We are not sure what this means - is she technically cancer free now? Is it possible to be "cancer free" after being diagnosed with stage IV lung and brain cancer?
Wow sounds too good to be true for sure, but hopefully it is true.
Oncologists are pretty cagey folks. They will rarely use the word cured. The preferred term is 'sustained remission'.
:)
Very happy to see it going well Berkut. Hope the good news keep coming.
That's great news :)
Indeed. :cool:
Quote from: Admiral Yi on April 10, 2014, 06:30:49 PM
Anyone here not have health insurance and have to pay the fine?
I'm curious how it works. I expected to see a "prove you're insured" part of the tax form, but it wasn't there.
Fines don't kick in till next year, I think.
Quote
US Quietly Earmarks Money for ObamaCare Insurers
It's a safety net to cover any losses; Republicans cry foul
(Newser) – ObamaCare just became a win-win proposition for insurance companies. Tucked into hundreds of pages of new rulings on the Affordable Care Act last week was a promise to pay insurers for any losses they incur by providing coverage on government exchanges, the LA Times reports. The Obama administration inserted the provision to try to keep premiums down; insurers get the money, which would be diverted from other health programs, only if they keep rate hikes modest.
Conservatives are already bashing the move as a "bailout," and some Senate Republicans are accusing Obama of making "another end-run around Congress." The administration defended the move by saying it was "highly unlikely" the funds would actually be needed. In other bad news for the law's supporters, a poll of emergency room doctors released today found that 46% had seen an uptick in visits since benefits kicked in, compared with 23% who saw a decline, the Huffington Post reports. One of the law's selling points was that giving people access to primary care would reduce ER visits.
http://www.newser.com/story/187241/us-quietly-earmarks-money-for-obamacare-insurers.html?utm_source=part&utm_medium=united&utm_campaign=rss_topnews
Ossum.
Oops. I'm shocked that such a well-written piece of legislation contained a flaw of some sort. I guess they had to pass it before they could check it for errors!
http://www.cnbc.com/id/101819065
What is the flaw and why is this bad news?
Presumably the payments are kicking in because the premiums are low. Wasn't that the objective?
Quote from: The Minsky Moment on July 22, 2014, 11:32:16 AM
What is the flaw and why is this bad news?
Presumably the payments are kicking in because the premiums are low. Wasn't that the objective?
From what I'm reading, the flaw is that the law did not provide for subsidies for those on the federal exchange, just for those on the state exchanges. So if the ruling holds then people on the federal exchange will lose their subsidies. I think the LA Times is calling it a "wording glitch".
But I'm sure a simple executive order would close the gap. Why not, at this point.
Quote from: derspiess on July 22, 2014, 11:42:41 AM
From what I'm reading, the flaw is that the law did not provide for subsidies for those on the federal exchange, just for those on the state exchanges. So if the ruling holds then people on the federal exchange will lose their subsidies. I think the LA Times is calling it a "wording glitch".
Got it.
I didn't open your link - I was responding to the "problem" raised in 11b's link.
Have to check out the DC circuit decision.
Quote from: derspiess on July 22, 2014, 11:22:19 AM
Oops. I'm shocked that such a well-written piece of legislation contained a flaw of some sort. I guess they had to pass it before they could check it for errors!
http://www.cnbc.com/id/101819065
Isn't that usually how it is with complex legislation, and the usual process involves some patches after it's passed? That's certainly what I've been led to believe.
Yes, but Congress will insist that it is broken, it's horrible, roll it all back rather than fix things as they come up.
Quote from: Jacob on July 22, 2014, 02:11:34 PM
Quote from: derspiess on July 22, 2014, 11:22:19 AM
Oops. I'm shocked that such a well-written piece of legislation contained a flaw of some sort. I guess they had to pass it before they could check it for errors!
http://www.cnbc.com/id/101819065
Isn't that usually how it is with complex legislation, and the usual process involves some patches after it's passed? That's certainly what I've been led to believe.
Well, it was also sort of rushed through if you'll recall.
Quote from: derspiess on July 22, 2014, 02:18:39 PMWell, it was also sort of rushed through if you'll recall.
Yeah, I recall.
What would be ideal - and until recently apparently the standard operating procedure - is a good faith effort to fix these sort of minor glitches to give the legislation a chance to work as designed, but I'm not sure how likely that is at this point.
Today's rulings don't take away my healthcare coverage, derfetus. So solly. Maybe next time.
Quote from: CountDeMoney on July 22, 2014, 02:35:54 PM
Today's rulings don't take away my healthcare coverage, derfetus. So solly. Maybe next time.
I was actually concerned about you, so I checked which states have their own exchanges and saw that Maryland had one. Your subsidy, if you have one, is safe :hug:
No subsidy, I'm paying my own way at the full advertised cost. So you can't use that one against me. :yeah: :suckithaters:
Maryland is in the 4th circuit anyways . . .
Checked out the DC Circuit ruling. 2 judges being quite deliberately dense.
Quote from: CountDeMoney on July 22, 2014, 03:07:44 PM
No subsidy, I'm paying my own way at the full advertised cost. So you can't use that one against me. :yeah: :suckithaters:
Fat cat.
Quote from: The Minsky Moment on July 22, 2014, 03:45:26 PM
Maryland is in the 4th circuit anyways . . .
Checked out the DC Circuit ruling. 2 judges being quite deliberately dense.
We need them on the USSC, stat! Some current justices can think. Others are named Roberts, Alito, and Thomas (I have no beef with Scalia, even if his votes are almost always "wrong" from my POV; he is a smart guy who has explicable reasons for his rulings).
Quote from: The Minsky Moment on July 22, 2014, 03:45:26 PM
Maryland is in the 4th circuit anyways . . .
Checked out the DC Circuit ruling. 2 judges being quite deliberately dense.
How's that? It sounds like the law only states that those who go through the state exchanges are eligible for subsidies. If it doesn't mention the federal exchanges, then who has the authority to issue subsidies for those folks?
It doesn't say that.
The language is a little goofy because the way the Exchanges are set up and structured under ACA is goofy. ACA doesn't say - a state can opt-out of creating exchanges. The section which is directly referenced by the IRS code actually mandates each State to create an exchange. There is no opt-out. It defines "Exchange" somewhat self-referentially as the organ established in that state that facilitates the purchase of qualifying health plans.
A totally different section of ACA provides that if a particular State fails to comply that HHS is supposed to do it for them. There is no such thing as a "federal exchange" in the law. The term "federal exchange" is just a phrase that some people use to describe what happens when a State doesn't comply. The actual word that ACA is uses to describe the thing that is created in that instance is simply "Exchange" - i.e. the very defined term used in the section about the State-mandated exchanges. This ends up being an embarrassment for the DC circuit plurality - they keep using the phrase "federal Exchange" which doesn't exist in ACA and involves sticking a common adjective "federal" in front of a defined term "Exchange".
Is it possible to read this in the way the 2 DC circuit judges did? Sure if you stand on your head, read it very selectively and grossly out of context, and completely ignore the purpose. Problem is, the IRS usually gets lots of deference when writing its rules. By law, their interpretation gets great deference and their reading of the statute can be upheld if it is "possible" reading of the statute. The DC judges know this and so were forced to argue that not only is their reading correct, but that it is totally plain and unambiguous. That doesn't pass the laugh test.
Hadn't read that take on it yet. Thanks :)
There is a pretty good summary of the Obamacare legal dispute at Scoutsblog for those interested:
http://www.scotusblog.com/2014/07/commentary-the-fate-of-the-obamacare-subsidies-in-the-supreme-court/
Goldstein is more generous about the statutory argument than I would be but it's a good description of the issues and some basic handicapping of the Supreme Court's likely take.
Goldstein regularly practices before the Court and so is a bit circumspect in how he talks about the justices but Scalia and Thomas are probably sure votes against the Act. These issues about "glitches" in Congressional language are not entirely uncommon and their usual approach is highly literalistic and hostile to intent and purpose.
Quote from: The Minsky Moment on July 22, 2014, 05:01:47 PM
It doesn't say that.
The language is a little goofy because the way the Exchanges are set up and structured under ACA is goofy. ACA doesn't say - a state can opt-out of creating exchanges. The section which is directly referenced by the IRS code actually mandates each State to create an exchange. There is no opt-out. It defines "Exchange" somewhat self-referentially as the organ established in that state that facilitates the purchase of qualifying health plans.
A totally different section of ACA provides that if a particular State fails to comply that HHS is supposed to do it for them. There is no such thing as a "federal exchange" in the law. The term "federal exchange" is just a phrase that some people use to describe what happens when a State doesn't comply. The actual word that ACA is uses to describe the thing that is created in that instance is simply "Exchange" - i.e. the very defined term used in the section about the State-mandated exchanges. This ends up being an embarrassment for the DC circuit plurality - they keep using the phrase "federal Exchange" which doesn't exist in ACA and involves sticking a common adjective "federal" in front of a defined term "Exchange".
Is it possible to read this in the way the 2 DC circuit judges did? Sure if you stand on your head, read it very selectively and grossly out of context, and completely ignore the purpose. Problem is, the IRS usually gets lots of deference when writing its rules. By law, their interpretation gets great deference and their reading of the statute can be upheld if it is "possible" reading of the statute. The DC judges know this and so were forced to argue that not only is their reading correct, but that it is totally plain and unambiguous. That doesn't pass the laugh test.
It seems there is a different point of view out there. A guy that supposedly played some role in crafting Obamacare in 2012 said:
"I think what's important to remember politically about this, is if you're a state and you don't set up an Exchange, that means your citizens don't get their tax credits."
http://www.forbes.com/sites/michaelcannon/2014/07/25/oops-gruber-did-it-again/
The implication being that the tax credits were in part an incentive to get states to act, and an exchange created by an entity other than a state (such as the federal government) is outside the scope of tax credit eligibility.
That's a bit different from the recent narrative.
Quote from: alfred russel on July 29, 2014, 03:32:31 PM
It seems there is a different point of view out there. A guy that supposedly played some role in crafting Obamacare in 2012 said:
"I think what's important to remember politically about this, is if you're a state and you don't set up an Exchange, that means your citizens don't get their tax credits."
http://www.forbes.com/sites/michaelcannon/2014/07/25/oops-gruber-did-it-again/
The implication being that the tax credits were in part an incentive to get states to act, and an exchange created by an entity other than a state (such as the federal government) is outside the scope of tax credit eligibility.
Yeah that little quote has been flying around the blogosphere for about a week now.
Problem of course is context. Forbes and lots of other folks are quoting that one line and assuming your implication. But the line itself doesn't mention the federal exchanges.
The mystery is solved if you view the original video and listen to the immediately preceding lines. He says the states are going to be "the place that people go to get their subsidies for health insurance.". He then goes on to say:
" In the law it says if the states don't provide them the federal backstop will. The federal government has been sort of slow in putting up its backstop in part because I think they want to sort of squeeze the states to do it."
So in context the implication is quite different. He is clearly indicating that the federal "backstop" will provide subsidies if the states don't but then notes that the feds have been dragging their feet. He then speculates about a political motivation for the slow pace. But the underlying assumption here is that people would get subsidies through the federal backstop if it was timely implemented.
Frankly I think Prof. Gruber is spinning here - the feds weren't dragging their feet as part of some brilliant political plot but because of poor implementation. But in any case he wasn't saying what certain elements of the blogosphere are trying to attribute to him.
The full DC Circuit has vacated the 3 judge panel decision and agreed to rehear the case "en banc" (as a full court).
Obamacare and me--I probably ought to have signed up. -_-
Quote
Estimated Enrollees for 2015 Health Care Decrease
WASHINGTON—The Obama administration said Monday it expects up to 9.9 million people to have private coverage through the Affordable Care Act's insurance exchanges in 2015, millions fewer than outside experts had predicted.
The exchanges, which reopen Saturday for the law's second year of health-insurance enrollment, previously were expected to enroll 13 million people in private coverage for 2015, according to an April 2014 projection by the Congressional Budget Office.
Administration officials said they were basing the new enrollment targets on observations from the first enrollment window, which ended mid-April. They also said that over the years participation in health programs aimed at a broad population had taken longer than the CBO had assumed.
The officials added that of 32 million uninsured people currently in the U.S., they expected about 17 million of them to be eligible for Medicaid, the federal-state insurance program for the poor, which has been expanded in some states as part of the law.
The administration also revised downward the number of Americans who had private coverage through the law's exchanges on the eve of the second round of coverage. The administration said Monday that around 7.1 million people across the country who picked plans during the current year's open-enrollment period were still paid up for their coverage. That is down from the eight million who the administration said had picked plans as of this spring, and from the figure of 7.3 million paid-up enrollees in mid-August.
Health and Human Services Secretary Sylvia Mathews Burwell said Monday the administration was aiming for 9.1 million paid-up enrollees by the end of 2015, though the range could extend to 9.9 million, according to the agency's analysis. Ms. Burwell said she respected the work of the CBO and its projections, but that she believed HHS figures were based on the best and most up-to-date information.
"I came in and said to the team, let's analytically build it, and this is where it's come out," she said in a public appearance at the Center for American Progress, a Democratic-leaning think tank.
The figures were part of a batch of updates released Monday on the health law's progress as the HealthCare.gov website prepares to reopen on Saturday.
HHS officials also said they had cut off tax credits for December for 120,000 households that hadn't responded to requests for more information about their income. Another 112,000 people have had their coverage terminated because the federal government couldn't confirm they were legally residing in the U.S. That number is down slightly from an earlier announcement from the federal government that it was cutting off 116,000 people over immigration and citizenship status issues.
A new window-shopping tool on the federal insurance website that made its debut late Sunday is giving consumers the first glimpse of health-insurance prices for next year. Many people who bought insurance plans through HealthCare.gov will see their premium increase in 2015 unless they are willing to switch insurance carriers.
Consumers won't be able to switch or buy plans until HealthCare.gov and state exchanges reopen Saturday. The exchanges allow consumers to buy plans under the Affordable Care Act and, for lower earners, access subsidies that offset the cost of their insurance premiums.
A scan of the rates posted late Sunday shows that in Florida, Georgia, Missouri and North Carolina, for instance, the monthly premium for the least-expensive midrange "silver" health plan available to people in the state capital area will go up by a few dollars. In Arizona and New Jersey, it will fall. But for customers in all those states, there is one important caveat: To get the lowest price, they will have to switch insurance carriers.
Proposed rates filed by insurers with state regulators over the past six months suggested that big carriers that snapped up a lot of customers last year are raising their rates for 2015, and new market entrants and plans that got fewer sign-ups in 2014 are slashing prices in a bid for more market share. The final rates, posted late Sunday on HealthCare.gov, have followed a similar pattern.
As a result, most people who bought coverage through the site last year will see their premiums increase for 2015, at the same time that the lowest rate available on the site remains relatively steady.
Federal officials want all of the people who currently have coverage to return to exchanges to shop around in the next month to see if they can get a better deal.
"We are strongly encouraging people to come back to HealthCare.gov," said Kevin Counihan, chief executive of the site, on Sunday.
In Tallahassee, Fla., the lowest-cost silver plan available to a 26-year-old nonsmoker for 2014 was sold by Florida Blue, or Blue Cross and Blue Shield of Florida, with a premium of $228 a month. For 2015, the cost would rise about 20% to $273, according to the premium information displayed on HealthCare.gov. The same 26-year-old could pay a $236 monthly premium for a United Healthcare plan that wasn't available for 2014.
The small increases in premiums for the lowest-cost plans are likely to calm supporters of the law who fear it was permanently damaged by its bumpy rollout last year.
The federal government and insurers may have to wrestle with additional paperwork problems if many people do decide to shop around. Gaps in the site's behind-the-scenes technology mean that the system doesn't yet have a way to tell insurers when a customer leaves them to switch to a new plan, insurance-industry officials have said. That increases the likelihood that some people who switch plans may find themselves enrolled in two insurance policies at the start of the new year.
http://online.wsj.com/articles/healthcare-gov-rolls-out-lineup-of-2015-health-plans-1415628091 (http://online.wsj.com/articles/healthcare-gov-rolls-out-lineup-of-2015-health-plans-1415628091)
QuoteAs a result, most people who bought coverage through the site last year will see their premiums increase for 2015, at the same time that the lowest rate available on the site remains relatively steady.
Mine is going up, but I'm not switching plans.
How much subsidy do you qualify for?
Roughly $60 a month, but I didn't take it. Just wanted to purchase it outright, without any additional bullshit. May try it this year, though.
They just told us that our premiums were going up $480 this year, so $20 per pay period for family coverage.
Turns out that with this change I will be paying $2900/year, and my employer will be paying $19,355/year. So I guess I am doing ok.
I haven't heard anything yet about premium increases. I work for a health care org that offers several plans, one being its own plan which is administered by an insurance company and that's the one I have. I'm assuming we'll see price increases but haven't heard as yet.
The Supreme Court is taking the challenge to the subsidy provisions of ACA, even though the DC circuit case is still pending. Which is probably not a good sign, at it might suggest at least 4 justices are ready to gut the law. Although it could be one or more voted to grant cert to get the issue resolved faster and remove any cloud.
What's argument about the unconstitutionality of the subsidy?
Quote from: Admiral Yi on November 11, 2014, 10:46:14 AM
What's argument about the unconstitutionality of the subsidy?
It isn't the constitutionality, it is whether the law permits subsidies on the federal exchanges.
Krugman's take:
http://www.nytimes.com/2014/11/10/opinion/paul-krugman-the-latest-frivolous-attack-on-obamacare.html?partner=rss&emc=rss&_r=1
Quote from: Admiral Yi on November 11, 2014, 10:46:14 AM
What's argument about the unconstitutionality of the subsidy?
Not constitution. The argument is that the statutory provision setting forth the formula for the subsidy provides for a subsidy of zero if the state exchange is established and operated by HHS, and therefore no subsidy can be paid in those instances.
Oh right, I remember this.
Quote
ObamaCare Architect Admits "Lack Of Transparency" Is Huge Advantage Against "Stupidity Of The American Voter"
Submitted by Mike Krieger via Liberty Blitzkrieg blog (http://libertyblitzkrieg.com/2014/11/10/video-of-the-day-obamacare-architect-credits-lack-of-transparency-and-stupidity-of-the-american-people-for-bills-passage/),
Earlier today, I published a post titled, Inside the Mind of an Oligarch – Sheldon Adelson Proclaims "I Don't Like Journalism (http://libertyblitzkrieg.com/2014/11/10/inside-the-mind-of-an-oligarch-sheldon-adelson-proclaims-i-dont-like-journalism/), (http://libertyblitzkrieg.com/2014/11/10/inside-the-mind-of-an-oligarch-sheldon-adelson-proclaims-i-dont-like-journalism/)" (http://libertyblitzkrieg.com/2014/11/10/inside-the-mind-of-an-oligarch-sheldon-adelson-proclaims-i-dont-like-journalism/) which zeroed in on the condescending attitude oligarchs and their technocrat minions have toward the general population. I wrote:
<blockquote>The term oligarch is reserved for those with extreme wealth who also want to control the political process, policy levers and most other aspects of the lives of the citizenry in a top-down tyrannical and undemocratic manner. They think they know best about pretty much everything, and believe unelected technocrats who share their worldview should be empowered so that they can unilaterally make all of society's important decisions. The unwashed masses (plebs) in their minds are unnecessary distractions who must to be told what to do. Useless eaters who need to be brainwashed into worshipping the oligarch mindset, or turned into apathetic automatons incapable or unwilling to engage in critical thought. Either outcome is equally acceptable and equally encouraged.
</blockquote> It's quite timely that those words appeared on the site the same day that a video clip emerged of MIT economics professor, and the architect of Obamacare, Jonathan Gruber, admitting that the legislation was intentionally complex and misleading in order to pass Congress and elicit limited outrage from the "stupid" American public.
The Hill reports (http://thehill.com/policy/healthcare/223578-obamacare-architect-lack-of-transparency-helped-law-pass) that:
<blockquote>An architect of the federal healthcare law said last year that a "lack of transparency" and the "stupidity of the American voter" helped Congress approve ObamaCare.
He suggested that many lawmakers and voters didn't know what was in the law or how its financing worked, and that this helped it win approval.
"Lack of transparency is a huge political advantage," Gruber said. "And basically, call it the stupidity of the American voter or whatever, but basically that was really, really critical for the thing to pass."
Gruber made the comment while discussing how the law was "written in a tortured way" to avoid a bad score from the Congressional Budget Office. He suggested that voters would have rejected ObamaCare if the penalties for going without health insurance were interpreted as taxes, either by budget analysts or the public.
</blockquote> The arrogance and destructiveness of this man knows no bounds. Look at how excited he gets, flailing his hands all over the place as he discusses the gigantic deception that is Obamacare.
https://www.youtube.com/watch?v=G790p0LcgbI (https://www.youtube.com/watch?v=G790p0LcgbI)
lol, "Liberty Blitzkrieg". FELDMARSCHALL OF FREEDOM
Why do people insist on posting quotes from internet bloggers as if it is news or interesting or relevant to anything?
I mean, if you want to spout of anonymous opinion why not just post your own?
Quote from: CountDeMoney on November 12, 2014, 02:32:34 PM
lol, "Liberty Blitzkrieg". FELDMARSCHALL OF FREEDOM
I see Ed Anger in the panzer cupola now. :lol:
Quote from: Berkut on November 12, 2014, 02:33:27 PM
Why do people insist on posting quotes from internet bloggers as if it is news or interesting or relevant to anything?
I mean, if you want to spout of anonymous opinion why not just post your own?
Gruber isn't relevant? He's one of the architects of the ACA. :rolleyes:
Actually, oligarchs aren't the only ones that don't like journalism; the ignorant hate it as well.
Quote from: citizen k on November 12, 2014, 02:39:51 PM
Quote from: Berkut on November 12, 2014, 02:33:27 PM
Why do people insist on posting quotes from internet bloggers as if it is news or interesting or relevant to anything?
I mean, if you want to spout of anonymous opinion why not just post your own?
You didn't post anything from him, you posted some dumbasses interpretation of him as if it is fact.
Gruber isn't relevant? He's one of the architects of the ACA. :rolleyes:
Quote from: Berkut on November 12, 2014, 02:48:37 PM
Quote from: citizen k on November 12, 2014, 02:39:51 PM
Quote from: Berkut on November 12, 2014, 02:33:27 PM
Why do people insist on posting quotes from internet bloggers as if it is news or interesting or relevant to anything?
I mean, if you want to spout of anonymous opinion why not just post your own?
You didn't post anything from him, you posted some dumbasses interpretation of him as if it is fact.
Gruber isn't relevant? He's one of the architects of the ACA. :rolleyes:
Then get it straight from the horse's mouth.
https://www.youtube.com/watch?v=G790p0LcgbI (https://www.youtube.com/watch?v=G790p0LcgbI)
Quote from: Berkut on November 12, 2014, 02:48:37 PM
The links at the bottom is to a video of Gruber speaking.
Quote from: citizen k on November 12, 2014, 02:39:51 PM
Quote from: Berkut on November 12, 2014, 02:33:27 PM
Why do people insist on posting quotes from internet bloggers as if it is news or interesting or relevant to anything?
I mean, if you want to spout of anonymous opinion why not just post your own?
You didn't post anything from him, you posted some dumbasses interpretation of him as if it is fact.
Gruber isn't relevant? He's one of the architects of the ACA. :rolleyes:
Quote from: citizen k on November 12, 2014, 02:50:56 PM
Quote from: Berkut on November 12, 2014, 02:48:37 PM
Quote from: citizen k on November 12, 2014, 02:39:51 PM
Quote from: Berkut on November 12, 2014, 02:33:27 PM
Why do people insist on posting quotes from internet bloggers as if it is news or interesting or relevant to anything?
I mean, if you want to spout of anonymous opinion why not just post your own?
You didn't post anything from him, you posted some dumbasses interpretation of him as if it is fact.
Gruber isn't relevant? He's one of the architects of the ACA. :rolleyes:
Then get it straight from the horse's mouth.
https://www.youtube.com/watch?v=G790p0LcgbI (https://www.youtube.com/watch?v=G790p0LcgbI)
Nothing interesting their at all.
They wrote the bill in a manner to make it politically palatable. That is news to you?
Are you really that naive?
Quote from: Berkut on November 12, 2014, 02:52:47 PM
Are you really that naive?
No, but the American electorate is.
Berkut hates transparent government. His journey toward the dark side is complete.
Quote from: derspiess on November 12, 2014, 03:05:01 PM
Berkut hates transparent government. His journey toward the dark side is complete.
I think transaprent government would be great. But I am not going to single out Obamacare as being the example of it not existing. None of it is transparent, because our system punishes transparency...mostly because of an electorate that is largely ignorant.
And Spicey, your tribe is by far, BY FAR, the more to blame for the embrace of ignorance and stupidity as a noble virtue.
Quote from: citizen k on November 12, 2014, 02:39:51 PM
Gruber isn't relevant? He's one of the architects of the ACA. :rolleyes:
The architects of the ACA were Heritage and Mitt Romney.
And they are super non-relevant.
Is that true? My understanding is Romneycare originated in the legislature and he signed it somewhat grudgingly.
Quote from: Admiral Yi on November 12, 2014, 03:42:28 PM
Is that true? My understanding is Romneycare originated in the legislature and he signed it somewhat grudgingly.
So his right hand was reluctant but his left hand made him do it? ;)
Quote from: The Minsky Moment on November 12, 2014, 03:44:09 PM
So his right hand was reluctant but his left hand made him do it? ;)
I don't get it. Are you unfamiliar with the concept of going along with something grudgingly?
Quote from: Berkut on November 12, 2014, 03:13:29 PM
I think transaprent government would be great. But I am not going to single out Obamacare as being the example of it not existing. None of it is transparent, because our system punishes transparency...mostly because of an electorate that is largely ignorant.
I single out Obamacare because 1) it's about as un-transparent legislation as you can get, and 2) Obama promised unprecedented transparency when he was elected. I'd like to think the old Berkut would have been dismayed by the lack of transparency.
QuoteAnd Spicey, your tribe is by far, BY FAR, the more to blame for the embrace of ignorance and stupidity as a noble virtue.
Now that stung :weep:
Quote from: derspiess on November 12, 2014, 03:48:24 PM
Quote from: Berkut on November 12, 2014, 03:13:29 PM
I think transaprent government would be great. But I am not going to single out Obamacare as being the example of it not existing. None of it is transparent, because our system punishes transparency...mostly because of an electorate that is largely ignorant.
I single out Obamacare because 1) it's about as un-transparent legislation as you can get,
Not even close. In fact, it "untransparency" is completely transparent. Anyone who cares at all knows exactly what was "hidden" in plain sight.
I am much more concerned by lack of transparency where politiciains do things like put people who feel the EPA should be disbanded in charge of the EPA, for example.
Or refuse to confirm Attorney Generals because they aren't approved by the NRA.
Quote
and 2) Obama promised unprecedented transparency when he was elected.
Oh noes. A poltician who promised something and didn't follow through to the extent that people who hate his guts say he should have. Oh dear, what a travesty of our political system.
Quote
I'd like to think the old Berkut would have been dismayed by the lack of transparency.
Every iteration of Berkut would laugh at the idea that THIS is the gold standard for offensive lack of transparency, and every one would, as always, laugh at the idea that you are motivated by anything other than your hatred for the purple drazi. You could not care less about transparency, or you would be bitching about it when it was someone other than the hated black guy supposedly doing it..but no, that isn't the case, now is it?
Quote
QuoteAnd Spicey, your tribe is by far, BY FAR, the more to blame for the embrace of ignorance and stupidity as a noble virtue.
Now that stung :weep:
I suspect you will get over it.
:lol: Okay, man.
I don't have many regrets in my life, but coming up with the Drazi analogy on this forum was one of them. :(
Quote from: Berkut on November 12, 2014, 03:13:29 PM
And Spicey, your tribe is by far, BY FAR, the more to blame for the embrace of ignorance and stupidity as a noble virtue.
:hmm: Those with just a high school education or less are disproportionately not in his tribe, and those with a college degree are disproportionately in it.
Quote from: alfred russel on November 12, 2014, 04:39:45 PM
Quote from: Berkut on November 12, 2014, 03:13:29 PM
Quote from: derspiess on November 12, 2014, 03:05:01 PM
And Spicey, your tribe is by far, BY FAR, the more to blame for the embrace of ignorance and stupidity as a noble virtue.
:hmm: Those with just a high school education or less are disproportionately not in his tribe, and those with a college degree are disproportionately in it.
Quote from: Admiral Yi on November 12, 2014, 03:45:44 PM
I don't get it. Are you unfamiliar with the concept of going along with something grudgingly?
He proposed it. Yes it was under political pressure but the essential of Romneycare were proposed by him and it was a middle way between the more state-based lower house and the far less ambitious state Senate version (they wanted to cut the number uninsured in half).
He subsequently tried to spin his way out of it rather than realising he'd always be associated with it so he might as well try and make it a virtue. But that's Romney :bleeding:
Quote from: DGuller on November 12, 2014, 04:23:13 PM
I don't have many regrets in my life, but coming up with the Drazi analogy on this forum was one of them. :(
Actually, it's from Babylon 5. I don't even think you were a member here when that analogy was first used here.
Quote from: grumbler on November 12, 2014, 07:13:46 PM
Actually, it's from Babylon 5.
Actually, Babylon 5 was a TV show.
QuoteI don't even think you were a member here when that analogy was first used here.
I'm pretty sure that I was the one who first used it here, and yes, I was a member here at that time. It was co-opted very quickly by the self-congratulatory duo here, though.
Quote from: DGuller on November 12, 2014, 04:23:13 PM
I don't have many regrets in my life, but coming up with the Drazi analogy on this forum was one of them. :(
Oh look, the fanatic is coming out to defend his fellow fanatic from the non-fanatics. What a shock.
I certainly don't regret my ability to get the nutbar left and the nutbar right to agree on *something*. MoveOn and TeaParty, united in hating on the non-tribal. :P
Quote from: Berkut on November 12, 2014, 10:45:24 PM
Quote from: DGuller on November 12, 2014, 04:23:13 PM
I don't have many regrets in my life, but coming up with the Drazi analogy on this forum was one of them. :(
Oh look, the fanatic is coming out to defend his fellow fanatic from the non-fanatics. What a shock.
I certainly don't regret my ability to get the nutbar left and the nutbar right to agree on *something*. MoveOn and TeaParty, united in hating on the non-tribal. :P
Yeah, I'm certainly notorious for defending derspiess. That's why people keep accusing me of calling that moron names.
This isn't a "fanatic defending a fanatic" (a phenomenon that BTW has always existed only in your head), this is just a normal person in reasonable touch with reality being annoyed at a self-appointed judge of validity of others' opinions. People who think that their shit doesn't stink tend to annoy other people a little bit extra when they drop a smelly turd. Your opinions are not much less superficial in derspiess's, they're just superficial for reasons other than "tribal allegiance".
Quote from: Admiral Yi on November 12, 2014, 03:45:44 PM
Quote from: The Minsky Moment on November 12, 2014, 03:44:09 PM
So his right hand was reluctant but his left hand made him do it? ;)
I don't get it. Are you unfamiliar with the concept of going along with something grudgingly?
He was the governor. Unless the legislative majority was veto proof, why sign?
Is that the bar? He didn't veto it, so it's Romneycare?
Quote from: Admiral Yi on November 13, 2014, 09:58:25 AM
Is that the bar? He didn't veto it, so it's Romneycare?
Before the ACA was passed I remember Romney touting the success of the program, so at the least he wasn't ashamed of signing it.
Quote from: DGuller on November 12, 2014, 07:20:14 PM
Quote from: grumbler on November 12, 2014, 07:13:46 PM
Actually, it's from Babylon 5.
Actually, Babylon 5 was a TV show.
Actually, only for the first four seasons. The fifth, it was a cable show.
QuoteI don't even think you were a member here when that analogy was first used here.
I'm pretty sure that I was the one who first used it here, and yes, I was a member here at that time. It was co-opted very quickly by the self-congratulatory duo here, though.
I'm pretty sure that it was used here before you were a member, at least under your DGuller guise. You may have been a member under a different 4user name, it is true. However, even then, you weren't the first to use the Drazi analogy here. Someone, maybe Crunchy, used it before you - but you wouldn't know that, not having been here. You just assumed, apparently, that the board began when you joined (under whatever 4name you were using at the time).
Quote from: DGuller on November 12, 2014, 11:31:44 PM
Quote from: Berkut on November 12, 2014, 10:45:24 PM
Quote from: DGuller on November 12, 2014, 04:23:13 PM
I don't have many regrets in my life, but coming up with the Drazi analogy on this forum was one of them. :(
Oh look, the fanatic is coming out to defend his fellow fanatic from the non-fanatics. What a shock.
I certainly don't regret my ability to get the nutbar left and the nutbar right to agree on *something*. MoveOn and TeaParty, united in hating on the non-tribal. :P
Yeah, I'm certainly notorious for defending derspiess. That's why people keep accusing me of calling that moron names.
I know, that is what is so hilarious about you doing it now. It is like when you see a Wesboro Baptist Church member and a Islamic fundy pause their fighting long enough to agree that yeah, the atheists will be the first against the wall when either of them take over.
It is the only things that opposite radicals can ever agree on...that really, they aren't radical at all, and that people who are not similarly "normal" are the crazy ones.
Quote
This isn't a "fanatic defending a fanatic" (a phenomenon that BTW has always existed only in your head),
Oh, I am pretty sure it exists in more places than just there - you are a special and unique flower DG, there are lots and lots of others like you out there.
They all think they are reasonable, sane, objective people as well. Nobody actually thinks they are barking at the moon nutbars.
But it is kind of obvious to the rest of us, because they do things like go on rants about how some particular legislation is terribly non-transparent, and how horrible that is, and what an asshole whatever other party politician who represents it is because of it....but never say a peep about even more non-transparent crap their party shovels out by the bucketload.
Or they do things like call people in their own party who are not radical enough for their tastes traitors and suggest that they be kicked out for being willing to compromise or work with others.
Of course the people making these kinds of arguments, I am sure, think they are perfectly reasonable. The rest of us can see things a little more clearly.
Quote
this is just a normal person in reasonable touch with reality being annoyed at a self-appointed judge of validity of others' opinions.
No, not at all - you judge the validity of other peoples opinions all the time - you are doing so RIGHT NOW in fact. Have to find another justification for your "annoyance".
Quote
People who think that their shit doesn't stink tend to annoy other people a little bit extra when they drop a smelly turd. Your opinions are not much less superficial in derspiess's, they're just superficial for reasons other than "tribal allegiance".
This is an especially stupid argument - all opinions are equally superficial? I presume that doesn't include yours, right - YOUR opinions are not superficial at all, I am sure, since they are the opinions shared by other green drazi.
Quote from: grumbler on November 13, 2014, 10:39:09 AM
Quote from: DGuller on November 12, 2014, 07:20:14 PM
Quote from: grumbler on November 12, 2014, 07:13:46 PM
Actually, it's from Babylon 5.
Actually, Babylon 5 was a TV show.
Actually, only for the first four seasons. The fifth, it was a cable show.
QuoteI don't even think you were a member here when that analogy was first used here.
I'm pretty sure that I was the one who first used it here, and yes, I was a member here at that time. It was co-opted very quickly by the self-congratulatory duo here, though.
I'm pretty sure that it was used here before you were a member, at least under your DGuller guise. You may have been a member under a different 4user name, it is true. However, even then, you weren't the first to use the Drazi analogy here. Someone, maybe Crunchy, used it before you - but you wouldn't know that, not having been here. You just assumed, apparently, that the board began when you joined (under whatever 4name you were using at the time).
The irony is that DG has gone so far bonkers on his anger over being labeled as just another tribal is that he is now denying that there is really any such thing at all - he is even arguing that spicey, for example, is not engaging in it when he blasts Obamacare for not being transparent, but has never once EVER made any such similar complaint about a Republican initiative. This is an obvious case of a purely political complaint.
Apparently DG, if he ever saw that episode, was just kind of confused by it - since he feels that there is no such thing as tribalism, and all opinions are equally superficial. Why would he even bring it up, if he feels so strongly that those who are unhappy about tribal-thinking are not just wrong, but actually much worse than even members of the not-DG tribe?
Did he bring it up to point out how silly B5 is for making the exact same point he so thoroughly rejects now?
DG: Russian.
Quote from: grumbler on November 13, 2014, 10:39:09 AM
I'm pretty sure that it was used here before you were a member, at least under your DGuller guise. You may have been a member under a different 4user name, it is true. However, even then, you weren't the first to use the Drazi analogy here. Someone, maybe Crunchy, used it before you - but you wouldn't know that, not having been here. You just assumed, apparently, that the board began when you joined (under whatever 4name you were using at the time).
Unless you've got a backup of the old forum posts somewhere, this is argument by assertion. :P
FWIW, my own memory of the first couple years of the forum sees "Binky the Space Dragon" or something like that as Berkut's go-to metaphor. Green and purple drazi weren't really on the radar.
I don't even remember who used that first.
Now does it even matter.
What is funny is DG claiming that the entire concept is moot and a figment of non-partisan imagination, while also claiming he was the first to reference the exact thing the episode was mocking.
He doesn't realize that the episode was mocking him, and is so upset by the idea that he has pushed himself into actually arguing that tribalism as represented by the drazi allegory doesn't even exist.
Quote from: Admiral Yi on November 13, 2014, 09:58:25 AM
Is that the bar? He didn't veto it, so it's Romneycare?
Ok so I went back and looked. And the legislature did have a veto proof majority. But as it turned out Romney used his veto anyway - to attack a few line items that he didn't like. But the overall bill he supported. He was part of the negotiations and when he signed it he issued a statement praising the law. Other than the specific items he vetoed I saw no sign of any reluctance.
Quote from: Berkut on November 13, 2014, 10:52:27 AM
This is an especially stupid argument - all opinions are equally superficial? I presume that doesn't include yours, right - YOUR opinions are not superficial at all, I am sure, since they are the opinions shared by other green drazi.
It's is indeed an especially stupid argument. I'm really glad that I wasn't stupid enough to even think of it. Perhaps if your reading comprehension weren't so shockingly bad, and your thought process were a little more tolerant of nuances, you wouldn't have such a distorted view of some things.
I wasn't talking about all opinions, I was talking about
your opinions. You certainly are not partisan, I'll give you that. However, the method by which you achieve your lack of partisanship leaves you with an enormous blind spot when it comes to understanding how things fit together, as you do not even understand the dynamics of why parties form, and why they are not necessarily a bad thing. If you start off with bad fundamentals, your conclusions are typically bad as well, especially when it comes to judging the validity of other posters' framework for opinions.
Also, your logic that people aligning themselves squarely with one party or against one party (as I freely admit myself to be) are necessarily more wrong on average than moderates is clearly deficient. If one party has the right idea 80% of the time, then hardcore supporters of that party do more to make their society better than moderates that support both parties equally. There certainly were times in our history where in hindsight one party had it right way more than the other, there is no reason that these days we're magically balanced to the point where each party is right half the time, however you define that. That's the difference between reality and the Drazi analogy: the Drazi conflict was by definition arbitrary, whereas the Democratic/Republican divide may very well be mostly good ideas in deathmatch with mostly terrible ideas.
In no way should all that be interpreted that I think derspiess's opinions are more valid than yours. He may as well be a bot as far as we're concerned. I just think that that neither of you are exactly Minsky material, and neither of you earned the right to sanctimoniously dismiss each other.
I, however, have the right to sanctimoniously dismiss pretty much everyone. After all I'm both Scandinavian and Canadian. It's like a super strain. Like the Magna Carta of sanctimonious dismissal rights.
Double Secret Sanctimony.
Quote from: Jacob on November 13, 2014, 06:38:44 PM
I, however, have the right to sanctimoniously dismiss pretty much everyone. After all I'm both Scandinavian and Canadian. It's like a super strain. Like the Magna Carta of sanctimonious dismissal rights.
800 years of sanctimocracy
Quote from: Maximus on November 13, 2014, 07:57:07 PM
Quote from: Jacob on November 13, 2014, 06:38:44 PM
I, however, have the right to sanctimoniously dismiss pretty much everyone. After all I'm both Scandinavian and Canadian. It's like a super strain. Like the Magna Carta of sanctimonious dismissal rights.
800 years of sanctimocracy
The foundation of Sanctimonity, basically.
Quote from: DGuller on November 13, 2014, 05:22:14 PM
Quote from: Berkut on November 13, 2014, 10:52:27 AM
This is an especially stupid argument - all opinions are equally superficial? I presume that doesn't include yours, right - YOUR opinions are not superficial at all, I am sure, since they are the opinions shared by other green drazi.
It's is indeed an especially stupid argument. I'm really glad that I wasn't stupid enough to even think of it. Perhaps if your reading comprehension weren't so shockingly bad, and your thought process were a little more tolerant of nuances, you wouldn't have such a distorted view of some things.
I wasn't talking about all opinions, I was talking about your opinions. You certainly are not partisan, I'll give you that. However, the method by which you achieve your lack of partisanship leaves you with an enormous blind spot when it comes to understanding how things fit together, as you do not even understand the dynamics of why parties form, and why they are not necessarily a bad thing.
Huge mis-representation of my position. I don't understand why parties form? What kind of ignorant thing to say is that?
Quote
If you start off with bad fundamentals, your conclusions are typically bad as well, especially when it comes to judging the validity of other posters' framework for opinions.
Wow, the irony is strong in this one. Your statement is 100% correct, and you are so blind by your allegiance you cannot see how clearly it applies to you.
Quote
Also, your logic that people aligning themselves squarely with one party or against one party (as I freely admit myself to be) are necessarily more wrong on average than moderates is clearly deficient.
Not necessarily so at all, of course. Another lie.
If, however, your alignment is based on the desired outcome of "get that other guy!" then, yeah, you will tend to be wrong more often than not. Or rather, if you are right, it will be based on luck rather than reason.
Quote
If one party has the right idea 80% of the time, then hardcore supporters of that party do more to make their society better than moderates that support both parties equally. There certainly were times in our history where in hindsight one party had it right way more than the other, there is no reason that these days we're magically balanced to the point where each party is right half the time, however you define that. That's the difference between reality and the Drazi analogy: the Drazi conflict was by definition arbitrary, whereas the Democratic/Republican divide may very well be mostly good ideas in deathmatch with mostly terrible ideas.
In no way should all that be interpreted that I think derspiess's opinions are more valid than yours. He may as well be a bot as far as we're concerned. I just think that that neither of you are exactly Minsky material, and neither of you earned the right to sanctimoniously dismiss each other.
Blahblahblah.
Your entire argument is based on your intentionally mis-interpreting what I've said about 500 times over the years, and me correcting you each time, you perfectly understanding that correction, then you re-stating the mis-interpretation again next time.
This is called being dishonest.
Neither party is "right" some magical 50% of the time, and not being a partisan hack is not about finding each party equally "right". It is about making decisions that are not based on the parties at all, and not caring to prop up either side because you are a member of that side. That is what being a partisan hack means - it means finding it a travesty of justice when the other guy does the exact same thing your guy does, but being incapable of seeing that. As in this case.
It is not being able to look at an issue without immediately insisting that it MUST BE cast in the light of "the other party is the problem, and voting for my party is not only a solution, but the only possible solution" and any opinion to the contrary must be dismissed out of hand - as you have done. It is insisting that only those who are as radical as you are are "true" Democrats/Green Drazi, and those who do not agree with you in every way ought to be expunged (Down with the Blue Dogs!).
That is what this is about - not about the same old bullshit caricature of Berkut that you trot out every single time I point out how silly partisan hacks are. What is funny about THIS time is that I pointed it out about someone else, not about you at all, and you immediately sail in to defend your fellow radical, because you've gotten so tied up into this that you've actually painted yourself into the ridiculous corner that not only are YOU not a partisan hack, but there isn't any such thing at all!
Note that your whine here is NOT that yeah, spicey is ultra-partisan, but hey, YOU are not...it is that HE is apparently not either, because apparently such a thing doesn't even exist.
So, is spicey right then - Obamacare is uniquely lacking in transparency, while Republican initiatives are all so very transparent, such that this is a perfectly legitimate claim on his part?
Or is he wrong, but somehow the fact that he has never made such a complaint actually not because he is partisan at all, but it is for some other reason?
Which is it?
Oral argument on the subsidy case today, transcript available here: http://www.scotusblog.com/2015/03/todays-transcript-46/
I count a least five votes in favor of ACA, as Kennedy appeared to lean to the government on federalism and constitutional avoidance grounds. Alito appeared to be against but even he was concerned about ruling against the government's position and explored the possibility of delaying a ruling to allow states time to comply. Roberts said virtually nothing although he did rescue the challenger's lawyer at one point and at another point made a cryptic comment on Chevron deference (a government argument).
My guess either 5-4 or 6-3 for the government.
Thought it could be of interest.
7 charts that show what Obamacare critics are getting wrong (https://www.vox.com/2015/4/16/8410585/obamacare-charts)
Good news. :)
http://www.nytimes.com/2015/09/17/us/politics/census-bureau-poverty-rate-uninsured.html?_r=1''
QuoteWASHINGTON — Nearly nine million people gained health insurance last year, lowering the ranks of the uninsured to 10.4 percent of the population. But there was no statistically significant change in income for the typical American household in 2014, the Obama administration said on Wednesday.
Median household income in the United States was $53,660 last year, the Census Bureau reported, and the poverty rate — 14.8 percent — also saw no improvement. About 46.7 million people were in poverty in 2014, the bureau said, the fourth consecutive year in which the number of people in poverty was not statistically different from the official estimate for the prior year.
Overall, the new census numbers suggest that one major government program, to provide health insurance under the Affordable Care Act, is working, but that for ordinary Americans, especially the poor, the economic recovery — now into its seventh year — has yet to deliver measurable benefits.
"Despite decent employment growth in 2014, the persistent high unemployment yielded no improvements in wages and no improvement in the median incomes of working-age households or any reduction in poverty," said Lawrence Mishel, president of the Economic Policy Institute, a liberal research group influential with Democrats in Congress.
"Anyone wondering why people in this country are feeling so ornery need look no further than this report," Mr. Mishel continued. "Wages have been broadly stagnant for a dozen years, and median household income peaked in 1999."
Representative Paul D. Ryan of Wisconsin, chairman of the House Ways and Means Committee, said the new numbers showed that Congress should revamp antipoverty programs.
"Rather than just treating the symptoms of poverty, our goal must be to help people move from welfare into work and self-sufficiency," Mr. Ryan said
In its annual report on income, poverty and health insurance coverage, the Census Bureau said that the percentage of people without insurance was 10.4 percent last year, down from 13.3 percent in 2013.
The fraction of the population without health insurance decreased last year in every state, the bureau said.
Much of the change was attributable to the Affordable Care Act, officials said, but the Census Bureau could not say exactly how much.
In the last two years, the Obama administration has issued a steady stream of upbeat reports showing a big expansion of coverage and a sharp reduction in the number of uninsured.
To support its claims, the administration has cited estimates by the Urban Institute, the RAND Corporation, the Gallup organization and the Centers for Disease Control and Prevention, among others.
None of those estimates, however, are as reliable or authoritative as the census data, which showed increases in both private and government coverage.
From 2013 to 2014, the bureau said, the overall rate of insurance coverage increased for all racial groups and for Hispanics, who may be of any race.
The increases were comparable for blacks, Asians and Hispanics (just over 4 percentage points) and lower for non-Hispanic whites (about 2 percentage points).
The lack of any significant change in median household income, after adjustment for inflation, was somewhat surprising to experts, who had expected to see some modest growth in income because of improvements in the economy last year.
Edward J. Welniak Jr., a Census Bureau statistician, said the income findings may reflect the fact that there were more "nonfamily households" in 2014.
These households — single people living alone or with roommates, and unmarried couples — "typically have much lower incomes than family households," Mr. Welniak said.
Many households have still not regained the purchasing power they had before the recession that began in December 2007. Median household income was 6.5 percent lower in 2014 than in 2007, the bureau said. The number of households with income above the median is the same as the number below it.
The report included these findings:
■ About 10 percent of households had incomes above $157,480 last year, while 5 percent had incomes above $206,570. At the other end of the spectrum, 10 percent of households had incomes less than $12,280.
■ The pay gap between men and women has changed little in recent years. Among full-time year-round workers, median earnings for women were 79 percent of those for men last year, compared with 78 percent in 2007. By contrast, in 1964, the ratio was 59 percent.
None of the major racial and ethnic groups experienced a statistically significant change in their poverty rates or in the number of people in poverty.
The poverty rate for blacks (26 percent) is about two and half times that for non-Hispanic whites (10 percent).
A family of four was classified as poor if its income was less than $24,230 last year. For one person, the threshold was $12,070.
The biggest gains in health insurance coverage occurred last year among households with incomes less than $50,000 a year. For households with incomes of $100,000 or more, the gains were small.
The extremes of coverage, as often in recent years, were found in Massachusetts, where 3.3 percent of the people are uninsured, and Texas, where 19 percent lack coverage.
In Vermont, Hawaii and Minnesota, small shares of the population are uninsured.
The reverse is true in Alaska, Florida and Georgia. Florida significantly expanded coverage under the Affordable Care Act, but 16.6 percent of Floridians were still uninsured last year, the bureau reported.
Some likely good news on health care coverage, but lots of bad or mixed news about the economy though.
Quote from: KRonn on September 18, 2015, 09:11:05 AM
Some likely good news on health care coverage, but lots of bad or mixed news about the economy though.
Like what?
Quote from: KRonn on September 18, 2015, 09:11:05 AM
Some likely good news on health care coverage, but lots of bad or mixed news about the economy though.
:huh: I thought the US economy was doing very well. Steady growth, falling unemployment...
Quote from: DGuller on September 18, 2015, 11:10:38 AM
Quote from: KRonn on September 18, 2015, 09:11:05 AM
Some likely good news on health care coverage, but lots of bad or mixed news about the economy though.
Like what?
Check the article, it outlines a lot of issues.
http://www.nytimes.com/2015/12/10/us/politics/marco-rubio-obamacare-affordable-care-act.html?smid=fb-nytimes&smtyp=cur
QuoteMarco Rubio Quietly Undermines Affordable Care Act
WASHINGTON — A little-noticed health care provision that Senator Marco Rubio of Florida slipped into a giant spending law last year has tangled up the Obama administration, sent tremors through health insurance markets and rattled confidence in the durability of President Obama's signature health law.
So for all the Republican talk about dismantling the Affordable Care Act, one Republican presidential hopeful has actually done something toward achieving that goal.
Mr. Rubio's efforts against the so-called risk corridor provision of the health law have hardly risen to the forefront of the race for the Republican presidential nomination, but his plan limiting how much the government can spend to protect insurance companies against financial losses has shown the effectiveness of quiet legislative sabotage.
The risk corridors were intended to help some insurance companies if they ended up with too many new sick people on their rolls and too little cash from premiums to cover their medical bills in the first three years under the health law. But because of Mr. Rubio's efforts, the administration says it will pay only 13 percent of what insurance companies were expecting to receive this year. The payments were supposed to help insurers cope with the risks they assumed when they decided to participate in the law's new insurance marketplaces.
Mr. Rubio's talking point is bumper-sticker ready. The payments, he says, are "a taxpayer-funded bailout for insurance companies." But without them, insurers say, many consumers will face higher premiums and may have to scramble for other coverage. Already, some insurers have shut down over the unexpected shortfall.
"Risk corridors have become a political football," said Dawn H. Bonder, the president and chief executive of Health Republic of Oregon, an insurance co-op that announced in October it would close its doors after learning that it would receive only $995,000 of the $7.9 million it had expected from the government. "We were stable, had a growing membership and could have been successful if we had received those payments. We relied on the payments in pricing our plans, but the government reneged on its promise. I am disgusted."
Blue Cross and Blue Shield executives have warned the administration and Congress that eliminating the federal payments could have a devastating impact on insurance markets.
Twelve of the 23 nonprofit insurance cooperatives created under the law have failed, disrupting coverage for more than 700,000 people, and co-op executives like Ms. Bonder have angrily cited the sharp reduction in federal payments as a factor in their demise.
But Mr. Rubio is pressing forward, demanding a provision in the final spending bill now under negotiation that continues the current risk corridor restrictions, or even eliminates the program altogether. That enormous spending bill is being worked out as Congress slides toward a deadline of Friday, when much of the federal government's funding runs out.
"If you want to be involved in the exchanges and you lose money, the American taxpayer should not have to bail you out," Mr. Rubio said on the Senate floor on Thursday.
A White House spokeswoman, Katie Hill, declined to offer the administration's position on proposals that she said were still theoretical. "We are not going to weigh in on the possible inclusion of proposals floated by members of Congress" in potential legislation, she said.
Congress established the program in 2010 to protect insurers against the uncertainties they faced in setting the level of insurance premiums when they did not know who would sign up for coverage under the Affordable Care Act. Under the law, the federal government shares risk with insurers, limiting their gains and losses on insurance sold in the public marketplaces from 2014 through 2016. If consumer payments to an insurer exceed the company's medical expenses by a certain amount, the insurer pays some of that profit to the government. But if premium payments fall short of medical expenditures by a certain amount, the insurer is eligible for payments from the government.
The hope was that payments into the program would be in balance with payments out, shielding taxpayers from responsibility.
Mr. Rubio latched on to the issue in late 2013, recognizing not only the importance of risk corridors to the operation of the Affordable Care Act but also the political potency of a program he labeled crony capitalism — putting taxpayers "on the hook for Washington's mistakes," as he said when he reintroduced his risk corridor bill in January.
The "bailouts" of big banks and other financial firms during the economic crisis of 2008 and the rescue of the Big Three automakers that year and the next remain politically unpopular.
Then the numbers rolled in from the insurance exchanges' first year of operation: Losses were so steep that insurance-company requests for risk corridor payments were $2.9 billion, compared with only $362 million paid into the program by profitable plans.
Mr. Rubio says he "saved taxpayers $2.5 billion" — the difference between those two amounts — because his measure prevented the government from using other sources of money for the risk corridor payments.
The administration has repeatedly told insurers that it will explore other funding sources to keep its commitment to companies losing money in the exchanges, but Mr. Rubio effectively tied the hands of federal health officials this year.
Like many other observers of the health law, the Obama administration initially failed to appreciate the impact of the Rubio restrictions. Kevin J. Counihan, the chief executive of the federal insurance marketplace, told state officials in July that money collected from insurance companies would be "sufficient to pay for all risk corridor payments." More recently, the administration consoled insurers by telling them that it would make additional risk corridor payments from money collected in 2015 and 2016.
But in a new report, the credit ratings agency Standard & Poor's says that money will not be there.
Mr. Rubio says Mr. Obama compounded his problems by diverting risk corridor funds to quell a 2013 furor over canceled insurance policies. That year, the president announced that states could let insurers renew canceled plans and continue coverage for several years even if those policies did not meet the requirements of the federal health law.
Insurers were shocked by the sudden change. They had set 2014 premiums on the assumption that healthy people with old insurance policies would move into the new marketplace, but Mr. Obama allowed many of them to stay out. In a letter to state insurance commissioners in November 2013, the administration said "the risk corridor program should help ameliorate unanticipated changes in premium revenue."
Five days later, Mr. Rubio introduced his bill to kill the risk corridor program.
Insurers now are lobbying to get more of the money they say they were promised, or to get relief in some other form.
Mr. Rubio has highlighted the role of Marilyn B. Tavenner, the former Obama administration official in charge of rolling out HealthCare.gov who is now president of the trade group America's Health Insurance Plans.
"The former Obama administration official who led the rollout of Obamacare's exchanges and now runs the health insurance lobby is working with her White House allies to secure a new bailout by providing more funding for the law's risk corridor program," Mr. Rubio said last week.
Clare Krusing, a spokeswoman for the insurance group, said the federal payments were not a bailout for the industry, but a way of stabilizing the market and thus protecting consumers. "When health plans cannot rely on the government to meet its obligations," she said, "individuals and families are harmed."
The risk corridor does not strike me as a terribly well designed incentive.
Time to revive 11B's and dersubsidy's favorite whack-off thread--
QuoteBenchmark Obamacare premiums jump 25 percent next year, HHS says
By Rachana Pradhan
politico.com
Updated 10/24/16 05:32 PM EDT
Premiums for a crucial category of Obamacare plans on HealthCare.gov will rise by 25 percent on average next year, more than three times larger than this year's price increases, the Obama administration said Monday.
By comparison, average prices for the second cheapest silver-level plan — which is used as the benchmark to determine premium subsidy levels — had increased by just 7.5 percent on average in 2016 and 2 percent in 2015.
The Department of Health and Human Services report, released just two weeks before Election Day, is sure to provide fresh fodder for Donald Trump and Republicans in down-ballot races to attack the law. Democrats, who have increasingly warned about the escalating costs of Obamacare coverage in some areas, have pushed for Republicans to give up on repeal and work on fixes to the law.
Federal health officials also confirmed that roughly one in five people in the states that use HealthCare.gov must shop from only one insurer following decisions by several major national and regional insurers to pull back from the Obamacare marketplaces in 2017. On average, exchange customers will have 30 plan options to choose from for 2017, down from 47 this year.
The average rate increases outlined in the report do not account for premium subsidies for which the majority of exchange customers qualify. HHS officials said nearly three-quarters of exchange customers will be able to find a plan for $75 a month or less after subsidies.
"Even in places with high rate increases this year, consumers will be protected," said Kathryn Martin, HHS acting assistant secretary for planning and evaluation.
HHS officials said their outreach and advertising will emphasize that most exchange customers won't pay the massive premium increases featured in headlines this year. The enrollment period begins Nov. 1 and lasts three months.
Still, the spike in benchmark plan prices may pose an additional obstacle in getting more people enrolled next year, especially young adults who administration officials are targeting.
As in past years, premiums vary greatly across the country. Some states will see average monthly prices for benchmark silver plans spike at least 50 percent for 27-year-olds. Those states include Arizona, Alabama, Nebraska, Oklahoma, Pennsylvania and Tennessee. The price increase for Arizona's benchmark plan, at 116 percent, is the highest of any state.
By contrast, Indiana's average benchmark plan price will decline by 3 percent for 27-year-olds. Arkansas, New Hampshire and Ohio will each see only a 2 percent increase.
Because the law's subsidies are tied to the cost of the benchmark plan, bigger premium increases mean the government will spend more to help lower costs for subsidy-eligible customers.
HHS says 15 new insurers will enter the exchanges in 2017, while 83 insurers are dropping off the marketplaces. About 80 percent of customers will have at least two companies to choose from; just more than half will have at least three.
The Obama administration expects 13.8 million people nationwide to pick a plan during the upcoming open enrollment season, about 1 million more than signed up this year.
grumbler compliant link--
http://www.politico.com/story/2016/10/hhs-benchmark-obamacare-premiums-jump-25-percent-next-year-230263
All according to plan, right?
For its haters, yeah. Free market at work. Yay capitalism amirite :yeah:
Quote from: derspiess on October 24, 2016, 07:19:51 PM
All according to plan, right?
Fortunately now that everybody has a green job they can easily afford it.
Quote from: derspiess on October 24, 2016, 07:19:51 PM
All according to plan, right?
Definitely going according to the plans of those who have planned to obstruct the law as best they can.
Quote from: Berkut on October 24, 2016, 09:09:58 PM
Quote from: derspiess on October 24, 2016, 07:19:51 PM
All according to plan, right?
Definitely going according to the plans of those who have planned to obstruct the law as best they can.
Nonsense. If Obama hadn't vetoed all those reforms passed by the Republican House and Senate, the healthcare plan problems would all have been addressed.
Quote from: Valmy on October 24, 2016, 07:43:54 PM
Quote from: derspiess on October 24, 2016, 07:19:51 PM
All according to plan, right?
Fortunately now that everybody has a green job they can easily afford it.
:thumbsup:
I have a green job. I am 100% recyclable. :)
Quote from: CountDeMoney on October 25, 2016, 12:51:36 PM
I have a green job. I am 100% recyclable. :)
Chairman Yang would agree.
So it *is* working as designed :lol:
https://youtu.be/D2vIObt6KgU
Quote from: derspiess on October 26, 2016, 10:59:14 PM
So it *is* working as designed :lol:
https://youtu.be/D2vIObt6KgU
It is, actually. They wanted the free market involved, they got the free market involved.
Are you satisfied?
I have the opportunity to purchase health care I would otherwise not have access to, despite your attempts to prevent me from doing so.
So sorry, motherfucker--you want to kill me, your niggerhating ass is going to have to catch a connecting flight to Maryland and do it yourself.
Chillax, brah. Remember I said I was glad you got some benefit from it.
And I was fighting for your freedom not to carry insurance if you didn't want it.
That's so kind. Fighting for him to go broke on medical bills.
Quote from: derspiess on October 26, 2016, 11:45:14 PM
And I was fighting for your freedom not to carry insurance if you didn't want it.
No, what you were really doing is fighting for him to not have any affordable options to purchase insurance.
Government tit healthcare is still fucking wonderful, BTW.
Quote from: derspiess on October 26, 2016, 11:45:14 PM
Chillax, brah. Remember I said I was glad you got some benefit from it.
And I was fighting for your freedom not to carry insurance if you didn't want it.
So touching. We are truly fortunate to have patriots like yourself willing to defend default choice logic.
Thank you for protecting my right to not buy Diet Coke.
Quote from: Scipio on October 27, 2016, 09:35:55 AM
Government tit healthcare is still fucking wonderful, BTW.
Millions of
welfare queens government employees agree!
I just got my open-enrollment package, for employer "provided" insurance and there is a big premium jump. So I suspect one significant reason Obamacare premiums are going up has nothing to do with Obamacare, but simply because insurance companies are raising premiums.
I put "provided" in quotes because although my employer offers an insurance plan, I pay for it at retail: there is no employer subsidy. So this I figured I'd compare it to the exchange plans. And lo and behold, there is an exchange plan equal to or better in every respect in terms of coverage and terms. And it is quite a bit cheaper.
Another reason why I started looking into this was because of the incredibly awful experiences with the current insurer. For example, virtually all claims are initially rejected or sent back for resubmission, typically without any grounds (e.g. they will say information was missing when in fact it was on the original claim form). On one occasion an insured went for a routine prescription refill, the company held it up on the ground that it was not "pre-approved" with them. There is no such requirement under the plan, but they still wouldn't budge even after it was explained that a delay would cause a dangerous break of the course of treatment.
The fundamental flaw in the US system is the private insurance market. The insurers are paid a fixed sum and hence have an incentive to screw over the plan beneficiaries, and shortchange doctors - it is a zero sum game. There is little incentive to try to build a rep for good customer service and claims management because the ultimate beneficiary typically has little or zero choice. It is a completely dysfunctional market.
All the bitching back and forth about Obamacare is a giant red herring. America has the shittiest and most expensive health coverage system in the world and will continue to do because we've been brainwashed about public provision of health insurance. As long as we continue to fork over billions in totally uncessary transaction costs to middlemen with a powerful and vested interest in having the system screw both health care providers and recipients, the problem will never be fixed, and ACA (or any reform of ACA) is just repositioning band aids on a gaping wound.
It's possible that the premium hikes we're seeing (and I guess I need to take a look at my out of pocket for next year) are simply a reversion to trend after several years of depressed prices caused by the explosion of new insurers following the start of Obamacare, who seem to have significantly underpriced risks, and many of whom have as a result gone out of business.
The co-ops got slaughtered.
ACA exchanges are prone to feedback effects. If costs go up, the better risks exit or go down plan tiers, driving up costs more etc
I am normally a small government and free market type, but I still think the US should adopt a free and universal healthcare system funded by government. Perhaps supplemented by a for profit tier that provides premium/primary care. I mean, the government already provides lots of insurance type services like fire and national defence, and nobody argues against those.
Quote from: The Minsky Moment on October 27, 2016, 02:41:51 PM
I suspect one significant reason Obamacare premiums are going up has nothing to do with Obamacare, but simply because insurance companies are raising premiums.
I dunno, man. These are publicly traded, for-profit insurance companies whose first duty is to shareholders we're talking about here.
Sounds pretty sketchy to me.
If we just had Medicare the economics of healthcare just won't work. Private insurers reimburse at higher rates than the government and in effect subsidize moderate underpayment by Medicare and severe underpayment by Medicaid.
Americans are never going to be okay with being told "No, we can't give you the standard of care because a government paper pusher at Centers for Medicare and Medicaid Services says your life isn't worth it based on table 418 line 12."
And Medicare isn't much better than private insurers when it comes to avoid paying doctors or hospitals for treatment provided. They constantly look for ways to increase underpayment under the guise of "quality measures" which aren't really intended to increase the quality of healthcare.
Quite your moaning guys, Trump will fix this shit, you won't believe how good it'll be.
Quote(https://media.giphy.com/media/6VfBxYjOuf9Je/giphy.gif)
Health & Science
Trump could quickly doom ACA cost-sharing subsidies for millions of Americans
By Amy Goldstein
December 24 at 5:22 PM
Even without Congress repealing the Affordable Care Act, the Trump administration could undermine the law by unilaterally ending billions of dollars the government pays insurers to subsidize the health coverage of nearly 6 million Americans.
Given that insurers would still be required to provide consumers that financial help, such a move could create upheaval in the ACA's marketplaces — prompting health plans to raise their prices or drop out, according to health-policy experts in both major political parties.
Intervention by the new president to stop the payments "would precipitate a pretty serious crisis almost immediately" unless Congress stepped in, said James Capretta, a resident fellow at the American Enterprise Institute.
The money is for a kind of financial assistance that is less familiar than the tax credits the law gives most people for their ACA plan premiums. These "cost-sharing reductions" are designed instead to lower the deductibles, co-pays and other out-of-pocket fees for nearly half the customers this year.
The payments are expected to total $9 billion in 2017. Eligible consumers would not feel their loss right away because the law still would compel insurers to lower the fees charged. But without government money to make up the difference, the insurers would take an instant hit.
The subsidies could be eliminated as soon as President-elect Donald Trump takes office, a consequence of an unusual lawsuit that House Republicans brought against the Obama administration two years ago.
The GOP's case, part of its sustained attack on the 2010 law, contends that the cost-sharing reductions to insurers are illegal because Congress has not provided a specific appropriation for them — an argument the administration disputes. In May, a federal district judge ruled in favor of the House but left the subsidies in place while Obama officials appealed the decision.
Once Trump is sworn in, his administration could simply drop the appeal. At that point, the payments would stop, barring a reversal by the Republicans who sued to get rid of the subsidies. Lawmakers would then have to approve funds to keep the payments in place. A three-judge panel of the Court of Appeals for the D.C. Circuit has granted a House request to pause the case until Trump takes office.
Members of Trump's transition team have not signaled whether the incoming president intends to exercise this power, and sources who have spoken with transition staffers say no decision appears to have been made. Transition spokespersons did not respond to multiple requests for comment.
However, Trump's choice to lead the Department of Health and Human Services, Rep. Tom Price (R-Ga.), is a vehement ACA critic who has been outspoken in opposing the cost-sharing subsidies. The day of the lower court's ruling, Price hailed the decision as "a momentous victory for the rule of law and against the Obama administration's overreach of constitutional authority."
The uncertainty over cost-sharing's future is alarming Obama administration officials, insurers that participate in ACA marketplaces and even some ACA detractors such as Capretta.
Andy Slavitt, acting administrator of the Centers for Medicare and Medicaid Services (CMS), the agency that carries out much of the sprawling law, said that ending the subsidies would be "a drastic move" and "an enormous step backwards."
The payments are one way in which the ACA helps make private insurance affordable for people with relatively low incomes who buy coverage through HealthCare.gov or similar marketplaces at the state level. While the law offers premium tax credits for marketplace customers with incomes up to 400 percent of the federal poverty line, the cost-sharing reductions are for a narrower group. They help those with incomes up to 250 percent of the poverty level — just under $30,000 for individuals or about $60,000 for a family of four — who buy the second-lowest tier of ACA coverage, known as silver plans.
Some 5.9 million consumers — or 56 percent of the people with ACA health plans — benefited from such subsidies in the first half of this year, HHS figures show. This week, two consumers went to court seeking to take part in the appeal. They argue that an end to the subsidies "will produce devastating consequences for the individuals who receive these reductions, as well as for the nation's health insurance and health care systems generally."
At America's Health Insurance Plans (AHIP), preserving the cost-sharing payments is a top priority during the industry trade group's private conversations with lawmakers over the GOP's plans to dismantle the health-care law. "Without those subsidies, that is a dramatic financial cost burden that goes to the plans," AHIP spokeswoman Kristine Grow noted.
Grow predicted that additional plans would follow the insurers that already have withdrawn from ACA marketplaces, citing unexpectedly high-cost customers. "If they feel the market is unstable and there is no pathway, there is a very high likelihood they will pull out of the market at the first logical opportunity," she said.
Typically, insurers must choose each spring whether to participate in the federal health exchange and state-run marketplaces for the coming year; that timing means the next round of decisions will be made a few months after Trump takes office. But a wrinkle in the plans' federal contracts gives them a possible way to withdraw much earlier.
The 10-page agreement that health plans sign with the CMS says the agency recognizes that plans designed their coverage and set their prices on the assumption that both premium tax-credits and cost-sharing reductions would be available. "In the event that this assumption ceases to be valid," the agreement says, plans "could have cause to terminate" their participation.
"Everyone is in limbo right now," said J. Mario Molina, president of Molina Healthcare, which sells ACA coverage in nine states. Two-thirds of its customers qualify for cost-sharing. As of last month, the company had received $172 million from the government this year for customer subsidies — about 12 percent of Molina's revenue.
If the payments ended, he said, that would "completely wipe out" the company's small operating margin. The uncertainty is particularly untimely, coming in the midst of the ACA's fourth enrollment period, as the insurer prepares to mail membership cards and benefit brochures to those who are signing up.
"We have no choice at this point [but] to go forward," Molina said. Yet he knows that if Trump stops the cost-sharing, his company will face the hard choice of losing money or dropping out of its ACA marketplaces.
In defending the cost-sharing reductions in court, Obama administration officials have pointed out that without the payments, ACA insurers would ultimately raise their prices, which would mean higher government costs for the law's premium tax credits. The amount of money going to those credits could jump by as much as 30 percent, the HHS estimates.
For their part, the House Republicans who sued say there is a constitutional issue to prove about the power of Congress over spending. The outgoing administration counters that authority for the subsidies is already embedded in the law.
A House leadership aide, briefing reporters last week, said it is not yet clear how lawmakers would respond if Trump moved to cut off the cost-sharing payments. But, the aide acknowledged, "There are cascading effects about insurance markets we are very aware of."
I got my ACA health care from the Massachusetts site. The bronze plan, higher deductibles and not as good coverage as the plan I had from work. I could have kept my company insurance plan for a year after retiring but premiums were quite a bit more expensive, though it might have evened out with lower or no deductibles. But the ACA/state plan should work well enough for a year until I sign up for Medicare and a private insurance company supplemental plan.
This state already had a plan in place before the ACA was implemented but the state still had to conform to the same laws as the ACA even though our dem governor at the time tried to get the Feds to give the state a waiver. Good news is that I won't be getting a rate increase next year, or a very small one. Bad news is that the premiums are apparently more than in many other states, at least some states that I've seen, but I assume they might be cheaper than some other states because Mass has had the plan in place for longer than the ACA.
Quote from: KRonn on December 25, 2016, 12:55:13 PM
I got my ACA health care from the Massachusetts site. The bronze plan, higher deductibles and not as good coverage as the plan I had from work. I could have kept my company insurance plan for a year after retiring but premiums were quite a bit more expensive, though it might have evened out with lower or no deductibles. But the ACA/state plan should work well enough for a year until I sign up for Medicare and a private insurance company supplemental plan.
This state already had a plan in place before the ACA was implemented but the state still had to conform to the same laws as the ACA even though our dem governor at the time tried to get the Feds to give the state a waiver. Good news is that I won't be getting a rate increase next year, or a very small one. Bad news is that the premiums are apparently more than in many other states, at least some states that I've seen, but I assume they might be cheaper than some other states because Mass has had the plan in place for longer than the ACA.
What % of the premium is covered by subsidy?
Quote from: derspiess on October 24, 2016, 07:19:51 PM
All according to plan, right?
One Trump gets rid of Obama care Health Care costs will never increase again!
Quote from: Phillip V on December 25, 2016, 02:08:37 PM
Quote from: KRonn on December 25, 2016, 12:55:13 PM
I got my ACA health care from the Massachusetts site. The bronze plan, higher deductibles and not as good coverage as the plan I had from work. I could have kept my company insurance plan for a year after retiring but premiums were quite a bit more expensive, though it might have evened out with lower or no deductibles. But the ACA/state plan should work well enough for a year until I sign up for Medicare and a private insurance company supplemental plan.
This state already had a plan in place before the ACA was implemented but the state still had to conform to the same laws as the ACA even though our dem governor at the time tried to get the Feds to give the state a waiver. Good news is that I won't be getting a rate increase next year, or a very small one. Bad news is that the premiums are apparently more than in many other states, at least some states that I've seen, but I assume they might be cheaper than some other states because Mass has had the plan in place for longer than the ACA.
What % of the premium is covered by subsidy?
I don't qualify for a subsidy. But I should be able to get a tax break on some portion of the premiums and the money I spend at doctors, etc. on my taxes at year end.
Quote from: Monoriu on October 27, 2016, 03:58:04 PM
I am normally a small government and free market type, but I still think the US should adopt a free and universal healthcare system funded by government. Perhaps supplemented by a for profit tier that provides premium/primary care. I mean, the government already provides lots of insurance type services like fire and national defence, and nobody argues against those.
Socialism doesn't work and is un-American. When my house catches fire I sell the opportunity to put it out for profit to the highest bidder, who will naturally do it better because they have been incentivized to do so.
Quote from: fromtia on December 26, 2016, 09:29:00 AM
Socialism doesn't work and is un-American. When my house catches fire I sell the opportunity to put it out for profit to the highest bidder, who will naturally do it better because they have been incentivized to do so.
Silly analogies are silly.
Quote from: grumbler on December 26, 2016, 09:45:07 AM
Quote from: fromtia on December 26, 2016, 09:29:00 AM
Socialism doesn't work and is un-American. When my house catches fire I sell the opportunity to put it out for profit to the highest bidder, who will naturally do it better because they have been incentivized to do so.
Silly analogies are silly.
Especially when it's been demonstrated that under privatized emergency services "some ambulance response times worsened, heart monitors failed and companies slid into bankruptcy." (http://www.nytimes.com/2016/06/26/business/dealbook/when-you-dial-911-and-wall-street-answers.html?_r=0)
On the positive side, for every person that dies from private equity control over government emergency response services, Yi's little penny stocks go up .0004% and he ejaculates like a Yosemite geyser all over a karaoke machine somewhere, spraying his capital-infused jizz all over everyone like a fire suppression system of cum.
Thanks for giving me that mental image for the day. :rolleyes:
Quote from: DGuller on December 26, 2016, 11:23:05 AM
Thanks for giving me that mental image for the day. :rolleyes:
Every time a job is lost, an angel gets its wings. And then Yi blasts it with a leveraged cum facial. OMG DEBT-TO-MOUTH IS SO HAWT
Quote from: KRonn on December 25, 2016, 08:32:01 PM
Quote from: Phillip V on December 25, 2016, 02:08:37 PM
Quote from: KRonn on December 25, 2016, 12:55:13 PM
I got my ACA health care from the Massachusetts site. The bronze plan, higher deductibles and not as good coverage as the plan I had from work. I could have kept my company insurance plan for a year after retiring but premiums were quite a bit more expensive, though it might have evened out with lower or no deductibles. But the ACA/state plan should work well enough for a year until I sign up for Medicare and a private insurance company supplemental plan.
This state already had a plan in place before the ACA was implemented but the state still had to conform to the same laws as the ACA even though our dem governor at the time tried to get the Feds to give the state a waiver. Good news is that I won't be getting a rate increase next year, or a very small one. Bad news is that the premiums are apparently more than in many other states, at least some states that I've seen, but I assume they might be cheaper than some other states because Mass has had the plan in place for longer than the ACA.
What % of the premium is covered by subsidy?
I don't qualify for a subsidy. But I should be able to get a tax break on some portion of the premiums and the money I spend at doctors, etc. on my taxes at year end.
:o
My aging parents' premiums are ~$2500/mo for a silver plan, but most of that is covered by the federal subsidy. Without the subsidy, I do not know what to do for my parents' healthcare; perhaps send them to live overseas.
Quote from: Phillip V on December 26, 2016, 03:16:04 PM
:o
My aging parents' premiums are ~$2500/mo for a silver plan, but most of that is covered by the federal subsidy. Without the subsidy, I do not know what to do for my parents' healthcare; perhaps send them to live overseas.
Do they not qualify for Medicare?
Quote from: Admiral Yi on December 26, 2016, 03:22:15 PM
Quote from: Phillip V on December 26, 2016, 03:16:04 PM
:o
My aging parents' premiums are ~$2500/mo for a silver plan, but most of that is covered by the federal subsidy. Without the subsidy, I do not know what to do for my parents' healthcare; perhaps send them to live overseas.
Do they not qualify for Medicare?
60 years old. Still too young.
I had health insurance through my employer for most of the last 10 or 15 years. Premiums went up steadily. For the last three years I have a FL Blue plan from .gov website. Me and the boy only costs me $550 (I'm 46 and in good health) I currently get about $100 in breaks from the Kenyan socialist. For 2017 my premium is set to rise by about $40.
I am eagerly anticipating which version of Mitt Romney care the Republicans will replace (once the mid terms are safely over) the unspeakable travesty that is Obamacare with.
Quote from: fromtia on December 26, 2016, 05:59:08 PM
I had health insurance through my employer for most of the last 10 or 15 years. Premiums went up steadily. For the last three years I have a FL Blue plan from .gov website. Me and the boy only costs me $550 (I'm 46 and in good health) I currently get about $100 in breaks from the Kenyan socialist. For 2017 my premium is set to rise by about $40.
I am eagerly anticipating which version of Mitt Romney care the Republicans will replace (once the mid terms are safely over) the unspeakable travesty that is Obamacare with.
How many insurance provider choices did you have? In my parents' North Carolina county, there was only 1 choice for 2017 (Blue Cross Blue Shield) compared to 3 for 2016.
Quote from: fromtia on December 26, 2016, 05:59:08 PM
I had health insurance through my employer for most of the last 10 or 15 years. Premiums went up steadily. For the last three years I have a FL Blue plan from .gov website. Me and the boy only costs me $550 (I'm 46 and in good health) I currently get about $100 in breaks from the Kenyan socialist. For 2017 my premium is set to rise by about $40.
I am eagerly anticipating which version of Mitt Romney care the Republicans will replace (once the mid terms are safely over) the unspeakable travesty that is Obamacare with.
Man, I didn't think anyone bought the "replace" part of "repeal and replace".
Quote from: Phillip V on December 26, 2016, 06:07:25 PM
How many insurance provider choices did you have? In my parents' North Carolina county, there was only 1 choice for 2017 (Blue Cross Blue Shield) compared to 3 for 2016.
Yeah...United Health doesn't see any profit in niggers with diabetes (despite their stock increasing $120 to $150 this year and their CEO making $66 million), Aetna had to act childish and pulled out of the state as payback for the Obama Administration snuffing their murder and acquisition plans with Cigna, and Cigna decided it's is only going to be in the Triangle, because that's where white people with money are.
Oh, and it didn't help that North Carolinians simply didn't enroll. Because America.
Quote from: Phillip V on December 26, 2016, 03:16:04 PM
Quote from: KRonn on December 25, 2016, 08:32:01 PM
Quote from: Phillip V on December 25, 2016, 02:08:37 PM
Quote from: KRonn on December 25, 2016, 12:55:13 PM
I got my ACA health care from the Massachusetts site. The bronze plan, higher deductibles and not as good coverage as the plan I had from work. I could have kept my company insurance plan for a year after retiring but premiums were quite a bit more expensive, though it might have evened out with lower or no deductibles. But the ACA/state plan should work well enough for a year until I sign up for Medicare and a private insurance company supplemental plan.
This state already had a plan in place before the ACA was implemented but the state still had to conform to the same laws as the ACA even though our dem governor at the time tried to get the Feds to give the state a waiver. Good news is that I won't be getting a rate increase next year, or a very small one. Bad news is that the premiums are apparently more than in many other states, at least some states that I've seen, but I assume they might be cheaper than some other states because Mass has had the plan in place for longer than the ACA.
What % of the premium is covered by subsidy?
I don't qualify for a subsidy. But I should be able to get a tax break on some portion of the premiums and the money I spend at doctors, etc. on my taxes at year end.
:o
My aging parents' premiums are ~$2500/mo for a silver plan, but most of that is covered by the federal subsidy. Without the subsidy, I do not know what to do for my parents' healthcare; perhaps send them to live overseas.
My premiums seem reasonable enough, in the 460 range monthly for a silver plan, though I have a 2k yearly deductible and additional payments for certain services, like $450 for an ED visit. Premiums are going up about 12 bucks monthly for next year. Not bad but it seems Massachusetts premiums are already equal to or higher and other states are catching up to us with their hefty rate increases. I did have many insurance companies to choose from, probably because Mass has had their plan in place before the ACA so it's matured.
I'm trying to avoid too many doctor and medical stuff but I may need to get some issues taken care of. Trying to hold off until late this year when I go onto Medicare, with the supplemental insurance in which I'll choose a private insurance carrier. Those should be easier on me with less that I have to pay out of pocket for services, plus the monthly premiums will be a bit cheaper.