Originally Posted by playwrite

Obviously one of Miss-Information's ploys is to provide only partial information. The ACA limits total out of pocket expenditures (deductibles, co-pays) to $6350 for individuals and $12,700 for families regardless of size.

Liars lie by omission as well. The ACA out-of-pocket limit only applies to "in-network", without making any clarification of what should and should not be in-network. Pre-ACA situations, where a hospital is in network, but the specialist working there are not (and therefore, where the amount out of your pocket is absolutely unlimited) are legion. And, connected-insider-handout that it is, the ACA does nothing whatsoever to slow or reverse that phenomenon.

To claim that the ACA will have any effect whatsoever on the incidence of medical bankruptcies is just more of the same outright lying that we've come to expect from you. ACA does nothing whatsoever* about the actual cause of those -- the cartelized price of medical services in the US market.


---
*Nothing positive, that is. It certainly does help to sustain the problem, if not to exacerbate it. Time will tell which of those comes to pass.

Originally Posted by Eric the Green

But also much more regulated.

Eric, the insurance industry is finding every loophole possible. Here's a major one:



Insurers using high drug cost sharing to scare away patients with expensive chronic disorders

AIDS advocates say drug coverage in some marketplace plans is inadequate

By Ariana Eunjung Cha
The Washington Post, December 9, 2013

The nation’s new health-care law says insurers can’t turn anyone away, even people who are sick. But some companies, patient advocates say, have found a way to discourage the chronically ill from enrolling in their plans: offer drug coverage too skimpy for those with expensive conditions.
Some plans sold on the online insurance exchanges, for instance, don’t cover key medications for HIV, or they require patients to pay as much as 50 percent of the cost per prescription in co-insurance — sometimes more than $1,000 a month.

“The fear is that they are putting discriminatory plan designs into place to try to deter certain people from enrolling by not covering the medications they need, or putting policies in place that make them jump through hoops to get care,” said John Peller, vice president of policy for the AIDS Foundation of Chicago.

As the details of the benefits offered by the new health-care plans become clear, patients with cancer, multiple sclerosis, rheumatoid arthritis and autoimmune diseases also are raising concerns, said Marc Boutin, executive vice president of the National Health Council, a coalition of advocacy groups for the chronically ill.

“The easiest way [for insurers] to identify a core group of people that is going to cost you a lot of money is to look at the medicines they need and the easiest way to make your plan less appealing is to put limitations on these products,” Boutin said.


More: http://www.pnhp.org/news/2013/decemb...xpensive-chron

Originally Posted by playwrite

If that's the complain you toadies are left with, it's game over.

It's one of many, but the plain fact is that if it takes longer than war and peace to write about it's unreasonable to expect for the average person to know and understand what's in it and therefore it becomes unenforceable. That, in and of itself talks me the law is cowardly and ineffective in nature.

Originally Posted by Kepi

It's one of many, but the plain fact is that if it takes longer than war and peace to write about it's unreasonable to expect for the average person to know and understand what's in it and therefore it becomes unenforceable. That, in and of itself talks me the law is cowardly and ineffective in nature.

Try reading the Code of Federal Regulation or even a single day volume of the Federal Register.

When the world was as simple as you think it should be, it was also very brutish.

Get over it.

Originally Posted by Kepi

It's one of many, but the plain fact is that if it takes longer than war and peace to write about it's unreasonable to expect for the average person to know and understand what's in it and therefore it becomes unenforceable. That, in and of itself talks me the law is cowardly and ineffective in nature.

In that case, I strongly advise you to stay well clear of all tax law. Tax law occupies numerous volumes evey time it's written. In 2006, it was 16,845 pages. In 2010, page count was 71,684.

Originally Posted by Deb C

Eric, the insurance industry is finding every loophole possible. Here's a major one:



Insurers using high drug cost sharing to scare away patients with expensive chronic disorders

AIDS advocates say drug coverage in some marketplace plans is inadequate

By Ariana Eunjung Cha
The Washington Post, December 9, 2013

The nation’s new health-care law says insurers can’t turn anyone away, even people who are sick. But some companies, patient advocates say, have found a way to discourage the chronically ill from enrolling in their plans: offer drug coverage too skimpy for those with expensive conditions.
Some plans sold on the online insurance exchanges, for instance, don’t cover key medications for HIV, or they require patients to pay as much as 50 percent of the cost per prescription in co-insurance — sometimes more than $1,000 a month.

“The fear is that they are putting discriminatory plan designs into place to try to deter certain people from enrolling by not covering the medications they need, or putting policies in place that make them jump through hoops to get care,” said John Peller, vice president of policy for the AIDS Foundation of Chicago.

As the details of the benefits offered by the new health-care plans become clear, patients with cancer, multiple sclerosis, rheumatoid arthritis and autoimmune diseases also are raising concerns, said Marc Boutin, executive vice president of the National Health Council, a coalition of advocacy groups for the chronically ill.

“The easiest way [for insurers] to identify a core group of people that is going to cost you a lot of money is to look at the medicines they need and the easiest way to make your plan less appealing is to put limitations on these products,” Boutin said.


More: http://www.pnhp.org/news/2013/decemb...xpensive-chron

Explain to us how the insurers get around the maximum $6350 total out-of-pocket requirement.

If you can't, you're obviously just croaking more horseshit. Lit' Miss-Information.

Originally Posted by Justin '77

Liars lie by omission as well. The ACA out-of-pocket limit only applies to "in-network", without making any clarification of what should and should not be in-network. Pre-ACA situations, where a hospital is in network, but the specialist working there are not (and therefore, where the amount out of your pocket is absolutely unlimited) are legion. And, connected-insider-handout that it is, the ACA does nothing whatsoever to slow or reverse that phenomenon.

To claim that the ACA will have any effect whatsoever on the incidence of medical bankruptcies is just more of the same outright lying that we've come to expect from you. ACA does nothing whatsoever* about the actual cause of those -- the cartelized price of medical services in the US market.


---
*Nothing positive, that is. It certainly does help to sustain the problem, if not to exacerbate it. Time will tell which of those comes to pass.

Ah, I was wondering when the king of toadies would report in. No need to wonder any more. It's croaking time!

Give us some facts, some actual situations, where someone with a particular illness cannot get the care within any plan's network. Sure, someone might not be able to access the top guy in a particular field, but I'll be damned if you can get away with saying there's a case where an alternative isn't available in a plan's network. But go ahead share with us one or two specific, credible, research-able cases - I mean it should be of utmost ease given that there is a "legion" of such cases.

Likewise for the bankruptcy, give us a specific, credible, research-able case where someone was forced into bankruptcy with the sole reason they owed $6350 for medical care.

You make this just too easy. I stand in awe how stupid your blind ideology can make you.

Originally Posted by playwrite

Explain to us how the insurers get around the maximum $6350 total out-of-pocket requirement.

If you can't, you'e obviously just croaking more horseshit.

Since this affects me personally, I actually know. Specialty drugs are not always considered to be drugs, but when they are, they are covered as such.

All drug plans have a formulary, which includes these specialty drugs or not. If it doesn't, then the costs shift to a different model, which is less restrictive in how it's applied. My wife uses a drug that, after many years in the marketplace, has now dropped to a cheap-cheap-cheap out-of-formulary price of $9,000 to $13,000 a year (depending on how often it's used). Note: the drug in question is an infusion, so when it's handled through the drug plan, it still needs to be administered as a separate procedure at additional cost. Since my wife is covered under my plan at work, which bundles the drug as part of the procedure rather than as a standalone drug, these issues don't apply to us ... but they could.

Many ACA plans keep prices low by moving these drugs to the formulary, making them prohibitive for people needing them. In fact, the insurers may be too clever by half. Many (most?) seem bent on being cheap and restrictive ... and this is now the norm, rather than the exception. We don't know the blowback from people getting plans that were inadequate to their needs yet, because this is all new. Tune in this time next year.

If the ACA fails, it will be the insurance industry that does it in.

Originally Posted by playwrite

Try reading the Code of Federal Regulation or even a single day volume of the Federal Register.

When the world was as simple as you think it should be, it was also very brutish.

Get over it.

Excess complexity, especially pointless complexity usually leads to a swift harsh display of brutality to set things right. In terms of our society, we've seen legal documents expand to beyond 3 times what they were not 40 years ago, as the useless elite has become more useless. So, you know, it'll be fun seeing them get the guillotine, I guess.

Originally Posted by Marx & Lennon

Since this affects me personally, I actually know. Specialty drugs are not always considered to be drugs, but when they are, they are covered as such.

All drug plans have a formulary, which includes these specialty drugs or not. If it doesn't, then the costs shift to a different model, which is less restrictive in how it's applied. My wife uses a drug that, after many years in the marketplace, has now dropped to a cheap-cheap-cheap out-of-formulary price of $9,000 to $13,000 a year (depending on how often it's used). Note: the drug in question is an infusion, so when it's handled through the drug plan, it still needs to be administered as a separate procedure at additional cost. Since my wife is covered under my plan at work, which bundles the drug as part of the procedure rather than as a standalone drug, these issues don't apply to us ... but they could.

Many ACA plans keep prices low by moving these drugs to the formulary, making them prohibitive for people needing them. In fact, the insurers may be too clever by half. Many (most?) seem bent on being cheap and restrictive ... and this is now the norm, rather than the exception. We don't know the blowback from people getting plans that were inadequate to their needs yet, because this is all new. Tune in this time next year.

If the ACA fails, it will be the insurance industry that does it in.

Sorry to hear you all are facing that.

It's a legitimate issue but it in not an issue solely for the ACA. Every form of insurance, public as well as private, has the same issue of what drugs/formulations (procedures as well) will be covered or not. Medicare and certainly Medicaid and VA all have their exclusions. It's getting down into the weeds of medical choices by doctors, influenced by pharmaceutical salesmen as well as drug researchers on the payrolls of drug companies to hype a particular magic bullet. It's tough to talk cost control measure without understanding the greed and game-playing that goes on in the midst of desperate people wanting a cure. We can't get away with from these difficult trade-offs and exceptions to the rule under any system including single payer.

What the ACA offers is a framework of requirements that the insurers MUST meet which I believe for drugs requires them to cover at least one magic bullet in each identified category. It also provides a means for appeal. It's laid out here somewhat -

http://www.washingtonpost.com/nation...0e1_story.html

Things you need to know about the Affordable Care Act and prescription drugs — but probably don’t

It's one thing for you to say an insurer under the ACA doesn't offer one particular formulation that one's doctor believes is the magic bullet (as influenced by the nice drug company salesman); it's a whole other thing for Debs to say the insurer can refuse to offer any drug coverage in that category. It is very similar to Justin's belief that if he can't get hisr insure to cover the expense of the top brain surgeon in the world to deal with his toadiness syndrome no other brain surgeon will do. I still think the latter should take a stab at helping him in Justin's case.

Originally Posted by Kepi

Excess complexity, especially pointless complexity usually leads to a swift harsh display of brutality to set things right. In terms of our society, we've seen legal documents expand to beyond 3 times what they were not 40 years ago, as the useless elite has become more useless. So, you know, it'll be fun seeing them get the guillotine, I guess.

I think if we held to your standard of what is too complex, we still be trying to figure out what that round thing called a wheel was good for. I'll pass; I like riding my Harley.

Originally Posted by playwrite

I think if we held to your standard of what is too complex, we still be trying to figure out what that round thing called a wheel was good for. I'll pass; I like riding my Harley.

Or more likely you'll find your head on a pike in your lawn. Keep in mind you're talking to generally well off millennials on this site, and pretty much every last one you've interacted with thinks you're a useless condescending dickhead.

I don't need to use any aspect of the ACA. I'm well off, my job provides a Cadillac policy that made my eyes bug out when I saw it. The people I know who've had to get ACA mandated coverage? They're pissed. They're compound pissed, because they're all still pissed that nobody's dragging bankers and investors behind their cars. Harleys are nice enough machines, but one metal pole and the driver's done. If those kids getting screwed don't get what they want soon, trust fund snobs such as yourselves won't be riding much of anything at all.

Originally Posted by playwrite

Ah, I was wondering when the king of toadies would report in. No need to wonder any more. It's croaking time!

Naturally. All you ever have to do is keep on lying, and I'll eventually get around to shining light on your lies as you throw up a cloud of irrelevancies and try to slink away.

Give us some facts, some actual situations, where someone with a particular illness cannot get the care within any plan's network.

Not what I said; not what's being argued. You can get the care... it's just that the specialist who is going to give it to you will be an out-of-network one. So the bill you see won't be capped at all. Igf you're pretending that this is something that doesn't happen now, you're being a transparent liar. If, on the other hand, you're arguing that the ACA does anything at all to change the situation, you're being a particularly transparent liar.

Likewise for the bankruptcy, give us a specific, credible, research-able case where someone was forced into bankruptcy with the sole reason they owed $6350 for medical care.

Falling back on your "out-of-pocket cap" lie again? The whole point here is that it explicitly doesn't hold in the exact same circumstances where it doesn't hold now.

You do know, of course, that pre-ACA health insurance plans (you know, the ones that people -- even insured people -- were being driven into medical bankruptcy by) had out-of-pocket caps. ACA's "caps" are no real new thing (except insofar as it requires that spending on drugs not be capped separately...).

So, absent any real evidence on your side (go ahead and look. there isn't any), it's clear that, as far as medical bankruptcies go, the ACA does no more than enshrine the status quo. Only the parasites get a guaranteed constant source of subscription fees now. So that's different.

TL;DR
You lie. Still. And as usual.

Originally Posted by Justin '77

Naturally. All you ever have to do is keep on lying, and I'll eventually get around to shining light on your lies as you throw up a cloud of irrelevancies and try to slink away.

Not what I said; not what's being argued. You can get the care... it's just that the specialist who is going to give it to you will be an out-of-network one. So the bill you see won't be capped at all. Igf you're pretending that this is something that doesn't happen now, you're being a transparent liar. If, on the other hand, you're arguing that the ACA does anything at all to change the situation, you're being a particularly transparent liar.

Falling back on your "out-of-pocket cap" lie again? The whole point here is that it explicitly doesn't hold in the exact same circumstances where it doesn't hold now.

You do know, of course, that pre-ACA health insurance plans (you know, the ones that people -- even insured people -- were being driven into medical bankruptcy by) had out-of-pocket caps. ACA's "caps" are no real new thing (except insofar as it requires that spending on drugs not be capped separately...).

So, absent any real evidence on your side (go ahead and look. there isn't any), it's clear that, as far as medical bankruptcies go, the ACA does no more than enshrine the status quo. Only the parasites get a guaranteed constant source of subscription fees now. So that's different.

TL;DR
You lie. Still. And as usual.

That's it??? I ask you for a specific research-able example of your claimed "legion" of people being denied access to care, rather than certain specialist or legions of bankruptcy cases and all you can do is once again play your word games.

What's really pathetic is you believe you can cover up your horseshit with some playground name calling that a 3rd grader would be embarrassed to try.

Pathetic dude, really pathetic. Your shit stinks. Not worth my time.

Originally Posted by Kepi

Or more likely you'll find your head on a pike in your lawn. Keep in mind you're talking to generally well off millennials on this site, and pretty much every last one you've interacted with thinks you're a useless condescending dickhead.

I don't need to use any aspect of the ACA. I'm well off, my job provides a Cadillac policy that made my eyes bug out when I saw it. The people I know who've had to get ACA mandated coverage? They're pissed. They're compound pissed, because they're all still pissed that nobody's dragging bankers and investors behind their cars. Harleys are nice enough machines, but one metal pole and the driver's done. If those kids getting screwed don't get what they want soon, trust fund snobs such as yourselves won't be riding much of anything at all.

Yea, dude, I just bet everyone of those 3.1 million 20-somethings are just seething about being allowed to stay on their parents' insurance until they're 26 years old. And I just bet the ones that are trying to make it on their own with incomes below $16K are just shaking their fist about being covered now for free by Medicaid. Oh, and those making less than $30K getting free subsidized private insurance are just beside themselves with anger.

Two thumbs up for your Cadillac policy; that is, two thumbs up your ass you ignorant elitist moron.

... and the damage being inflicted upon one of them by GOP assholes -



- the difference is going to grow substantially and be a stark contrast that will push aside all other Obamacare issues (maybe ALL issues) this coming November.

To make the chart complete, I would add two additional sets of bar graphs. One would be for Debs and other toads doing nothing but denigrating those that have brought health coverage to millions. The other would be for Justin, Kepi and other toadies doing nothing but shedding horseshit crocodile tears for others less fortunate than themselves

In both cases, the charts would show nothing but a BIG FAT ZERO for their helping anybody, which of course would indicate their being more of an asshole that the asshole GOP denying millions of health care coverage.

Funny how graphs can make things so clear.

Pictures help too, like this one indicating where all these toads and toadies are headed -

Originally Posted by playwrite

Yea, dude, I just bet everyone of those 3.1 million 20-somethings are just seething about being allowed to stay on their parents' insurance until they're 26 years old. And I just bet the ones that are trying to make it on their own with incomes below $16K are just shaking their fist about being covered now for free by Medicaid. Oh, and those making less than $30K getting free subsidized private insurance are just beside themselves with anger.

Two thumbs up for your Cadillac policy; that is, two thumbs up your ass you ignorant elitist moron.

They're pissed because they, the people who couldn't afford it before, now have to pay for it at rates they can't afford. These people aren't getting a free lunch for all the hell you pig fondlers put them through, it's nothing more than ensuring there's a company that will make sure they get charged for medical bills they accrue so it doesn't spill on to the rest of us. If they become pauperized and bankrupt in the process, well, no skin of your back, huh?

That's what ACA, it's affordable for the useless rats holding the cash bag. And they're rightfully pissed, being forced to buy something they can neither afford nor use. Do you even know one person using ACA's core provisions? I do. I know several, and they're all pissed. I brought up my insurance policy to point out that I don't rely on this shit law and I think you're a useless necrophiliac, a colostomy bag of human irrelevance stuck in guilt and despair for participating in the great American going out of business sale but so addicted to sniffing his own rectum he can't take his head out to have a look around. That's me and I'm accomplished.

These other guys? They needed something and the neo-liberal trustfund babies fucked them over thrice. So what I'm getting at is... in order to continue at any standard of living, you have to make other people happy. Meanwhile everyone I know really hates trust fund babies, and really hates shit attitudes from old douchebags who think they know everything and meanwhile ruined it all. How long do you think you can maintain? Even the people who make enough money to not work there jobs think you're a skidmark on the tighty whities if society and I see it in every conversation anyone bothers to have with you, what are you going to do when the people who work 70 hours a week realize there's more money in taking it from you?

As someone who teaches Millies (and previous generations for the past 20 years), there has been a significant shift with ACA for people under 26 to remain on their parents' insurance. I used to have to refer my seriously ill students to Cook County Hospital while telling them they'd have to spend the day there. They couldn't afford even the local clinic. One student with epilepsy had been aged out of her parents insurance and warned me that she's probably start having grand mal seizures in class since they could not afford her medications--until ACA kicked in four months later. And she did have them. In class.

I had no health insurance from age 21 to age 32. Since medical care was cheaper back then I could pay out of pocket for the mild illnesses I had that required antibiotics. When I developed an ongoing GI problem and went to my PCP he thought I might have gall stones. I told him I had no insurance. He responded, "We did not have this conversation," and it was never entered in my records. Because a pre-existing condition would screw me and he knew it.

Thank goodness I didn't have huge dental problems. Although I couldn't afford a dental cleaning for 10 years, either. And neither did many of the people I knew. My current periodontal issues may be a result of that or not. Who knows?

ACA is no panacea, but it's a shitload better than what came before it. It looks like it will cost some young males more money in the short run. So don't sign up and pay the penalty. Some people will be hurt financially by ACA. I got my financial ass kicked by Reagan and Bush and have somehow managed to live to tell the tale. .

I have above average health insurance from my job, although it is less than it was. It is supposedly at least $25,000 of my compensation package. And I use it for everything it's worth. Flexible spending, physical therapy for back problems that includes massage (and yes, I tip).

A close friend who paid individual health insurance with a $5000 deductible paying $700 a month is now on her new husband's cadillac health insurance. And she still believes she can't spend anything because she'll be denied. Because she had breast cancer last year she believes she shouldn't rock the boat with GI medication she knows improves her health. She's convinced she's not worthy, in part because her former individual insurance policy had riders for just about everything and wouldn't pay for shit. She won't listen when I tell her that she actually deserves the medication that works for her. She paid tens of thousands of dollars and got nothing. So she's used to that.

I would prefer universal health care because I am at the least a social democrat.

God, I'm so tired of the screaming from both sides. This is the first actual attempt to do something about the abysmal state of healthcare in the US and the drama is just tiresome.


ETA: I couldn't afford to have my wisdom teeth removed in my 20s. I did so when I was 40 and the oral surgeon told me "It was bad." Since he was in his 50s, I believed him. I lost a back molar as a result of impaction. Perhaps if I'd told my skinflint (rather wealthy) GI father I needed dental care in my 20s he would have helped out. But I was an independent little cuss and not willing to present him a business plan to prove it was necessary. All these years later I know he would have helped out, but there was a lot of water under the bridge.

And you don't see that as an encouragement for companies to drop their insurance coverage? People staying on their parent's coverage is a benefit... Until you're 27 and find yourself in a dead end job because that's what's available to you and you don't have coverage so you have to get garbage coverage. When I worked as an attractor (speaking of dead end), the number one reason for people to have major judgements against them was medical care. And we're not talking copays, either, because we're talking 300 and 500 thousand dollar judgements on a house, so we're not talking uninsured people either. This is exactly the sort of bad law making that comes packed with consequences because it is designed not to be comprehensive and it passes the buck down to folks who flat out can't afford it, it also lacks reasonable regulation to ensure that the douche bag insurance companies mind their ps and qs, even though they're clearly douche bags.

Originally Posted by playwrite

... It's one thing for you to say an insurer under the ACA doesn't offer one particular formulation that one's doctor believes is the magic bullet (as influenced by the nice drug company salesman); it's a whole other thing for Debs to say the insurer can refuse to offer any drug coverage in that category. It is very similar to Justin's belief that if he can't get hisr insure to cover the expense of the top brain surgeon in the world to deal with his toadiness syndrome no other brain surgeon will do. I still think the latter should take a stab at helping him in Justin's case.

The biggest issue is efficacy. When drugs get exotic, they tend to have a narrower range of suitable use. Exotic drugs tend to be poison that only poisons some people. As such, two nearly identical drugs can have widely different results, with drug A working well for patient 1 and drug B for patient 2, yet having no beneift or creating real harm when 1 gets B or 2 gets A. Unfortuanately, insurers don't see it that way, so people with needs like that have to be exceedingly careful when choosing plans.

It gets even worse when the current drug loses efficacy, and the search is on for a replacement. Often, that means eating some high costs in the current year, while actively looking for new insurance for the next.

Originally Posted by Kepi

Excess complexity, especially pointless complexity usually leads to a swift harsh display of brutality to set things right. In terms of our society, we've seen legal documents expand to beyond 3 times what they were not 40 years ago, as the useless elite has become more useless. So, you know, it'll be fun seeing them get the guillotine, I guess.

Complexity is often the lesser of evils. If something needs to be cerulean, blue just won't cut it.

Remember, language is used for many reasons, and legal language is intended to define and limit. That takes verbiage, and lots of it. If all that overbearing and exacting language isn't there, then the reader has the legal right to bend the generalities that are there. For one bad example: language noting that it is illegal to stab someone doesn't preclude bludgening, shooting or burning.

Originally Posted by Kepi

They're pissed because they, the people who couldn't afford it before, now have to pay for it at rates they can't afford. These people aren't getting a free lunch for all the hell you pig fondlers put them through, it's nothing more than ensuring there's a company that will make sure they get charged for medical bills they accrue so it doesn't spill on to the rest of us. If they become pauperized and bankrupt in the process, well, no skin of your back, huh?

That's what ACA, it's affordable for the useless rats holding the cash bag. And they're rightfully pissed, being forced to buy something they can neither afford nor use. Do you even know one person using ACA's core provisions? I do. I know several, and they're all pissed. I brought up my insurance policy to point out that I don't rely on this shit law and I think you're a useless necrophiliac, a colostomy bag of human irrelevance stuck in guilt and despair for participating in the great American going out of business sale but so addicted to sniffing his own rectum he can't take his head out to have a look around. That's me and I'm accomplished.

These other guys? They needed something and the neo-liberal trustfund babies fucked them over thrice. So what I'm getting at is... in order to continue at any standard of living, you have to make other people happy. Meanwhile everyone I know really hates trust fund babies, and really hates shit attitudes from old douchebags who think they know everything and meanwhile ruined it all. How long do you think you can maintain? Even the people who make enough money to not work there jobs think you're a skidmark on the tighty whities if society and I see it in every conversation anyone bothers to have with you, what are you going to do when the people who work 70 hours a week realize there's more money in taking it from you?

You would have a much better point if you argued, as I do, that there is a cross-generational demand for support that is not being met by anyone. The young deserve a free or at least nearly free college education. The old deserve healthcare. Neither happens without subsidies by those not directly benefitting. Neither happens unless those most affected get out there and demand it.

Originally Posted by Kepi

They're pissed because they, the people who couldn't afford it before, now have to pay for it at rates they can't afford. These people aren't getting a free lunch for all the hell you pig fondlers put them through, it's nothing more than ensuring there's a company that will make sure they get charged for medical bills they accrue so it doesn't spill on to the rest of us. If they become pauperized and bankrupt in the process, well, no skin of your back, huh?

That's what ACA, it's affordable for the useless rats holding the cash bag. And they're rightfully pissed, being forced to buy something they can neither afford nor use. Do you even know one person using ACA's core provisions? I do. I know several, and they're all pissed. I brought up my insurance policy to point out that I don't rely on this shit law and I think you're a useless necrophiliac, a colostomy bag of human irrelevance stuck in guilt and despair for participating in the great American going out of business sale but so addicted to sniffing his own rectum he can't take his head out to have a look around. That's me and I'm accomplished.

These other guys? They needed something and the neo-liberal trustfund babies fucked them over thrice. So what I'm getting at is... in order to continue at any standard of living, you have to make other people happy. Meanwhile everyone I know really hates trust fund babies, and really hates shit attitudes from old douchebags who think they know everything and meanwhile ruined it all. How long do you think you can maintain? Even the people who make enough money to not work there jobs think you're a skidmark on the tighty whities if society and I see it in every conversation anyone bothers to have with you, what are you going to do when the people who work 70 hours a week realize there's more money in taking it from you?

Not a single presentation of fact or logical argument; just trash talk and near gibberish. Why is it that people like you and Justin think that such unintelligent diarrhea helps cover up your initial stupidity. At least Justin has developed it into an art form that fools some people (see "toadies"); yours doesn't do it even for a fifth grader. I guess Justin just been at it for a lot longer.

In hopes that you are at a crossroad in your life, let me give you some pointers on how to have a thoughtful argument. I'll note some of the difference with the horseshit objective of Justin's, but will mostly leave it to him to school you in that particular art of horseshit castle building - after all, he is the master of the form.

First, try to stay on topic. The initial conjecture was that the ACA is flawed because it is a long written document; but, you soon wind up with the entire Millie ennui and banksters not being perp walked. Justin is a master of this; I don't believe anyone has had discourse with him of more than four exchanges without the need to go back to his initial post of stupidity - he covers his tracks very well and lets the initial horseshit slowly slip away with piles and piles more of horseshit. Your's on the other hand is nearly instantaneous as soon as you get the first pushback. It comes immediately across as some primodial scream - perhaps a catharsis is what you're looking for but to everyone else its just nonsensical screech. Why not just fart, eat some more bean dip and return to your marathon viewing of Dancing with the Stars DVDs? Or again, perhaps the similarly valuable use of your time of some one-on-ones with Justin to raise your art form?

Second, really think about that initial conjecture and ask yourself, are you really about to put in writing something really stupid. Take a moment and Google "ACA bill length" and just for once screen out your usual sources of information like Faux News and Rush Limbaugh, i.e. stick your head out of the echo chamber every once in a while. Maybe you would come by something like this -

http://www.leadertelegram.com/blogs/...9bb2963f4.html

I was curious to know how the length of the Affordable Care Act compared with other major pieces of legislation. Take, for example, the Wisconsin state budget (officially known as Act 32) signed into law last July by Gov. Scott Walker. The PDF of the budget, as approved, is 532 pages long. I cut and pasted the text into my word processor, and learned the budget ran to 409,629 words (give or take -- the figure includes some page headers and other extraneous verbiage). How long is the Affordable Care Act? By my count, it’s 418,779 words (again, that’s approximate).

In other words (pardon the pun), a law refashioning one of the major sectors of the U.S. economy is only slightly longer than a law setting the two-year budget for one of the 50 states.

Maybe even cut thorough the clutter of biased secondary or, more likely, tertiary analysis and go to the source for your own fresh view; for instance -

http://housedocs.house.gov/energycommerce/ppacacon.pdf

- and notice things about fonts, margins, page size. Maybe compare them to other weighty documents such as this one -

http://www.amazon.com/Storm-Swords-S.../dp/B000FBFN1U

- which was over 1000 manuscript pages. Now I and millions are pounding on George to write faster his upcoming 1,500 page next book in the series to see if [SPOILER ALERT!!!] Jon Snow is going to come back as his wolf or if Daenerys is going to have Drogon stir fry Jhaqo. However, even George would agree that his entire set of novels (over 6000 manuscript pages) is not going to have anywhere near the impact on real peoples' lives like the landmark ACA.

Bottom line here is if you avoid writing something really really stupid in the first place, you can simply avoid the need to pile on even more stupid horseshit. Don't get as old as Justin and be beyond the ability to learn this simple truth.

Third, enough already with the anecdotes - the 'I have a friend whose brother knows a guy that once dated a girl who befriended this Millie that was really pissed about Obamacare." Dude, start with some research-able facts, a link here, maybe a graph there, that makes your point in a factual and logical way. Maybe throw in an anecdote (preferable a real one) for some flavor. You may notice that most of the media (not Faux News or Rush) actually name the source of their anecdotes - not suggesting you go that far because this medium is different, but because it is different you should rely a lot less on anecdotes - it makes you look intellectually desperate.

Fourth, and this is likely the hardest one for you to grasp because of its self-centered nature, don't be an elitist a-hole. It doesn't help your argument (assuming you actually had one, which is not the case here) to present yourself as representing a downtrodden group (in this case, Millies with low incomes) by telling us that you have a Cadillac plan which obviously means you have the luxury of highly govt subsidized employer-assisted health insurance. Now, obviously here is where you push back about my wealth. The difference is I don't talk about the emotional well-being of these downtrodden Millies of yours; I don't pretend as you do that I know how they are all pissed off and ready to lead a revolt into the next Turning. I merely present the facts - 3.1 million now covered by their parents insurance; 100s of thousands (exact number to be determined soon) getting free subsidized private insurance through the exchanges; hundreds of thousands more getting some level of support; and all not being subjected to exclusion due to pre-conditions.

So there you are. You have raised several issues in your great conflation. If you want to tease out one or some rational combination of a few and argue them in some rational factual manner, let's do it! This thread is about national health care policy and has focused for a while on what the ACA does and doesn't do; if you have some issues (e.g. banksters) better fitted to other threads, then maybe you can post them there instead - that might send a signal that you are actually interested in pursuing some factual, rational arguments.

The other choice, I guess, is that you and Justin could go get a room together and practice the art of horseshit castle building.

Originally Posted by Kepi

And you don't see that as an encouragement for companies to drop their insurance coverage? People staying on their parent's coverage is a benefit... Until you're 27 and find yourself in a dead end job because that's what's available to you and you don't have coverage so you have to get garbage coverage. When I worked as an attractor (speaking of dead end), the number one reason for people to have major judgements against them was medical care. And we're not talking copays, either, because we're talking 300 and 500 thousand dollar judgements on a house, so we're not talking uninsured people either. This is exactly the sort of bad law making that comes packed with consequences because it is designed not to be comprehensive and it passes the buck down to folks who flat out can't afford it, it also lacks reasonable regulation to ensure that the douche bag insurance companies mind their ps and qs, even though they're clearly douche bags.

Let's assume you've actually have some facts about this and have given it a lot of thought. Please explain exactly who (e.g. income group) you are talking about.

As you have at least acknowledged, 3.1 million Millies will be covered by their parents' insurance as a result of the ACA.

We also know that the Medicaid expansion will be covering several million people over the next few years. I'm assuming you know that under Medicaid you don't pay much of anything and you have included that fact in your calculation that supports your assertion.

In the private insurer market, we have projections that 6.1 million people will be paying less than $100 a month and not have any out of pocket expenses over $6350 with many having even a smaller ceiling -

http://thinkprogress.org/health/2013...dollars-month/

This is based on income levels, so the people paying more than $100 a month have some level of income that is relatively affluent. I'm assuming you understand that logic and its part of the calculation that you have made for your assertion.

Please explain to me then who exactly you have in mind that will still be downtrodden particularly enough where the cost of their medical needs (including premiums and a maximum $6350 OPE) will inevitable lead to bankruptcy.

If you can't make a rational case for your assertion, just what do you think you've been doing since your initial statement of the ACA being bad because it is long?

Maybe this -

Originally Posted by Marx & Lennon

The biggest issue is efficacy. When drugs get exotic, they tend to have a narrower range of suitable use. Exotic drugs tend to be poison that only poisons some people. As such, two nearly identical drugs can have widely different results, with drug A working well for patient 1 and drug B for patient 2, yet having no beneift or creating real harm when 1 gets B or 2 gets A. Unfortuanately, insurers don't see it that way, so people with needs like that have to be exceedingly careful when choosing plans.

It gets even worse when the current drug loses efficacy, and the search is on for a replacement. Often, that means eating some high costs in the current year, while actively looking for new insurance for the next.

I understand and can sympathize with those facing these circumstances.

I was trying to think of an analogy and came up with this imperfect one -

These actually effective drugs (or procedures) are like little lifeboats floating on a very violent stormy sea of health care costs and the politics that surround them. Whatever insurance mechanism is set up (private, private/public partnership, or full-bore govt single payer) is the rescue squad tasked to wade into the stormy seas and pluck out the little lifeboats and bring them safely to harbor (for use by needing patients). It's very very expensive to do so with the greatest cost being plucking various things out of the sea that turn out to be just flotsam and jetsam (i.e. unnecessary costs). As such, the rescue squad (again, including single payer) has standard operating practices (SOPs) to keep the flotsam and jetsam costs down while plucking as many lifeboats as possible. Inevitable any system is going to have failures. Also, as you noted, one may pick a certain rescue squad because it has SOPs that favor their picking the particular lifeboat of interest.

I'm not sure how you can improve on the model overall. Single payer has the potential for deeper pockets to pay for more rescue squads - but that gets you not only more lifeboats to harbor but more flotsam and jetsam as well - given my MMT beliefs, I'm okay with that, but politically it's a loser in the current environment.

I think the answer is on the tech side - making the lifeboats much more obvious and cheaper to pluck - I think that is coming in the next few years. I particularly hope it does for you and your wife's needs.