Originally Posted by playwrite

Only the weak-minded and the contemptible would blame the firefighter as much as the arsonist

When the firefighter goes around starting fires willy-nilly himself, and always helps the arsonist get away and cover his tracks... it kind of makes a whole lot of sense to blame them both just the same.

Originally Posted by Justin '77

When the firefighter goes around starting fires willy-nilly himself, and always helps the arsonist get away and cover his tracks... it kind of makes a whole lot of sense to blame them both just the same.

And I try to ignore the flamethrowers.

Originally Posted by Justin '77

When the firefighter goes around starting fires willy-nilly himself, and always helps the arsonist get away and cover his tracks... it kind of makes a whole lot of sense to blame them both just the same.

The election of Scott Brown killed any hope of single payer or a public option then and far into the future. He was a repub. That is all there is to it. Anyone who does not understand that is living in magic pony land, period.

Originally Posted by radind

I still do not like the Affordable Care Act (ACA) , but we do need a way to have health care insurance on a national level.

Consider Plan B-a federally backed risk pool. I can imagine a politician arguing for it as an extension of the safety net. Trying to use a model from a European welfare state, on the other hand, may run afoul of regional differences in America.

Originally Posted by TimWalker

Consider Plan B-a federally backed risk pool. I can imagine a politician arguing for it as an extension of the safety net. Trying to use a model from a European welfare state, on the other hand, may run afoul of regional differences in America.

Perhaps a modified French health care system would work, if we could convince a majority that this is not a European welfare plan.
-We continue to consume French Fries

Health Care Reform Series: The French health care system
http://www.examiner.com/article/heal...th-care-system

…"focus on health care in France, where social safety net programs are far more expansive than in the US; but whose health care system bears a closer resemblance to our own than the socialized, government-run systems in Britain and Canada. The French also earn consistently higher marks on health care measures than the U.S."...

http://crooksandliars.com/nicole-bel...-leaves-mcconn

KY Gov Praise of Obamacare Leaves McConnell, Rand Dumbfounded
By Nicole Belle

Lord love Democratic Governor of Kentucky Steve Beshear. Speaking to a crowd of Kentucky voters at a fundraising breakfast, Beshear took the opportunity to praise the Affordable Care Act (also known as Obamacare) to the overwhelming support of the audience and take subtle jabs at those who were opposing Obamacare, which include Senators Mitch McConnell and Rand Paul who were also attending.

Republican Senators Mitch McConnell and Rand Paul, also attending, weren’t expecting the onslaught. Jill Lawrence reported, “It was not what anyone expected—least of all Republican Sens. Mitch McConnell and Rand Paul, who sat stone-faced onstage with Beshear as he unloaded on them without using names.”

Beshear finished with a stab to the heart of GOP’s NoCare, no alternative. “It’s amazing to me how people who are pouring time and money and energy into trying to repeal the Affordable Care Act sure haven’t put that kind of energy into trying to improve the health of Kentuckians,” according to the National Journal.

Ouch. That had to hurt Mitch McConnell especially, who is in a serious fight to retain his seat against challenger Alison Grimes. The National Journal reports that Beshear got very pointed with his criticism:

The governor compared health insurance to "the safety net of crop insurance" and said farmers need both. He said 640,000 Kentuckians—15 percent of the state—don't have health insurance and "trust me, you know many of those 640,000 people. You're friends with them. You're probably related to them. Some may be your sons and daughters. You go to church with them. Shop with them. Help them harvest their fields. Sit in the stands with them as you watch your kids play football or basketball or ride a horse in competition. Heck, you may even be one of them."

Beshear went on to say that "it's no fun" hoping and praying you don't get sick, or choosing whether to pay for food or medicine. He also said Kentucky is at or near the top of the charts on bad-health indicators, including heart disease, diabetes, cancer deaths, and preventable hospitalizations. He said all that affects everything from productivity and school attendance to health costs and the state's image.

"We've ranked that bad for a long, long time," he said. "The Affordable Care Act is our historic opportunity to address this weakness and to change the course of the future of the commonwealth. We're going to make insurance available for the very first time in our history to every single citizen of the commonwealth of Kentucky."

THIS is what I want to see Democrats doing as we near the 2014 mid-terms. Be unapologetic. Put the Democratic agenda in human terms everyone can understand. Push Republicans back on their heels and force them to defend their record.

Take note, Democrats. This is how you do it.

Obamacare not yet implement and already showing the vulnerability of GOP stalwarts - the Senate Minority Leader and the best chance at a 2016 Presidential bid from the Libertarian wing. No wonder there is increasing hysteria from the Right as we draw closer to 2014... and wait until 2016 when the baggers will be holding protest signs reading "Keep the Govt Socialist hands off my Obamacare!"

Perhaps the only ones likely to become more hysterical than the Right are those on the Far Left - imagine millions thanking the evil corporatism Obama for their getting health insurance for the first time.

Originally Posted by radind

Perhaps a modified French health care system would work, if we could convince a majority that this is not a European welfare plan.
-We continue to consume French Fries

If you want to go Euro, there's more than one model -

http://nation.time.com/2012/08/16/he...-and-loves-it/

Switzerland Has Its Own Kind of Obamacare — and Loves It
The country requires everyone to purchase private health insurance, a system that seems to work efficiently while keeping costs under control.

...“Switzerland’s system is superb: consumer-driven, cost-effective, and equitably distributed,” says Regina Herzlinger, a Harvard Business School professor who has studied the Swiss model extensively. “For quality care, patient satisfaction, and chronic disease management and prevention, the Swiss come out on top.” Indeed, Switzerland’s population is among the healthiest in the world. According to United Nations, they have the second-highest life expectancy in the world, while the United States lags behind in the 38th place, proving, perhaps, that the highest price tag — nearly $8,000 per person in healthcare spending each year in the U.S. — doesn’t guarantee the best or most equitable care...

Some argue Switzerland has the best health system in the world -

http://www.forbes.com/sites/theapoth...h-care-system/

Why Switzerland Has the Best Health Care System in the World

"ObamaCare has become big business for an elite network of Washington lobbyists and consultants who helped shape the law from the inside."

ObamaCare’s architects reap windfall as Washington lobbyists

he voracious need for lobbying help in dealing with ObamaCare has created a price premium for lobbyists who had first-hand experience in crafting or debating the law.Experts say that those able to fetch the highest salaries have come from the Department of Health and Human Services (HHS) or committees with oversight power over healthcare.

Demand for ObamaCare insiders is even higher now that major pieces of the law, including the healthcare exchanges and individual insurance mandate, are being set up through a slew of complicated federal regulations.

“Congress is easy to watch,” said Tim LaPira, a politics professor at James Madison University who researches the government affairs industry, “but agencies are harder to watch because their actions are often opaque. This leads to a greater demand on K Street” for people who understand the fine print, he said.


“K Street’s agenda follows the government’s agenda. It’s not typically the other way around,” he said.

Watchdogs say the rise of the ObamaCare lobbyist is another example of the “revolving door” that turns public service into private enrichment.

"The windfall from the healthcare overhaul is being reaped at firms large and small. Some veterans of the legislative push have landed at boutique firms that are increasingly specializing in lobbying niches."

Even the president needs some lobbying know-how when it comes to advancing ObamaCare.The White House brought on Clinton administration veteran and former lobbyist Chris Jennings last month to help navigate the implementation of the law.

During a call with several directors of the state healthcare exchanges on Wednesday, Jennings was seated in a plum position — right next to Obama.

http://www.healthcare-now.org/obamac...gton-lobbyists

Originally Posted by Deb C

"ObamaCare has become big business for an elite network of Washington lobbyists and consultants who helped shape the law from the inside."

ObamaCare’s architects reap windfall as Washington lobbyists





"The windfall from the healthcare overhaul is being reaped at firms large and small. Some veterans of the legislative push have landed at boutique firms that are increasingly specializing in lobbying niches."



http://www.healthcare-now.org/obamac...gton-lobbyists

Only the most naive person in the world (or, one with "an agenda") would believe that Obamacare is unique in having an army of lobbyists. Even if there was "single payer" or the public option, there would be armies of lobbyists angling for their special interests. Do you have any idea how many lobbyists are involved in Medicare?

Get a clue.

Pennsylvania grows a brain and buys into the Medicaid expansion.

Obamacare bringing health care (single payer!) to another 400,000 people!

Remember this when the GOP a-holes use Obamacare to shutdown the govt and hold us hostage to the debt ceiling. The a-holes are willing to cripple our economy so 10s of millions will not get health insurance coverage for the first time! You go, a-holes!

At least this will differentiate the true Progressives who want to ACTUALLY help people from the far-Left the PINO's (Progressive in name only) who just want to just BITCH on the Internet.

http://livewire.talkingpointsmemo.co...nder-obamacare

Report: Pennsylvania Will Expand Medicaid Under Obamacare


Pennsylvania Gov. Tom Corbett (R) will relent and expand Medicaid under the Affordable Care Act, according to a local report, extending health coverage to more than 400,000 people.

LancasterOnline cites "sources close to the governor" in its report. An announcement is expected next week.

Corbett had previously balked at accepting federal money to expand the program. He cited concerns about the federal government's funding committment and demanded that the Obama administration allow Medicaid reforms before he would aggree to the expansion.

The news site noted it was "not immediately clear" what changed Corbett's mind.

- what happens to a nation when about a 1/3rd of its legislative body are complete morons?

http://www.washingtonpost.com/blogs/...p-off-a-cliff/

Wonkbook: Obamacare is driving the GOP off a cliff
By Ezra Klein and Evan Soltas

In 2010, congressional Democrats lost a lot of seats as a consequences of voting for Obamacare. The expectation was that much the same might happen in 2014, as the GOP took advantage of the various glitches and hiccups sure to manifest during the roll-out.

But congressional Republicans are increasingly worried that Obamacare is going to lead them to losses -- or at least stand in the way of key wins -- come 2014.

The issue isn't that Obamacare is suddenly popular. It's not. But it's so unpopular among Republicans that the party's right flank is embracing desperate and destructive tactics to oppose it.

Consider this sentence from today's Times: "Just five scheduled legislative days stand between the House and a government shutdown that has loomed for months. As of now, Republican leaders appear to have no idea how to stop it."

The reason they have no idea how to stop it? Obamacare. Conservatives are refusing to fund the government if that funding includes the money intended for the Affordable Care Act. So Obamacare might lead the GOP to force an unnecessary and unpopular government shutdown -- one that even most members of their party don't support.

And after the government-funding deadline, of course, comes the debt ceiling. There, Republican leadership is arguing that the deal should be a year of debt-ceiling increase for a year of Obamacare delay. The Obama administration obviously won't go for that -- in fact, they say they won't negotiate over the debt ceiling at all -- so GOP leaders will need to find a way out of that promise.

But what if they can't manage that legislative two-step? What if they actually cause a debt ceiling breach, and take the blame for the resulting economic chaos, and the permanently higher borrowing costs?

The GOP's strategy for ending Obamacare has gone from "repeal-and-replace" to "shutdown-and-default." That's a disaster for their party -- and the leadership knows it. Obamacare has begun working politically for the Democrats, but not in a way that anybody ever expected.

GOP - on the eve of destruction. Makes me smile.

Originally Posted by playwrite

Pennsylvania grows a brain and buys into the Medicaid expansion.

Obamacare bringing health care (single payer!) to another 400,000 people!

Remember this when the GOP a-holes use Obamacare to shutdown the govt and hold us hostage to the debt ceiling. The a-holes are willing to cripple our economy so 10s of millions will not get health insurance coverage for the first time! You go, a-holes!

At least this will differentiate the true Progressives who want to ACTUALLY help people from the far-Left the PINO's (Progressive in name only) who just want to just BITCH on the Internet.

http://livewire.talkingpointsmemo.co...nder-obamacare

Obamacare is so sensible that some politicians who won election on a reaction to the progressive agenda of Barack Obama have latched onto it. If that isn't political success, then what is? Obamacare has become "an offer that they can't refuse".

Originally Posted by TimWalker

Consider Plan B-a federally backed risk pool. I can imagine a politician arguing for it as an extension of the safety net. Trying to use a model from a European welfare state, on the other hand, may run afoul of regional differences in America.

But there is also another "model" out there, as I have pointed out here before, on numerous occasions - from the "socialist" state of Utah!

Surely anything that is not too far "left" for Utah cannot be too far "left" for the USA as a whole (and New Jersey is a somewhat less politically-jarring example).

Originally Posted by playwrite

http://nation.time.com/2012/08/16/he...-and-loves-it/

Some argue Switzerland has the best health system in the world -

"Only the most naive person in the world" would actually believe that there's more than a superficial similarity between Swiss healthcare and the ACA. The glaring difference is that all private insurers in Switzerland are required to offer their basic plans at a zero-profit cost. The ACA, on the other hand, guarantees a generous profit margin that can only be increased by raising premiums.

Now, even with the obvious advantage of cutting out private insurer profits, healthcare in Switzerland is still more expensive, per capita, than any other universal systems out there.

"Hey guys, let's take the next most expensive healthcare system as a model - then figure out how to stuff even more costs in it! Instead of defending this lobbying give-away, let's just insult the people who see through the charade!"

Originally Posted by JohnMc82

"Only the most naive person in the world" would actually believe that there's more than a superficial similarity between Swiss healthcare and the ACA. The glaring difference is that all private insurers in Switzerland are required to offer their basic plans at a zero-profit cost. The ACA, on the other hand, guarantees a generous profit margin that can only be increased by raising premiums.

Now, even with the obvious advantage of cutting out private insurer profits, healthcare in Switzerland is still more expensive, per capita, than any other universal systems out there.

"Hey guys, let's take the next most expensive healthcare system as a model - then figure out how to stuff even more costs in it! Instead of defending this lobbying give-away, let's just insult the people who see through the charade!"

This is a good example of the disingenuous horseshit that so readily falls out of the mouths of the increasingly desperate Right these days. It's superficiality posing as some deep insight.

The Swiss system is a mandated insurance system that gets everyone in the pool to lower overall insurance cost. One could make a full stop at this point because that is the most central premise of Obamacare, everything else is relatively the small details. But let's take a look at those "small detail" differences.

If anyone believes that a company, including insurance companies, anywhere in the world, including Switzerland, will operate without the possibility of profit... well, there's this bridge in NYC that goes into Brooklyn that I can arrange for you to buy; just let me know.

That should be enough for most people to blow-off John's latest horseshit. If not, however, let me give you some clues to look for. Swiss insurers have to provide "base insurance" to everyone at no profit in order to quality for providing "supplemental insurance" that they can profit from. Now, maybe a smart person might want to compare that Swiss "base insurance" to what Obamacare offers, at the Bronze and up level, to get a sense of whether the typical Swiss person would seek for-profit supplemental insurance. Hmm.

Some other details one might want to throw in the mix are, of course, the Obamacare subsidies, that help pay a larger part of the insurers' bill and thus their profit to perhaps the tax advantages the Swiss insurers get for offering no-profit insurance. Hmmm.

Oh, and by now, all should be familiar with the Lost Medical Ratio that says ALL costs to the insurer (including profits and salaries as well as the cost of conducting business - rent, electricity etc) can not exceed 15% of the premium revenues for their group insurance and 20% for their individual insurance - that is where the insurers have to squeeze out any profit. Anyone have an idea how much profit they'll get after ALL other costs are covered? Yea, I didn't think so, but that doesn't really stop the whining now does it?

We're almost over the last major hump of desperate whining. If we can get by this govt shutdown and debt ceiling craziness, we're in for a year of diminishing whines. A year from now, we will just begin to see the baggers carrying their signs of "keep the socialist govt hands off my Obamacare!" For me, it can't come soon enough.

-- coming down to the wire on the last gasp of Obamacare obstruction.

We have now entered the week where the pressure on the GOP House to get a bill to the Senate starts to become a real issue in regard to shutting down the govt. At the end of this week, no House bill will start setting everybody on edge including incessant media coverage particularly this coming Sunday talking heads shows.

Lot's of last minute machinations in the House that basically comes down to House GOP forgoing a shutdown and maybe getting a symbolic vote or some sort of weird one-upmanship on the Senate (that will be eventually reversed within a year as people come to love Obamacare or at least realize the lies about the world coming to an end with its passage).

Then we enter the Octoberfest of debt ceiling craziness with the global economy hanging in the balance.

It's going to be desperation time and brace for a lot of craziness.

But, it is coming to an end. I say by December, the trend will be increasingly looking back at this time with increasing amusement of just how stupid certain people are and how that stupidity gets them attention and unfortunately, power to do more stupid stuff.

But again, it is coming to an end.

Any doubt about where this ends becomes clear when you pause and look at the details of the reality; such as -

http://www.dailykos.com/story/2013/0...nbsp-insurance

Six million Americans will pay less than $100/month for health insurance
by Joan McCarter

More bad news for House Speaker John Boehner, who thinks that the premium rate shock people are going to experience in the first few weeks of Obamacare enrollment will strengthen his hand in holding the debt ceiling hike hostage for a delay in Obamcare. Here's his problem: For more than six million people there won't be any rate shock, according to a new report that the Department of Health and Human Services Tuesday, obtained by USA Today.

WASHINGTON — About 6.4 million Americans eligible to buy insurance through the new health exchanges will pay $100 or less a month in premiums because of tax subsidies, according to a Department of Health and Human Services report to be released Tuesday and obtained by USA TODAY.
The report by the HHS office for planning and evaluation said the lower premiums would primarily apply to insurance customers who buy what are called "silver" plans on the exchanges that open Oct. 1. [...]

Although not all of the states nor the federal exchange have announced their rates yet, researchers determined they could estimate payments without that information. As an example, the Affordable Care Act states that someone making 150% of the federal poverty level, or $17,235 a year, would pay 4% of their income—or $57—for the second-lowest-cost plan. So, that person's subsidy would be the difference between the $57 and the cost of the silver plan in that state.

"Consequently, it is not necessary to know the actual second-lowest-cost silver premium to determine how many people will pay $100 or less per person per month for a silver plan," the report states.

Note that the researches didn't use the cheapest, least generous plan offered on the exchanges—the Bronze plan—but the second-cheapest. Silver plans will cover 70 percent of medical expenses, with patients paying the other 30 percent, with deductibles expected to be about $2,000, and must include services in 10 categories of essential health benefits defined by the law. It's important to remember when considering deductible costs how much of annual care—cancer screenings, annual exams, vaccinations, immunizations, wellness checks—will not require a copay.

In addition to the 6.4 million who will be able to get insurance for less than $100 on the exchanges, about 12.4 will be included in expanded Medicaid in the states that have opted in to the program. Those people will pay nominal premiums or nothing at all.

All of which makes the Boehner's strategy, to wait until the debt ceiling fight to take on Obamacare, even more ridiculous. See, Boehner thinks that they'll have more leverage after all that rate shock people will experience in the first few weeks of Obamcare enrollments. Where there's no rate shock, there's no outrage. Where there's no outrage, there's no justification for delaying Obamacare.

evils I's tell ya, evils! That Obama bringing health insurance to 10s of millions!!!

The people who helped screw us over, now screws us over by working with the very industry that is already screwing us over.

"The health care industry now spends more money on lobbying in Washington than any sector of the economy — more than $243 million last year alone, slightly higher than the $242 million spent by financial, insurance and real estate companies, according to the Center for Responsive Politics here.Of the “revolving door lobbyists” profiled by the center, those specializing in health care account for 12 percent, more than any other economic sector."


Reaping Profit After Assisting on Health Law

Washington’s health care revolving door is spinning fast as the new online health insurance marketplaces, a central provision of President Obama’s health care law, are set to open Oct. 1. Those who had a hand in the law’s passage are now finding lucrative work in the private sector, as businesses try to understand the complex measure, reshape it by pressing for regulatory changes — or profit from it.

Really?

Oh how shocked I am that the insurance industry will have the upper hand. Not!

Liz Fowler, a onetime executive with WellPoint, the insurer, helped draft the legislation as the chief health counsel for the Senate Finance Committee and later joined the administration. Now she runs global health policy for Johnson & Johnson, the medical equipment and pharmaceutical giant, which strongly backed the health bill and stands to benefit from it.
Ms. Fowler is not a registered lobbyist, but she does provide in-house advice on the bill — work that has drawn criticism from publications like the British newspaper The Guardianand the Web sites Salon and The Huffington Post, where the journalist Bill Moyers singled out Ms. Fowler, asserting that “when push comes to shove, corporate interests will have the upper hand.”

Conflicts of interest? You betcha!

Many of the former health care officials are lawyers or lobbyists, though not all. Nancy-Ann DeParle, Mr. Obama’s former “health czar” and later his deputy chief of staff, now guides health care investments as a partner in a new private equity firm, Consonance Capital, with colleagues from her pre-White House days. Bob Kocher, a doctor, management consultant and former member of Mr. Obama’s economics team, is a California venture capitalist, helping finance health start-ups.

While Obama made them sign an ethics document on how they could not lobby while he was still president, many sure found ways around that agreement. Not to mention that some were already working for the insurance industry to begin with.

The revolving door benefits the creators of ACA, while millions of citizens will still be without insurance coverage, others will have junk policies that will be useless when needed.

http://www.nytimes.com/2013/09/18/us...ewanted=2&_r=0

Originally Posted by Deb C

The people who helped screw us over, now screws us over by working with the very industry that is already screwing us over.

"The health care industry now spends more money on lobbying in Washington than any sector of the economy — more than $243 million last year alone, slightly higher than the $242 million spent by financial, insurance and real estate companies, according to the Center for Responsive Politics here.Of the “revolving door lobbyists” profiled by the center, those specializing in health care account for 12 percent, more than any other economic sector."


Reaping Profit After Assisting on Health Law




Really?

Oh how shocked I am that the insurance industry will have the upper hand. Not!



Conflicts of interest? You betcha!



While Obama made them sign an ethics document on how they could not lobby while he was still president, many sure found ways around that agreement. Not to mention that some were already working for the insurance industry to begin with.

The revolving door benefits the creators of ACA, while millions of citizens will still be without insurance coverage, others will have junk policies that will be useless when needed.

http://www.nytimes.com/2013/09/18/us...ewanted=2&_r=0

Dearie, I hate to break the news to you, but slavery went out the window back around 1865 - people can work wherever they damn well please.

A "conflict of interest" is a legal term. Do you have a law degree and are prepared to make that case? If not, you might want to look into laws concerning libel.


13 days before the health exchanges open; you can smell the desperation from the obstructionist and whiners. Imagine, a year from now, 10s of millions praising Obamacare and scratching their heads about how they listened to so many a-holes before.

Originally Posted by playwrite

13 days before the health exchanges open; you can smell the desperation from the obstructionist and whiners. Imagine, a year from now, 10s of millions praising Obamacare and scratching their heads about how they listened to so many a-holes before.

Many of us without insurance are looking forward to even the most minimal plan. When people without insurance can finally get it, things will get better for everyone.

Note: Walgreens, Sears Holdings, and other corps are terminating thier employer health plans, and giving employees cash allowances for private insurance exchanges. Our march to Mexico continues. Employers have looong wanted to get out of the HR hassle/cost, and the employees will find out, again, just what cheap bastards thier employers are. This is the defined benefit-to-401k shuffle. Fund your own frakking life!

Somehow, I don't think that will make employers very popular. Or healthcare providers, after being forced to disclose obscene pricing.

Give it another eight years from 2016, to 2024, and a single payer option just might fly.

Originally Posted by Bad Dog

Many of us without insurance are looking forward to even the most minimal plan. When people without insurance can finally get it, things will get better for everyone.

Note: Walgreens, Sears Holdings, and other corps are terminating thier employer health plans, and giving employees cash allowances for private insurance exchanges. Our march to Mexico continues. Employers have looong wanted to get out of the HR hassle/cost, and the employees will find out, again, just what cheap bastards thier employers are. This is the defined benefit-to-401k shuffle. Fund your own frakking life!

Somehow, I don't think that will make employers very popular. Or healthcare providers, after being forced to disclose obscene pricing.

Give it another eight years from 2016, to 2024, and a single payer option just might fly.

Trader Joe's and Starbucks have just increased their employees premiums. Many of our friends who work in hospitals are telling us that there are numerous cutbacks in staff because of the skimpy payments they will be getting for patient care.

There's an underbelly of ACA that needs to be exposed. You might want to read the following article.

"Leave policy decisions to private insurers and they will always select policies that will advance their business models as opposed to policies that would provide optimal access, quality and affordability for patients. Having cheap premiums is no solution when you can’t get a doctor when you need one, and, when you finally do, you’re left broke."


Insurers limiting doctors, hospitals in health insurance market

By Chad Terhune
Los Angeles Times, September 14, 2013


The doctor can’t see you now.

To hold down premiums, major insurers in California have sharply limited the number of doctors and hospitals available to patients in the state’s new health insurance market opening Oct. 1.

New data reveal the extent of those cuts in California, a crucial test bed for the federal healthcare law.
Consumers could see long wait times, a scarcity of specialists and loss of a longtime doctor.

“These narrow networks won’t work because they cut off access for patients,” said Dr. Richard Baker, executive director of the Urban Health Institute at Charles Drew University of Medicine and Science in Los Angeles.
To see the challenges awaiting some consumers, consider Woodland Hills-based insurer Health Net Inc.
Across Southern California the company has the lowest rates, with monthly premiums as much as $100 cheaper than the closest competitor in some cases. That will make it a popular choice among some of the 1.4 million Californians expected to purchase coverage in the state exchange next year.

But Health Net also has the fewest doctors, less than half what some other companies are offering in Southern California, according to a Times analysis of insurance data.

In Los Angeles County, for instance, Health Net customers in the state exchange would be limited to 2,316 primary-care doctors and specialists. That’s less than a third of the doctors Health Net offers to workers on employer plans.

Other major insurers have pared their list of medical providers too, but not to Health Net’s degree. Statewide, Blue Shield of California says exchange customers will be restricted to about 50% of its regular physician network.

“We are nervous about these narrow networks,” said Donald Crane, chief executive of the California Assn. of Physician Groups. “It was all about price. But at what cost in terms of quality and access? Is this contrary to the purpose of the Affordable Care Act?”


http://www.latimes.com/business/la-fi-insure-doctor-networks-20130915,0,…

These new data on use of narrow provider networks in state insurance exchanges, using Los Angeles County as an example, are important because they show us the extent to which this concept is being applied. Narrow provider networks reduce health care spending by limiting patient access to low cost providers – taking away choice – and by impairing access though supply-side contractions, that is, rationing care by limiting the supply of covered health care providers.

Read very carefully.

Another table accompanying the Los Angeles Times article (available at the link above) lists premiums for typical policies issued by these insurers for the benchmark silver plans. When comparing premiums with the numbers of physicians in the network, there are several interesting observations. Health Net, with the fewest number of physicians in their network, has the lowest premiums – no surprise. Blue Shield, California’s nonprofit Blues plan, has premiums on the lower end though it has a much larger number of physicians than does for-profit Anthem Blue Cross, yet their premiums are similar. The nonprofit seems to be more concerned about patient access whereas the for-profit seems to be concerned more about profits. However, Anthem’s EPO (exclusive provider organization) offers a larger choice in providers but extracts a much larger premium for that coverage. Comparing Anthem’s two products, it looks like if you want an accessible doctor, you’re going to have to pay for that right. Considering that Kaiser is a closed, integrated health system, it does have a fairly decent number of physicians, but it also has the highest premiums. It is likely that Kaiser’s premiums are not high because of the number of physicians, but rather they are high to prevent destabilization of their business model by allowing too many new enrollees which might strain their capacity.

Health Net’s silver plan premiums are set far enough below the others such that they will be very attractive for shoppers in the insurance exchange. The bronze plans have even lower premiums and will also be attractive. Most shoppers will be relatively healthy and will select their plans based on the premium – not on the physician networks nor on the out-of-pocket costs they would face if major health problems were to develop. Some of these people will become ill or suffer significant injuries. At that time they will discover that their choices of providers are too limited, that access may be impaired because the physicians are too busy or because they are too far away, and that the out-of-pocket expenses to which they are exposed will cause financial hardships.

Originally Posted by Deb C

"Leave policy decisions to private insurers and they will always select policies that will advance their business models as opposed to policies that would provide optimal access, quality and affordability for patients. Having cheap premiums is no solution when you can’t get a doctor when you need one, and, when you finally do, you’re left broke."


Insurers limiting doctors, hospitals in health insurance market

By Chad Terhune
Los Angeles Times, September 14, 2013


The doctor can’t see you now.

To hold down premiums, major insurers in California have sharply limited the number of doctors and hospitals available to patients in the state’s new health insurance market opening Oct. 1.

New data reveal the extent of those cuts in California, a crucial test bed for the federal healthcare law.
Consumers could see long wait times, a scarcity of specialists and loss of a longtime doctor.

“These narrow networks won’t work because they cut off access for patients,” said Dr. Richard Baker, executive director of the Urban Health Institute at Charles Drew University of Medicine and Science in Los Angeles.
To see the challenges awaiting some consumers, consider Woodland Hills-based insurer Health Net Inc.
Across Southern California the company has the lowest rates, with monthly premiums as much as $100 cheaper than the closest competitor in some cases. That will make it a popular choice among some of the 1.4 million Californians expected to purchase coverage in the state exchange next year.

But Health Net also has the fewest doctors, less than half what some other companies are offering in Southern California, according to a Times analysis of insurance data.

In Los Angeles County, for instance, Health Net customers in the state exchange would be limited to 2,316 primary-care doctors and specialists. That’s less than a third of the doctors Health Net offers to workers on employer plans.

Other major insurers have pared their list of medical providers too, but not to Health Net’s degree. Statewide, Blue Shield of California says exchange customers will be restricted to about 50% of its regular physician network.

“We are nervous about these narrow networks,” said Donald Crane, chief executive of the California Assn. of Physician Groups. “It was all about price. But at what cost in terms of quality and access? Is this contrary to the purpose of the Affordable Care Act?”


http://www.latimes.com/business/la-fi-insure-doctor-networks-20130915,0,…




Read very carefully.

And now let's add the part that the Obamahater conveniently left off -

In response, California officials have been pressing Health Net and other insurers to add more doctors since companies filed their initial rosters in May. The state exchange, Covered California, says it will monitor enrollment closely once it begins next month and it's prepared to step in if problems arise.

"Our interest is in assuring everyone enrolled in a plan has ready access to the clinicians they need," said Peter Lee, executive director of Covered California. "That means if a plan can't serve patients, we'll close it down from taking new enrollment. That is in some ways the nuclear option."

Rather than mere head count, officials say they are scrutinizing what capacity physicians have to accept new patients. And to assist consumers, California will enable people to search for specific doctors online during enrollment to determine what, if any, health plans they will be part of in Covered California.

"Does the doctor have room for one more patient or 40 patients? It's about available seats," Lee said. "We want to make sure every network has enough doctors."

Health Net says price will probably matter most to the uninsured and people who buy their own health insurance now, so it built a narrow network to serve those "value seekers."

"We have more than enough doctors for our projected enrollment through 2014, and we have time to adjust if it becomes necessary," Health Net spokesman Brad Kieffer said. "We continue reaching out to providers, and we are bringing more on board."

Anyone who thinks that insurers trying to limit doctor pools never happened before Obamacare, please see me about this bridge in NYC that goes to Brooklyn; it's a sure money maker and I can make a deal for you!

The thing is with the Health Exchanges, the insurers are MANDATED to provide more information in the most straightforward extent than they have EVER been required to do before, to allow for informed comparisons. Of course that is meaningless to someone like Debs who believes all evil started with Obamacare and only purity was before.

Seriously, isn't it funny how Obamahaters forget to give you the full picture?

Yea, real funny, just like this piece of work in the media about his responsibility for just being a megaphone for the GOP propaganda and never questioning the horseshit he helps spew -

MSNBC host Chuck Todd said Wednesday that when it comes to misinformation about the new federal health care law, don't expect members of the media to correct the record.
During a segment on "Morning Joe," former Pennsylvania Gov. Ed Rendell (D) speculated that most opponents of the Affordable Care Act have been fed erroneous information about the law. Todd said that Republicans "have successfully messaged against it" but he disagrees with those who argue that the media should educate the public on the law. According to Todd, that's President Barack Obama's job.

"But more importantly, it would be stuff that Republicans have successfully messaged against it," Todd told Rendell. "They don't repeat the other stuff because they haven't even heard the Democratic message. What I always love is people say, 'Well, it's you folks' fault in the media.' No, it's the President of the United States' fault for not selling it."

What wankers.

Countdown to Oct 1 still going! Can't wait, but then again, the world seems to hold endless horseshit for those that ride magic ponies!

Originally Posted by Bad Dog

Many of us without insurance are looking forward to even the most minimal plan. When people without insurance can finally get it, things will get better for everyone.

Note: Walgreens, Sears Holdings, and other corps are terminating thier employer health plans, and giving employees cash allowances for private insurance exchanges. Our march to Mexico continues. Employers have looong wanted to get out of the HR hassle/cost, and the employees will find out, again, just what cheap bastards thier employers are. This is the defined benefit-to-401k shuffle. Fund your own frakking life!

Somehow, I don't think that will make employers very popular. Or healthcare providers, after being forced to disclose obscene pricing.

Give it another eight years from 2016, to 2024, and a single payer option just might fly.

It's going to be a mixed bag. Yes, some employers are going to be able to treat their employees like dirt - so what else is new? Other employers are still going to have to give competitive offers to get the best employees and health care benefits will be a part of that. It's going to be a mixed bag, but it is going to much more obvious than it ever was before, and yes, it will put pressure for a public option to be offered on some state exchanges. I see that happening out West first and eventually Calif combining into a huge regional program with OR, WA, CO and even NV and AZ will want to combine due to the lower costs in pooling that large.

More importantly, there will be the pressure from the other end with the MLR at 85/80% group/individual squeezing the shit out of the insurers - it's only a matter of time. And after awhile, the public option will become single payer.

But of course, people like Debs will caulk it up to their incessant whining on Internet chat rooms.

Originally Posted by Deb C

Trader Joe's and Starbucks have just increased their employees premiums. Many of our friends who work in hospitals are telling us that there are numerous cutbacks in staff because of the skimpy payments they will be getting for patient care.

There's an underbelly of ACA that needs to be exposed. You might want to read the following article.

Here's a more balanced view of at least what Trader Joe is trying to do for their PART-TIME (under 30 hours) workers [note- Deb's lack of informing you of that]

http://swampland.time.com/2013/09/17...r-part-timers/


Oh, a friend of a friend whose brother knows Deb's friends says they are generally full of magic pony poo.

Originally Posted by playwrite

Here's a more balanced view of at least what Trader Joe is trying to do for their PART-TIME (under 30 hours) workers [note- Deb's lack of informing you of that]

http://swampland.time.com/2013/09/17...r-part-timers/

Is that $500 monthly (hmmmm), or a one-time yearly check from Trader Joe's? I suspect the latter. $500/12= $41.67/month. Ouch.

I have no doubt that the insurers will attempt to game the system. It will take at least two presidential election cycles to focus the anger on the insurers, and cheap employers. And two more to get a Supreme Court to lay the smack down on greedy bastards. By 2040, a better healthcare system should start to emerge. Just in time to die.