Thank you. I try to work one in, once in a while.

Originally Posted by The Rani

What would be even better is overcoming our ingrained assumption that "health care" necessarily means "hospitals."
For example, here's what's going on in my community right now, sponsored by a local co-op:

Hey Rani.

Any chance you might attend?
If so, would you be willing to give a brief synopsis of the proceedings?


Prince

Originally Posted by The Rani

Well, I posted that mostly in response to stupid crap like this:



Some people can't separate heath care from politics.
Public option? Legislating against doctors? Is Obama the Messiah? Who cares. Getting involved in your own community is "a tad more worthwhile" than arguing about any of those things.

And some people can't help but live in magic pony land.

Next time you run into someone who has cancer or whose wife, child or parents have cancer AND they are on the verge of bankruptcy as a result, go ahead and tell them that they should have eaten more organic granola bars and now just need to stay away from those expensive hospitals and medical care.

I'm sure they'll appreciate your sanctimonious insight.

Speaking of sanctimony, I don't really think that was the point being made.

Originally Posted by JordanGoodspeed

Speaking of sanctimony, I don't really think that was the point being made.

You're not going to stop people from going bankrupt from health costs by finding speakers on the benefits of granola to speak to people who have enough time on their hands to attend a community meeting.

Health care for life-threatening diseases takes money and a lot of it, period. The arena for that is either in govt or with charities - anybody who thinks the latter is less political than the former is pretty naive.

But admittedly, I don't spend much time in magic pony land. Perhaps those magic ponies poop cancer-killing granola bars as well as gold nuggets to pay for them. Now if Rani could just find one that talks, she's got a speaker for a community meeting that I might even go to!

Originally Posted by playwrite

You're not going to stop people from going bankrupt from health costs by finding speakers on the benefits of granola

Funny, because we've been trying to explain to you that health insurance doesn't stop Americans from going bankrupt, either.

"Unless you're a Warren Buffett or Bill Gates, you're one illness away from financial ruin in this country," ... because three-quarters of the people with a medically-related bankruptcy had health insurance

Frankly, eating oatmeal goes a lot further to reducing the risks of illness than any American health insurance plan does.

Originally Posted by JohnMc82

Funny, because we've been trying to explain to you that health insurance doesn't stop Americans from going bankrupt, either.

Or that care for people under not-American health systems does not costs "lots of money" of even remotely the magnitude as the One and Only that pw recognizes.

Originally Posted by JohnMc82

Funny, because we've been trying to explain to you that health insurance doesn't stop Americans from going bankrupt, either.

More horseshit from magic pony land. Obviously from someone who has not talked with anyone in the situation.

I posted this analysis earlier, but maybe you missed it. Tell me where this analysis goes wrong -

What Is The Out of Pocket Maximum You Will Pay Under the PPACA?
run75441 | May 7, 2013 8:00 am


Healthcare There are quite a few blogs in the blogosphere who tend to get the PPACA wrong and conflate the issues of it well beyond what is reasonable and truthful. Maybe they just do not know what the facts are and miss the benefits of the PPACA to dwell on the negatives exclusively. Many tend to dwell on the amount of money one has to pay out in insurance and deductibles, what the PPACA does not do, and why we should go back to . . . ahh nothing? For the record, the PPACA is not single payer nor is it even universal healthcare. It is a convenient compromise which has many positives which did not exist previously. Some thoughts for those who think differently . . .

Maggie Mahar at The Health Beat Blog: “Even if you do not qualify for a subsidy, your out of pocket spending is capped at about $5,500 for an individual; $12,000 for a couple. (That includes deductible and co-pays under a Bronze plan–or any other plan).

A couple earning $65,000 joint might not have $12,000 lying around –especially if they were young. But they could work out a payment plan with the hospital or surgeon– paying, say $5,000 up front as a sign of good faith, and $7,000 over time. If they had to, they could borrow the $5,000 from relatives or friends or a credit card.(These days it’s pretty easy to get a credit card that charges 0% interests on cash withdrawals for 6 months to a year).

Bottom line: they don’t lose their house, and they don’t go bankrupt. A $12,000 bill is the worst that can happen to them, even if they’re in a horrible accident and in the hospital for 3 months.

There will also be no annual limit or lifetime limit on how much the policy will pay out.

This is why the ACA is a boon—even for people who don’t qualify for subsidies. You can’t be ruined by medical bills, and they can[not] stop paying even if you have a very expensive chronic disease.

As for poor people –if they’re below 133% of poverty, they’ll be on Medicaid (once all of the states expand Medicaid which, eventually, they will).If they’re above 133% of poverty, the subsidies are rich enough to make insurance comprehensive affordable.” Maggie Mahar in an email.

Families USA Foundation: Worry Less, Spend Less: Out-of-Pocket Spending Caps Protect America’s Families; ”The Affordable Care Act initially sets the level of these new caps by referencing an existing definition—the annual out-of-pocket spending limits for high-deductible health plans that are associated with Health Savings Accounts (HSAs). If these caps went into effect in 2011,they would be $5,950 for individuals and $11,900 for families.” http://www.familiesusa2.org/assets/p...nal-Report.pdf “Worry Less, Spend Less: Out-of-Pocket Spending Caps Protect America’s Families”

I am not a big fan of Barack Obama who wanders down the double yellow, weaving from one side to the other in attempts to secure his place in presidential history; but in the end, we are better off with the PPAC than what we had before “nothing.”

As I noted earlier, as well -

"Duh."

Originally Posted by Justin '77

Or that care for people under not-American health systems does not costs "lots of money" of even remotely the magnitude as the One and Only that pw recognizes.

That's unfair if it implies that I said that our system is the best.

If what you mean by "one and only" as being the one we are going to be living with for a decade or two if not our entire lifetimes, then you are correct about my belief.

Which can be summed up rather quickly - "I don't live in magic pony land."

- which seems to be a problem with many on both the Right and the Left around here on this forum.

Originally Posted by playwrite

A couple earning $65,000 joint might not have $12,000 lying around –especially if they were young. But they could work out a payment plan with the hospital or surgeon– paying, say $5,000 up front as a sign of good faith, and $7,000 over time. If they had to, they could borrow the $5,000 from relatives or friends or a credit card.(These days it’s pretty easy to get a credit card that charges 0% interests on cash withdrawals for 6 months to a year).

Yeah... hell, that's just a few trips to Disney World they'll have to delay!

Originally Posted by JohnMc82

Yeah... hell, that's just a few trips to Disney World they'll have to delay!

Yep, but imagine if they had a $100K+ in bills due.

They won't make that up by skipping Disney for just a few years.

Add this self-inflicted element to the demographic trends eating away at the GOP as a national political force -

http://articles.latimes.com/2013/may...nsion-20130519

Medicaid opposition underscores states' healthcare disparities


...Colon cancer deaths in states opposing Medicaid expansion, for example, are an average of 16 percent higher than in pro-expansion states, according to a Los Angeles Times analysis of state health data. Deaths from breast cancer are 8 percent higher on average in anti-expansion states. And adults under 65 are 40 percent more likely on average to have lost six or more teeth from decay, infection or gum disease...

Originally Posted by The Rani

I'm hoping to be one of the volunteers!

I figured as much. I believe they would be well-served to consider your POV.

Originally Posted by Rani

It probably won't happen for a few months, but yes if I remember I'll be glad to post the details.

It does sound interesting; I'll do my best to remember as well.


Prince

Stupid politicians try to save military spending from the sequester, saying take the money from Obamacare. Meanwhile hospitals are not free market organizations. They take whatever money they can get, charge whatever they want for services they didn't order or need, and pocket enormous profits, feeding off of patients who have no choice and no "free market." But stupid libertarians and republicans keep trotting out free-market slogans anyway. Insurance companies and drug companies rack up prices and profits, claiming R&D needs that are only lies. Stupid Republicans demand that we reduce the debt by cutting Medicare and Obamacare, and save unnecessary aircraft carriers and drones to shoot innocent people overseas. Meanwhile poor people get no help, whether voluntary or "involuntary." But we have to cut these programs, even though it retards economic recovery, because these programs are "government forcing people to do things." What wretched crap; I'm tired of hearing it. Take some medicine to stop your "stop government from forcing people to do things" from coming out of your mouths.

http://money.msn.com/now/post.aspx?p...a-f42d5d3297d9

http://www.nytimes.com/2007/11/25/op...anted=all&_r=0

Want to "reduce the national debt?" Rein in medical costs.

Before reading the following article, consider this:



Some unions protest Obamacare’s impact on Multiemployer Health Plans

The Affordable Care Act (ACA) of 2010, also known as Obamacare, presents challenges to the multiemployer plans through which some unions bargain collectively to provide health care insurance for their members. These plans, often called Taft Hartley Plans, currently cover about 26 million workers, families, and retirees. Unless there is a major regulatory change made by Health and Human Services, these union negotiated plans will be struck a harsh blow once the exchanges go into effect in 2014.
A quiet effort by many unions to persuade the Obama administration to make this change is now becoming very public.

In an Op Ed published in The Hill, Joseph T. Hansen, President of the United Food and Commercial Workers (UFCW), said,

“But as currently interpreted, the ACA would block these plans from the law’s benefits (such as the subsidy for lower-income individuals and families) while subjecting them to the law’s penalties (like the $63 per insured person to subsidize Big Insurance). This creates unstoppable incentives for employers to reduce weekly hours for workers currently on our plans and push them onto the exchanges where many will pay higher costs for poorer insurance with a more limited network of providers. In other words, they will be forced to change their coverage and quite possibly their doctor. Others will be channeled into Medicaid, where taxpayers must pick up the tab.

Originally Posted by Deb C

...union negotiated plans will be struck a harsh blow...

...block these plans from the law’s benefits (such as the subsidy for lower-income individuals and families) while subjecting them to the law’s penalties (like the $63 per insured person ....

Debs, do you ever give a single moment of critical thought to the propaganda you post here?

These guys have cadillac plans; on what planet would they be subjected to the ACA penalty??? [Note, the penalty is $93 for the entire year and generally non-enforced]

And more importantly, these employer-based insurance plans are ALREADY heavily subsidized by the govt. The employer contribution receives favorable tax reduction.

It is the last magic pony poop that is the real issue behind this. In lieu of wage increases, these unions have negotiated what are referred to as cadillac health insurance plans whereby the plans basically pay for everything and the premiums are mostly covered by the employer. The employer is willing to go along with this because of that favorable tax deduction - much more than if that same money went into wages.

It's not just a matter of these unions getting a great deal (at the expense of their wages) but these cadillac plans negatively distort salaries (downward) across the industry and distort (upward) health care prices.

The ACA takes away the tax subsidy of these cadillac plans. It forces the unions back to the table with the employers.

Just try giving a moment's thought to the possible motivation of why someone is saying what they say - it will open a whole new world to you; yes, a little bit more scary world but it might give you a better chance of negotiating it - something that magic pony poop is unlikely to provide much help.

Good news reported here on Calif's new health insurance exchange that should be up and running this coming Fall -

http://news.yahoo.com/california-rev...221300803.html

California reveals prices for health insurance under Obamacare

...In California, a 40-year-old who makes less than four times the federal poverty level - that is, $95,000 for a family of four or $46,000 for an individual - would pay as little as $40 per month for a mid-level plan in which about 70 percent of medical costs and all preventive care is covered. This excludes additional costs to cover children or a spouse.

The same plan for a person who makes too much to qualify for a subsidy would run about $300 per month on average, the state said. In addition, the total amount consumers would have to pay each year for co-payments and other out of pocket costs would be limited to $6,350 or less, depending on income.

Here, they are talking about the Silver level plan that covers 70% of all costs (until costs reach a maximum and then the insurer picks up 100%). For a Bronze level plan that covers 60% of cost, a person in their 20s making under $20K would pay NOTHING as a result of the subsidies. Those subsidies continue, on a sliding basis, up to income of $46K or if they get married, $95K!

More analysis here -

http://www.washingtonpost.com/blogs/...rss_ezra-klein

Essentially, medical bankruptcy (the primary reason for personal bankruptcy) will be a thing of the past in California.

The hope is that the CA exchange will morph into a regional exchange that could combined all the states west of the Plains - this would result in incredible efficiencies, competition and lower insurance costs to millions - that is on top of the 10s of millions who will get health insurance coverage for the first time.

This could, however, make it difficult for historians to determine if the demise of the GOP as a national party was soley a result of demographics. On the other hand, I have no doubt that there will still be parades of t-baggers but this time holding signs, "Keep the Socialist Govt Hands OFF My Health Insurance Exchange!!!"

Originally Posted by playwrite

Debs, do you ever give a single moment of critical thought to the propaganda you post here?

These guys have cadillac plans; on what planet would they be subjected to the ACA penalty??? [Note, the penalty is $93 for the entire year and generally non-enforced]

And more importantly, these employer-based insurance plans are ALREADY heavily subsidized by the govt. The employer contribution receives favorable tax reduction.

It is the last magic pony poop that is the real issue behind this. In lieu of wage increases, these unions have negotiated what are referred to as cadillac health insurance plans whereby the plans basically pay for everything and the premiums are mostly covered by the employer. The employer is willing to go along with this because of that favorable tax deduction - much more than if that same money went into wages.

It's not just a matter of these unions getting a great deal (at the expense of their wages) but these cadillac plans negatively distort salaries (downward) across the industry and distort (upward) health care prices.

The ACA takes away the tax subsidy of these cadillac plans. It forces the unions back to the table with the employers.

Just try giving a moment's thought to the possible motivation of why someone is saying what they say - it will open a whole new world to you; yes, a little bit more scary world but it might give you a better chance of negotiating it - something that magic pony poop is unlikely to provide much help.

Golly gee, PW, if only we Americans would continue to believe that having a substandard health care system is what we deserve. You know, the current system that limits care, has high premiums, expensive co-pays and out of pocket expenses. And far be it that we have the same kind of insurance that our Washington representatives have. Because, dog gone it, that kind of health care system is only for the rich and elite. What the heck were those unions thinking?

Darn those socialist unions for wanting a system where people who have life threatening illness' don't go bankrupt trying to stay alive. Maybe we should demand that all of those selfish countries that have a compassionate health care system for all, should follow our country's example. Maybe you could be this country's spokesperson that convinces Americans to see the folly of wanting the same health care as our Washington leaders. I suggest starting your speech with; You selfish Americans, you do realize that only the wealthiest deserve health care that doesn't make them choose between paying a bill or getting attention for that pain in your chest.

Originally Posted by Deb C

Golly gee, PW, if only we Americans would continue to believe that having a substandard health care system is what we deserve. You know, the current system that limits care, has high premiums, expensive co-pays and out of pocket expenses. And far be it that we have the same kind of insurance that our Washington representatives have. Because, dog gone it, that kind of health care system is only for the rich and elite. What the heck were those unions thinking?

Darn those socialist unions for wanting a system where people who have life threatening illness' don't go bankrupt trying to stay alive. Maybe we should demand that all of those selfish countries that have a compassionate health care system for all, should follow our country's example. Maybe you could be this country's spokesperson that convinces Americans to see the folly of wanting the same health care as our Washington leaders. I suggest starting your speech with; You selfish Americans, you do realize that only the wealthiest deserve health care that doesn't make them choose between paying a bill or getting attention for that pain in your chest.

While I KNOW that what you want (i.e. nationalization of the health systems by act of Congress) has less of a chance than a snowball in Hell, I don't have a problem with those of you who continue to agitate for it.

I also don't really care that much of your magic pony poop propaganda posting actually hurts your cause by turning off those who are in positions to do something about it. And once Obamacare is actually up and running with all its benefits, even more people will turn away from your magic pony poops as being just silly - I don't really care about that either.

What I do care about is that Obamacare is going to soon be bringing enormous benefits to 10s of millions of people. Yes, it will not bring magic ponies pooping gold nuggets, but the benefits are going to be tangible and significant. The delivery of those massive benefits is very vulnerable politically at this moment particularly at the state level with both the Medicaid expansion and the setting up of the health exchanges as well as sufficient funding needed at the national level due to the t-baggers in the House. Your false propaganda doesn't help with that current vulnerability.

I just ask that you first post the truth. From there, any honest analysis of Obamacare compared to the only viable alternative, which is doing NOTHING, would be icing on the cake.

Insurers dump debt on physicians

A loophole in California's upcoming health care overhaul could be exploited by families gaming the system or responding to hardship in a way that doctors say could leave a pile of unpaid bills.

Comment:

By Don McCanne, M.D.

This looks like another provision of the Affordable Care Act (ACA) designed specifically to protect insurers, at least partially, from untoward losses.

To protect patients who have financial hardships that prevent them from paying their premiums on time, ACA requires that their insurance remain in force for three months before it can be cancelled for non-payment. Physicians contracted with the insurers providing plans through the exchanges will have to continue to provide services for three months after non-payment begins. The insurers, on the other hand, are required to pay the bills for only the first month. After that, the physicians bear the losses.

This is one more example of the role played by the private insurers in both creating ACA and then in implementing it, taking care of their own interests first.

Summary:

Although we can be angry with the insurers for dumping on the physicians, we should hold greater contempt for the politicians and policy makers who brought us this highly flawed financing system. They know that we could have prevented these problems by enacting an improved Medicare that automatically includes everyone, forever, but they didn't do it.

Entire article and comment:

http://www.pnhp.org/news/2013/may/in...-on-physicians

Originally Posted by Deb C

Insurers dump debt on physicians

A loophole in California's upcoming health care overhaul could be exploited by families gaming the system or responding to hardship in a way that doctors say could leave a pile of unpaid bills.

Comment:

By Don McCanne, M.D.

This looks like another provision of the Affordable Care Act (ACA) designed specifically to protect insurers, at least partially, from untoward losses.

To protect patients who have financial hardships that prevent them from paying their premiums on time, ACA requires that their insurance remain in force for three months before it can be cancelled for non-payment. Physicians contracted with the insurers providing plans through the exchanges will have to continue to provide services for three months after non-payment begins. The insurers, on the other hand, are required to pay the bills for only the first month. After that, the physicians bear the losses.

[COLOR=#333333][FONT=Georgia]This is one more example of the role played by the private insurers in both creating ACA and then in implementing it, taking care of their own interests first.

I would suggest those with a tad more critical thinking skills read the original article indicating the implausibility of this -

http://www.sacbee.com/2013/05/21/543...law-could.html

- rather than rely on Deb's link to some doctor concerned about his Mercedes Benz payments

Originally Posted by Deb C

[B]Summary:

Although we can be angry with the insurers for dumping on the physicians, we should hold greater contempt for the politicians and policy makers who brought us this highly flawed financing system. They know that we could have prevented these problems by enacting an improved Medicare that automatically includes everyone, forever, but they didn't do it.

Oh, gag me with a spoon. Barf.

They didn't do it because a large majority of voters didn't want them to.

Originally Posted by playwrite

I just ask that you first post the truth. From there, any honest analysis of Obamacare compared to the only viable alternative, which is doing NOTHING, would be icing on the cake.

Generously assuming you're right, and these really are the only choices...

Then it really doesn't matter because America is FUBAR and we're all just whistling past the graveyard.

Originally Posted by playwrite

Oh, gag me with a spoon. Barf.

They didn't do it because a large majority of voters didn't want them to.

"President Obama and a majority of Democrats in the last Congress opted for the Republican model even though many Democrats would have preferred Medicare for all, or at the very least a public option. Most polls showed that the public favored such an option. But the White House hoped for Republican support and wanted to ward off opposition from health insurers and pharmaceutical companies by promising them some 30 million additional customers." ......... Robert Reich

- he must be reading my posts here at 4T!

http://krugman.blogs.nytimes.com/201...r-republicans/

Obamacare Will Be A Debacle — For Republicans

It's not that much of a secret that much of the New Deal coming out of the last 4T was of disproportion aid to the South and to other rural areas - much of what is considered deep Red states today. Back then, politicians on both sides of the aisle were much more about getting help for their own constituents then; it was much harder to manipulate the masses with overpowering political ads and propaganda - you had to demonstrate bringing home the bacon. Today, particularly on the Right, the masses are viewed as malleable sheeple easily brought around to policies that cause personal economic harm by waving in front of them freedom fries and images of having the potential to become one of Ayn Rand's Supermen.

It will be interesting to see what happens as the tangible benefits of Obamacare roll out in Blue states and purposefully and clearly held back by the GOP in the Red States. I kind of doubt the swelling number of Millie, Hispanic, female, urban voters are going to placated by freedom fries.

Originally Posted by Deb C

"President Obama and a majority of Democrats in the last Congress opted for the Republican model even though many Democrats would have preferred Medicare for all, or at the very least a public option. Most polls showed that the public favored such an option. But the White House hoped for Republican support and wanted to ward off opposition from health insurers and pharmaceutical companies by promising them some 30 million additional customers." ......... Robert Reich

The public option is not nationalized health care.

And as I told you before, the public option went down because Ted Kennedy died of a brain tumor, Scott Brown took his seat, and Joe Lieberman is a big a-hole.

Anyone who doesn't understand this basic history and wants to talk about the politics of health care will be seen as a clueless clown by those that do know their history.

And in case you haven't notice, the House is now firmly in the hands of the GOP and Harry Reid is now even further away from being able to override a veto - even with Scott Brown and Joe Lieberman both, thankfully, gone.

But who cares about those realities when one can post magic ponies poo on the Internet?!!