Originally Posted by Deb C

One giant plus to doctor groups, is that they can focus on being a doctor and not have to wear so many administrative hats.

More advantages:

They are now employees, like the rest of us. Doctors start voting Dem.

They get their comeuppance's just like the rest of the troops. They get fired for screwing up, or pissing people off.

Yes, this results in fewer MD's. It also means the SNCO's (the nursing staff) will get listened to more. We are moving to a military medicine model, including explicit triage, right from the start.

Welcome to the battlefield. Or, IT.

Interesting thought: The insurance companies have data warehouses. They decide to go NSA with them. (This has happened. Hospitals have "no bed" lists) A new industry forms- medical identity theft, so you can get treatment.

Speaking of hospitals and big data...

Originally Posted by JordanGoodspeed

Speaking of hospitals and big data...

Thanks, Jordan. BJC here in STL is amalgamating the data of the many hospitals it has acquired- and is being blackballed by the MO exchanges for price-gouging. Check with Deb.

Originally Posted by Bad Dog

Thanks, Jordan. BJC here in STL is amalgamating the data of the many hospitals it has acquired- and is being blackballed by the MO exchanges for price-gouging. Check with Deb.

Interesting information. Where did you hear this? Was it the NPR interview with one of the BJC doctors?
I didn't hear the entire show but heard how many of the individual policies will exclude one of the best non-profit research hospitals in the US. I did hear him say that denying access to some of the most innovative cancer treatments, the insurance industry was acting like a death panel.

A friend of mine was losing her battle with ovarian cancer. She was sent to BJC and was basically saved by their advanced treatments. The same with my granddaughter's friend from school.

PS: I believe it was the Anthem Blue Cross individual policies that were being exclusive.

Well it's nice to know that I'm in the "top bracket" when it comes to maximum premium costs (9.5% of annual income).

Originally Posted by '58 Flat

Well it's nice to know that I'm in the "top bracket" when it comes to maximum premium costs (9.5% of annual income).

Here's what you need to do, what anyone who believes they know what this is all about needs to do. And you only have a few days left to do it (and it may already be too late depending on your specific situation for insurers are pulling down their old marketing schemes as we speak)

Go out and price the insurance that you need, right now, before the Exchanges kick in this coming Tuesday, Oct. 1 (if you want to compare to insurance under Obamacare federal exchanges for small business or for Hispanic speaking, you have until Nov 1).

If you, like 85% of the population with insurance, have that insurance through work or Medicare/Medicaid, don't bother, you will not be effected one way or another.

If you are in that other 15% or don't have any insurance whatsoever, then try to get the insurance you want, right now, and see what it will cost you. Then, starting on Tuesday, go to Healthcare.gov and take probable less effort that finding an airline ticket or booking a hotel room, and see what that same insurance is going to cost you.

This is great fear that the GOP and the Far Left share. The relative ease you are going to have to find that with prices and subsidies, you are going to have a much better deal available to you on Tuesday than you had today.

For someone like you (if born in '58, likely near peak income levels, so maybe making too much for the subsidies and having to pay the full fare), even the lower costs providing by the ACA may still seem un-affordable. Health care is EXPENSIVE. On the other end, younger, healthier people, even if subsidize so premiums are 0-$80, it's just not worth the effort.... and besides, they are indestructible.

Those are the people that will have complaints - rational or not. Depending, they may have done better under a a public option or single payer approach (the risk being if you have a very serious illness, cost controls may result in you dying while waiting "your turn").

However, for every one of you (assuming you are one - do the homework) there are thousands that are going to be very very happy.

That is what all the commotion of this has been about. The GOP and Far Left have played up that those who will wind up with complaints (rational or not) are going to be most people.

After this Tuesday, and increasingly so as this rolls out over the coming year, they are going to be shown to have lied, lied big time, and lied big time repeatedly for years now.

You can feel their collective desperation.

Just 4 days now before the Blackhawk heilcopters swoop in, confiscate your freedom fries, and take grandma to the death panels. Cross your fingers for her!

Consumer Groups Criticize Anthem’s Narrow Network In Missouri’s Obamacare Marketplace

The network for the Anthem BlueCross BlueShield plans, which will be sold through Missouri’s “Obamacare” marketplace, does not include BJC HealthCare and its 13 hospitals -- among them Barnes-Jewish Hospital, the area’s premier academic medical center, and St. Louis Children’s Hospital.

What about those children in Missouri that have hard to treat cancers?

“That is a major concern for a lot of reasons,” said Andrea Routh, executive director of the Missouri Health Advocacy Alliance. “Children’s Hospital, which in my mind is an essential community provider, is part of that network. If they’re not including the Children’s Hospital, care for children could really be compromised.”

Anthem confirmed Wednesday that policies sold through Missouri’s online insurance marketplace, scheduled to open for enrollment Oct. 1, will not include BJC.

The insurance industry, with their millionaire CEO's, just love mandated premiums. But not so much the very sick who slice into their extreme profits, with which they then recycle into politicians who keep them extremely rich.

The plans are similar to “narrow networks” assembled elsewhere by Anthem and other insurers to bypass higher-priced health systems and offer more-affordable coverage. But consumer advocates worry tighter networks will disrupt care and limit access for middle- and lower-income consumers, many sicker than average.

See the power these insurance corporations have??? They can keep providers in the dark...... because they now have even more power. And you better believe they are gong to use it.

Joseph Pierle, CEO of the Missouri Primary Care Association, said his group’s community health centers serving low-income patients still don’t know whether they’re in Anthem’s exchange network.

Excluding key care providers from exchange plans has generated concern and complaints in other states.

Washington regulators initially rejected four carriers from that state’s exchange, expressing concerns that their networks were too restrictive. All were eventually approved.
Maine regulators held public hearings on Anthem’s intention to exclude some hospitals from its ACA marketplace plans. Anthem is the only insurer to offer policies next year on the exchange in New Hampshire, where it left 10 of 26 state hospitals out of the network

http://www.kaiserhealthnews.org/Stor...m_campaign=mhp

Originally Posted by Deb C

Interesting information. Where did you hear this? Was it the NPR interview with one of the BJC doctors?
I didn't hear the entire show but heard how many of the individual policies will exclude one of the best non-profit research hospitals in the US. I did hear him say that denying access to some of the most innovative cancer treatments, the insurance industry was acting like a death panel.

A friend of mine was losing her battle with ovarian cancer. She was sent to BJC and was basically saved by their advanced treatments. The same with my granddaughter's friend from school.

PS: I believe it was the Anthem Blue Cross individual policies that were being exclusive.

Deb, I'm glad for the positive outcomes for your friends. When Anthem/BCBS slams the door on BJC, prices go up for BJC access. It then becomes a cycle.

As for BJC's big data consolidation, I'm one of the few people who can design/configure RS-232 interfaces anymore, it seems... Hams would be ashamed of some of the Rube Goldberg contraptions used. The project included a roaming profile, BJC wide, for staff and doctors to use a unified data system bedside. The grand unified concept was for doctors to go bed/station/OR/lab/office, and have the same UI and data available. No duplicate/corrupt/bad data. No "miscommunications" due to handwriting or transcriptions of dictated reports.

You may scream or laugh, now. When I went through the "other" teaching hospital's procedures in 2007, for my own GI work, I personally corrected the errors that the lab techs, the residents, and the attendings made. I caught no less than FIVE for the X-Ray series, because I was paying attention.

There is nothing in the world like being able to make doctors look bad, and have to apologize, in front of others, for their errors. One of them was a Reserve flight surgeon, who *cringed* when she found out I was a former tactical driver. For a pilot to beat the doctors *on thier own turf*, and make them openly admit defeat, is sweet indeed.

Hi, Rani!

Back to BJC.

Anyone who has gone through migration hell will understand the difficulty of merging (last I checked) 15,000+ unique, and proprietary, pieces of software. and, a *lot* of it 8-bit. No ****. And, they treat thier people like less-than-chattel.

Originally Posted by Bad Dog

Deb, I'm glad for the positive outcomes for your friends. When Anthem/BCBS slams the door on BJC, prices go up for BJC access. It then becomes a cycle.

As for BJC's big data consolidation, I'm one of the few people who can design/configure RS-232 interfaces anymore, it seems... Hams would be ashamed of some of the Rube Goldberg contraptions used. The project included a roaming profile, BJC wide, for staff and doctors to use a unified data system bedside. The grand unified concept was for doctors to go bed/station/OR/lab/office, and have the same UI and data available. No duplicate/corrupt/bad data. No "miscommunications" due to handwriting or transcriptions of dictated reports.

You may scream or laugh, now. When I went through the "other" teaching hospital's procedures in 2007, for my own GI work, I personally corrected the errors that the lab techs, the residents, and the attendings made. I caught no less than FIVE for the X-Ray series, because I was paying attention.

There is nothing in the world like being able to make doctors look bad, and have to apologize, in front of others, for their errors. One of them was a Reserve flight surgeon, who *cringed* when she found out I was a former tactical driver. For a pilot to beat the doctors *on thier own turf*, and make them openly admit defeat, is sweet indeed.

Hi, Rani!

Back to BJC.

Anyone who has gone through migration hell will understand the difficulty of merging (last I checked) 15,000+ unique, and proprietary, pieces of software. and, a *lot* of it 8-bit. No ****. And, they treat thier people like less-than-chattel.

You must be one very smart person, and/or your very good at being your own best advocate. No wonder there were so many mistakes at this "other" teaching hospital - it stinks. This Tenant owned place they call a health center, cuts corners everywhere they possibly can. At their West county location, the nurses were expected to clean floors when their census wasn't what this for profit so called hospital expected.

I belong to a support group for women who have my auto-immune illness. Many of them go to the renowned doctor at this other teaching hospital. However, they say when it comes time for a transplant, they want BJC. Go figure.

With my husband being in the health care field for most of his career, it's amazing what one learns about the ins and outs of the hospital systems.

Originally Posted by Deb C

You must be one very smart person, and/or your very good at being your own best advocate. No wonder there were so many mistakes at this "other" teaching hospital - it stinks. This Tenant owned place they call a health center, cuts corners everywhere they possibly can. At their West county location, the nurses were expected to clean floors when their census wasn't what this for profit so called hospital expected.

I belong to a support group for women who have my auto-immune illness. Many of them go to the renowned doctor at this other teaching hospital. However, they say when it comes time for a transplant, they want BJC. Go figure.

With my husband being in the health care field for most of his career, it's amazing what one learns about the ins and outs of the hospital systems.

Auto immune sucks. You have my sympathies.

Mom was a super-RN for more than forty years. My first cousin is chief radiologist of her oh-so-expensive Dallas hospital. It helps that I have still a "command presence" and the ability to use it, while being the complete Southern Officer And Gentleman. Mailed Fists In Nomex Gloves, so to speak (holding both a spade royal, and a .45). Flying airplanes and firing automatic weapons at age four, reading at collegiate levels at age five. I suck.

I also play poker.

But don't the Republicans see that they're coming across looking like Cruella de Vil from 101 Dalmatians with their willingness to die on the barricades - and quite possibly take the entire global economy with them - just for the sake of denying health care to those who can't afford it?

Wouldn't it be better if they positioned themselves as David Sumner from Straw Dogs instead?

And they can do that by making the Second Amendment and not ObamaCare the centerpiece of their ultimatum. They could demand pretty much the repeal of all gun laws, up to including a national "concealed carry" law - along with the adoption nationwide of Florida's "10-20-Life" law, plus a federal death penalty for anyone who uses a so-called "assault weapon" to kill two or more people concomitantly (much like the federal death penalty that Nidal Hassan has just been sentenced to, and Dzhokhar Tsarnaev could get) in exchange for not shutting down the government.

And they would probably post huge gains in Congress in 2014, instead of huge losses if there is a government shutdown over ObamaCare.

Exchange rates posted. MS is the highest premiums in the country behind Montana and Alaska. But MS is the poorest state in the nation.

So this makes sense how? No one I know without employer based healthcare can afford this. Well, they can if they give up grocery shopping or having electricity.

Originally Posted by Danilynn

Exchange rates posted. MS is the highest premiums in the country behind Montana and Alaska. But MS is the poorest state in the nation.

So this makes sense how? No one I know without employer based healthcare can afford this. Well, they can if they give up grocery shopping or having electricity.

Mass poverty itself creates health problems from tooth decay to malnutrition. Nervous overeating contributes to obesity. High violent crime rate. Mississippi is toward the top in tobacco use and sedentary 'activities' such as watching TV. Educational standards are low. If I had to choose between living in a politically-conservative state with a below-average income that does many things well in health habits like Utah and a low-income state in which people tend toward very bad habits (like Mississippi) I would choose Utah. In Utah one does not have to pay for so much lung cancer and cirrhosis. Crime rates are low. Maybe climate plays a role, with Utah being fairly good for outdoor activity all year. One can go hiking or bicycling at any time of the year -- "It's a dry heat", so one must carry water, and winter temperatures around Salt Lake City aren't too bad. Utah may not spend heavily upon education, but it gets good results. Dislike the Mormon Church if you wish, but Utah does some things right, and you don't have to be a Mormon to live there.

People who watch more TV (and viewing of TV is on the whole negatively related with education, occupational status, income, and personal health) see more advertising, and much of what is advertised is junk food -- sodas, beer, pastries, crackers, chips, candy, and fast food -- who do you think buys the stuff? Sophisticates who attend the symphony and spend much time in libraries?

I see it here in Michigan -- lots of people with walrus physiques, chain smokers, heavy drinkers, drug addicts... people generally toward the low end in educational and vocational performance. They watch lots of TV... and they are white, in case you bring up that issue. I wouldn't want to insure their health.

Montana and Alaska? Probably distance to a hospital (and especially to a specialty center), and that adds to the cost of care for trauma and makes medical treatment less reliable but more costly. Mississippi? Poverty, violent crime (gunshot wounds are infamously expensive to treat), and bad health habits. If you live in Mississippi you pay for those bad habits even if you don't have them yourself.

Originally Posted by Danilynn

Exchange rates posted. MS is the highest premiums in the country behind Montana and Alaska. But MS is the poorest state in the nation.

So this makes sense how? No one I know without employer based healthcare can afford this. Well, they can if they give up grocery shopping or having electricity.

Sorry about that. Have you considered moving? I'm quite serious.

Originally Posted by Danilynn

Exchange rates posted. MS is the highest premiums in the country behind Montana and Alaska. But MS is the poorest state in the nation.

So this makes sense how? No one I know without employer based healthcare can afford this. Well, they can if they give up grocery shopping or having electricity.

Unfortunately, a state with high poverty rates is considered a liability by the insurance industry. They bank on healthy young people to stuff their already full pockets of profits. Their motto is "profits over people".

To add insult to injury, there have been numerous hospitals and doctors eliminated from the policies. This often makes for longer travel to see a health care professional. Many who live in poverty have fewer options to travel long distances because of the lack of having a car or easily accessed public transportation.

ACA is certainly a mixed bag. While more people will now have insurance and can have their health needs met, some will still find it unaffordable, with high co-pays and out of pocket expenses. Having insurance isn't the same as having quality, affordable and accessible health care. I'm grateful that more people will be covered and sad for the millions who will still be without coverage.

Maps for persistent poverty in the US:

http://www.ers.usda.gov/data-product...x#.Ukb7ez9abpc

Note the maps including the low-education counties, persistent child-poverty, on the page. The persistent child-poverty map shows a familiar geography, and voting pattern...

Didn't you say you were going to kill yourself?

Goddamn Boomers, they never keep ANY of their promises!!

MS's ranking in household income, poverty, child poverty, teenage pregnancy, and education have nothing to do with the exchange's insurance premiums. Really.

My family, friends, life and heart is southern. I am a Mississippian to the core. Can't imagine living anywhere else ever again. The weather is tolerable here. People friendly. And it's beautiful country here.

Originally Posted by Bad Dog

MS's ranking in household income, poverty, child poverty, teenage pregnancy, and education have nothing to do with the exchange's insurance premiums. Really.

Ability to buy this unaffordable crap has everything to do with it. Where do you expect poor people to get that much money on an already low income?

Originally Posted by Deb C

ACA is certainly a mixed bag. While more people will now have insurance and can have their health needs met, some will still find it unaffordable, with high co-pays and out of pocket expenses. Having insurance isn't the same as having quality, affordable and accessible health care. I'm grateful that more people will be covered and sad for the millions who will still be without coverage.

Please note new "Criitenden Compromise" thread. The term that comes to mind is Plan B.

Originally Posted by JordanGoodspeed

Didn't you say you were going to kill yourself?

Goddamn Boomers, they never keep ANY of their promises!!

I had breakfast. The Cards are going to the playoffs. The Rams are on course for 0-16, so Stan Kroenke can forget about asking for another billion for the dome. Gloat. The GOP is in full self destruct mode. Mega-gloat.

Gotta be alive to gloat some more.

Originally Posted by Danilynn

Ability to buy this unaffordable crap has everything to do with it. Where do you expect poor people to get that much money on an already low income?

Possibly Belize.

http://en.wikipedia.org/wiki/Belize

Marketplace rates are not yet up for Missouri. Awaiting 1 OCT.