The Affordable Care Act II - Because Mr. Obama Loves You All

[B-Man]

TRAIN WRECK UPDATE:

 

Under the ACA, the Doctor Won’t See You Now.

 

Getting access to a preferred, in-network doctor is getting harder all the time. Three big stories about access blocks under the Affordable Care Act came out this week. First, the NYT profiles the troubling rise of contract ER doctors. The emergency medicine departments in many hospitals now employ doctors who are out-of-network for a given insurer, even when the ER itself is listed as “in-network” for that same insurer. The result is that even patients who have the ability to choose an ER in an in-network hospital often wind up with out-of-network doctors treating them—and large, unanticipated, out-of-pocket bills as a result. . . .

 

The ACA does nothing to address this trend, which is just one example of the barriers to access popping up all across the U.S. health care system. The LA Times reports that, despite several lawsuits challenging it, California intends to stick with its narrow doctor networks for ACA plans next year. Even worse, some insurance companies are planning to cut the number of in-network providers even further. There is still no registry that would allow people to make a comprehensive assessment of which doctors will be covered under their ACA plans, a gap which caused a lot of confusion for patients in the last year.

 

Nor are those insured through the exchanges the only ones facing access problems. A Department of Health and Human services report on the ACA’s Medicaid expansion finds that many Americans newly insured through the program often have to “wait for months or travel long distances” to get care, according to the NYT. Though the federal government requires states to ensure “adequate access to all services covered,” the definition of “adequate access” is left to the states. This access problem for Medicaid recipients is not new, as Avik Roy repeatedly points out in How Medicaid Fails the Poor, and has been exacerbated as large numbers of people have joined the program.

 

In all three of these reports, we see under the ACA a declining level of access to a covered care provider. This is not what progress in health reform looks like

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PAUL HSIEH: Who Decides What Medical Care You Receive At End of Life?

 

 

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[Nanker]

The Democrats who voted for this abortion are not interested in providing healthcare for anyone - other than their special interest groups. They don't give a flying !@#$ about anything related to costs. They could give a **** about how much more insurance costs for the average Joe and whether or not they lost their previous insurance/plan/insurer/doctor/or other benefits. THEY GAVE THE COUNTRY AN AFFORDABLE HEALTHCARE LAW. It's the law, but nothing about it is affordable nor does it provide for healthcare for many people other than the Guatemalans streaming across our borders.

 

!@#$ you Democrats, and double !@#$ you Obama. You're a putz, and your wife's ugly too.

[OCinBuffalo]

Reading through the last few pages of this thread, I realized that I was more interested in cabinet making/fine furniture/Maine/Delaware than the ACA.

 

The hilarious part is they really think continuing to lie about the ACA, or deny their own utter failure, or defend a system design that now anyone can see for themselves is flawed(5 years ago you had to be a designer/have health care/insurance knowledge to see...which is why I have been calling BS for 5 years now)....

 

....is somehow "working". It's going to "turn things around". They keep digging. The shovel should've been put down, and the climbing out of the hole should have started, 18 months ago.

 

Once again, they think that their election/marketing = governing = actually doing the job, not talking about the job.

 

The Democrats have hitched themselves to a Marketer-in-Chief. The wise among us know that we have to keep marketing/sales on a short leash, or they will run wild and over-promise. Barack Obama is what happens when you let marketing/sales become CEO. It's the Barbarians at the Gate story all over again: a great sales guy is great, but never let him be a CEO.

 

A more updated version, in 3 words? Steve Ballmer Microsoft. The guy that made the thing is who you want, not the guy that talks about the thing.

 

And here's my 2 cents on Delaware:

 

There are 0 taxes in Delaware, not low taxes. Delaware is like a giant Indian Reservation, with better stores. It's 20-30 mins away from Center City depending on traffic. And, having lived in Philly for a cumulative of 5 years? Winter is a F'ing joke in Delaware compared to living in Buffalo, or really anywhere in NY.

 

It's more like an impression of winter.

 

I would talk about the packs of hotties running around all over Delaware, especially Dewey Beach, but...with a wife....not relevant. At least I hope it isn't.

[boyst]

http://ktla.com/2014/10/07/wal-mart-cuts-health-benefits-for-30000-part-time-employees/

Walmart cutting 30k part time employees healthcare plans because of Bush and the big greedy corporations.

 

Wal-Mart, the country’s largest retailer, is eliminating health benefits for about 30,000 employees to control its rising healthcare costs.

The cut applies to part-timers who work fewer than 30 hours a week, Wal-Mart said Tuesday. It impacts 2% of the company’s U.S. workforce.

... 2%!¡¡

[B-Man]

Health-Care Hell : Doctors and patients get burned by the world’s worst middleman.

By Kevin D. Williamson

 

In the first circle of Dante’s Hell, things aren’t so bad: The unbaptized and the virtuous pagans get to kick back, forever, with Homer and Ovid, watch Julius Caesar and Saladin do the limbo, etc. But things take a pretty sharp turn for the worse thereafter: Paris, Tristan, and Cleopatra get buffeted about by the winds of lust in the second circle, Cavalcante de’ Cavalcanti suffers a ghastly punishment for his heresy in the sixth, and soon enough you’ve got Satan himself gnawing on Brutus, Cassius, and Judas. But even with Virgil to guide him, Dante never looked into the little-known tenth circle of Hell, the joint headquarters of the federal health-care bureaucracies, i.e., Satan’s outhouse.

 

And if you think spending eternity submerged in a river of excrement sounds bad, try getting an appointment with a dermatologist. Dante had “Abandon Hope, All Ye Who Enter Here,” but we have “Please hold and your call will be answered in the order it was received.”

 

Researchers at JAMA Dermatology decided to do a little investigative journalism and cracked open the physicians’ directories for Medicare Advantage in twelve metropolitan areas. They invented a father with a suspicious itch, and started trying to make appointments. (Reuters provides an excellent summary of their findings

here.) With 4,754 dermatologists to choose from, you’d think that would be pretty easy — and it’s lucky for you that there’s not a level of Hell for the naïve.

That population of 4,754 dermatologists turns out to have been decimated — about a tenth of them had moved on to one of the three sections of The Divine Comedy, or, short of that, had retired or were no longer practicing medicine. But the headcount has to be reduced further, and drastically: About half of the physicians were double-listed; unsurprisingly, the federal government is a much more attentive bookkeeper when it comes to your tax liabilities than it is when it comes to your health care. Another 18 percent were simply unreachable, and 9 percent were not taking new patients. Of those 4,754 theoretical dermatologists, there turned out to be 1,266 actual dermatologists still among the living, practicing medicine, and willing to make an appointment. But not for everybody: In some cases, there was not one dermatologist willing to see patients with certain Medicare Advantage plans. That’s what happens when you put politicians in charge of health care: You get a great deal on an insurance policy that no one accepts.

 

More at the link:

 

 

At the rural managed care program that I help run in WNY, we have pretty much given up trying to get into the one Dermatalogist in the area, who is overbooked months ahead. It is just not cost-effective to transport them to Buffalo, Rochester or Erie, so we are looking into a web-cam type of arrangement where our participant will sit in front of the screen and be diagnosed by someone (not really familiar with them)

 

Seniors do not really like this type of impersonal approach according to the other rural PACE programs that I have spoken with across the U.S. ( Tennessee, Iowa) but what are you going to do.

 

and its even harder to find a Neurologist or Psychiatrist.

 

 

 

 

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Edited October 30, 2014 by B-Man

[Nanker]

Hope everyone's open enrollment period is going well, and you all remember who brought this abortion into the world and act accordingly next Tuesday.

 

Wifey and I are still getting adjusted to the idea of our swell new $2,600 deductible in 2015, which is well, $2,600 more than it was in 2014. Thank YOU B. O.

[Keukasmallies]

I'm just enchanted w/ the Obamacare fallout impacting my Medicare supplemental policy. Currently, the change in my monthly supplemental policy premium through Excellus is an increase of $43.00 (from $140 to $183) effective 1/1/15. Additionally, I get to enjoy higher co-pays for MD visits, medical equipment, etc. It seems that the complaints originally mentioned by the programs detractors have come to pass; but, HA HA, it's too late now! Hey, who doesn't enjoy a 30.7% increase?

 

On the other hand, if I could manage to ingest ever more generic prescription drugs, the decrease in cost from $4.00 to $2.00 per prescription might just offset the premium increase. Yeah, that's it, I'll focus on that ray of sunshine....

 

As soon as I post this comment, I'm going to go through our neighborhood and see if I can get more 24 - 35-year-olds to sign up for the ACA to take the pressure off those of us who were perfectly satisfied pre-fiasco.

Edited October 31, 2014 by Keukasmallies

[ExiledInIllinois]

Hope everyone's open enrollment period is going well, and you all remember who brought this abortion into the world and act accordingly next Tuesday.

 

Wifey and I are still getting adjusted to the idea of our swell new $2,600 deductible in 2015, which is well, $2,600 more than it was in 2014. Thank YOU B. O.

 

What's the deductible for? Hospitalization?

 

Should I say this? Hate to rain on the parade.

 

My is the same as usual, yet I am paying 300 bucks LESS a month... Loving it. My share was always going up and up for the last 15 years. I am back down to pre-2000 cost.

[boyst]

Open enrollment is coming, got an email to plan ahead now and pick the right plan for me! The costs, those come later. But, pick your plan now and sign up for it! We'll send you the cost and bill when we can.

[DC Tom]

Open enrollment is coming, got an email to plan ahead now and pick the right plan for me! The costs, those come later. But, pick your plan now and sign up for it! We'll send you the cost and bill when we can.

 

To paraphrase one of its proponents: You have to buy it to know how much it costs.

[Koko78]

Open enrollment is coming, got an email to plan ahead now and pick the right plan for me! The costs, those come later. But, pick your plan now and sign up for it! We'll send you the cost and bill when we can.

 

Let me be clear: If you like your premium, you can keep your premium. Period.

[Nanker]

 

 

What's the deductible for? Hospitalization?

 

Should I say this? Hate to rain on the parade.

 

My is the same as usual, yet I am paying 300 bucks LESS a month... Loving it. My share was always going up and up for the last 15 years. I am back down to pre-2000 cost.

No. It's for any and everything. The plan pays **** until I've spent $2,600 out of my own pocket.

!@#$ you B O I hope you get Ebola.

[birdog1960]

hmmmm….http://www.forbes.com/sites/rickungar/2014/10/31/key-study-on-obamacare-2015-premium-rates-is-out-and-you-wont-believe-whats-going-to-happen/

[Keukasmallies]

birdog 1960, thanks for the link. I'm going to forward it to Excellus BCBS and ask them to rescind the 30.7% increase they just visited upon me. Maybe they hadn't read the article yet, huh?

 

Of course, as we all know, ObamaCare really describes a somewhat narrow component of the entire health care spectrum. The "outer concentric circles" of health insurance suffer negative impacts in order to fund the core of the ACA.

Edited November 2, 2014 by Keukasmallies

[Dorkington]

My out of pocket rates stayed about the same, my service is the same/better since preventative visits are covered in full, and my company is contributing less.

 

Thanks Obama!

[IDBillzFan]

My out of pocket rates stayed about the same, my service is the same/better since preventative visits are covered in full, and my company is contributing less.

 

Thanks Obama!

 

Funny how progressives seem to be the only people talking about what a sweet deal Obamacare has been for them.

[Dorkington]

Funny how progressives seem to be the only people talking about what a sweet deal Obamacare has been for them.

Hey, if it hasn't worked for you, that's fine... I'm not making **** up about my personal experiences.

 

I had to change insurance providers to get the same price, but I actually switched to a provider that I prefer, so I'm ok with it.

 

Also, of note, I'm relatively young, and healthy, so I'm not attached to "my doctor", and I don't have prescriptions to worry about, so I have no clue if those prices went up or not. For me, the ACA has worked well... going in for a general check up doesn't cost me anything, when it used to. Prices went up every year for me, until this year. The only change this year, was that my company gave us access to an insurance exchange, whereas before they chose the company for us. Competition is good, I think both conservatives and progressives can agree on that. No clue if ACA is what caused my company to take part in an exchange, or if it's simply more profitable for them.

 

Anyways... "Obamacare" is kinda funny in that it's based on old conservative ideas, yet when Democrats implemented it, it became a "progressive idea"... yet, speak to most progressives, and they'll tell you that this is a bandaid at best, and we really should implement a single payer system. (which has it's pros and cons, as we've seen here in debate) This whole subject kinda created a large divide over what's relatively small changes.

[Azalin]

 

Anyways... "Obamacare" is kinda funny in that it's based on old conservative ideas, yet when Democrats implemented it, it became a "progressive idea"... yet, speak to most progressives, and they'll tell you that this is a bandaid at best, and we really should implement a single payer system. (which has it's pros and cons, as we've seen here in debate) This whole subject kinda created a large divide over what's relatively small changes.

 

how is Obamacare based on 'old conservative ideas', and why is it considered a 'bandaid at best' when it was sold as a complete overhaul of our helthcare system?

[Dorkington]

I was under the impression that it's largely based on ideas from the Heritage Foundation (and then supported by various conservative politicians), and similar to work done under Romney in Mass. If I'm wrong, feel free to correct me, I'm not an expert.

 

And political sales pitches are always bull ****. Left side, right side, whatever... a capitalist system with a couple more regulations here and there, and some subsidy availability is not an overhaul, it's an adjustment. It appears most here have had negative experiences with the outcome of the law. Mine have been "business as usual", and that's not good enough. I want to see America join the rest of the modern world.

[IDBillzFan]

I was under the impression that it's largely based on ideas from the Heritage Foundation (and then supported by various conservative politicians), and similar to work done under Romney in Mass. If I'm wrong, feel free to correct me, I'm not an expert.

 

Just a thought: if you're genuinely not sure what you're talking about...stop talking. Because when you try to sound like an authority by referencing something you 'were under the impression' about, you sound less like an authority and more like gatorman.