Generational Dynamics
Fourth Turning Forum Archive


Popular links:
Generational Dynamics Web Site
Generational Dynamics Forum
Fourth Turning Archive home page
New Fourth Turning Forum

Thread: It's time for national healthcare - Page 213







Post#5301 at 11-29-2013 10:12 PM by annla899 [at joined Sep 2008 #posts 2,860]
---
11-29-2013, 10:12 PM #5301
Join Date
Sep 2008
Posts
2,860

The biggest change I've seen with ACA is that my college students get to stay on their parents insurance until age 26. A few of them have serious pre-existing conditions.

Krugman has an interesting column from the NY Times. http://tinyurl.com/nlpt4ug

So what aspects of Obamacare might be causing health costs to slow? One clear answer is the act’s reduction in Medicare “overpayments”... A less certain but likely source of savings involves changes in the way Medicare pays for services. The program now penalizes hospitals if many of their patients end up being readmitted soon after being released — an indicator of poor care — and readmission rates have, in fact, fallen substantially. Medicare is also encouraging ... “accountable care,” in which health organizations get rewarded for overall success in improving care while controlling costs.
It's still not single-payer which I wouldn't mind paying taxes for, just like I don't mind paying taxes for public education, although I hate the No Child Left Behind and Race to the Top testing bs. And I don't have kids, either. I like the idea of a minimum guaranteed income. So I guess I'm the opposite of an Objectivist. (Besides, Ayn Rand is a terrible, awful, turgid writer. On a side note, a friend was one of her lovers in the early 70s. Dudette was wayyy into "the life.")







Post#5302 at 11-29-2013 10:53 PM by Deb C [at joined Aug 2004 #posts 6,099]
---
11-29-2013, 10:53 PM #5302
Join Date
Aug 2004
Posts
6,099

Quote Originally Posted by annla899 View Post
The biggest change I've seen with ACA is that my college students get to stay on their parents insurance until age 26. A few of them have serious pre-existing conditions.

It's still not single-payer which I wouldn't mind paying taxes for, just like I don't mind paying taxes for public education, although I hate the No Child Left Behind and Race to the Top testing bs.

Unfortunately, penalizing hospitals for readmission is the medical equivalent of "teaching to the test."
Last edited by Deb C; 11-29-2013 at 11:16 PM.
"The only Good America is a Just America." .... pbrower2a







Post#5303 at 11-30-2013 08:47 AM by Marx & Lennon [at '47 cohort still lost in Falwelland joined Sep 2001 #posts 16,709]
---
11-30-2013, 08:47 AM #5303
Join Date
Sep 2001
Location
'47 cohort still lost in Falwelland
Posts
16,709

Quote Originally Posted by annla899 View Post
The biggest change I've seen with ACA is that my college students get to stay on their parents insurance until age 26. A few of them have serious pre-existing conditions....

It's still not single-payer which I wouldn't mind paying taxes for, just like I don't mind paying taxes for public education, although I hate the No Child Left Behind and Race to the Top testing bs...
Think of the process we’re traveling through as retraining. We’ve all learned bad behaviors, entrenched them through decades of immersion, and now we need to move on. Only a few will be able to shrug-off the conditioning, and the most successful will be the ones least indoctrinated: the young.

We can hope that’s enough.
Marx: Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies.
Lennon: You either get tired fighting for peace, or you die.







Post#5304 at 11-30-2013 01:31 PM by playwrite [at NYC joined Jul 2005 #posts 10,443]
---
11-30-2013, 01:31 PM #5304
Join Date
Jul 2005
Location
NYC
Posts
10,443

Quote Originally Posted by JohnMc82 View Post
Can I hyperventilate about the literal meanings of political economy jargon? That isn't single payer!!!

Single payer means one payer. The only good contemporary example is in Taiwan, where everyone is on something like Medicare, and that's all there is to it. Even the NHS, Canadian, and Australia health services are moving toward multi-payer universal solutions as you've described above. It's the "common" universal healthcare solution, and it's one that hasn't even entered the debate here in America.
That's right, John, supplemental insurance is not single payer, its supplemental; that's why it's called "supplemental insurance." It is found in every nation that has single payer: it can range from people signing on to a single group practice that takes care of their every need without any wait times (costing far more than what single payer will pay for those services) to places like France where over 90% of the population purchases supplemental insurance to cover what that nation's govt structured insurance will not cover.

Quote Originally Posted by JohnMc82 View Post
Single-payer universal systems are best at containing costs, but they don't deliver the best service. Universal access is offset by relatively long waiting times, and mediocore, uniform care.

Multi-payer universal systems cost a bit more in the aggregate, but tend to deliver superior health outcomes. You can get whatever you can pay for, but even if you can't afford it, you'll get something. Basic plans are almost always non-profit. (Really, America is the only country I can think of that would try to force someone to buy a for-profit health insurance plan)

Patchwork, for-profit, multi-payer systems that leave millions without coverage, have the highest per-capita costs and worst health outcomes. I am absolutely opposed to expanding such a system piece by piece, especially as that leaves huge gaps in coverage while doing nothing to address the perverse profit incentives.

Does that make sense? I mean, it's really cool that some people who haven't had access to healthcare in forever are covered by the Medicare expansion. There are a lot of others who won't, just because they were born in the wrong state. Then even more who won't make the Medicare cutoff, but still won't be able to afford expensive premiums that barely cover anything.

But the Democrats spent a LOT of political capital to make this happen. Obama has pretty much staked his entire presidency on it.

Is that the best we can do with eight years? A half-baked Heritage Institute plan turned lobbyist wet dream? That isn't what the voters supported, that isn't what the economists supported, and it certainly isn't what the doctors supported. So we don't listen to the relevant experts, we don't listen to the population, we just listen to the people with money. Until that's fixed, every policy coming out of D.C. is destructive, regardless of how many pure and noble motivations one can spin into the intent.
The answer to your question in bold above - yep.

And one of the biggest impediments to moving forward is the utter intellectual/emotional inability of those wanting more to fully grasp what they are up against. As close an example as one can get: look at all the whining that you have done over the cancellation of your individual market insurance. You really believe reeving that up to everyone (including employer-based) having their insurance cancelled is politically viable??? Whatever you all are smoking, you really need to share.
"The Devil enters the prompter's box and the play is ready to start" - R. Service

“It’s not tax money. The banks have accounts with the Fed … so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. It’s much more akin to printing money.” - B.Bernanke


"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman

If you meet a magic pony on the road, kill it. - Playwrite







Post#5305 at 11-30-2013 01:42 PM by playwrite [at NYC joined Jul 2005 #posts 10,443]
---
11-30-2013, 01:42 PM #5305
Join Date
Jul 2005
Location
NYC
Posts
10,443

Quote Originally Posted by The Rani View Post
Right. I should have used the word "kill" to be completely accurate:

"Killing" without "destroying" ... zombie insurance companies? That sounds pretty awesome.
Now you're getting it. Yes, at some point on the timeline, they will look like zombie primary insurance companies or more precisely "shell" primary insurance companies. They'll still be called BlueCross, AETNA, CIGNA, etc and referred to as "the insurers" but they will be mostly out of the primary insurance business model and into supplemental insurance as well as diversified into quite a lot of other things.

Good to see you coming along. Tell the truth, you found that 4th grader, right? Good for you, lassie!
"The Devil enters the prompter's box and the play is ready to start" - R. Service

“It’s not tax money. The banks have accounts with the Fed … so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. It’s much more akin to printing money.” - B.Bernanke


"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman

If you meet a magic pony on the road, kill it. - Playwrite







Post#5306 at 11-30-2013 01:55 PM by playwrite [at NYC joined Jul 2005 #posts 10,443]
---
11-30-2013, 01:55 PM #5306
Join Date
Jul 2005
Location
NYC
Posts
10,443

Quote Originally Posted by The Rani View Post
Another thing to file under The Law of Unintended Consequences (bolding added)


http://www.thefreelibrary.com/Medica.....-a0310255321
Yes, and I've been bringing this up over and over again. It is why a number of the hospitals that serve the lower middle class and below are freaking out in Texas, Florida, and other states that did not accept the Medicaid Expansion. And it's not only those hospitals but nearly the entire system in the state because this puts tremendous pressure on the entire system.

The Medicaid expansion was to far exceed any loss of the DHS payments, but no one foresaw what the SCOTUS was going to do. Behind closed doors, there are many GOP governors that will confess that John Roberts put them in an impossible situation of having to choose between their rabid t-bagger base and the moral correct choice of helping the most needy in their states while bringing billions in economic activity. Being both ethical dirtbags and economic morons, we see what they decided to do,

Their actions, the ones that really matter on this issue, are very much intended with known consequences. It's just that too many people want to ignore that because it doesn't fit their worldview of being Obama haters - something you and more that just a few others here well know.
Last edited by playwrite; 11-30-2013 at 02:10 PM.
"The Devil enters the prompter's box and the play is ready to start" - R. Service

“It’s not tax money. The banks have accounts with the Fed … so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. It’s much more akin to printing money.” - B.Bernanke


"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman

If you meet a magic pony on the road, kill it. - Playwrite







Post#5307 at 11-30-2013 02:09 PM by playwrite [at NYC joined Jul 2005 #posts 10,443]
---
11-30-2013, 02:09 PM #5307
Join Date
Jul 2005
Location
NYC
Posts
10,443

Quote Originally Posted by Deb C View Post
First I must say that I'm glad that more people will have coverage to at least some degree. However, the ACA will leave many in the hands of the very corporations that lobbied with millions of dollars to stay in control of our health care.

I see the ACA as a very flawed system. People were told that this is all we can get. Therefore, the left just rolled over and never challenged that statement. There wasn't even a major backlash to the public option being thrown out. Instead, the left just decided to roll over and let the bullies win. So the poor little Democrats handed over their lunch money to the bullies. And the result is millions of dollars of subsidies being handed to some of the richest companies in this country.

The ACA has merely strengthened our already corporatized health care system and will continue it as just another product to be purchased.

I'll quote my mentor Dr. Margaret Flowers to further my reply.

" I actually see the Affordable Care Act as a step backwards. It takes us farther in the direction of privatized health care. And the way that we really need to go is towards greater--a publicly financed universal health care system. That's the most efficient and most equitable way to provide health care"

"What the Affordable Care Act does is it requires people to purchase private insurance. But that doesn't equate to actually being able to get the health care that you need. We haven't changed the behavior of the private insurance companies. And so they're still going to find ways to deny payment for care. And people are going to find that while they've paid out hundreds of dollars for health insurance, they won't have the money to actually pay for health services, because a lot of that cost is going to be coming up front first from the patients before their insurance even kicks in."
Not a single fact in the entire piece; just emotional claptrap to ensnare the sheeple.

Millions of people are going to get health insurance coverage for the first time and most of them will get it for free or for relatively little cost. That is a fact.

People will have limits on what they have to pay so that medical bankruptcy (the most common form of household bankruptcy to date) will be thing of the past. That too is a fact.

These two facts completely destroy what you have posted. And as more and more people come to understand what the ACA offers, even those that prefer single payer (some, actually working behind the scenes to make it happen) are going to throw up their hands and ask why bother.
"The Devil enters the prompter's box and the play is ready to start" - R. Service

“It’s not tax money. The banks have accounts with the Fed … so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. It’s much more akin to printing money.” - B.Bernanke


"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman

If you meet a magic pony on the road, kill it. - Playwrite







Post#5308 at 11-30-2013 02:41 PM by pbrower2a [at "Michigrim" joined May 2005 #posts 15,014]
---
11-30-2013, 02:41 PM #5308
Join Date
May 2005
Location
"Michigrim"
Posts
15,014

Quote Originally Posted by playwrite View Post
Yes, and I've been bringing this up over and over again. It is why a number of the hospitals that serve the lower middle class and below are freaking out in Texas, Florida, and other states that did not accept the Medicaid Expansion. And it's not only those hospitals but nearly the entire system in the state because this puts tremendous pressure on the entire system.
It could also be that states that succeed in solving the medical-payments mess get an advantage over those that don't. The current mode of politics in some states is that politics serves the loudest and best organized interests, typically exempt from economic competition, especially if those interests bleed the economy. The key to political success may be to reward the 'right people' even if such devastates the general public.

The Right has been telling us for at least a century that high taxes bleed an economy. But don't high medical costs do much the same? General Motors has found that the difference in medical costs alone (GM pays the same wages in Canada and the US in accordance with the UAW contract) makes assembly work less expensive in Canada than in the US. To adjust to that American workers must accept lower wages or the medical racket must lose some of the inordinate profits.

The Medicaid expansion was to far exceed any loss of the DHS payments, but no one foresaw what the SCOTUS was going to do. Behind closed doors, there are many GOP governors that will confess that John Roberts put them in an impossible situation of having to choose between their rabid t-bagger base and the moral correct choice of helping the most needy in their states while bringing billions in economic activity. Being both ethical dirtbags and economic morons, we see what they decided to do,
Do we remember when we were expected to vote for our politicians based upon their wisdom? When is the last time that we saw anyone call our politicians "Solons"? The word poltroon or stooge now fits the great bulk of them far better. A political system that exists to enrich one group of people at the expense of everyone else inevitably fails.

The politicians are not all at fault. Some powerful interests buy their subservience and use a barrage of Orwellian propaganda to keep them in office. When such begins to fail we are well on the way to solving 4T problems instead of allowing 3T vices to fester in public life.

Their actions, the ones that really matter on this issue, are very much intended with known consequences. It's just that too many people want to ignore that because it doesn't fit their worldview of being Obama haters - something you and more that just a few others here well know.
A majority of voters voted in Democratic majorities into the House and Senate in 2006 and 2008, elected Barack Obama twice, voted in a majority for Democrats (mostly going along with President Obama) in 2012 -- but it may be that the only election that mattered was 2010, in which the super-rich got a one-time electoral advantage with which to corrupt the electoral system so that the system better represents wealth and economic power than the People. Those people are cruel -- and their moral appeal goes no further than "Suffer for my greed, you peon!"

People who want me to suffer for their greed can roast in Hell, so far as I am concerned.
The greatest evil is not now done in those sordid "dens of crime" (or) even in concentration camps and labour camps. In those we see its final result. But it is conceived and ordered... in clean, carpeted, warmed and well-lighted offices, by (those) who do not need to raise their voices. Hence, naturally enough, my symbol for Hell is something like the bureaucracy of a police state or the office of a thoroughly nasty business concern."


― C.S. Lewis, The Screwtape Letters







Post#5309 at 11-30-2013 04:39 PM by princeofcats67 [at joined Jan 2010 #posts 1,995]
---
11-30-2013, 04:39 PM #5309
Join Date
Jan 2010
Posts
1,995

Quote Originally Posted by pbrower2a View Post
People who want me to suffer for their greed can roast in Hell, so far as I am concerned.
Highbrower, you sound like you could really, really, really use a day off.


Prince

PS: Be Good To Yourself
I Am A Child of God/Nature/The Universe
I Think Globally and Act Individually(and possibly, voluntarily join-together with Others)
I Pray for World Peace & I Choose Less-Just Say: "NO!, Thank You."







Post#5310 at 11-30-2013 05:18 PM by Deb C [at joined Aug 2004 #posts 6,099]
---
11-30-2013, 05:18 PM #5310
Join Date
Aug 2004
Posts
6,099

Quote Originally Posted by princeofcats67 View Post
Highbrower, you sound like you could really, really, really use a day off.


Prince

PS: Be Good To Yourself
Leave it to you, Prince, to bring much wisdom through music. Your a hoot!!!
"The only Good America is a Just America." .... pbrower2a







Post#5311 at 11-30-2013 05:51 PM by princeofcats67 [at joined Jan 2010 #posts 1,995]
---
11-30-2013, 05:51 PM #5311
Join Date
Jan 2010
Posts
1,995

Quote Originally Posted by Deb C View Post
Leave it to you, Prince, to bring much wisdom through music. Your a hoot!!!



Prince

PS: <chuckle! x9!>
I Am A Child of God/Nature/The Universe
I Think Globally and Act Individually(and possibly, voluntarily join-together with Others)
I Pray for World Peace & I Choose Less-Just Say: "NO!, Thank You."







Post#5312 at 11-30-2013 06:16 PM by Deb C [at joined Aug 2004 #posts 6,099]
---
11-30-2013, 06:16 PM #5312
Join Date
Aug 2004
Posts
6,099

Quote Originally Posted by princeofcats67 View Post



Prince

PS: <chuckle! x9!>


Dearly beloved We are gathered here today 2 get through this thing called life - See more at: http://www.videoscache.com/prince-an....TYmXNWV4.dpuf

And since we are all just trying to get through this life, wouldn't it be nice if we could all be a bit more kind to one another?
"The only Good America is a Just America." .... pbrower2a







Post#5313 at 11-30-2013 07:04 PM by playwrite [at NYC joined Jul 2005 #posts 10,443]
---
11-30-2013, 07:04 PM #5313
Join Date
Jul 2005
Location
NYC
Posts
10,443

You're getting sleepy

Two of our finest team up to distract you -





Don't worry, I have my eye of them both -

"The Devil enters the prompter's box and the play is ready to start" - R. Service

“It’s not tax money. The banks have accounts with the Fed … so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. It’s much more akin to printing money.” - B.Bernanke


"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman

If you meet a magic pony on the road, kill it. - Playwrite







Post#5314 at 11-30-2013 07:16 PM by princeofcats67 [at joined Jan 2010 #posts 1,995]
---
11-30-2013, 07:16 PM #5314
Join Date
Jan 2010
Posts
1,995

Quote Originally Posted by Deb C View Post


And since we are all just trying to get through this life, wouldn't it be nice if we could all be a bit more kind to one another?
Well Deb, if you're speaking to me personally, I'd say
that being "nice" and "kind" are pretty relative terms,
and that actions are often mis-perceived by others.
Generally speaking, I basically try to stick with Thumper
(with obvious notable exceptions. )


Prince

PS: But of course "... don't say nuthin' at all" is a double-negative, so...!
I Am A Child of God/Nature/The Universe
I Think Globally and Act Individually(and possibly, voluntarily join-together with Others)
I Pray for World Peace & I Choose Less-Just Say: "NO!, Thank You."







Post#5315 at 11-30-2013 07:46 PM by annla899 [at joined Sep 2008 #posts 2,860]
---
11-30-2013, 07:46 PM #5315
Join Date
Sep 2008
Posts
2,860

Quote Originally Posted by princeofcats67 View Post
Well Deb, if you're speaking to me personally, I'd say
that being "nice" and "kind" are pretty relative terms,
and that actions are often mis-perceived by others.
Generally speaking, I basically try to stick with Thumper
(with obvious notable exceptions. )


Prince

PS: But of course "... don't say nuthin' at all" is a double-negative, so...!
You mean like this?








Post#5316 at 11-30-2013 07:59 PM by princeofcats67 [at joined Jan 2010 #posts 1,995]
---
11-30-2013, 07:59 PM #5316
Join Date
Jan 2010
Posts
1,995

Quote Originally Posted by playwrite View Post
Two of our finest team up to distract you -


LOL! Love it!

I'm honored that you would bestow upon me such a sincere 'guest-gift'.
(I'll have to think up something real "nice" to return the 'hospitality'. )


Prince

Quote Originally Posted by P
Don't worry, I have my eye of them both -
For me personally, "no worries" at all, P!

Last edited by princeofcats67; 12-01-2013 at 05:12 PM. Reason: Fixed broken-link
I Am A Child of God/Nature/The Universe
I Think Globally and Act Individually(and possibly, voluntarily join-together with Others)
I Pray for World Peace & I Choose Less-Just Say: "NO!, Thank You."







Post#5317 at 11-30-2013 08:52 PM by princeofcats67 [at joined Jan 2010 #posts 1,995]
---
11-30-2013, 08:52 PM #5317
Join Date
Jan 2010
Posts
1,995

Quote Originally Posted by annla899 View Post
You mean like this?

I guess, sorta. I mean, what do you tell your spoiled-child when they want
a car, and some other kids have cars, and the damn thing doesn't even work
right, and in fact, is actually kinda dangerous i/r/t their own reckless-ness?
(Not to mention who's gonna pay for it, or the insurance).

It might be a case of not enough Information.


Prince

PS: Or maybe, not enough(or even a desire for) Peace, Love, and Understanding.
[Note: I love Nick Lowe; Sweet Harmony! ]
I Am A Child of God/Nature/The Universe
I Think Globally and Act Individually(and possibly, voluntarily join-together with Others)
I Pray for World Peace & I Choose Less-Just Say: "NO!, Thank You."







Post#5318 at 11-30-2013 09:03 PM by Deb C [at joined Aug 2004 #posts 6,099]
---
11-30-2013, 09:03 PM #5318
Join Date
Aug 2004
Posts
6,099

Quote Originally Posted by princeofcats67 View Post
Well Deb, if you're speaking to me personally, I'd say
that being "nice" and "kind" are pretty relative terms,
and that actions are often mis-perceived by others.
Generally speaking, I basically try to stick with Thumper
(with obvious notable exceptions. )


Prince

PS: But of course "... don't say nuthin' at all" is a double-negative, so...!
Nah, I was speaking about all of us on this forum. I've always respected you and what you have to say. I realize we are not always on the same page when it comes to politics, but we are respectful toward one another. That says volumes about your character.
"The only Good America is a Just America." .... pbrower2a







Post#5319 at 12-01-2013 07:29 AM by '58 Flat [at Hardhat From Central Jersey joined Jul 2001 #posts 3,300]
---
12-01-2013, 07:29 AM #5319
Join Date
Jul 2001
Location
Hardhat From Central Jersey
Posts
3,300

Quote Originally Posted by playwrite View Post
Yes, and I've been bringing this up over and over again. It is why a number of the hospitals that serve the lower middle class and below are freaking out in Texas, Florida, and other states that did not accept the Medicaid Expansion. And it's not only those hospitals but nearly the entire system in the state because this puts tremendous pressure on the entire system.

The Medicaid expansion was to far exceed any loss of the DHS payments, but no one foresaw what the SCOTUS was going to do. Behind closed doors, there are many GOP governors that will confess that John Roberts put them in an impossible situation of having to choose between their rabid t-bagger base and the moral correct choice of helping the most needy in their states while bringing billions in economic activity. Being both ethical dirtbags and economic morons, we see what they decided to do,

Their actions, the ones that really matter on this issue, are very much intended with known consequences. It's just that too many people want to ignore that because it doesn't fit their worldview of being Obama haters - something you and more that just a few others here well know.


But if they were receiving automatic reimbursements from a gigantic national charity care "slush fund" from taxes on the sale of legalized marijuana, they would have more money than they know what to do with - and the 30 million whom ObamaCare won't provide one iota of help to will be taken care of as well.

And best of all, no right-winger will get to rail against the "tyranny" of being forced to buy health insurance; indeed, the only argument that could be raised against this arrangement is that the poor - up to and including the working, lower-middle class - are "the enemy" and shouldn't be treated when they get sick at all (besides, of course, opposition to legalizing marijuana, which is already firmly into minority territory, and fading fast).

The bottom line is that does it really make that much difference to progressives whether health care becomes a de facto entitlement rather than a de jure entitlement - and is the obsession with the latter worth the risk of coming away with nothing at all - the outcome if a resurgent Republican Party does get to repeal ObamaCare?
Last edited by '58 Flat; 12-01-2013 at 08:48 AM.
But maybe if the putative Robin Hoods stopped trying to take from law-abiding citizens and give to criminals, take from men and give to women, take from believers and give to anti-believers, take from citizens and give to "undocumented" immigrants, and take from heterosexuals and give to homosexuals, they might have a lot more success in taking from the rich and giving to everyone else.

Don't blame me - I'm a Baby Buster!







Post#5320 at 12-01-2013 07:44 PM by playwrite [at NYC joined Jul 2005 #posts 10,443]
---
12-01-2013, 07:44 PM #5320
Join Date
Jul 2005
Location
NYC
Posts
10,443

S
Quote Originally Posted by The Rani View Post
Really. Which GOP governors have you spoken with behind closed doors?

But I guess you missed this part:

Growing number of underinsured = new Medicaid patients who can't afford to buy that wonderful supplemental insurance from the zombie insurance companies. DSH funding that would have helped make up that difference is being redirected into (surprise!) subsidizing private insurance companies.
No, for those DSH-dependent hospitals it is NOT the Medicaid under-insured that is the problem; the DHS was never intended to address that faux issue. DSH was about the UN-insured. These hospitals lobbied hard for the Medicaid Expansion, even with the loss of DSH, because they would be better compensated for the same people coming in their doors AND their patients would be much better off.

You're grasping at straws to keep that Obama-hatin alive. I realize its all you got left to grasp, but if you could just instead let go of the hatin, you'd be better off for it.
"The Devil enters the prompter's box and the play is ready to start" - R. Service

“It’s not tax money. The banks have accounts with the Fed … so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. It’s much more akin to printing money.” - B.Bernanke


"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman

If you meet a magic pony on the road, kill it. - Playwrite







Post#5321 at 12-02-2013 11:10 AM by playwrite [at NYC joined Jul 2005 #posts 10,443]
---
12-02-2013, 11:10 AM #5321
Join Date
Jul 2005
Location
NYC
Posts
10,443

Quote Originally Posted by The Rani View Post
Nope, you're lying again.

Medicaid Disproportionate Share Hospital (DSH) Payments

As I've said before, do your research or shut the hell up.

ETA:
Here's another one, dipshit:
No, you will have to do a little bit more homework than a quick Google search that gives you only the outer layer of the onion of official bureacratisese. Look at the math and you will eventually get to the point of grasping that the Medicaid numbers are a wash between state allotments and hospital allotments; that what makes the real difference is the uncompensated care of the uninsured - before and after the ACA. Start here, and report back when your 4th grader tells you that you're ready -

http://kff.org/medicaid/issue-brief/...under-the-aca/

Oh, and I guess you might understand that this would make you the liar by your own implicit definition. Hopefully, disproving that will give you enough motivation to move beyond your typical lack of understanding on just about any issue including this one, and actually do some homework, but who knows for sure?
Last edited by playwrite; 12-02-2013 at 11:13 AM.
"The Devil enters the prompter's box and the play is ready to start" - R. Service

“It’s not tax money. The banks have accounts with the Fed … so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. It’s much more akin to printing money.” - B.Bernanke


"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman

If you meet a magic pony on the road, kill it. - Playwrite







Post#5322 at 12-02-2013 11:21 AM by playwrite [at NYC joined Jul 2005 #posts 10,443]
---
12-02-2013, 11:21 AM #5322
Join Date
Jul 2005
Location
NYC
Posts
10,443

The Big Khauna has spoken

Sorry, handwringers and naysayers -

http://krugman.blogs.nytimes.com/201...cation-begins/

Benghazification Begins

Healthcare.gov is much better. It’s not running like, say, Amazon — but remember, mainly the government is trying to give you money, namely subsidized insurance, rather than to sell you something, so it doesn’t have to match commercial performance right away. There are still serious problems with the back end — the delivery of information to insurers. But the site is no longer a laughingstock, it’s going to get better, and a lot of people are going to sign up by the time open enrollment ends on March 31.

In short, the crisis is over — for Obama and the Democrats. It’s just beginning for the Republicans, who won’t be able to let go of the notion that it’s a criminal scandal, and that mobs with pitchforks will march on the White House if only they can find the right words.

They’ll try everything. They’ll hold endless hearings; they’ll get the usual suspects to publish many op-eds. Maybe they’ll get 60 Minutes to do a report that has to be retracted.

And yes, maybe they’ll gain some seats in the midterms, although those are a long way away.
Benghazi! Benghazi! Bengha'macare! Bengha'macare! Obama'ghazi'carei! Obma'ghazi'care! Mufasa! Mufasa!

Oh, almost forgot - IRS! IRS! Mufasa! Mufasa!

http://www.youtube.com/watch?v=xI8G3UefIkU
"The Devil enters the prompter's box and the play is ready to start" - R. Service

“It’s not tax money. The banks have accounts with the Fed … so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. It’s much more akin to printing money.” - B.Bernanke


"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman

If you meet a magic pony on the road, kill it. - Playwrite







Post#5323 at 12-02-2013 11:25 AM by playwrite [at NYC joined Jul 2005 #posts 10,443]
---
12-02-2013, 11:25 AM #5323
Join Date
Jul 2005
Location
NYC
Posts
10,443

Quote Originally Posted by The Rani View Post
Let's get back to this one:

This is a blatant falsehood. You're either lying, or too stupid to realize that your comment is in direct contradiction to information posted on the actual Medicaid website.
Still not willing to do the homework, hey?

One thing to be ignorant, a whole other thing to be willfully ignorant.

Mufasa! Mufasa!
Last edited by playwrite; 12-02-2013 at 11:27 AM.
"The Devil enters the prompter's box and the play is ready to start" - R. Service

“It’s not tax money. The banks have accounts with the Fed … so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. It’s much more akin to printing money.” - B.Bernanke


"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman

If you meet a magic pony on the road, kill it. - Playwrite







Post#5324 at 12-02-2013 11:58 AM by playwrite [at NYC joined Jul 2005 #posts 10,443]
---
12-02-2013, 11:58 AM #5324
Join Date
Jul 2005
Location
NYC
Posts
10,443

A atypical clear-headed look -

- at the "limited provider network" issue -

http://www.californiahealthline.org/...rks-a-bad-idea

hen Health Plans Drop Your Doctor: Are Narrow Networks a Bad Idea?

Search Covered California's website, and you'll find a list of 33 "frequently asked questions."

The 33rd and final question -- below questions like "Why should I buy health insurance?" and "I'm pregnant and do not have insurance. What health coverage is available for me?" -- is "Will patients be able to keep their same doctor when they purchase health insurance through Covered California?"

The question may be last on Covered California's list, but it's top-of-mind for many consumers. About one million Californians, and millions of other Americans, are losing their health plans through the individual market and turning to Obamacare's new insurance exchanges to shop for replacement coverage. And in many cases, it's still unclear if the family doctor will be coming with them.

The Mechanics Behind Narrow Networks

This issue began to emerge back in May when Covered California announced its low premiums to some fanfare -- a "home run" for the state, officials said at the time.

But some critics seized on news that participating insurers had achieved those lower costs, in part, by relying on narrow networks that excluded UCLA Medical Center and Cedars-Sinai Medical Center -- two of the state's most prominent, if expensive, hospitals.

Similar stories followed in other states, as exchanges released their rates and participating health care providers.

"We knew it was going to be narrow," one Missouri insurance broker told Kaiser Health News after one local briefing. But the actual list of participating hospitals "was kind of eye-opening."

The issue plays directly to one of the biggest fears sparked by the Affordable Care Act: The law will limit patient choice. But supporters say that's not the case.

"Narrow networks may seem like a bad idea," David Dranove and Craig Garthwaite blogged last month. The two Northwestern University professors acknowledged that excluding some providers from health plans offered through the exchanges runs the risk of disrupting care patterns.

But the model is "not some cruel attempt to limit patient choice foisted upon us by the insurance industry," the professors added. "Instead, these plans may provide our best opportunity for harnessing market forces to lower prices."

The simple equation: Insurers say that limiting the size of the network allows them to steer patients to high-quality facilities and doctors; participating providers, meanwhile, may agree to price cuts in exchange for new volumes. (A previous edition of "Road to Reform" took a closer look at the narrow network model.)

And narrow networks aren't necessarily a new idea, Darius Tahir points out at National Journal. In some ways, it's the same concept behind payers' attempts in the 1980s and 1990s to limit their network size, which met with criticism and helped create Any Willing Provider laws.

Could narrow networks be better perceived -- and received -- with better phrasing? Industry consultant Vince Kuraitis thinks so.

"The very term 'narrow network' creates a negative connotation and doesn't speak to potential benefits," Kuraitis comments at The Health Care Blog. But choosing to describe "the same networks as 'high-performance networks' or 'intelligent networks'... [t]he connotations here are much more positive."

Do Providers Want In? It's Complicated.

Some hospitals -- initially left out of exchange plans -- are fighting to be included.

Seattle Children's Hospital sued the state insurance commissioner, which helped begin a battle with a local insurer over whether the facility's rates are too high.
Eleven Kentucky hospitals have filed complaints; so far, the department has ordered Anthem to accept applications from three of those hospitals.

(At Kaiser Health News, Jay Hancock has an in-depth look at the battles between state officials, providers and payers over the emerging networks.)

But not all providers want to be a part of the exchange plans. Some doctors are sitting out, citing low reimbursement.

Presented with contracts that paid up to 30% less than traditional rates, "we said, this doesn't make a whole lot of sense for us," Richard Thorp, president of the California Medical Association told the Wall Street Journal.

And hospitals also are wary of participating, with many top facilities choosing to opt out of exchange plans.

Why? In part, prominent providers' doubts echo the concerns of Aetna, Cigna and other insurers that pulled out of the exchanges: The startup uncertainty and potential patient population aren't worth the risk in year one.

But hospital executives also are fearful that agreeing to price concessions to play on the exchanges will hamper their efforts to bargain in the future.

"[O]nce you've agreed to low rates for one company, how do you ever negotiate for more with that company or any other company?" Michael Green, CEO of Concord Hospital, wrote in an op-ed explaining why his hospital wouldn't participate in New Hampshire's exchange.

"If the insurers decide to move small groups along with individual to the exchange, you could find that you've put your organization in financial peril," Green wrote.

Moving Forward

Every indication is that the narrow network model will become the standard.

"I don't think there is anything about this trend that is limited to the exchange market," Sara Rosenbaum, a health policy professor at George Washington University, told Modern Healthcare.

But in the meantime, the provider fights -- and still-troubled websites -- mean that there's considerable confusion over which doctors and hospitals will be included in which plans next year.

On Covered California's website, the FAQ encourages consumers to check directories available on the site to see if their doctor is listed. But one practical challenge: That provider directory has been glitchy. Another: Providers may end up negotiating "right up to the Jan. 1, 2014 starting date," Phil Daigle of California Health Benefit Advisers writes.

Meanwhile, the dust-up over Covered California's hospitals is a sign of how quickly things can change -- and perhaps the lingering resistance to narrow networks, too.

After this summer's fuss, officials eventually ensured that Cedars-Sinai is now available through a few plans on the state's exchange. And so is UCLA, which announced the news with a banner ad: "Covered California now offers a choice U know."
California is the state to watch as the bellweather for the rest of the nation. It's not just that their website is one of the best and they are off to a good start, avoiding much of the problems of the federal website. They are huge in population and number of uninsured, and have a very diverse population. They've accepted the Medicaid Expansion. They are talking to other states in a low-key way about the possibility of combining into a regional exchange.

Vermont's attempt at single payer will get the attention, but its going to be both tough as a small state to afford it (estimates are around $2B in state funds needed) and to be seen as a model for other states. California has the financial capacity to afford it; if it can be done in CA, it can be done just about anywhere; and they have the political clout to get federal support for it. The insurers know this, look at all the plans they're offering in that state and the relatively low costs; they've got to fend off the public option path to single payer there.

Funny how the mass media is missing what is likely to be the longer-term big underlying issue that will emerge and the role of California.

I guess they're too busy with dispersing the Mufasa! Mufasa memes of the Right - the mass media know what the sheeple want to hear.
"The Devil enters the prompter's box and the play is ready to start" - R. Service

“It’s not tax money. The banks have accounts with the Fed … so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. It’s much more akin to printing money.” - B.Bernanke


"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman

If you meet a magic pony on the road, kill it. - Playwrite







Post#5325 at 12-02-2013 12:09 PM by playwrite [at NYC joined Jul 2005 #posts 10,443]
---
12-02-2013, 12:09 PM #5325
Join Date
Jul 2005
Location
NYC
Posts
10,443

Quote Originally Posted by The Rani View Post
Stick with the lies and insults if that's all you've got, but the fact remains that DSH payments are intended to support health care providers that treat large numbers of low-income Medicaid/Medicare patients as well as the uninsured:

https://www.federalregister.gov/arti...eductions#h-34

P.S. I'm not going to do YOUR homework for you. If you can find evidence that contradicts mine, look it up and post it yourself.
You doing my homework??? Too funny; you have learned well from the master of ignorant obfuscation and misdirection.

But what you do reflect well is I have grown tired of educating you on these issues. You supposedly have a higer degree education in this field but your ignorance is only exceeded by your unwillingness to do much about it.

I'll give you a couple of hints but that's going to have to do; more would be a waste of time, my time.

The original context of this discourse was how the lack of Medicaid Expansion in some Red states would impact the reimbursements of the DSH payments. To understand the extent of that one would need to move beyond the basic definitions of the DSH that one can find by simply googling ( can be done no matter how intellectually lazy one is - you being the case in point) and actually work out the math. That math will show that what is important on this issue it the reduction in the number of uninsured, which was my original point.

The problem here is that you are really not interested in understanding the issue, you are only interested in trying to find something to get back on with me because I have so often pointed out your ignorance if not downright stupidity. But it's okay, I find it entertaining.
Last edited by playwrite; 12-02-2013 at 01:47 PM.
"The Devil enters the prompter's box and the play is ready to start" - R. Service

“It’s not tax money. The banks have accounts with the Fed … so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. It’s much more akin to printing money.” - B.Bernanke


"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman

If you meet a magic pony on the road, kill it. - Playwrite
-----------------------------------------