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Americans may accept Obamacare just as they did with Medicare



Published: Mon, October 7, 2013 @ 12:00 a.m.

Americans may accept Obamacare just as they did with Medicare

Reading the article head- lined “Valley doctors say confusion reigns with ACA” in the Sept. 27 Vindicator took me back almost a half-century to the year 1965. President Lyndon Johnson and the Democrats who controlled the U. S. Congress were pushing for enactment of a health care program for seniors and disabled persons. It was called Medicare, and it stirred great controversy.

The American Medical Association has little political power nowadays, but back then its pronouncements carried real muscle among physicians and politicians. I was among the many docs who went around their local communities badmouthing Medicare and praising the AMA’s anemic substitute, which was called Eldercare. We predicted doom and disaster if the Medicare bill passed, just as some doctors are doing today with regard to the Affordable Care Act. Our own patients listened to us politely, but the Democrats had the votes, and Medicare became the law of the land.

None of the predicted horrors came to pass. As time went on older patients came to appreciate their ability to get medical services without risking bankruptcy, and doctors found their incomes rising rather than crashing. The paperwork was a nuisance, but the rise of computers made it much easier to cope with.

Some of the physicians quoted in the recent article complain about complexity and confusion relating to the ACA takeoff. That is inevitable but tolerable. The 1965 Medicare startup was messy, and this year’s will probably be worse, largely because many political foes want it that way. They have been building legislative roadblocks and misrepresenting the truth at a frantic pace, but eventually the dust will settle and Americans will see the new system’s long-term benefits.

We need to understand two powerful forces driving this new legislation. The first is the cost of medical services. One of every six dollars spent in the U. S. today goes for health care. That’s far more, per capita, than any other industrialized nation.

The other force is the staggering complexity of current medical knowledge. Specialists of all types tend to think that whatever they do is crucially important and should be available to everyone. We need to understand the big picture and offer the most useful, cost-effective services selectively.

It is time for Americans to come to terms with the truth: no medical system is perfect, but as other industrialized nations learned long ago, a national program is essential to providing high quality health care to all citizens at a reasonable cost.

Dr. Robert D. Gillette, Poland


Comments

1SeriouslyNow(192 comments)posted 1 year ago

Thank you Dr Gillette, a well written and thoughtful letter from someone that's "been there, done that".

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2redeye1(4561 comments)posted 1 year ago

Dr Gillette you must be a liberturd who is banking on making a boatload of money from the people who get OBAMMY care. This isn't anything like Medicare. If the demoncrats hadn't borrowed so much money from Soc Security without ever paying any back, there wouldn't even be a need for this plan. The people would have great medical coverage, This just another liberturd plan to take even more money for other foolish ideas that they may come up with for the entitlement mob. Besides where is the money coming from to pay for this BS?

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3andersonathan(669 comments)posted 1 year ago

http://www.isthatbaloney.com/21-impea...

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4formerdemliberal(182 comments)posted 1 year ago

Dr. Gillette, your beloved Medicare program is currently on the road towards insolvency as early as 2016. This has resulted in reduced Medicare reimbursements to doctors, many of whom no longer accept Medicare patients. To "save" the system, revenues will have to be increased (higher employee taxes), or costs cut by eliminating covered services, reducing provider reimbursements or allowing employees to opt out of Medicare coverage to purchase cost competitive private health insurance subsidized by fixed government subsidies (paid by taxpayers).

The following research link may enlighten you on the FINANCIAL realities facing the Medicare system sponsored by 16 of your fellow physicians currently serving in Congress.

http://www.aei.org/files/2012/07/20/-...

Your suggestion that Obamacare will benefit Americans in the long-term is flawed for three reasons:

1. You advocate giving control of 1/6 of our national GDP to the inefficiencies of the federal government, rather than to local doctors and individual patients. Many Americans have no desire to give away 1/6 of our private sector economy to federal bureaucrats.

2. Your first force driving Obamacare is that medical costs are skyrocketing, Obamacare does not directly deal with controlling medical service costs. There are no guarantees that Obamacare will control future medical service costs short of rationing health services. The stated goal of Obamacare to reduce health insurance costs by an average of $2,500 per household is a complete sham. When was the last time Medicare health insurance premiums were reduced? If Medicare mirrors the long-term results of Obamacare, then insurance rates will likely increase for many without substantial government taxpayer subsidies.

3. Your second "force" driving Obamacare is unnecessary medical procedures performed by specialists. However, your proposal to "offer the most useful, cost-effective services SELECTIVELY" smells of health care rationing. Your statement shifts making medical decisions from patients and their families to doctors arbitrarily choosing what is minimally best for their patients. Your statement reeks of typical doctor arrogance that "doctor knows best" despite patient and family wishes. I want to maintain my ability to make my own health care choices rather than a physician "selectively" to control costs by deciding what is best for my life.

The long-term financial FAILURE of the current Medicare system in reducing medical costs and health insurance premiums should serve as an example of the false premise that Obamacare will somehow be different than a similar program that is currently bleeding cash and will have trillions of dollars of debt incurred over the next 20 years as baby boomers wipe out Medicare funding.

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5SeriouslyNow(192 comments)posted 1 year ago

@formerdemliberal,
There are a lot of things in your comment that I'd challenge, but how
about we take just the first two sentences.
You might sway me with some facts; specifically,

Number 1: Who says that the ACA is insolvent beginning in 2016?

Number 2: Who are these many doctors who no longer accept medicare patients?
I could be influenced if you could name a few. I called about 15 local doctors and couldn't find any, so if you could name some of the MANY that you are are acquainted with.... well that might be helpful to convince me and others.

Can you provide some facts about these two items????

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676Ytown(1254 comments)posted 1 year ago

The important question for your doctor is "do you accept the Medicare assignment" rather than "do you accept Medicare patients". Doctors who do not accept assignment may bill you a higher rate so your out of pocket costs may be higher and you may have to bill Medicare for services directly. http://www.medicare.gov/your-medicare...

http://www.pbs.org/newshour/rundown
/2013/03/access-to-doctors-shrinks-for-some-medicare-patients.html

And here are figures for Medicaid. http://www.kaiserhealthnews.org/stori...

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7jojuggie(1294 comments)posted 1 year ago

Not one Republican, in the House or Senate, voted for Obamacare. You can't say that about Medicare.

There must be a substantial reason why every major union, in this country, wants a waiver.

Dr Gilette writes like a liberal Democrat. There are a few of those around.

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8jojuggie(1294 comments)posted 1 year ago

Let me get this straight.... We're going to be "gifted" with a health care plan we are forced to purchase and fined if we don't, which purportedly covers at least ten million more people, without adding a single new doctor, but provides for 16,000 new IRS agents, who have recently demonstrated their objective and professional integrity; written by a committee whose chairman says he doesn't understand it, passed by a Congress that didn't read it but exempted themselves from it, and signed by a Dumbo President who smokes, with funding administered by a treasury chief who didn't pay his taxes, for which we'll be taxed for four years before any benefits take effect, by a government which has already bankrupted Social Security and Medicare, Fannie Mae and Freddy Mac, and the Post Office all to be overseen by a surgeon general who is obese, and financed by a country that's broke!!!!!

'What the hell could possibly go wrong

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9formerdemliberal(182 comments)posted 1 year ago

SeriouslyNow,

No. 1 Answer: Try READING my comment. My first sentence states "your beloved Medicare (NOT THE AFFORDABLE CARE ACT) program is currently on the road towards insolvency as early as 2016." Also, I know it can be confusing, but try tapping the article link posted with your little fingers to reference details.

No. 2 Answer: Why would I divulge a private conversation between my physician and myself? Who were the 15 doctors that you called? Did you actually talk to the doctors or a receptionist? Why didn't you use their names?

Here's another article link to support my Medicare assertions.

http://www.heritage.org/research/repo...

One referenced quote from this article states, "The Centers for Medicare and Medicaid Services released information that 9,539 physicians who had accepted Medicare opted out of the program in 2012, which is significantly more than the 3,700 who dropped out in 2009.......it is likely that more physicians will choose to leave the Medicare program in coming years."

Noticed the linked article includes the term "research". Where are your references?

Seriously, read and try comprehending something before you comment or you WON'T be taken seriously. God forbid you read a different perspective about something that you are so sure about.

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10formerdemliberal(182 comments)posted 1 year ago

BTW, as opposed to SeriouslyNow, thanks 76Ytown for the informative article references.

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11SeriouslyNow(192 comments)posted 1 year ago

@former,
regarding @1, you are correct I intended to say medicare. However, I'm not really inclined to take the "research" conducted by Jim Demint's conservative organization as the last word.
I'm more inclined to accept work by the Congressional Budget Office.

Regarding the second question I posed, Ytown76 may have correctly stated that less are taking assignment, but that is NOT what you asserted. You said "doctors, many of whom no longer accept Medicare patients." I am asking you to prove your assertion.

If there are many doctors who are not accepting medicare it would be useful to give examples.

It's not up to me to prove you wrong, it up to you to validate your assertion.

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12jojuggie(1294 comments)posted 1 year ago

Obamacare is such a disaster that the people who wrote it refuse to live under it themselves. That's right. Congress won a waiver from Obamacare.

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13SeriouslyNow(192 comments)posted 1 year ago

@former...
There are about 685,000 physicians in the U.S. who accept Medicare patients. Last year, according to the Centers for Medicare and Medicaid Services (CMS), some 9,539 doctors chose to opt out of Medicare. That's up from 3,700 in 2009, but it’s still less than 2 percent, which is hardly a mass exodus.

Less than 2% .... hard to call that "many"

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14andersonathan(669 comments)posted 1 year ago

http://www.dailymail.co.uk/news/artic...

Despite many reports do not think Americans are running to Obama Care. In fact sign up will take forever now that the word free is gone. IRS involvement, fines and a ID is required. Unlike voting Obama Care sounds like a kick back to Jim Crow days with that ID thingy. Second of all people will wait till the end up in at the hospital avoiding everything they can along the way.

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15jojuggie(1294 comments)posted 1 year ago

If only we had a Free Press instead of a Liberal Press, in this country, Obamacare would be a bloody mess in their eyes. As it is, it's only business as usual for liberals & liberalism.

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16HappyBob(285 comments)posted 1 year ago

Less than 2 percent of the physicians...

No wonder SeriouslyNow couldn't find any locals that were dropping out.

Sounds like formerlib's claim is bull**it

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17birdseed(66 comments)posted 1 year ago

the american people have the government they wanted and deserved. they are now learning the lessons that those who lived under the soviet union learned.

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18Jerryl(105 comments)posted 1 year ago

The american people fought for this this type of government (a democratic replublic).
Using that type of government, the voters have elected those who govern.

Are you saying that type of government leads to the "lessons learned" by those who lived under the Soviet Union?

I don't understand your logic. Do you have some disagreement with a democratic republic? Do you believe that a democratic republic leads to Soviet style governance?

What is your point?

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19southsidedave(4784 comments)posted 1 year ago

It is a shame that the U.S. has taken so long to provide healthcare for its citizens particularly when compared to Canada and the United Kingdom

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20jojuggie(1294 comments)posted 1 year ago

Obamacare passed without one Republican vote. Let them fund it without one Republican vote.

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21andersonathan(669 comments)posted 1 year ago

No what is a shame is that America has given away it's work force along with it's industry to to other countries.

So say thank you EPA, Thank You trade agreements, Thank You tax loopholes, Thank you Government.

And this includes every administration for a long time.

One of my first jobs was at 4.50 a hour and I had health care imagine that.

factory work non-union wages 6-9 a hour always had health care it was the difference. people would change jobs for better health care not wage. The destruction of America's industry from the little people making motor mounts for the big three in a grease pit stamping plant had health care.

So I do not want to hear about social health care system, when the simple fact is when this country had those jobs health care was not on the plate and scoffed at.

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22SeriouslyNow(192 comments)posted 1 year ago

@formerdemliberal,
It's also a shame that you won't defend yourself. You claimed that many doctors are no longer accepting medicare patients. When confronted with the fact that the "many" is less than 2%, you are very very quiet.

Just maybe your sources are not being honest, but you believe them anyway?

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23kk80586(227 comments)posted 1 year ago

a "democratic republic" does lead to a soviet style governance.... examples are Democratic People's Republic of Korea/ Lao People's Democratic Republic. The U.S.A is a "Constitutional Republic".
"A Republic is representative government ruled by law (the Constitution). A democracy is direct government ruled by the majority (mob rule). A Republic recognizes the inalienable rights of individuals while democracies are only concerned with group wants or needs (the public good)." *
To put it in simpler terms...democracy is two wolves and a lamb voting on what's for dinner, liberty is a well armed lamb.(hence, the Second Amendment).
Now this is not to say that we are not sliding down the slippery slope of becoming a "democratic republic".
"Many of F.D.R.'s policies were suggested by his right hand man, Harry Hopkins, who said,
"Tax and Tax, Spend and Spend, Elect and Elect, because the people are too damn dumb to know the difference". " *

* stolen quoted material

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24kk80586(227 comments)posted 1 year ago

gooooooooogle The Six Main Reasons Physicians Are Dropping Medicare Patients

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25formerdemliberal(182 comments)posted 1 year ago

Several comments to my posts basically follow classic liberal scripts.

1. Attempt to discredit one statement out of context with emotional generalizations (e.g., bulls**t) while failing to address the primary facts of my posts. Medicare is a financial time bomb that is and will continue to negatively affect senior citizens health care in a variety of negative ways in the future.

2. Two can play the numbers game to support their point. Using figures cited by other posters, doctors opting out of Medicare have increased by approximately 200%, or tripled, in the past four years. Trends often are a better indicator of the future than points in time (2% of current doctors). Perhaps you could ask yourself in your haste to vilify my facts, why the increase in doctor opt-outs if medical reimbursements are adequately covering provider costs? This trend supports my original point that these opt-outs will likely continue to rise in the future as Medicare reimbursements to providers are further reduced in order to save the program from financial collapse.

3. Liberals love to discredit the messenger by making unsubstantiated claims to support their own opinions without factual support. My family physician is a young, honest, straight forward physician who is not afraid to state his observations. He served me well when I was diagnosed with cancer and I trust his judgment. I didn't call 15 anonymous doctors that I have no association with (btw, a very small sample size statistically, even in this area) and state unequivocally that you have proven that few doctors are opting out of Medicare. My post point was that the numbers indicate a likely worsening of available health care providers for Medicare in the future as attempts are made to reduce the financial bleeding of the system and Obamacare subsidies rise to counter likely higher average health insurance premiums.

4. Liberals love to twist semantics to discredit others. If more doctors nationally are opting out of Medicare, isn't that equivalent to stating that they are no longer accepting patients covered under Medicare (my earlier point)?

5. Lastly, liberals continue to bash alternative opinions until their repetitions are believed to be fact by those less knowledgable. I have made my points based upon referenced facts (regardless of your opinion of the authors). I stand by my assertions based on expert research. Medicare was financially viable in a different demographic and economic time in our country. It has greatly benefited senior citizen health care, but at a long-term cost that is no longer be sustainable under current demographic, economic, and federal program demands. Some may be in denial, but Medicare health care will likely worsen in the future when the full effects of Obamacare cost increases are partially borne by seniors who have contributed to Medicare throughout their working lives.

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2676Ytown(1254 comments)posted 1 year ago

The national debt clock shows our Medicare unfunded liability at $87,490,705,000,000 and rising, not including our prescription drug liability or our social security liability. Folks, were broke!

http://www.usdebtclock.org/index.html

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27jojuggie(1294 comments)posted 1 year ago

Washington can't manage a website - they can't manage the government - & they expect me to trust them to manage my HEALTH CARE - All I can say is WOW!

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28Jerryl(105 comments)posted 1 year ago

@kk80856
So what type of government is the US?

Do we use democratic process to elect our representatives and adopt our Constitution?

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29SeriouslyNow(192 comments)posted 1 year ago

@former...
I asked a simple question that you seem to want to evade.

So for clarity, here it is again: who are these MANY who no longer accept Medicare patients?

as 76Ytown pointed out, it's not that they are no longer accepting Medicare patients. Rather some doctors, are electing to no longer be paid directly (accepting assignment) by Medicare.

Your script .... "MANY are no longer accepting Medicare patients"... Is just intended to scare the elderly.

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30SansArmes(17 comments)posted 1 year ago

To kk80865,
For what your consideration;
"If you want the most technical term, our country is a constitutionally limited representative democratic republic. Our form of government, the constitution limits the power of government. We elect representatives, so it's not a pure democracy. But we do elect them by majority rule so it is democratic. And the form of, the infrastructure, the total form of government, is republican, it is a republic.
James Madison in 1834 said, you can use the words interchangeably. And that was about the time that the Democratic Republican party that Jefferson created dropped the word "republican" from its name. And that was about the time that Madison, who was one of the early founders of the Democratic Republican party started again using the word democracy.
So from the 1830s, so from the founding or in the mid 1780s until the mid 1830s we referred to America as a Republic. From the 1830s until the modern era we referred to it as a democracy.
And ... that's the bottom line, we live in a democratic republic."

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3176Ytown(1254 comments)posted 1 year ago

As a recent American Medical Association survey makes clear, physicians are reaching the breaking point. According to the survey, physicians will respond as follows to the impending fee reduction:

32 percent will decrease the number of new Medicare patients they treat
28 percent will stop accepting new Medicare patients
32 percent will decrease the number of established Medicare patients they treat
8 percent will stop treating established Medicare patients

When asked about their response to the 40 percent fee reduction anticipated by 2016, physicians gave the following answers:

13 percent will decrease the number of new Medicare patients they treat
64 percent will stop accepting new Medicare patients
44 percent will stop treating established Medicare patients

http://www.aaos.org/news/aaosnow/jul0...

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32kk80586(227 comments)posted 1 year ago

The bottom line... We were formed as a Constitutional Republic, we are fast becoming a "democratic republic" (i.e. democratic republic of the congo) due to leftist policies. you can say our "form of government" is a democracy and yes, you can say we are a "representative republic". But the U.S. is NOT in the list of "democratic republics" and IS in the list of "Constitutional Republics".

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33SeriouslyNow(192 comments)posted 1 year ago

@76Ytown,

"The AMA survey found that more than one-third (38%) of physicians will decrease the number of new Medicare patients they accept"

Published on April 2005 http://urologytimes.modernmedicine.co...

My point is this... the AMA has been saying this for years and years, but when push comes to shove the number of doctors who decrease their medicare clientbase is practically non-existant.

As you pointed out earlier, not accepting new medicare patients and not accepting assignment are two different things.

My mother was on medicare and she went to a family physician who did not accept assignment. The difference was that Medicare sent a check to my mother rather than to the doctor. He could charge more than the medicare payment (but his office told me that he was limited by law to no more than 15%).

However, he chose to accept the amount that Medicare sent to my Mom. When I asked his office why not just accept assignment (since the payment was the same), the response was "it saves us from having to do the paperwork to submit claims"

.

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34Jerryl(105 comments)posted 1 year ago

@kk80866,

I'm not really concerned about where or what your "list" says.

I'm more interested in understanding what your point is.

Are you trying to say that democracy leads to soviet style governance?

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35Sensible(118 comments)posted 1 year ago

To Formerdemliberal:

Your post at #16 above is more like a 500 word essay bashing liberals rather than a worthwhile comment.

Perhaps you should say less and keep your comments pertinent.

Another commenter asked you to validate your statement that many doctors are no longer accepting medicare patients. Sounds like a simple request. Can you provide any evidence to support your statement?

As at least a couple of commenters have mentioned there is a significant difference between opting out of Medicare assignment and not accepting Medicare assignment. Do you understand that difference?

Try keeping your responses to the point and avoid the bashing that you yourself complain about.

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36Dagwood(129 comments)posted 1 year ago

99.6% of healthcare.gov visitors DID NOT enroll in Obamacare!!!!

http://www.americanthinker.com/blog/2...

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37SeriouslyNow(192 comments)posted 1 year ago

@Dagwood,

your link is dead.

American Thinker is not recognized as being an unbiased source.

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38Dagwood(129 comments)posted 1 year ago

http://www.americanthinker.com/blog/2...

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39kk80586(227 comments)posted 1 year ago

My point is that there is a difference in a DR and a CR. This Country was founded as a Constitutional Republic. Search for the list of "democratic republics" and tell me the one that has U.S. on it...

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40uptowngirl(113 comments)posted 1 year ago

I think Dr. G is wrong. The people who must write checks to get Obamacare will protest. Nobody had to write a check to get into the Medicare program. When they take small amounts out of your paycheck people tend to be complacent.

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41jojuggie(1294 comments)posted 1 year ago


Obama will go down in history as America's most unaccountable president. He has skated over one calamity after another, with none of the blame attached to his party -- our economic stagnation, the suffering of our neediest citizens, the destabilization of the Middle East, a looming nuclear Iran, Benghazi, the IRS, the spying on ordinary citizens and the press. None of these significant failures have mattered one whit to loyal Democrat voters.

Why would ObamaCare be different? When you are never blamed for failure, failure is acceptable. All that matters is political advantage. The worse your performance, the more important politics becomes. Obama's politics is all about defaming voters who disagree with him, so his own followers would be ashamed to listen to their valid criticism.

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42dontbeafool(951 comments)posted 1 year ago

There be a lot of smart people in this forum! lol. Formerdem, you do seem a little tense, seriouslynow just asked asked to clarify a couple points in your statement. He/she even said that you may sway him with some clarification, then you got all nasty. I am not smart enough to know if the ACA will be successful over time, but only TIME will tell. You mentioned you had cancer, sorry to hear about that, hopefully you beat it. Question though, what if you lost your current insurance and no other insurance would pick you up for a pre-existing condition, or your premiums would be so high you couldn't afford it. That is one good feature of the ACA. Parlay, I just have learned to ignore your comments. Eivo, you are a broken record with the freeloader sarcasm. If the free loading life is so great, get fired and start mooching and get it over with. I don't like ABUSE of programs either, but jeez.

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4376Ytown(1254 comments)posted 1 year ago

My mother got a letter in the mail from United HealthCare (Medicare) Two of her doctors 3 doctors are no longer with the plan beginning 1/1/14. So much for keeping your doctors.

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44Cosmo19(53 comments)posted 1 year ago


Sorry to hear that Ytown.
But it's not that unusual that doctors drop out of a network.

I could be mistaken, but I'd guess that your Mom had a medicare advantage type plan through United Healtcare. The reason that Medicare advantage programs are able to offer either reduced premiums or more commonly services that Medicare does not cover (like vision or gym memberships, or other "perks") is because they operate a managed care network. Consequently doctors can and do move out of the UH network.

My parents had similar experiences with medicare advantage plans in the past, before Obama. As far as I know, there is nothing in the ACA that requires doctors to stay in a particular private network.

While I was complaining to one of my parents doctors who was dropping the United network (he also happened to be a personal friend) he admitted that his "compensation" with the United network was actually less than he would have gotten from traditional medicare.

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4576Ytown(1254 comments)posted 1 year ago

In this case UHC dropped the docs, they didn't drop UHC.

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4676Ytown(1254 comments)posted 1 year ago

Called both docs today to find out what plans they contract with because we want to keep those docs. Both offices advised checking again before open enrollment ends to be sure no other changes. They were uncertain of what to expect.

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47Cosmo19(53 comments)posted 1 year ago

Was I correct, that your Mom has a medicare advantage plan?

Unfortunately, you may get caught in the insurance-provider merry go-round, where one tells you call the insurer, then when you call the insurer, they tell you call the provider. FRUSTRATING !!!!! You'd think that a provider would know who they are contracted with.

Moreover, you'd think that a network would have established a contract for next year before they opened enrollment..

Does UHC have a webpage that lets you locate network docs?

Sorry your Mom is going through this, as I said I've had my turn on the merry-go-round and I didn't enjoy it.

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4876Ytown(1254 comments)posted 1 year ago

Actually, it's called AARP UHC Medicare Complete HMO.

She'll be changing carriers during this open enrollment.

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49ytowntomg(26 comments)posted 12 months ago

Here's the real truth; wise citizens don't trust the government to do anything but protect us. NOTHING! Everything they touch, they screw up. EVERYTHING! EVERYTHING! EVERYTHING! And now they want to control our health care system. They will now hire another million tax sucking federal workers to sit around and talk about their kids and their weekends and retire with 95% of their highest earnings while the rest of us sit around and skimp on everything because we don't have the luxury of an obscene retirement plan. Just wait till you have to call a federal worker about your health insurance. Just wait. The system needed retooling, and provisions put in place to protect us from being bankrupted by sickness, but the federal government running things, really???? REALLY???? Go to Canada and see how wonderful their health care system is. This is the federal government ballooning out of control and laughing all the way to their pensions (which don't include Obamcare by the way).

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50Cosmo19(53 comments)posted 12 months ago

Again, sorry to hear that your Mom has to deal with this agravation.

Since this network shuffling has been going on ever since HMOs were "popularized" in the 1970s, maybe this can't be blamed on Obamacare.

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51SeriouslyNow(192 comments)posted 12 months ago

@ytowntomg:

Go join parlayhenry in the troll's corner

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52kk80586(227 comments)posted 12 months ago

You are confusing "facts" with "trolling" because you are too closed minded to recognize the truth...

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53SeriouslyNow(192 comments)posted 12 months ago

@kk,

You say facts.....

Can you point out any facts in ytownomg's post above @ 41 ?

Mind you, I'm asking about facts as distinguished from opinion.

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5476Ytown(1254 comments)posted 12 months ago

seriouslynow:

Here are some facts that support that the government can screw up things:

Unemployment benefit overpayments: http://money.cnn.com/2012/07/09/news/...

Social Security overpayments: http://money.cnn.com/2013/09/13/pf/so...

IRS tax credit overpayments: http://www.washingtontimes.com/news/2...

And the ACA website which our government contracted with a CANADIAN company (jobs creation?). CGI, the same company that the Canadian province of Ontario fired CGI and canceled a $46 million contract, accusing the company of failing to build an online medical registry on time. Some estimate the cost to be 5 times what comparable websites built by Silicon Valley programmers would have cost even before adding in the computer glitch fixes. http://www.foxnews.com/politics/2013/...

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55SeriouslyNow(192 comments)posted 12 months ago

@76Ytown,
I accept your suggestion that that the government CAN screw things up, however that's not the position that Ytownomg took. His statement is:"Everything they touch, they screw up. EVERYTHING! EVERYTHING! EVERYTHING!"

That is an opinion, not a fact. There is a significant difference between the two.

KK challenged me so I asked KK to point to any facts in Ytownomg's rant. So far he is silent.

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5676Ytown(1254 comments)posted 12 months ago

Seriouslynow. I'm at a loss. Can you name something that they have done efficiently?

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57DwightK(1263 comments)posted 12 months ago

Social Security runs at less than 1% operating cost, has been solvent for decades and raised seniors out of poverty.

Credit is due.

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58dontbeafool(951 comments)posted 12 months ago

76, I can. I work for the gov. Yes some aspects and departments run well, some poor, but don't lump everyone together. Government runs our military quite well I think. Think about the logistics dealing with that. For a country with open borders, and a country who is the "World Police" with many enemies, I think our government protects us fairly well against terrorism through intelligence, considering the diffucult task they are facing. I haven't heard of any FEDERAL inmates who have escaped into the community and caused you harm. Just a few examples. Like I said, by far not perfect, but you could point to the private sector as well and find very inefficient systems.

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59dontbeafool(951 comments)posted 12 months ago

I should say BROKEN borders, not open.

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6076Ytown(1254 comments)posted 12 months ago

dontbeafool: Many aspects of the military are run efficiently as anyone with "boots on the ground" can tell you but we still have waste.

In the past, as much as $60 billion in U.S. funds has been lost to waste and fraud in Iraq and Afghanistan over the past decade through lax oversight of contractors, poor planning and payoffs to warlords and insurgents, an independent panel investigating U.S. wartime spending estimates. http://www.huffingtonpost.com/2011/08...

DwightK: No doubt social security has been a lifesaver for our seniors but it was never intended to be a retirement plan.

Saying that they run at less than 1% operating cost is all relative. How much money is that? We're talking about a budget of 20% of our GDP.

Social security has it's share of waste and overspending. The social security trust fund is empty. It has been raided for years. Let's say I'm the child and you're the parent. You tell me that I need to save a portion of my paycheck to buy a car in a few years and you'll hold the money in a fund until I need the money. When the time comes for me to buy my car, I find that the money I've been saving has been going toward your bills. I sure hope that you can cough up the money when it comes time to pay up because if you can't I'd sure feel like you screwed up!

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61kk80586(227 comments)posted 12 months ago

Fact for ya-->"Go to Canada and see how wonderful their health care system is. This is the federal government ballooning out of control and laughing all the way to their pensions (which don't include Obamcare by the way)."
although the fed govt is (technically) included in oblamocare they do get a subsidy that others in the same pay range do not get. (Also, though not a fact YET, the unions will be exempted or get extra subsidy before the next election. )
The military is a different animal when considering govt. bureaucracies. The fed govt provides funding, gives the ultimate order (go to war, etc) but not much else. The military runs the military (from the pentagon) with military personnel (for the most part). Vietnam was not the military's fault, it was the fed govt. The military performed brilliantly in Iraq and our fed govt screwed that up. There are other examples but you get the picture. The other big difference with the military is it is the only function of the govt that is REQUIRED of the fed govt. The fed govt. does NOT HAVE TO provide welfare, foodstamps, housing, phones, etc., etc., etc.....it CHOOSES to. By choosing to do things that are better done by the private sector or States they continue to make themselves bigger and more powerful and take more money from those who are supposed to be free citizens. We now have one sector of the fed govt. spying on our every move and communication, another that uses it's nearly unlimited power to harass one political party to help the other, another to use ink and paper to print out billions and trillions of dollars they do not have (and then charge us interest to borrow the fake money).
When are you people gonna wake up??

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62kk80586(227 comments)posted 12 months ago

Even if ytown is only giving an opinion (some of it is), it is still a far cry from "trolling".... YOU should "Go join parlayhenry in the troll's corner" for saying "Go join parlayhenry in the troll's corner" since it is only YOUR opinion and not a fact that ytown was even trolling.

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6376Ytown(1254 comments)posted 12 months ago

My post #17 above "The national debt clock shows our Medicare unfunded liability at $87,490,705,000,000 and rising, not including our prescription drug liability or our social security liability."

As of a few minutes ago, almost $87,584,900,000,000.

Our national debt: $17,066,783,000,000. That's almost 67 billion more since 10/17/13)

http://www.usdebtclock.org/index.html

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64Cosmo19(53 comments)posted 12 months ago

To 76Ytown at #48,

Not sure what you would define as efficient, or how to measure it but:

In my opinion the federal air traffic controllers have been pretty efficient,and the CDC is pretty efficient.

I'm sure that there could be improvements, but isn't that the case with any human endeavor?

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65SeriouslyNow(192 comments)posted 12 months ago

Troll “ a person who sows discord on the Internet by starting arguments or upsetting people, by posting inflammatory, extraneous, or off-topic… in an online community either accidentally or with the deliberate intent of provoking readers into an emotional response…” (Wikipedia)

Trollers also have a tendency to shout (type in all caps).

Review post 30 by parlay
Review post 41 by ytownomg

Both posters are raising extraneous issues, both are posting in a manner intended to provoke, both are ranting. Neither posters have contributed to the discourse.

Ergo.....Troll Corner

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6676Ytown(1254 comments)posted 12 months ago

Parlayhenry = troll

Ergo = annoying sarcasm

Ytownomg = joining the conversation

Btw, entire post in caps, shouting. Word in caps, emphasis

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67SeriouslyNow(192 comments)posted 12 months ago

EVERYTHING! EVERYTHING! EVERYTHING!

Seems like shouting to me.

"Ergo (therefore) Troll Corner " ....has nothing to do with poster eivo. I made no reference to him.
-----------------------------
That's all beside the point because the subject is Obamacare and if the public will grown to accept it like they accept Medicare.

I take the view that the elderly like medicare, and that those that are not elderly but who are caring for or watching out for their elderly parents like medicare. Those who don't fall into the above catagories who think that the nation should help the elderly cope with the costs of healthcare like medicare.

Of course there are those who don't think that medicare is a good thing; many who adhere to that premise also don't like the concept of Obamacare.

Will medicare "lovers" grow to accept Obamacare, (which by the way is the subject of the original letter) only time will tell.

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6876Ytown(1254 comments)posted 12 months ago

Note to self: don't use your iPhone to post. Autocorrect is not your friend.

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69SeriouslyNow(192 comments)posted 12 months ago

For anyone interested,

Try this to anonymously shop in the Obamacare exchange…

https://www.healthcare.gov/find-premi...

Very simple and fast, information is non-specific, you only need enter State, County, age ranges, family or individual coverage.

In Mahoning County there are 43 estimates available, ranging in price from 194 to 522 per month for individuals from 5 or 6 different insurers.

IMPORTANT NOTE: The estimates shown on this tool don't reflect the lower costs you may qualify for based on household size and income.

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70dontbeafool(951 comments)posted 12 months ago

@Seriously.... this is what I got by clicking on your link.....
Sorry, we can't find that page
on HealthCare.gov
We've recently reorganized our site, and that may explain it.
It's also possible that you typed the address incorrectly.

--------------------------------------------------------------------------------

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71SeriouslyNow(192 comments)posted 12 months ago

Yes, dontbeafool. That was the correct link as of this morning sometime.

The new link is:
https://www.healthcare.gov/find-premi...

I'll post this then reload vindy's letters and try it out. Let you know in a couple of minutes if it works from this thread.

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72SeriouslyNow(192 comments)posted 12 months ago

Ok, checked it out.
Happy Shopping
https://www.healthcare.gov/find-premi...

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7376Ytown(1254 comments)posted 12 months ago

SeriouslyNow: Unfortunately, the pricing you get is too generic. If you are under age 50, the quote you receive is based on a 27 year old. If you are over age 50, the quote will be based on a 50 year old. The actual rates can be twice the pricing shown. You also have to throw out the catastrophic plan unless you are under age 30.

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74Cosmo19(53 comments)posted 12 months ago

Can you tell me where you got your information?

Particularly the "actual rates can be twice the pricing shown".... not saying that you are incorrect, just want to know what is the source of your info.

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7576Ytown(1254 comments)posted 12 months ago

Cosmo19:

http://www.cbsnews.com/8301-505269_16...

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76Cosmo19(53 comments)posted 12 months ago

I was hoping that your information was coming from one of the five insurers that are servicing Mahoning County.
They are the ones that you and I should be most interested in.

I don't mean to nit-pick, but I could not find any thing in the written part of your link that supports the "actual can be twice" claim. Where did that come from?

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77SeriouslyNow(192 comments)posted 12 months ago

@Cosmo19

Hannity said premiums are skyrocketing and the average man would pay twice as much.

So it must be true !

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7876Ytown(1254 comments)posted 12 months ago

There are many variables to consider. CBS News didn't use Youngstown, Ohio for their example, but you get an idea of what the differences may be. You can choose anything from a catastrophic plan to a gold plan. Deductible, coinsurance and out of pocket max and of course premiums are based on which plan you choose, your age and your whether you need individual or family coverage.

"CBS News ran the numbers for a 48-year-old in Charlotte, N.C., ineligible for subsidies. According to HealthCare.gov, she would pay $231 a month, but the actual plan on Blue Cross and Blue Shield of North Carolina's website costs $360, more than 50 percent higher. The difference: Blue Cross and Blue Shield requests your birthday before providing more accurate estimates.

The numbers for older Americans are even more striking. A 62-year-old in Charlotte looking for the same basic plan would get a price estimate on the government website of $394. The actual price is $634."

SeriouslyNow: For those of us with individual plans, the ACA plans can be twice as much as I've stated in an another article's post after receiving my letter from Aetna where my health plan premium will go from $508 to $1099 per month eff 1/1/14.

Hey, you don't have to believe me or CBS News or any other news source. You can go onto the ACA website to apply to see what your actual rates will be vs the generic rates!

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79dontbeafool(951 comments)posted 12 months ago

Eivo, quit whining already and make some intellectual comments. Either that, or quit your job and start freeloading if food stamps and welfare sounds so glamorous to you. Either way, you sound like a broken record. I don't agree with some people on here, but at least they try to articulate their views and opinion with reason, and often support their stance with some form of study or news article. Does anyone else agree?

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80SeriouslyNow(192 comments)posted 12 months ago

75Ytown:
Found your other thread, your example of premiums moving from 500 to 1100 compares your 2013 policy to 2014. That is not the same as the comparisons that the CBS news article is talking about.

I'm assuming that cbs used the healthcare.gov to obtain an estimate and then went to the same insurer and asked for pricing for a person with a specific age. That would be an appropriate basis to conclude that the website estimates were way off.

But we don't know that they did that, because they did not tell us. Is it possible that they did a honest comparison and the premiums (between 2014 estimate and 2014 actual for the same policyholder)? Sure, however it should be also pointed out that the same policy premium and it's comparison will vary by location.

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8176Ytown(1254 comments)posted 12 months ago

SeriouslyNow:
My example of premium increase is my personal experience with my individual health plan. Because of the ACA, my plan, which is was not in effect in 2010 therefore not grandfathered will cost $1099 in order to comply. On the surface it is remains the same... $5500 deductible per person, $11,000 per family but it will now include all the ACA benefits like maternity, no pre-x, etc. which would not have been necessary in my case. Although Aetna did not drop my coverage, they are essentially forcing me to enter the exchange based on the egregious cost.

Seriously...you can nit-pick all you want but until you personally go to the ACA website to apply you are not going to see what your actual cost will be. At this point, I am not willing to give the ACA website my personal information in order to "shop". The information entered into this site is shared with the IRS, SSA, DHS, DOJ, HHS.

http://news.investors.com/ibd-editori...

But you have to sign up to find out what's in it according to Nancy Pelosi.

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82Jerryl(105 comments)posted 12 months ago

CBS affiliate KDKA asked one of the insurers if the ACA web estimates were misleading (as posited by CBS linked above.

"Is it misleading?, KDKA money editor Jon Delano asked Kristen Ash of Highmark Blue Cross/Blue Shield that sells insurance on the exchange.

"No. I wouldn't suggest that it's misleading," said Ash. "That shopping procedure is really only to give you a general guideline."

On the other hand (in the same article) Jonathan Wu (noted industry analyst)says: "Incredibly misleading for people who are trying to get a sense of what they are paying"

So there you have it, two polar opposite views, one from an actual insurer and one from someone that does not actually sell insurance. You decide.

Anyone who thinks that premiums would not vary as a function of age really hasn't though it through.

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8376Ytown(1254 comments)posted 12 months ago

An improvement to the generic search would be to add age bands such as "up to age 29", "30-39", "40-49" etc.. Under 50 over 50 doesn't work.

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84Cosmo19(53 comments)posted 12 months ago

@ 76Ytown.
I'd agree that reducing the age bands would be an improvement, maybe even better would be bands that are only 1 year wide.

Did you ever find something to support your comment awhile back about the "actual rates can be twice the pricing shown"?

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8576Ytown(1254 comments)posted 12 months ago

SeriouslyNow: I took the search one step further. I played with it to see what comes up when I click "Only You" or "You and Your Spouse"

* Only You UNDER 49:
Asks if you are UNDER 49 or OVER 50. Clicked UNDER under 49.
The plans are $113.78 - $317.87. (which we know is based on the generic age 27)

* Only You OVER 50:
Asks if you are UNDER 49 or OVER 50....clicked OVER 50.
The 1st FOUR options shown are all catastrophic plans which are only available to people under age 30 so you have to throw those rates out.
The plans shown range from $193.91 to $541.71 when they should actually range from $287.88 to $541.71.

* You and Your Spouse....SEARCH 1:
Starting out at the beginning of the search...clicked "Only You".
On that page it asks if UNDER 49 or OVER 50. I clicked OVER 50.
Further on that same page, it also gave options for you and your spouse so I also clicked "You and Your Spouse".
The 1st option shown here is the catastrophic plan and the
2nd option is Market Young Adult Essentials.
3rd option is SomaCare Individual Value...hello? Aren't we searching for "You and Your Spouse? Why is an individual plan coming up?
4th option is Anthem Catastrophic Direct Access.
All four of these options are catastrophic plans. Note...I already clicked over 50 so catastrophic is not an option!
The rates shown range from $227.50 to $775.26.
You actually need to take out the first 4 plans which are not available. The rates are then $412.00 - $775.26

* You and Your Spouse...SEARCH 2:
This time I clicked "You and Your Spouse" at the beginning. It did not ask for age.
The first four options again appear but are not available.. .
Starting with the first option, the prices range from $227.50 to $775.26.
What the heck? What if "You and Your Spouse" are under 50??? Your rates should be $412.00 - $775.26,

*You and Your Spouse...SEARCH 3:
So I went back to square one. Went through motions similar to Search 1 except clicked "UNDER age 49".
Once again, the rates listed range from $227.50 to $775.26.

Seems as though you'll get the same generic rates for "You and Your Spouse" no mater what you click.

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8676Ytown(1254 comments)posted 12 months ago

Cosmo19: "actual rates can be twice the pricing shown"

Let's say you are single and 49 years old.
Using the above examples, we can safely say that you're probably closer to the generic 50 + pricing than you are to the 49 and under generic pricing since that is based on a figure for a 27 year old.

The single under 49 rate is $113.78 - $317.87.
The single over 50 rate for eligible plans is $287.88 to $541.71.

Do the math. When you get your actual price...the actual rate can be twice the amount shown. (just my opinion of course).

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87dontbeafool(951 comments)posted 12 months ago

@76 yeah but it is doubling because you are moving from one age bracket to another. One price is for 49 or younger and it it costing more because you are moving to 50 years or older. If that is what u r trying to compare. It would be different if it said for example only, a single 45 yr old is est $300 per month and in reality, it is $600 for a 45 year old.

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8876Ytown(1254 comments)posted 12 months ago

dontbeafool: From what I understand, the actual rates will be based on your age, not age brackets and this is about the link that SeriouslyNow gave us to anonymously shop in the Obamacare exchange

If the ACA gives you only two options, under age 49 or over age 50, and we already know that the under age 49 premium on the website is actually for a 27 year old, a closer guess of what a 49 year old would pay is to use the over age 50 rate which is, per the ACA, the actual 50 year old rate.

If you are lucky enough to be 27 years old or even 50 years old, you could probably use the website's estimator to get the true cost without an application. But, if you're not 27 or 50, it's everyone's guess as to what it will cost.

Again, you have to sign up to find out what's in it according to Nancy Pelosi.

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89Cosmo19(53 comments)posted 12 months ago

@76Ytown,
Honestly, I think the last thing you said was correct (or nearly so)...

If I might rephrase it a bit, "you have to actually apply to be able to properly compare the shopping estimate with the actual"

I'm not sure where the concept that the "under 50 is actually a real quote for a 27 year old', came from, but I've always heard it as "the under 50 estimate is the average of all the (same class) policies for those under 50." I suppose that it's possible that both of these could be true, it just a means of expressing a group.

I would concede that the estimator would better serve if, in it's explaination, it would explicitly state the derivation of the given estimates.

As dontbeafool points out, your comparison (to achieve doubling) jumps from one pool into another. You have assumed that the 50+ estimate is for a person who is actually 50. Is there evidence for that, or is it possible that the 50+ estimate the AVERAGE of policies for persons actually 50-65 years old? So I'm not so sure that the "actual" rate for a 50 year old will be what is given as the 50+ estimate.

In any event, the assertion that "actual rates can be twice the pricing shown" must have come from somewhere. Your example doesn't work out because you are jumping into another class, and more importantly..... you don't have an actual to compare against.

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9076Ytown(1254 comments)posted 12 months ago

Ah ha! Now I see why we aren't on the same page. The rates are not as you say "the under 50 estimate is the average of all the (same class) policies for those under 50." and the rates are not a "pool".

Prices for everyone in the 49-or-under group are based on what a 27-year-old would pay. In the 50-or-older group, prices are based on what a 50-year-old would pay. If you are at the top end of the under/over 50 group the actual rate when you apply will be much higher..

If the rates were as you say a "class", "pool" or even an "average" I would understand your point, but since the rates given are for a 27 year old and a 50 year old, you are getting a figure that represents the lowest of rates for the option chosen (under/over 50).

http://www.cbsnews.com/8301-505269_16...

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91Cosmo19(53 comments)posted 12 months ago

You've misread what I wrote above. What I said was: "I'm not sure where the concept that the "under 50 is actually a real quote for a 27 year old', came from, but I've always heard it as "the under 50 estimate is the average of all the (same class) policies for those under 50." I suppose that it's possible that both of these could be true, it just a means of expressing a group."

The CBS article doesn't source where their information came from.. I'm equally unsure about the accuracy of the "average of policies in the group" of under/over 50.

One of the reasons I'm a bit leary of accepting the CBS assertions, without authentication, is because of their mangled math. They state that people could be paying nearly double what the website says. In common terms "double" would mean a 100% increase. But the example they provide is only a 55% increase... hardly double.

If they could support authenticate their "nearly double" claim, I suspect that they would have provided an example, but they didn't. If they can't get the math right..... well, you se what I mean.

I think I recall that you personally were going shopping on the website, to find a replacement for your current policy.

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92dontbeafool(951 comments)posted 12 months ago

I guess the bottom line is they shouldn't have an general estimate site. Just have what the actual rates are for the specific age/age group. It would eliminate all confusion, not to mention about 30 comments related to this article. :-)

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93Jerryl(105 comments)posted 12 months ago

To dontbeafool,
So very true, but the converse is also true.
There would be no confusion if the site never allowed anonymous window shopping.

A certain political party just has to push forward the notion that everything the government says or does is a lie (or deliberately misleading).

If Obamacare succeeds or fails, it won't be over the issue of inaccurate estimates of premiums.

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9476Ytown(1254 comments)posted 12 months ago

Why do you have to apply to find out the rate? What's the big secret? Where is the transparency? If they are offering affordable care at a $2500 savings per year as was touted by our president, it would serve them well to allow anonymous window shopping to encourage people to get on board. Isn't the purpose to create competition in the marketplace? If rates and benefits are better with the Obamacare plans than in the individual markets, people will flocking to sign up. No need to low-ball the estimate to only find that the true cost is higher.

The success/failure of Obamacare is largely by design. Why does this have to be a Democrat Republican debate? We need to apply common sense to solving our health care issues. But, by design they already know that this will fail and the next step will be to implement a single payer system which was the goal in the first place

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95Cosmo19(53 comments)posted 12 months ago

@76Ytown,

Try the KFF estimator:

http://kff.org/interactive/subsidy-ca...

To get unsubsidized premiums, just enter 250,000 dollars into the income box. That calculator uses age and location (but doesn't give the names of insurers).

Who is the "they" in your last sentence?

If you are suggesting that the authors of the ACA designed it to fail, so that "they" could implement a single payer system, I think you are neglecting one critical element. Implementation of a single payer system would require and act of congress. Not very likely for the foreseeable future.

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9676Ytown(1254 comments)posted 12 months ago

KFF estimator... where do I enter age? I see only number of adults (21 and older) enrolling in exchange coverage.

Don't think it could happen?

http://news.yahoo.com/-harry-reid-say...

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97Cosmo19(53 comments)posted 12 months ago

76Ytown....

On point #6 (Number of adults), when you enter a value, boxes will open below that for you to enter the age of each adult and if they use tobacco or not.

Same with children.

Didn't take time to look at yahoo news.

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98Cosmo19(53 comments)posted 12 months ago

Despite Reid's hopes (in August '13), I still contend that it unlikely to get both Houses of Congress and the President to agree to adopt a single payer system any time in the foreseeable future. Like maybe when the Federal debt is close to zero.

American's like divided government and I happen to think that (if congresscritters can get over their rage), the best decisions are made when healthy debate is allowed to exist.

But if a divided government comes to a consensus on a single payer (taxpayer) system then the voters (who are ultimately responsible for their representatives choices) have choosen that system. I just don't see it happening soon.

Certainly not in Harry's lifetime!

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9976Ytown(1254 comments)posted 12 months ago

Healthy debates are good.

America is becoming more divided. Maybe another goal... divide and conquer.

The representatives are trying to let the people's voices be heard but that isn't working.

Went back to the HJK link you gave. Plugged in age age 49 for self and 49 for spouse, non smoking to get a comparison of the rates on the generic site before subsidies.

Here's what I got taking the age to the top of the range rather than the ages used in the generic site (27 or 50):

Generic site under age 49: $193.91 to $541.71 but disregard the 1st 4 options since they are not available to over age 30. Should range $287.88 to $541.71. (see post 79)

HJK site age 49: $6600 to $9,112 per year = $550 - $759.33 per month

Here's for age 64:

Generic site over age 50: $227.50 to $775.26 per month.

HJK site age 64: $11,420 to $15,767 per year = $951.67 to $1313.92 per month

If you are age 49 and want to get an idea of what ACA coverage may cost, you may think that you would pay as little as $193.91 but the actual quote will probably be closer to $550 per month for the bronze plan

If you are age 64 and want to get an idea of what ACA coverage may cost, you may think that you would pay as little as $227.50 but the actual quote will probably be closer to $951.67 per month for the bronze plan.

Of course you'll have to apply to find out for certain.

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100SeriouslyNow(192 comments)posted 11 months, 4 weeks ago

@76Ytown,

The Kaiser link is on the Healthcare.gov website, so I don't think that you can really claim that the .gov website is misleading.

Your comment that "the representatives are trying to let the people's voices be heard, but that isn't working" is intriguing. Surely you realize that in a democracy there is a probability that up to 49.9% of a representative constituients are going to believe that their representative is voting against their expressed desires.
It's just the nature of democracy.

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10176Ytown(1254 comments)posted 11 months, 4 weeks ago

SeriouslyNow: I used your link to the govt website to get a premium estimate. (post #64). It doesn't say that you need to go to the Kaiser link to get a custom rate, in fact no mention of Kaiser, although it does say "Final price quotes are available only after someone has completed a Marketplace application." Since the link you provided took me directly to the premium estimates page, I wasn't aware of any other options.

I also used the link that Cosmo19 gave to go to the Kaiser information (post #90) in which premium estimates are based on age given. I found that the rates are much different than the gov estimates.

I won't go as far as to say that the gov. website is intentionally misleading, but I will say that the premium estimates given are not accurate. No matter what your age, you have 2 choices, under 49 or over 50 and the estimate given is based on the lower end of the one size fits all opening it up to sticker shock when you apply!

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102dontbeafool(951 comments)posted 11 months, 4 weeks ago

I thought this article was interesting.
http://us.cnn.com/2013/10/28/opinion/...

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103jojuggie(1294 comments)posted 11 months, 4 weeks ago

"If you like your plan, you can keep your plan."
"If you like your DR, you can keep your DR."
Where have I heard these phrases before?
Can you imagine the chaos that would result if the Republicans were in office? From The Boston globe to the NYT, to the Cleve.Plain Dealer, The Youngstown Vindy, to the St Louis Post Dispatch, all the way to the LA Times, & it wouldn't stop there. ABC, CBS, NBC, MSNBC, CNN, would also be involved. The Repubs would be hung in effigy in every major city in the US, but not Obama (the beloved).
Of course, Hollywood would involved also.

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104dontbeafool(951 comments)posted 11 months, 4 weeks ago

It may have failed on its own, idk, but you have to agree that the Repubs have been trying to sabotage it from day one. The article was more about showing their hypocrisy. But if you can't admit that they are trying everything in their power to make it fail, then you aren't being objective or honest.

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105SeriouslyNow(192 comments)posted 11 months, 4 weeks ago

@76Ytown,
On the www.healthcare.gov homepage
click on "Individuals & Families" tab immediately below the words HealthCare.gov

At the next page in the lower left click on "How can I get an estimate of cost" (depending on how your screen displays, you may have to scroll)

On the next page, click on the blue underscored words "health insurance costs and savings calculator"

This should take you to the Kaiser site.

I got a message from one of my relatives to call him tonight for some really exciting news about ACA.

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10676Ytown(1254 comments)posted 11 months, 4 weeks ago

The generic info is accessed with one click directly on the home page: "see plans now"

You have to search to find the Kaiser site as you explain above. Too bad they aren't more transparent with the Kaiser info from the start instead of having to dig for the information. Why can't they just use the Kaiser link for premium estimates instead of the generic?

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10776Ytown(1254 comments)posted 11 months, 4 weeks ago

Why is Kaiser Family Foundation, a non-profit organization being linked to the government's website to provide rates?

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108SeriouslyNow(192 comments)posted 11 months, 4 weeks ago

Here’s my relative’s situation. He lives in Greenville SC with his wife and 13 year old child. Their combined annual income is just barely 80,000. He is 38, she is 35. They are currently paying 711/mo for a 70/30 health insurance plan that covers himself and their child, but she is not covered due to a pre-existing (breast cancer) illness. They are not eligible for any subsidy.

He looked up on KFF and saw the estimated premium for his 70/30 was 653.83/mo. He was happy!

He checked the Healthcare.gov estimate and was discouraged that they were estimating a range between 729 and 871/mo.

But in either case, even though it would be more than he is currently paying, his wife would now be covered!

So he applied and got the official news today that his 70/30 policy premium for 2014 will be 685.34. He is beside himself with joy!

He also says that maybe being a democrat helped ! (He thought that was funny)

So congratulations to him and his family!

But there’s another side to this story, namely to remind us that what we are reading in these websites are ESTIMATES.

Also, it is very interesting to see that the KFF calculator was low (even though that calculator asks for ages) and the Healthcare.gov was high (and that one doesn’t ask anything about his age).

I wondered about the age thing and tried it out, the HC.gov site doesn’t ask for ages if you are shopping for family coverage. Go figure!

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109SeriouslyNow(192 comments)posted 11 months, 4 weeks ago

note to eivo:
Millions of elderly would disagree with your statement about the government has no business in health care. They might even beat you with their cane!

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11076Ytown(1254 comments)posted 11 months, 4 weeks ago

SeriouslyNow: Good news for your relative. Pre-x is something that needed to be fixed with our current health care.

I'm not sure that we could not have fixed that by excluding insurance companies from denying pre-x or creating having the govt. act as a secondary insurance to cover only the pre-x conditions for a period of time. Insurance plans have had stop loss insurance on their own plans to cover their butt in case the expenses exceeded their limits. And group plans generally have a waiting period for the pre-x before they pay for related expenses, like 12 months but they'll cover anything else not pre-x. If your relative had an individual plan, they were free to deny or exclude coverage in the past.

I do have one question for your relative. What are the out of pocket max's in their current 70/30 and ACA 70/30 plans?

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111SeriouslyNow(192 comments)posted 11 months, 4 weeks ago

@76Ytown,
I take a shot at your two questions.

Why didn't they just use the Kaiser link....?
I don't know, but I speculate that since the Kaiser link only provided limited info (nothing on HDHC plans, nothing on gold, no names of insurers or the policy names, etc) that someone thought that people might want more detail than Kaiser either had or was about to share.

Why the link on a gov't website...?
Kaiser and NPR collaborated to get the silver estimates and calculate the subsidy bands, they released this estimator on Sept 30, just before the HC,gov was launched.

I can only speculate that someone at CMS thought it would be helpful.

BTW, other CMS webpages provide to links to non-governmental sites, so this is not at all unusual

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11276Ytown(1254 comments)posted 11 months, 4 weeks ago

What use were names of insurers on the govt site since everything else was generic? Just saying.

Kaiser was doing a public service as far as I can tell. Although I'm sure they are not allowing their link to the govt site for free. Why is it that they can withstand the volume of inquiries to their piddly little website but the government can't? Again...just saying.

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113SeriouslyNow(192 comments)posted 11 months, 4 weeks ago

@76Ytown,
I'll call him tommorrow confirm, but I "think" he said that there was a slight change in OOP, but wasn't consequential (to his situation)

I know from another thread that you are shopping, so I would be very cautious to use his experience as any sort of guide. The most interesting lesson in this was the age-based KFF estimator was low and the non-age calculator was high!

I also haven't a clue as to why the HC.gov estimator only asks the age for single persons...mysterious!

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11476Ytown(1254 comments)posted 11 months, 4 weeks ago

Every situation is different. Rates are based on so many factors, Single, family, smoker, non-smoker, and the biggee...age.

Your relative's individual plan for a 38 year old and 13 year old was actually quite high for a 70/30 plan unless it had a very small or no deductible. A 38 year old male is still in lower risk territory and a 13 year old is definitely cheaper to insure. Sometimes it pays to get them their own individual policy. I know that recently a 19 year old male could get a 70/30 plan with a $1000 ded for less than $100 per month.

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115dontbeafool(951 comments)posted 11 months, 4 weeks ago

yeah, I should watch Fox's Fair and Balanced......wait, or maybe Rush. I think they are still doing DNA on Obama's birth certificate.

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116SeriouslyNow(192 comments)posted 11 months, 4 weeks ago

76Ytown,
Very true about factors, include in that location.
I'll find out about his deductable and OOP when he gets home from work today.

Location.... Several years ago, when I had moved from the suburbs of Pittsburgh to the suburbs of Philly, I was shocked to see the change in my auto insurance policy. When I inquired about it with the PA insurance commission, what they told me was: the principle reason rates are higher in the Philly region is that auto accident "victims" are seven times more likely to sue in Eastern PA versus western PA. The insurance industry factors that in as well.

Regarding the 19 year old.... and there is a world of difference between a 19 year old (presumably single) and a 38 year old with a wife and child. The 19 year old is probably more healthy than the 38 year old but the 19 year old is more likely to be involved with risky (health-wise) behavior. The insurance actuaries have this down to a fine science to make money for their companies.

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117SeriouslyNow(192 comments)posted 11 months, 4 weeks ago

76Ytown,
I see you like clocks... try this one:
http://www.poodwaddle.com/worldclock.swf

************
You asked what was the use (purpose ??) to put insurers names on the .gov website. So you could contact them directly,

.gov link to Kaiser... free???....
I suspect that Kaiser is neither being paid nor paying for a link.

Did you contact your insurer about the premiums for your policy next year (you showed nearly double)? Is the answer that they are offering a different policy because last year's policy didn't meet the baseline standards

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11876Ytown(1254 comments)posted 11 months, 4 weeks ago

SeriouslyNow,

Interesting app.
US Debt: $16,750,193,000,000 - trillion
US National Debt Per Person: $52,199.69
Total US debt per taxpayer $146,052.07

Those were rhetorical questions.

Aetna dropped my current individual coverage because it doesn't meet the ACA standards even though I liked my coverage, it suited our family and I didn't need maternity or pre-x coverage. The new premium for the same benefit levels will be double the cost.

When we buy auto insurance we have an option of purchasing add-ons but in health care we're going to be forced into purchasing a one size fits all plan.

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119jojuggie(1294 comments)posted 11 months, 4 weeks ago

The O-man, Barack Hussein Obama, is an eloquently tailored empty suit. No resume, no accomplishments, no experience, no original ideas, no understanding of how the economy works, no understanding of how the world works, no balls, nothing but abstract, empty rhetoric devoid of real substance.

He has no real identity. He is half-white, which he rejects. The rest of him is mostly Arab, which he hides but is disclosed by his non-African Arabic surname and his Arabic first and middle names as a way to triply proclaim his Arabic parentage to people in Kenya . Only a small part of him is African Black from his Luo grandmother, which he pretends he is exclusively.

What he isn't, not a genetic drop of, is 'African-American,' the descendant of enslaved Africans brought to America chained in slave ships. He hasn't a single ancestor who was a slave. Instead, his Arab ancestors were slave owners. Slave-trading was the main Arab business in East Africa for centuries until the British ended it.

Let that sink in: Obama is not the descendant of slaves, he is the descendant of slave owners. Thus he makes the perfect Liberal Messiah.

It's something Hillary doesn't understand - how some complete neophyte came out of the blue and stole the Dem nomination from her. Obamamania is beyond politics and reason. It is a true religious cult, whose adherents reject Christianity yet still believe in Original Sin, transferring it from the evil of being human to the evil of being white.

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12076Ytown(1254 comments)posted 11 months, 4 weeks ago

Yeah, and it's all Bush's fault.

But the fox in the white house already knows it will fail. That's the plan. But wait..socialized medicine will save the day!

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121SeriouslyNow(192 comments)posted 11 months, 4 weeks ago

all,
I got my brothers information and I was about to share it with you all, reading over your latest comments I've come to the conclusion that that you all have made up your minds and that your not really interested in information that does not support your bias. So why should I go to any effort to answer your questions or provide information. It's a waste of my time.

My brother is happy that his problem is solved. I am content with my health insurance coverage. 76Ytown you will just have to go shopping or deal with your doubled rates. It's not my problem.

So I'm signing out of this thread; if you don't like the ACA get the law changed. If you don't like your representative change him, if you don't like your president change him. If you don't like the IRS don't pay your taxes etc etc.

But by all means...keep whinning !

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122dontbeafool(951 comments)posted 11 months, 4 weeks ago

That makes no sense that Obama knows and wants it to fail. This is his signature piece and he doesn't want to be remembered for a failed program. Anything will fail if enough people are determined to make it fail. Our country's leaders are like a football team and half of them aren't blocking on purpose.

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12376Ytown(1254 comments)posted 11 months, 4 weeks ago

Seriously, don't go away. We'd like to know what what your bro's ded & OOP maxes were compared to the ACA plan.

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124dontbeafool(951 comments)posted 11 months, 4 weeks ago

Again, very intellectual response eivo. It shows your character. Go listen to Rush some more and believe every thing you hear. Or is Ted Cruz your new hero? I don't think Obama is doing a great job either, but I GAVE him a chance and wanted him to succeed, for the country's sake. I think your hatred for him is pretty clear and always existed, even before he opened his mouth, and you are happy to see him fail. Most R-A-C-I-S-T people never gave him a chance from day one. I believe that is your foot, and the shoe fits!

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125dontbeafool(951 comments)posted 11 months, 3 weeks ago

@eivo, and before you assume, I am not black. I believe in equality and fairness. Being white, I hear a lot of the racist bigotry that goes on, and has been going on about the President prior to being elected. I have never seen a President face so much opposition from day one in my life. It is a miracle that he can get anything done facing that. I will be the first to get on someone for using the race card as an excuse when not warrented. In fact, you can click on my comments and on the second page, read my post about the Warren Vigil.

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126ytowntomg(26 comments)posted 11 months, 3 weeks ago

"Not doing a great job" Kind of like Pearl Harbor was a kind of bad thing the Japanese did to us. Are you really going to turn a blind eye to his disastrous policies and his Chicago style, agenda driven presidency, just so you can tell everyone you're not a racist? Really? Nothing is better. Nothing. Wages-down. Employment-down. Moral-down. Outlook-down. International relations-down. Welfare-up. Disability-up. Federal government employment-up. National debt-up. Scandals-up. Racial tension-up. Hatred-up. Don't be a sucker dontbeafool. You're being played.

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127ytowntomg(26 comments)posted 11 months, 3 weeks ago

Oh, and by the the way toolateyourealreayafool, the blacks in this country are 500% more racist than the whites. Just in case you've been asleep for the last 20+ years.

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128dontbeafool(951 comments)posted 11 months, 3 weeks ago

It isn't a contest about who is more racist ytown. It isn't right for ANYONE to be racist. I have people I like, and people I don't, of all races, but I always give them a fair chance to be a good person and not judge them right away based on their skin. From your last statement, you just basically said, "I am a racist, but black people are bigger racist". Which proves my point that you couldn't be any happier to the black guy in office fail. I suppose the last Pres was a lot better and left the country in thriving conditions before he handed over the reigns. Clinton had the country in the BLACK before a witch hunt was conducted by Gingrich and co., who ironically wasn't very moral himself at the time. Hypocrite. I didn't even vote for Obamba the second term because of the job I thought he was doing, but at least I gave him a chance, unlike the good old boys (GOP) and like minded whose mission was to obstruct and destroy.

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129Rooster(78 comments)posted 11 months, 3 weeks ago

I don't know why we think this whole mess has anything to do with what party is in charge. This Obamacare is bigger than Ebay, bigger than Amazon and we think it's a matter of some political hack building this apparatus - like they could run Ebay? This Sebelius lady can't run Ebay, and couldn't if she was Republican either. Only reason I'm a Republican any more is that at least we can grasp the idea that people in government aren't as good at running enterprises as folks running their own businesses. Democrats somehow figured some appointee could do the equivalent of starting up an Ebay enterprise.

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13076Ytown(1254 comments)posted 11 months, 3 weeks ago

Toni McCall Townes-Whitley, Senior Executive VP with CGI, the company that earned the no-bid contract to design the Obamacare website is also Michelle Obama's former Princeton classmate and friend who even spent Christmas at the White House in 2010 and supported the Obama election.

Interesting.

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131dontbeafool(951 comments)posted 11 months, 3 weeks ago

No bid contracts are sadly way too common and have been going on way too long, Haliburton was a major one, and they are unfair. Cronyism. They should have a minimum amount of applicants required to bid. I watched a good 60 Minutes show last week about how Congress by-passed using Campaign contributions for personal funds by creating Leadership PAC accounts. From these accounts they spend over 100K per year on golf outings, weddings, wine trips, sporting events, etc. They put their wives, kids, cousins, grand kids, all on their payroll. Some even take loans from it and charge their campaign 18% interest. I wrote my Congressman about passing legislation to abolish Leadership PAC accounts. I'm sure a lot of Congress/Senate members will jump on board for that piece of legislature. LOL. You have to be stupid to give any donation to any politician!

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132jojuggie(1294 comments)posted 11 months, 3 weeks ago

Remember the couple that sneaked into the White House with no credentials?

THEY'RE STILL THERE!

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133ytowntomg(26 comments)posted 11 months, 3 weeks ago

youjustafool, I don't give a crap what color the president is. I'm a conservative. That's what all you followers call everyone who disagrees with Ocrapa these days; racists. How stupid!!!!!!!! Get off the friggin band wagon. It's a distraction youjustamoron. Like the tea party is a racist group. NO, they are anti-liberal and therefore the democrat licking media and blind obeyers like you call them racists. Get an original thought before something grows inside that big hollow space inside your skull. He's the racist. He's the anti-america. Race has nothing to do with the damage he is doing to my country. I'd vote for friggin no-accomplishment Clinton first. I'd vote for Ronald Regan and he's dead. Get it?

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134dontbeafool(951 comments)posted 11 months, 3 weeks ago

If you don't think that race plays a part in the obstruction that the President has faced before he was even sworn in, then you have the hollow space in your head. If you read any of my posts, I want fraud and waste eliminated from social programs, and I don't like the leadership he is showing. I am just stating the fact that no other President has faced the opposition that he has from day one, and I believe that race has something to do with it? Why else would Repubs publicly state that they want to see him fail? 4 years ago, anyone not on board with the President would be labeled unpatriotic. And by the way, this is MY COUNTRY too. I served it, and have a right to my opinion.

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13576Ytown(1254 comments)posted 11 months, 3 weeks ago

Could the opposition have anything with incompetence?

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136dontbeafool(951 comments)posted 11 months, 3 weeks ago

I think the hatred for Bush came from being in constant wars and losing young men's lives uneccessarily. I personally didn't hate Bush, I thought he was a stammering idiot, but didn't hate him. I disliked Cheney more so. @76, I am assuming you are referring to Obama and not Bush. Was Obama incompetent before he was even sworn in? Because USUALLY you have to be given a chance, do something to show incompetence, and then get opposition. To you, one second he is incompetent and stupid, but in another comment he has to be highly intelligent in order to pull off all of these "masterful grand schemes" like creating a health care plan that he wants to fail on purpose.... People's health premiums were rising at staggering rates over the last 10 years, and people couldn't get coverage for pre existing conditions. What plan did the Repubs come up with? Nothing. Repubs are hypocrites period. Do everything to obstruct and cause problems for the ACA and then be outraged that their constituants can't sign up for the plan. I thought conservatives are supposed to be the church going, moral people, yet they are the ones who don't want any social programs at all. If it was up to you, it would be everybody for themselves. Let others starve. Or if people can't afford medical coverage, let them die.

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137dontbeafool(951 comments)posted 11 months, 3 weeks ago

It is a free country, you can like or dislike who you want. You are missing my point completely, so I will say it one final time. I believe that most of the Republican party has been doing everything since DAY 1 to see the President fail. Rep Congressman/Senators came out on record as saying that they hoped he failed. I have never seen that with any other president ever. Yes, I think a lot of it had to do with race. That is my point. Whether or not you are racist or not, only you can answer that. And I know that not everyone who is anti Obamba is racist either, there are many other reasons why you can dislike him.

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138dontbeafool(951 comments)posted 11 months, 3 weeks ago

Can you even acknowledge that there are still a lot of racist people out there, and don't like him just because he is black, or are you in total denial? Disregard his policies, or how good or bad he is doing, ARE THERE RACIST PEOPLE OUT THERE THAT JUST DON'T LIKE HIM BECAUSE HE IS BLACK?

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13976Ytown(1254 comments)posted 11 months, 3 weeks ago

dontbeafool:

There was plenty of opposition to Bush. Notice that R's don't have names for other candidates yet D;s always have labels and putdowns, pulling the race card and calling people idiots.

There is much we really don't know about Obama to this day, but if we pull the race card or other label, is he white like his mother's side of the family or is he black like his father's side? Is he communist or an atheist like his mother's side of the family or is he Muslim like his father, stepfather and half brothers side of the family in Kenya?
http://atlasshrugs2000.typepad.com/at...

Before you call someone an idiot, you might want to know what is their education:

Bush's Education
College
1968 Yale University, BA History 3.6 GPA.

Graduate School
1975 Harvard University, Master of Business Administration (The only president to have a Master's Degree)

Career and Public Service
F-102 pilot for the Texas Air National Guard
Owner, oil and gas business
Managing Partner, Texas Rangers Baseball Team
Governor of Texas
President of the United States

Obama's Education
1979 - 1981 Occidental College
1981 - 1983 Columbia University, B.A. Political Science
1988 - 1991 Harvard Law School, J.D. magna cum laude

Obama worked as a community organizer in Chicago.
Author of "Dreams of my Father"
Attorney
Worked as a professor of constitutional law at the University of Chicago.
Illinois Senator
President of the United States

In his autobiography, Dreams from My Father, Barack Obama describes himself as an unfocused high school student whose mother scolded him for being a "loafer" (142). He describes his attitude toward his studies at Occidental as “indifferent” (146), calling himself a “bum” who abused drugs (138) and who was notorious for partying all weekend (165).

Obama writes in Dreams: "When I heard about a transfer program that Occidental had arranged with Columbia University, I’d been quick to apply"(172).

However, there is no record of such a "transfer program" existing at either Columbia or Occidental.

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140dontbeafool(951 comments)posted 11 months, 3 weeks ago

@76, You have way too much time on your hands. You must be out of work schoolteacher. I don't have time to read a history lesson that is 20 pages long from FOXNews. And Republicans always talk down to people on here towards Democratic comments.

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141dontbeafool(951 comments)posted 11 months, 3 weeks ago

@eivo why didn't blacks hate Clinton then, he is white?

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142dontbeafool(951 comments)posted 11 months, 3 weeks ago

Yep, he is racist, and probably his followers are too. So what's your point? It is okay then for u and others to be since they are? It is ok to sabatage the prez from day one because there are black racist out there! It is wrong by all who do it. Okay, I'm done on this thread. People are who and what they are, and I'm certainly not going to be able to change them. I know by the hate and anger in certain posts.

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14376Ytown(1254 comments)posted 11 months, 3 weeks ago

dontbeafool:
A couple of things... no, I'm not a teacher but if you learned something, I'm flattered, and Clinton was actually was called the first black president by supporters!

"In writing about the impeachment in 1998, Toni Morrison wrote that, since Whitewater, Bill Clinton had been mistreated because of his "Blackness":

Years ago, in the middle of the Whitewater investigation, one heard the first murmurs: white skin notwithstanding, this is our first black President. Blacker than any actual black person who could ever be elected in our children’s lifetime. After all, Clinton displays almost every trope of blackness: single-parent household, born poor, working-class, saxophone-playing, McDonald’s-and-junk-food-loving boy from Arkansas."

Personally, I wouldn't care what color or race or heritage a person comes from as long as they have the following qualities: Integrity, honesty, trustworthy, intelligence, leadership, courage, common sense, empathy, good moral character, respect for our values, put our country's needs before others, hardworking, strives to make this nation stronger and better while protecting its people from harm. Insure that future generations are provided the same securities as past generations.

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144dontbeafool(951 comments)posted 11 months, 3 weeks ago

And Bush....
Stategery
Invades wrong country
Couldn't get Bin Laden
AWOL during most of his so called military career
Did cocaine
Daddy got him every job he had
Takes a lot to buy a baseball team with daddy's money.
Sorry I didn't reference every news source to try and prove a point. I can tell that you are the type that is never wrong.........EVER. Vote for Ted Cruz, the Cubanadian, just don't complain when you are older after he and his cronies abolishes Medicare and any other programs you may depend on. God bless!

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145Sensible(118 comments)posted 11 months, 3 weeks ago

What does any of this have to do with Obamacare?

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14676Ytown(1254 comments)posted 11 months, 3 weeks ago

I would sure vote for Dr. Carson.

Carson has said he is not a member of any political party. "If I were part of one, it would be called the 'Logic party', and it would be dedicated to commonsense approaches we all should be able to see." This would include "recognizing that our debt is so great we have got to stop digging the hole and spend less."

Though Obama thinks big government should solve people's problems, many Americans believe in individualism and responsibility,

"That doesn't mean that those people don't care about anybody else," Carson said.

Obama is an excellent campaigner who can create a rosy picture while ignoring the programs' problems, Carson said.

"Our founding fathers would be horrified" to see the government telling individual citizens they are required to spend their money a certain way, such as to buy health insurance, "This is certainly not what was intended in a free state."

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147dontbeafool(951 comments)posted 11 months, 3 weeks ago

Stupid comparison eivo. I might as well debate a potato. I would vote for the best candidate based on my views, regardless of race. If my candidate didn't win, then I would support the winner regardless of his race. I would give the winner a fair shake, an opportunity to succeed. Why, because the voters spoke, and I respect the position of the President. May I disagree with things along the way, sure, but I wouldn't try to sabotage him from day 1. Then, if I think he did a crappy job, I would not vote for him again.

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148SeriouslyNow(192 comments)posted 11 months, 3 weeks ago

@76Ytown:
I can accept your objection to the word substandard because of the implications associated with it. Viewed in retrospect, it implies that you specifically choose a policy that exposes your family to risk. I'm fairly certain that was not your intention or motivation.

I appreciate your taking the time to relate the 'back of the letter' notification from Aetna, but it doesn't say anything specific about the difference in policy coverage that justifies a doubling of your rate. It seems to just say..."blame it on ACA"

As I said above, I don't comprehend how the extra services (that you identify as being the only coverage difference) translate to an increase of over 500/mo.

Regarding the insurers doubling their profits... It’s my understanding that insurers are now (under ACA) required to payout (in actual medical benefits) at least 80% of the premiums that are collected. Hopefully that is an overall standard, so that insurers are not able to play one class (group policies) against another (individual policies).

Lastly, I'm intrigued by your last comment about the Insurance companies being the authors of ACA. I think you have previously opined that the ACA was designed to fail. That "designed to fail" is the current talking point of those who think that failure of ACA is intended to lead to a single payer system.

It doesn't make sense that the insurance companies would author a plan that is intended to lead to a single payer system, like Medicare for all.

(Unless of course that the insurance companies believe that the single payer would be privatized to the insurance companies themselves --- I can't believe that they are anxious to get into the business of insuring the elderly!)

Have you shopped the exchange yet? How does Aetna's 2014 offer to you compare with what's available on the exchange?

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149dontbeafool(951 comments)posted 11 months, 3 weeks ago

You may have, but to my original point, the Repubs in congress/senate did not.

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15076Ytown(1254 comments)posted 11 months, 3 weeks ago

seriouslynow post # 150

The "substandard" word play is just divisive rhetoric from the administration. We've already established that the difference between the new standards and old standards is that they are now a one size fits all which includes maternity, pediatric dental and vision, mental health and substance abuse. Of the 10 essential standards now required, the previous standard plans offered all other services in nearly 100% of the plans.

I would scan my original policy in adobe format for you to scrutinize however that is about as pointless as having to look at the now over 11,000 pages of the ACA. You will just have to take my word for it that of the 10 essential standards, the extras mention above were the only exclusions.

Sorry that you cannot comprehend the 100% rate increase, but if you do not understand the actuarial process, I can't help you.

The 80% payout (85% for large carriers) is a little more complex than at face. I hope that you do not think that the return means that if you personally don't have any claims for the year, they will refund you money.

"It doesn't make sense that the insurance companies would author a plan that is intended to lead to a single payer system, like Medicare for all". In this case, you need to understand the difference between insured and administered services only (ASO). The insurance company profits either way. In the insured model, they assume all risk, in the ASO model, they are a Third Party Administrator (TPA) paid to administer the claims reimbursement but do not provide the funding for the actual claim.

Have I shopped the ACA? Yes, I have spent time on their website to see what is offered. Have you?

The ACA is designed to be an Data Hub in order to gather information to determine eligibility for an insurance subsidy. It will share info with IRS to the DOD, DHS and HHS and you can't opt out. Privacy issues are still being worked out.

Hey, wouldn't it have been easier for them to have asked the NSA for our info?

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151dontbeafool(951 comments)posted 11 months, 3 weeks ago

Dems didn't block legislation for Bush. Each of the following major laws was enacted on a bipartisan vote:

The 2001 tax cuts;
the No Child Left Behind Act in 2001-2;
the 2002 extension of Trade Promotion Authority;
the 2003 medicare law;
the 2005 energy law focused on electricity;
the 2006 pension reform law;
the 2007 energy law focused on fuel;
the 2008 stimulus law;
the 2008 housing reform law; and
the 2008 TARP law.

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152dontbeafool(951 comments)posted 11 months, 3 weeks ago

I just gave you 10 pieces of legislation that were bipartisan. (Eivo That means Dems working with republicans to get stuff done). These were Bush's puppies that went through. So you are too far in denial to be helped. You use Dr Carver as your "one token black friend" to try and convince yourself and others that you aren't what you are.

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15376Ytown(1254 comments)posted 11 months, 3 weeks ago

dontbeafool... why must everything be racist to you? Read Dr. Carson's bio before you pass judgement.

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15476Ytown(1254 comments)posted 11 months, 3 weeks ago

dontbeafool... why must everything be racist to you? Read Dr. Carson's bio before you pass judgement.

http://www.biography.com/people/ben-c...

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155dontbeafool(951 comments)posted 11 months, 3 weeks ago

It isn't ALWAYS about race with me. I hate racism in all forms. Like I said, I am white, and you can read other comments I made calling some black people out for using racism as an excuse (look at warren vigil comment). But It makes me irate when you read the racial comments of others, then they can't own up to it, and they act like it doesn't exist. I would almost respect people more if they just came out and said, yeah I hate Obama or this person because they are black.

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156dontbeafool(951 comments)posted 11 months, 3 weeks ago

And Dr Carver sounds very qualified..... To be a minister or a surgeon. What political experience does he have?

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15776Ytown(1254 comments)posted 11 months, 3 weeks ago

dontbeafool, what are you 15 years old?

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158dontbeafool(951 comments)posted 11 months, 3 weeks ago

I meant Carson, not Carver. Why would Carver be racist?

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159SeriouslyNow(192 comments)posted 11 months, 3 weeks ago

76Ytown,
Having previously worked with a self-insured company who had BC as their administrator I do know the difference. I fail to see how that relates to your contention that the " ACA system was designed to fail"

What do you believe was the end game for the authors (you contend the insurance industry) in designing ACA to fail?

++++++++++++++++++++++

No, I do not think that premiums would be refunded if my personal claims were less than 80%. However I do believe that policy holders did have refunds last year because the carrier failed the 80-85% rule.

++++++++++++++++++++++++

Yes, I have spent time shopping on the .gov website. But my existing plan apparently meets all the requirements, and is better than the that offered.

++++++++++++++++++++++++++++++++
I have no need for you to scan your contract (I hope you were being sarcastic) by the way the ACA is only about 900 pages.
http://www.gpo.gov/fdsys/pkg/PLAW-111...

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16076Ytown(1254 comments)posted 11 months, 3 weeks ago

* He always wanted a single payer health system but says it will take a transition. http://www.youtube.com/watch?v=Kvg8qV...

and a viewpoint of "designed to fail"
http://communities.washingtontimes.co...

* Did you get a refund last year? I didn't.

* You say your plan apparently meets all the requirements. If your plan is an employer plan, or even a grandfathered individual plan (prior to 3/23/10) you won't see the change due to the implementation postponed for 1 year.

* The link you gave is the consolidated version of the ACA with 906 pages.

The certified full text version is 2,409 pages:
http://www.hhs.gov/healthcare/rights/...

Since the law was enacted the President has already signed 14 laws to amend, retract or simply change the Affordable Care Act, and he has also taken five steps to delay the federal law.. Each of these changes added pages to the law.

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161dontbeafool(951 comments)posted 11 months, 3 weeks ago

Seriously, just give up, you will never win, so don't waste your time and energy.

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162thinkthentalk(265 comments)posted 11 months, 3 weeks ago

Death Panels. What about the Death Panels? Night after night after night, GOP leaders Sarah Palin, Michelle Bachman and Sean Hannity hammered on Fox that Obama was instituting death panels. Can anybody show the specific verbage in the ACA that says the govt will pull the plug on seniors?

Perhaps that was just republican misinformation.....

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163SeriouslyNow(192 comments)posted 11 months, 3 weeks ago

@dontbeafool,
Yes, maybe I am being foolish when I try to engage people in a rational (non-extremist) discussion.
I'm detecting that one of the tactics used by the Fox / Newsmax / WND / MRC devotees is to dilute the discussion with other non-pertient issues.
For example, I just don't get the connection betwen who went to Princeton with Michele Obama and the Obamacare law. (If Issa's committee wants to examine that - well OK, but it has more to do with the website than it does with the law)

Similarily It is petty to be arguing that the GPO certified Public Law is 2,000 pages versus 900 pages, when the apparent difference that the 2000 page version is double spaced with extra wide margins. Double spaced or not, the law is the same. (but it makes for dandy diversion to claim that the law is 11,000 pages)

76Ytown has exhibited that she is occasionally been willing to at least listen to, and research a more moderated, less hyperbolic conversation. To that I give credit, and perhaps some hope.

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164Sanjay1976(37 comments)posted 11 months, 3 weeks ago

A couple of good reasons not to vote for eivo for president

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165SeriouslyNow(192 comments)posted 11 months, 3 weeks ago

@76Ytown,

1) Your contention was that the insurance companies authored the ACA and that it was designed to fail. I watched/read your links but it still doesn’t explain why the insurance companies would author something that would lead to a single payer (government) system. A single payer system would effectively kill the health care insurance industry.

2) No I didn’t get a refund, because my insurer certified that their overhead (including profit) was less than 20%. However an estimated $1.1 billion -- came in rebates to consumers required because insurers had exceeded the required limits. (http://articles.latimes.com/2012/dec/...)

3) No response needed (however I can see a potential for abuse by the insurance companies. In short, at the end of 2011 or 2012 just change an existing plan “just a little bit” so that you can avoid grandfathering))

4) The link I gave is for the certified GPO text of PL-111-148, There is nothing consolidated about it. The principle reason it is different is because your link is to a double spaced version with wider margins. The words of the Act are the same.

I looked at the amendments to PL-111-148 (PPACA) as reported by CRS to Tom Coburn on Sept 5 2013. CRS, in the report to Sen. Tom Coburn, said all sides have already agreed to 14 laws that changed parts of Obamacare, though they were USUALLY MINOR changes or clarifications. (www.washingtontimes.com/news/2013/sep...)

I went through the full text of the CRS report, and closely examined the first 7 amendments. The first two amendments added 37 words and modified 36 words respectively. The next PL 111-226 dealing with the FAA clarifies FAA regulations by the addition of 23 words to the FAA Modernization act.
The next PL111-309 (8 pages) amends with Medicare and Medicaid Extenders act that postpones cuts to physicians (the so-called doctor fix).
The next PL 111-312 (31 pages) The unemployment reauthorization act mentions PL111-148 but does not amend the act.
The next PL111-383 adds 7 words to the National Defense authorization act for 2011, it makes no changes in the ACA, but includes Tricare coverage for dependants less than 26, so as to be in compliance with ACA.

At that point, I gave up. So far out 7 of the 14 amendments have not added or detracted substantially from the ACA as was written……

Your contention that these changes added pages to the law is incorrect, at least not to the extent of doubling the page count.

I think that you are just repeating what your conservative / tea party bloggers want you to believe.

The more important thing for you to do is to protect your family the best you can, and if that means buying on the Obamacare exchange or accepting a subsidy, so be it.

But railing about Obamacare is just venting, it does nothing to help your family.

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166jojuggie(1294 comments)posted 11 months, 3 weeks ago

Hey seriously, can you give me and idea of how many Democrats actually read the Obamacare bill before they voted for it?

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167paulydel(1308 comments)posted 11 months, 3 weeks ago

Who wants to pay more for premiums get less for your money and pay a fine if you don't have it? Not me thats for sure. You have to be brain dead or a moron to think this is a good thing. Doctor you or anyone else cannot name one thing the govt has gotten invoved in that has not cost the taxpayers of the United States an unbelievable amount of money. Obuma and his band of thieves have got to go.

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16876Ytown(1254 comments)posted 11 months, 3 weeks ago

1. I guess we'll just have to be patient as this transition progresses. As far as killing the insurance industry, you're mistaken. What a sweet deal would it be to have a business where everyone is required to purchase your product with government subsidies? .

2. That breaks down to a couple of $s per insured. Note that they didn't necessarily refund directly to the employee, group plans were able to use the "rebate" as a premium offset.

3. Hence the reason we're seeing the individual market collapse. After the 1 year extension, changes will hit the group market where we'll see increases in premiums as well.

4. The number of pages associated with the PPACA is highly debatable. Anywhere from 900 - 20,000 or more depending on how you look at it. Each amendment passed into law has it's share of associated pages to be added to the ACA.

Both the consolidated and full text versions are on the HHS website:
http://www.hhs.gov/healthcare/rights/... Here, they state: "The first link listed above contains the full text of the Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 in one document. It is not official and is provided for your convenience. The second and third links contain the official certified full text of the law."

- SeriouslyNow, "railing about Obamacare is just venting"

What's the difference between ignorance and apathy?

I don't know and I don't care.

While most people seem to fit the above, I prefer to take an informed approach to the changes taking place in our country. From the way this is unfolding, Obamcare is doing nothing to help my family and it's becoming evident it's more of a tax than an affordable health care option.

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169jojuggie(1294 comments)posted 11 months, 3 weeks ago

Hey seriously, & 76, don't you guys have anything better to do? Neither of you can win this debate.
It seems that you're both working this message board around the clock & probably missing time that could be spent with your families.

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170GailsMom(16 comments)posted 11 months, 3 weeks ago

My son got a rebate check last year for 203 dollars. His cousin, in seattle, got a check this year for 407.

They were grateful for the 80-20 law.

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171SeriouslyNow(192 comments)posted 11 months, 3 weeks ago

1) Are you saying that the insurance industry would have a “sweet deal” under a single payer system???
Your contention has been that the ACA (that actually drives business to the insurance industry) was “designed to fail” presumably so that it could be replaced with single payer. I’m suggesting that a single payer system would devastate the health care insurance industry.

2) 2.7 million Americans, will actually receive physical checks, or direct refunds to their credit or debit cards…. The largest average rebates will be seen in Washington state, where 3,007 consumers will receive an average $512 this summer. In Massachusetts, more than 473,000 people will see an average rebate of $457.

3) The only debatable argument relative to the number of pages in PL111-148 is the formatting. The version certified by the Superintendent of Documents of the PPACA is found at: http://www.gpo.gov/fdsys/pkg/PLAW-111.... This version is 906 pages, there is nothing condensed or consolidated. If the same text is reprinted with 2.5 line spacing is becomes more like the number 2000, but it is the same number of words.
It is a silly argument to somehow suggest that the value of a law is associated with the number of pages it is printed on. After I actually looked at the amendments, it is equally ridiculous to suggest that those amendments added tens of thousands of pages to PPACA.

For your consideration… Yesterday’s (11/3/13) front page article titled “Loss of Insurance Baffles some Ohioians”. The couple featured in this article had the same issue that you raise about coverage that they don’t need. In particular this 64 year old couple were objecting to being offered maternity coverage.
Now, with the help of the Dayton paper they actually went on the HC.gov website and found a better policy: “But when the newspaper helped him view different options available through the federal government’s online marketplace, HealthCare.gov, Moyer discovered he could find better coverage for $100 less than the $800 per month he’s paying for coverage.”

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172jojuggie(1294 comments)posted 11 months, 3 weeks ago


The Obama administration has been claiming that insurance companies will be competing for your dollars under the Affordable Care Act, but apparently they haven’t surveyed the nation’s top hospitals.

Americans who sign up for Obamacare will be getting a big surprise if they expect to access premium health care that may have been previously covered under their personal policies. Most of the top hospitals will accept insurance from just one or two companies operating under Obamacare.

“This doesn’t surprise me,” said Gail Wilensky, Medicare director for the first Bush administration and senior fellow for Project HOPE. “There has been an incredible amount of focus on the premium cost and subsidy, and precious little focus on what you get for your money.”

Regulations driven by the Obama White House indeed have made insurance more affordable – if, like Kathleen Sebelius, you’re looking only at price. But responding to Obamacare caps on premiums, many insurers will, in turn, simply offer top-tier doctors and hospitals far less cash for services rendered.

Watchdog.org looked at the top 18 hospitals nationwide as ranked by U.S. News and World Report for 2013-2014. We contacted each hospital to determine their contracts and talked to several insurance companies, as well.

The result of our investigation: Many top hospitals are simply opting out of Obamacare.

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173HappyBob(285 comments)posted 11 months, 3 weeks ago

Yesterday's Vindicator:
http://www.vindy.com/news/2013/nov/03...

Good read. I wonder how many people dropped their grandfatherable policy without realizing the consequences.

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17476Ytown(1254 comments)posted 11 months, 3 weeks ago

And if you need care, head over to your local hospital and tell them that you're not in the country legally. They can't turn you away and you get your treatment for free!

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175HappyBob(285 comments)posted 11 months, 3 weeks ago

Evio,
Your link for Edie is dead or non-functional.

In your convoluted life plan to avoid being a responsible citizen ( aka the NRA's "law abiding citizen), do you not think that the IRS will keep track of a penalty for the rest of your life?

I'd like to see you try to get insurance after you've broken a leg or punctured a lung and before you try to get care. 76ytown's comment is right on, responsible citizens don't transfer the cost of their care to others.

V

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17676Ytown(1254 comments)posted 11 months, 3 weeks ago

Except transferring the cost of care is what obamacare does. You're forced to pay for services you can't possibly need.

Without pre-x limits, I don't think they can deny coverage except you can only enroll during open enrollment so you may have to wait to get on the exchange.

So who pays for the uninsured that show up at the hospital for treatment. Are they now responsible for their own bills since they didn't sign up? (Unless they are illegals).

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177HappyBob(285 comments)posted 11 months, 3 weeks ago

Famous eivo quotes:"the government has absolutely no business in health care"
And " find a way to transition myself from a worker to a freeloader"

Famous eivo teaching... How to cheat (#178)

And you want to be taken seriously???

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178HappyBob(285 comments)posted 11 months, 3 weeks ago

Actually happened to me:
Cat scan at the hospital, I was charged 1400.00
Cat scan actual cost (including overhead and profit) 140.00.

Hospital explains that difference " to make up and recover costs from those patients that are either uninsured or underinsured"

Does it sound like it might be helpful
that everyone had insurance??

Do you want the government to step in and create a single payer system with the taxpayers covering all healthcare costs for all Americans??

And since you brought it up, should hospitals require your passport or proof of citizenship before care is administered?

(eivo: I already know that you think that the government has absolutely no business being in healthcare, are you also calling for repeal of medicare, the FDA, the CDC)

*the charges cited above did not include reading the CAT

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179HappyBob(285 comments)posted 11 months, 3 weeks ago

eivo, only the morons thought that "he" was delivering some universal truth that had no conditioning, stipulations or context.

Those of us that have lived know that doctors die, move, retire, drop out of networks, so the notion that "you can keep your doctor" was not some 'carved on two tablets' axiom of life.

Those of us who have worked with employers know that employee sponsored insurance plans change almost annually, not in response to ACA but in response to pressure from stockholders and Boards of Directors. Those of us who have held private insurance plans know that insurers change policies whenever their actuaries tell them a policy is no longer as profitable as before, long before ACA.

What we all understood was that the ACA did not require you to change doctors, did not require you to change your policy. His statements were all in the context of the ACA, at least that's what the rational among us understood.

I guess "he" gave too much reliance to some in his audience, maybe he thought there was no need to explain the details and the caveats that you don't put kitty in the microwave to dry her off.

Rationality does not seem to exist at the extremes of political posturing of either party - especially tea

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18076Ytown(1254 comments)posted 11 months, 3 weeks ago

HappyBob, #185
The difference between the charge and the actual cost as you said $1400 vs $140 is called the negotiated rate. It's the amount that the provider has agreed to accept from the carrier for that particular charge and in most cases you don't owe the difference. Interesting however is that if you don't have insurance, you're billed the full rate.

Your point that employers change health plans annually because of stockholders and Board of Directors is not true. Many plans are self-insured. Benefits managers shop around for the best price just as you should shop your auto or homeowners insurance. If plan rates are expected to increase, changing administrative carriers may save money although it's a huge undertaking for a health plan. People buy individual plans for the short term, between jobs, alternative to COBRA, and self employed. The ACA says that if there was any change since 3/23/10 to your co-pay, deductible, premium, annual limits, benefit, or out of pocket limits, you are no longer grandfathered.

Obama's claim that you can keep your docs and plans left out the rules that you can...as long as you bought your original plan on the 2nd Tuesday of the WEEK!

We won't even begun to see the effects of this because until after the extension. This is only the first wave affecting individual plans and small groups.

The PPACA has everything to do with paying for premiums for insurance coverage and not the cost of affordable CARE.

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181HappyBob(285 comments)posted 11 months, 3 weeks ago

76Ytown,
Actually the negotiated rate was 327.00 of which my carrier paid 80%, I paid the remainder. The 140 cost was confirmed by my hospital when I questioned them after another Hospital administrator testified before the US Senate that the actual cost was 138.00. I just so happened that the procedure code that he had testifed to was the same as my procedure. I called the local hospital and they confirmed that the cost "was about 140.00"

Benefit managers do shop for the best deals, because that is what their supervising VPs demand. And their VPs demands that because the Board demands that, and the Board demands that because their only objective is to make money for the stockholders. So while the shopping is not directly conducted by the board, it is certainly done at the Board's insistance.

Self-insured entities do the same, the difference being that the benefits managers have more direct control of the product (insurance coverage line items). The insurance companies managing the self insured generally will offer model plans and the self-insured will modify the coverage to their specifications (based on the pecularities of the employees and their loss experience).

True enough about the ACA and March 23 2010. If the of the conditions that you mentioned were changed, then a new policy would be issued, and the prior one expired.

I don't get where your going with the 2nd Tuesday of the week comment. It would be fair to say that he neglected to say 'if you bought your plan before the 3rd Tuesday of March in 2010...' (but it is easier to say March 23 2010, which is what the law provided).

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182HappyBob(285 comments)posted 11 months, 3 weeks ago

evio,
Re: your post #187.
Can you express yourself in sentence form?

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18376Ytown(1254 comments)posted 11 months, 3 weeks ago

Happy: interesting story about your CR Scan. Senate testimony and all. The cost of an aspirin is just pennies but that's not what we're billed.

H.R. Is non revenue and private companies do not have stockholders.

Actually, a change to a policy does not require a new policy to be issued, especially rate increases.

"2nd Tuesday of the week" yeah. Good luck with that.

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184HappyBob(285 comments)posted 11 months, 2 weeks ago

Family members, partners,stakeholders, or individuals guiding private or closely held companies all are interested in controlling labor costs including benefits such as health. That Human Resources is or is not a profit center is immaterial.

I'd agree that a rate increase would not require a new policy. But I also think that a modification of coverage , particularly dropping a coverage element, would trigger a new agreement of the contract of coverage.

I'm just saying that I don't follow your "2nd Tuesday of the WEEK remark from post 189. What are you talking about?

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18576Ytown(1254 comments)posted 11 months, 2 weeks ago

HappBob; How many Tuesdays are there in a week?

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186dontbeafool(951 comments)posted 11 months, 2 weeks ago

Happy Bob I like you, so I am going to give you a tip. 76 will be spewing her facts, figures, and opinion on this particular thread until the ACA's 10th anniversary or until you stop commenting, whichever comes first. She will not let you have the last word. And you will have better luck, and fun for that matter, by pulling a potato out of the cupboard and debating it rather than Eivo.

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18776Ytown(1254 comments)posted 11 months, 2 weeks ago

dont'beafool:

It's called a discussion and everyone is entitled to their comments unless offensive. It's within your rights to remain uninformed or to gather the facts. If you don't like it, you don't have to read my comments or links to substantiate my claims.

Should you have any opinions to which you are qualified to contribute, please feel free to jump right in and have a high level discussion. As I've stated before, I'm flattered that you are learning something from me.

Respectfully declining to further converse with you. You are now free to have the last word.

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188dontbeafool(951 comments)posted 11 months, 2 weeks ago

@76, Usually your posts are in book form, as many pages as the ACA itself, so I usually stop reading after a sentence or two, due to boredom. The only thing that I have learned, is that you are an extreme right conservative that cannot be swayed an inch, and are determined to try to prove how Obamacare is failing before it even started.

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189dontbeafool(951 comments)posted 11 months, 2 weeks ago

Repubs had the sky falling before it even started. Yes the website is a failure, I will give you that, but that can and will be fixed. It may or may not work, but I am not falling for the Tea Bagger's doom and gloom scare tactics. Only time will tell, and I am going to give it longer than a week to give it a chance to succeed. Repubs want it to fail for political reasons and political reasons only. And with many of your posts, I have no idea what you are referring to with Baghdad Bob.

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190jojuggie(1294 comments)posted 11 months, 2 weeks ago

Virtually everyone I know has had their HOSP. policies cancelled. Mine was cancelled as of Dec 31, & the policy that I just signed up for has less to offer.
Repubs don't want it to fail for political reasons. they want it to fail because it's a terrible plan.
Remember, that not 1 Repub voted for Obamacare. I don't know of any major bill where the opposition party didn't cast at least 1 vote.
Many Repubs were against Social Security, but there were some Repubs who voted for that plan. Also, many Repubs were against Medicare, but some Repubs voted for the plan..
We just found that there is no background check for those hired to be Navigators which means that some may be criminals. Criminals exposed to Social Security numbers. WOW, that's a HOOT. Also, many Navigators are former ACORN people. That's another HOOT.

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191dontbeafool(951 comments)posted 11 months, 2 weeks ago

Nope. By now, you mean in a month? That is like judging a President's term in his first 30 days. Oh wait, you did do that. Probably not that long. And it is early, but I am liking Christie as of now.

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192HappyBob(285 comments)posted 11 months, 2 weeks ago

76Ytown,
back many posts ago you said "as long as you bought your original plan on the 2nd Tuesday of the WEEK!"

I'm still trying to figure out what you were attempting to say. Is it some sort of code, or a joke that I'm not in on?

I talked with a couple of carrier reps today who discussed the details of their offerings in the exchange. Just considering the catastrophic catagory, in some plans the PCP copay is accrued towards deductable, but in others it is not. One of the reps said that a policy holder (pre-deductable fulfillment) should expect to pay the PCPs copay PLUS 100% of the office visit charge. The also pointed out that some plans had a 200 hospital ER copay, in addition to the charge for actual services (the charge for services they would cover, the copay... not so much).

Both reps confirmed that if a service is not covered in the itemized list of covered services, their company would not pay anything even after the OOP was fulfilled.
They gave several examples of things that might not be covered that some people otherwise might think would be.

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193HappyBob(285 comments)posted 11 months, 2 weeks ago

"pulling a potato out of the cupboard and debating it rather than Eivo"

Amen to that !, besides eivo hasn't offered anything even slightly or remotely intelligent

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19476Ytown(1254 comments)posted 11 months, 2 weeks ago

Sorry it went over your head.

To rephrase, you can keep your docs and health insurance as long as you bought your original plan on the second Tuesday of the week, during a blue moon while seeing pigs fly in the sky.

Then your good.

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19576Ytown(1254 comments)posted 11 months, 2 weeks ago

HappyBob,
Be sure that when you talk to the navigators about catastrophic coverage that you mention your age since it's only available to those under 30.

HappyBob have you been talking to Sanjay? This sounds alot like a question that I answered in another thread. http://www.vindy.com/news/2013/nov/03...

Only "eligible" charges apply to the deductible or OOP. If you have cosmetic surgery after reaching your OOP max, it still won't be covered. And co-pays aren't applied to your deductible.

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19676Ytown(1254 comments)posted 11 months, 2 weeks ago

or Sebelius:

"Whatever"

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19776Ytown(1254 comments)posted 11 months, 2 weeks ago

this is strange... part of my other post is missing...trying again.

Is it really a lie if you cross your fingers behind your back? We'll have to watch his hands next time.

Or, we can ask Hillary but we already know what her answer will be...

"What difference does it make"

or Sebelius:

"whatever"

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198HappyBob(285 comments)posted 11 months, 2 weeks ago

@ 76Ytown,
OK, I get it now, it was meant as a joke

@evio,
It's entirely possible that there is more than one person who thinks your input is inane.
Perhaps if the seniors did beat you with their canes (see above post) that you might revert to actually contributing something to the conversation.

I don't agree with 76Ytown's conclusions, at least most times she offers some substance and background.

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199HappyBob(285 comments)posted 11 months, 2 weeks ago

@76Ytown,

I can agree that "you can keep your doc..etc" was not a good political statement. But I hardly think that it rises to the level of a lie
Each time I heard it I cringed, because I knew that it would be blown out of proportion and out of context and characterized as a lie.

As I understand your prior postings, your mom "lost" her doctor or will have to change her insurance. Can you say that was because of ACA?

Doctors leave networks, carriers negotiate with doctors to stay in network or not. The cause of your mothers situation was because that negotiation was not successful. I don't think that you can conclude that ACA was the proximate cause of her either losing her doctor or having to change into a new network.

People have "lost" their doctors or the insurance they "like" with common regularity in the past, way long before ACA.

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200HappyBob(285 comments)posted 11 months, 2 weeks ago

@76Ytown,
I headed over to that other conversation, and I guess that sanj and I had similar concerns about the application of deductables to out of pocket.

But as I said in post 203, (based on my direct questioning) the exclusion of copays from oop accrual is not universal even within the same carrier at the same catastrophic catagory. The concern I have is that it is still very difficult to do a apples to apples comparison with out the "nitty-gritty details"

I actually called Anthem and asked to speak with one of their reps, I don't know if you would consider him to be a "navigator" or not. I presumed that he was employed by Anthem, and not a federal employee (or volunteer).

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201dontbeafool(951 comments)posted 11 months, 2 weeks ago

ALL politicians lie. Conservatives, liberals, middle of the roaders....ALL. You are naive if you think otherwise. Yeah, resist the liars programs, good idea. Don't enroll, change your withholdings so you don't get a return, then the IRS won't be able to collect your fines. Do that Eivo... Watch your fines from the money you owe the IRS rack up. See you in prison for not paying your taxes. But the good news is that Fed inmates only have a $2 co pay for their medical needs.

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202dontbeafool(951 comments)posted 11 months, 2 weeks ago

go ahead and try it. I supervise a bunch of inmates who didn't pay the government's ransom in the form of taxes.

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203dontbeafool(951 comments)posted 11 months, 2 weeks ago

oooh, I didn't know that because I don't listen to that pill popping, hypocrite, Rush L. I see that is his loop hole and where you got the info. How long do you think that it will take for the Government to fix that loophole? The government will get their money one way or another, believe me. But by all means, don't sign up and take advantage of it while you can. You will be as good as the moochers that you complain about.

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20476Ytown(1254 comments)posted 11 months, 2 weeks ago

HappyBob:
- My mom's ins with AARP/United Healthcare dropped 2 of her 3 doctors and searching online doesn't unearth the reasons other than THOUSANDS of doctors have been dropped from the network nationwide. Even the doctors were not given an explanation and it's important to note that the doctors did not decide not to accept the contract, it was UHC, the ins. co. that decided to drop the doctors.. Once the open enrollment ends, folks won't be able to change their plan till the next year and I wonder how many seniors are savvy enough to know that means more out of pocket cost to them? Does it have to do with the ACA? Don't know because Medicare is is a totally different animal.

- Co-pays and co-insurance are two different things. A co-pay does not apply to the OOP. That's the amount you pay at the dr's office at the time of your visit. Co-insurance is the percentage that you pay after insurance approves the bill, like in a plan that pays 80%, you pay 20% and that is counted to your OOP as long as it was an eligible charge.

- When speaking to Anthem you are most likely speaking to an Anthem employee however you are going to get info based on their knowledge and expertise. The govt website has navigators recently hired to answer questions. Of course, technology allows all of them to access a knowledge base on the computer if they don't actually know the answer. Every plan is different and can be underwritten according to need except the must include the 10 essentials in all plans.

The statement that you can keep your plan is still on the Whitehouse website (2nd paragraph) Someone didn't get the memo! LOL http://www.whitehouse.gov/healthrefor...

- The ACA website asks "would like to register to vote?" What's that got to do with your healthplan?

- We should be hearing from Sebelius very soon about the number of enrollees in Obamacare. I want to see the number of Medicaid eligible vs paying enrollees.

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205Jerryl(105 comments)posted 11 months, 2 weeks ago

all,
So 76Ytown told us that you have to be under 30 to purchase catastropic coverage.

76 neglected to mention that there are at least twelve exceptions to that.

Does that make 76 a liar? I don't think so. I simply means that 76 did not include all the details.

evio, you seem to be obsessed with the liar meme and how to wriggle out of accepting your role in society. When the elders come to beat you with a cane, I'll be right there with them.

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20676Ytown(1254 comments)posted 11 months, 2 weeks ago

Obamacare promise. Get high quality affordable health care for less than your cell phone bill:
http://www.youtube.com/watch?v=Mcyv1R...

Obamacare only works if young people sign up but he forgot that young people are still on their parent's health plan until age 26...even if married.

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20776Ytown(1254 comments)posted 11 months, 2 weeks ago

Jerry1: Thanks for the info. about the 12 execptions, From the website

People 30 and over who have received a hardship exemption may be able to buy a catastrophic plan. Hardship exemptions from paying the penalty are granted to some people based on income or other circumstances that prevent them from getting coverage.

Here are the exceptions.
1. You were homeless.
2. You were evicted in the past 6 months or were facing eviction or foreclosure.
3. You received a shut-off notice from a utility company.
4. You recently experienced domestic violence.
5. You recently experienced the death of a close family member.
6. You experienced a fire, flood, or other natural or human-caused disaster that caused substantial damage to your property.
7. You filed for bankruptcy in the last 6 months.
8, You had medical expenses you couldn’t pay in the last 24 months.
9. You experienced unexpected increases in necessary expenses due to caring for an ill, disabled, or aging family member.
10. You expect to claim a child as a tax dependent who’s been denied coverage in Medicaid and CHIP, and another person is required by court order to give medical support to the child. In this case, you do not have the pay the penalty for the child.
11. As a result of an eligibility appeals decision, you’re eligible for enrollment in a qualified health plan (QHP) through the Marketplace, lower costs on your monthly premiums, or cost-sharing reductions for a time period when you weren’t enrolled in a QHP through the Marketplace.
12. You were determined ineligible for Medicaid because your state didn’t expand eligibility for Medicaid under the Affordable Care Act.

Catastrophic care:https://www.healthcare.gov/can-i-buy-a-catastrophic-plan/

Keep in mind that catastrophic plans keep you protected from very high (catastrophic) health care costs. They have a lower premium but a very high deductible which means you pay for all health care until you meet the deductible with the exception of possibly 2 or 3 office visits for the year at no cost.

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208Jerryl(105 comments)posted 11 months, 2 weeks ago

You didn't need to go all through that.

My point is that you are not a liar,, because you stated the case that is true, but slightly inaccurate.

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20976Ytown(1254 comments)posted 11 months, 2 weeks ago

Thank you Jerry, I understand you point.

I posted the exceptions.in case it might be useful for some. (copied/pasted from the website so it only took a minute)

I think that it's obvious according to my posts that I'm not a fan of the direction the ACA is taking us. There is so much info we need to know about it yet so many rely on talking points rather than exploring the facts.

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210dontbeafool(951 comments)posted 11 months, 2 weeks ago

Don't you mean snake? It finally hit me!!! Eivo really wants to be a mooch on society and get something for nothing. Now you have your chance to do it and you get to blame someone or something for it. I bet you don't even have a job, talking about the workers and takers all the time. Now it all makes sense.
@76, I will be a man and apologize. I don't agree with your style, I think you just reminded of my ex mother in law, that is why I was rough on you. Lol. Everyone has their opinions, and at least you articulate your comments well. Now don't comment back because you gave me the last word. :-)

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211HappyBob(285 comments)posted 11 months, 2 weeks ago

76Ytown,
Very interesting article at:
http://www.propublica.org/article/ans...

It discusses why two Obama loyalists lost their health policies.

There are some really interesting facets (like Kaiser and Blue Cross asking to be allowed to cancel policies for some 900,000 that were to otherwise supposed to be cancelled)

But the really central point is one that is easy to overlook, prior to ACA carriers had the ability to cherry pick from the applicants within an age group to decrease the carrier's exposure. After ACA they have to accept all applicants (within age and smoking groups) alike.

Quoting from the article... prior plans "were medically underwritten, meaning that it carefully chose members based on their health status. The Affordable Care Act eliminates such screening and requires that insurers take all comers. “Because their current insurance pool is comprised of healthier people who use fewer medical services, the premium level needed to pay for those services is also less,” Stenrud (Kaiser Permanente spokeperson) wrote."

Very interesting and well documented article.

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21276Ytown(1254 comments)posted 11 months, 2 weeks ago

Do you think he'll apologize for saying "You’re going to be able to purchase high-quality health insurance for less than the cost of your cell phone bill"

Or for "We'll lower premium by $2500 for a typical family per year"?

There's going to be a heck of a lot of back-peddling.

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213HappyBob(285 comments)posted 11 months, 2 weeks ago

@76Ytown,

Have you shopped for a replacement for your 1100/mo policy?

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214dontbeafool(951 comments)posted 11 months, 2 weeks ago

I found this to be a very good read. Maybe instead debating about dollars and cents, premiums, and coverage, everyone should take a look at the human aspect of things.
http://religion.blogs.cnn.com/2013/11...

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215jojuggie(1294 comments)posted 11 months, 2 weeks ago

Obama on Insurance Cancellations: People Will Be Better Off, They Just ‘Don’t Necessarily Know It’ Yet

Can you believe this statement?

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21676Ytown(1254 comments)posted 11 months, 2 weeks ago

HappyBob, I may not need to if I can keep my plan.

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217HappyBob(285 comments)posted 11 months, 2 weeks ago

I thought a while back that you said that your 2014 prem was going to be increased from 500 to 1100/mo.
OUCH!

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218jojuggie(1294 comments)posted 11 months, 2 weeks ago

The Obama administration has been claiming that insurance companies will be competing for your dollars under the Affordable Care Act, but apparently they haven’t surveyed the nation’s top hospitals.

Americans who sign up for Obamacare will be getting a big surprise if they expect to access premium health care that may have been previously covered under their personal policies. Most of the top hospitals will accept insurance from just one or two companies operating under Obamacare.

“This doesn’t surprise me,” said Gail Wilensky, Medicare director for the first Bush administration and senior fellow for Project HOPE. “There has been an incredible amount of focus on the premium cost and subsidy, and precious little focus on what you get for your money.”

Regulations driven by the Obama White House indeed have made insurance more affordable – if, like Kathleen Sebelius, you’re looking only at price. But responding to Obamacare caps on premiums, many insurers will, in turn, simply offer top-tier doctors and hospitals far less cash for services rendered.

Watchdog.org looked at the top 18 hospitals nationwide as ranked by U.S. News and World Report for 2013-2014. We contacted each hospital to determine their contracts and talked to several insurance companies, as well.

The result of our investigation: Many top hospitals are simply opting out of Obamacare.

Chances are the individual plan you purchased outside Obamacare would allow you to go to these facilities. For example, fourth-ranked Cleveland Clinic accepts dozens of insurance plans if you buy one on your own. But go through Obamacare and you have just one choice: Medical Mutual of Ohio.

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219Jerryl(105 comments)posted 11 months, 2 weeks ago

I'm here also, and I see that you are still trolling.
I might agree with you but I don't have to be disrespectful to gain attention.

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22076Ytown(1254 comments)posted 11 months, 2 weeks ago

HappyBob, Yes, I'm one of the 12 million responsible citizens with an individual health plan that was pushed out of their current plan because Obama lied, my health plan died. No, this was not a "substandard" or "lousy" plan. I chose not to have coverage for maternity, pediatric dental and vision and substance abuse. My plan would have been more expensive had I elected the add on's and the new rates include the cost for these unnecessary benefits. If they approve a delay, my family should be able to keep our $508 mo individual policy.

This is a total disgrace that Pelosi said "you have to sign the health care bill so we can find out what's in it" and they voted it through without reading it.

It was the stonewalling by the POTUS and the Senate over the House of Representatives request for a delay that caused the partial shutdown, yet the Republicans were blamed.

Now we have the website fiasco, the cancellation of plans, waivers, exceptions, changes, and this is just the tip of the iceburg when the one year employer delays are up. I'll bet they regret not taking the offer.

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221HappyBob(285 comments)posted 11 months, 2 weeks ago

76,
Does that mean that you are going to hope for a delay?

In the meanwhile, have you shopped on the exchange. I should think that a family of 3 should be able to get an exchange policy in your current price range.

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22276Ytown(1254 comments)posted 11 months, 2 weeks ago

HappyBob,

A delay would be good, a defunding even better.

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223dontbeafool(951 comments)posted 11 months, 2 weeks ago

Never said it was a great law/program. Show me where I have. In fact, I have stated that it could be good or bad, but it would take time to tell, and people to not intentionally trying to sabotage it. And eivo, I take from not responding to my previous comment about you probably not having a job and now you have an excuse to be a taker, that I probably hit the nail on the head. I also noticed nobody had a comment about my religious point of view article. Probably because when you all are sitting in a pew tomorrow, you don't want to face your own hypocrisy. It is okay to have millions of people, a lot of who are working and have medical conditions, to have NO medical coverage at all, as long as you don't have to pay one penny more for yours. God forbid you may have to give up a night out to dinner.

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224HappyBob(285 comments)posted 11 months, 2 weeks ago

@76Ytown,
Based on what you told Comso1976 a couple of weeks ago, it looks like your family is probably mid twenties with one minor child. (Silver at 555/mo for your family)

Check out:
http://www.valuepenguin.com/ppaca/exc...

You have 10 silver options that range in price from 550 to 668/mo

you have 15 bronze options that range in price from 426 to 555/mo

You have 4 catastrophic options that range from 286 to 404/mo.

Depending on the choices that you make you could actually save money on the exchange compared with your 2013 premium, and well below your current carriers offer of 1100/mo. for 2014

Of course these premiums are assuming that you family income exceeds 70,500/year. If not, then the savings are even more.

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22576Ytown(1254 comments)posted 11 months, 2 weeks ago

HappyBob: Happy guessing on my age. LOL No, you didn't guess right.

You're not trying to sell me on Obamacare are you?

I'd much rather not change my current plan, I'd much rather not receive subsidies or have the government tell me what is best for me. I'd much rather see our government provide a safety net for those that need help rather than to deteriorate our middle class. I'd much rather address the cost of health care, fix the pre-x limitation problems, and provide coverage to the uninsured. By the way, Obamacare does not even begin to address the millions of uninsured illegals. And lastly, I'd much rather not have to provide all of my personal information to the data collection exchange in order for them to collect and share with the IRS, DOD, HHS, SSA, VA, DHS and the Peace Corps.

There are many people who cannot work for various reasons, but for those who can, the lack of jobs, the reduction in work hours and erosion of pay scale is fundamentally changing America.

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226dontbeafool(951 comments)posted 11 months, 2 weeks ago

That's your problem eivo, unless Rush gives you an extreme right thought, you can't have one on your own. Closed minded. If you would have read the article, it talked about the many WORKING poor people who fall into the uninsured gap. But never mind, go back to your coloring book until Rush comes back on the radio.

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227HappyBob(285 comments)posted 11 months, 2 weeks ago

@76Ytown,
Obviously I misunderstood your comment a couple of weeks ago to Comso1976 when you said :

"The only way to get a government subsidy or to keep my costs close to what they were before ACA is to enroll in the exchange."

But you are entitled to stand on principle, and not save money for your family.

As far as confidential information sharing is concerned, have you ever heard of the MIB Group Inc. Did you really think that your medical records were not shared with others?

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22876Ytown(1254 comments)posted 11 months, 2 weeks ago

HappyBob, The trouble with the "entitlement society" is that it's all about "me, me, me" People don't care about the consequences, they just "want, want, want". The fact that our country has a national debt of over 17 trillion 186 billion dollars should be a concern to all of us. In past generations, there was a certain pride in taking welfare. Obamacare has eroded the middle class since you can now earn up to 400% of the poverty level and still get some sort of subsidy. We are subsidizing health insurance premiums not controlling the cost of health care.

I'm very familiar with the MIB as well as HIPAA and we'll throw in FCRA. The laws are very specific as to what information can be shared, whom it can be shared as well as providing you notice when or where it will be shared.

The Federal Data Hub (exchange) is far reaching and allows information accessed and shared with 7 other agencies and you cannot opt out. http://www.youtube.com/watch?v=IDPDGm...

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229HappyBob(285 comments)posted 11 months, 2 weeks ago

@76ytown,
Suit yourself, but I'm not certain that you are required to accept a subsidy.
You can also elect to purchase off-exchange.

Btw, MIB is not subject to HIPAA regulations. (Per www.privacyrights.org)

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230HappyBob(285 comments)posted 11 months, 2 weeks ago

@76

You might want to check this out:

“I didn’t want my new plan to be a part of a subsidized government-mandated health care,”
http://www.factcheck.org/2013/11/the-...

Be sure to read the whole article, because it eventually has a happy ending.

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23176Ytown(1254 comments)posted 11 months, 2 weeks ago

HappyBob: MIB (Medical Information Bureau) is used for life insurance applications but also for health insurance, LTD or Long Term Care policies.

In order to access your information from the MIB, a HIPAA compliant authorization form must be signed by you giving the insurance company access to your information so yes, they are subject to HIPAA regulations.

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23276Ytown(1254 comments)posted 11 months, 2 weeks ago

Yes and it shows how much misinformation is out there. As if health insurance wasn't complicated enough for the lay person, enter Obamacare. Next thing you know, we'll need people to handle our health insurance questions much like we have tax preparers to handle our tax forms. Oh wait... that would be the new "navigators".

This guy started out believing that he'd be OOP $26,000 but didn't know that was because his doctor would be out of network. His in network OOP was $4500.

Then it goes on to say that the new plan cost less but doesn't have a specialty prescription drug benefit for cancer drugs. OUCH! For someone with leukemia he might want to ask a few more questions before buying that plan before we decide whether it's a happy ending.

And the media doesn't always have responsible news reporting. They tend to sensationalize and get everyone all worked up without checking the facts.

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23376Ytown(1254 comments)posted 11 months, 2 weeks ago

Speaking of options, you may not be aware but for years, people have joined "medical cost sharing programs". Although not an insurance company, they resemble the concept. You pay an amount each month into a pool. Should you have an illness or injury that is greater than a certain amount (much like a deductible) you would then send the request for the charges to be paid out of the pool. The idea is that you can handle the small bills, but you want protection against large losses. These groups are actually exempt from the ACA.

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23476Ytown(1254 comments)posted 11 months, 2 weeks ago

HappyBob, Since you are eligible for Medicare, Obamacare won't directly affect you.

One problem I have with the whole ACA program is that I find it hard to see how this is going to be affordable to individuals and how our government is better off spending money through the administration of the website, the navigators, the extra involvement of so many other governmental agencies, and the subsidy of insurance premiums for people up to 400% of the federal poverty level which for a family of 4 is $94,200 and goes up an additional $16,000 for each additional family member. http://www.familiesusa.org/resources/...

Had we looked at ways to curb health care COSTS it would be more affordable for all. It would cost less to subsidize the medical claims for those without health insurance than to create this grandiose and unrealistic program.

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235thinkthentalk(265 comments)posted 11 months, 2 weeks ago

Really eivo! 3 full pages, with benefits no less! I checked it out. Youre right! Lots of opportunity for those people if they just "WANTED" to work.

I skimmed over the ads. I have a job, im not looking. But i thought of this. How about if YOU take up THIS challenge. Tell us which jobs that YOU would apply for if you were down on your luck and on welfare. And please be truthful. Understand that maybe, just maybe, you werent that book smart and didnt go to college. Lets go with that assumption. A lotta people out there like that. Like they say, the world needs ditch diggers too. Gotta be a lot of jobs for you, heck, 3 full pages!!!
How about that Structural Engineer ad. That looks pretty good, pays well, clean office job. Thats the one id go for. I can picture you and 1000 welfare queens showing up at walter sobchaks place at 8:00am tomorrow. walts pretty good, he'll show ya the ropes.
Woho! and look at all those truck driving jobs. Ya think you can handle one of the big rigs? As easy as it looks? Hey, get off your butt and show up there and apply ya lazy bum. Even if ya never driven a truck before. See what they tell ya. No CDL? Well dammit, shell out $1K and go to truck driving school. Dont have the $1k?. Eh, we'll work on that....
Oh look, theres a lot of nursing jobs. But doggone it, i bet you dont have a nursing degree. Eh, go ahead, apply anyway. All ya gotta do is hand the doctor a scapal and give people their pills, shots. Tell 'em you got experience, you seen nurses do it on tv lots of times, on the couch watchin tv all day. You'll do fine.
Hey, here ya go! Look at all the telemarketing opportunities! I wonder why they are always hiring? Probably because when me and everybody else in the world have to get up off the couch to answer the stupid phone, we threaten to choke the guy if he calls again. Maybe theres a lot of stress involved, lotta turnover. Go in with a good attitude man.
Fitter welder. mmmm.... How hard could that be.... Home all day playing X-Box, adept fingers,eye coordination... go for it! Theyre lookin for guys like you.
Oh, honey, look at this bank manager job. Yeah, i want that one. Thanks eivo for encouraging me. Im on welfare, so, i should be REALLY qualified! No takers for that one for months? Chances are lookn good to land that one!!!!

So tell me, if you had some bad luck and lost your job, which ones would YOU go for? Come on man! Theres 3 full pages. Enough jobs for ALL of the 7.35% unemployed.
Just like you, i cant understand why these people just dont wanna work!

Challenge. After eliminating the SKILLED jobs, Tell us the exact number of jobs that there are that these lazy bums are qualified for. Tell us all how many, if any, jobs in ALL 3 PAGES that a welfare king and queen is qualified for. Just curious, 10, 100, 1000? 47% of the population doesnt want to work and should get off the dole ya know..... Please show them the way.

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236thinkthentalk(265 comments)posted 11 months, 2 weeks ago

God bless those employers. I wish them and the successful applicants well, and my sincere hopes for the unsuccessful applicants.

So lemme see, 11 ads.
Lets hit the pavement tomorrow bright and early before they get taken. 5 are looking for one person. Heck, i bet theres a go-getter that might apply and take 2 of the jobs. Work at the counter in the am, make donuts at night.
Maybe the other 6 ads are looking for, what, 5 people at each position? Awright!l, thats 35 people off of welfare.

Or most likely, 35 people from the 7.3% of the unemployed competing for those jobs. I bet they get first dibs.

What can you do for the rest? What else do you have for all your alleged welfare cheats. Where in your dream world are all the plentiful jobs that you claim to exist for them? You just proved that they are not there.
Is 35 jobs gonna eliminate the welfare drag? solve your problem? Wow, youre a genius. You figured it out when nobody else could. Hey, run for congress if its that easy. Ill vote for ya.

You make it sound like there are SOOOO MANY jobs and SOOOO MANY people that DONT want to work. How many? Give us an actual fact based number. How many cant work? Then subtract 35 from that number.
My point is, you are wrong when you make a general statement that 100% of the people on welfare do not want to work.

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23776Ytown(1254 comments)posted 11 months, 2 weeks ago

The current welfare system acts as a deterrent to work.

http://object.cato.org/sites/cato.org...

In the state of Ohio:

The welfare to work Hourly Wage Equivalents: $12.60. (table 3)

Pretax Wage Equivalents Compared to Median Salaries: 80% (table 4)

Welfare Benefits Packages as Percentage of Federal Poverty Level (FPL) is 141.1 % (table 5)

Total Value of Welfare Benefits (table 14)
TANF SNAP HOUSING MEDICAID WIC LIHEAP TFAP TOTAL
4,920 . 6,312 . 8,152 ..... 7,857 ...... 864 .... 317 . ..300 ... 28,723

Welfare Benefits, Taxes and Pretax Wage Equivalents (table 15)
Total Welfare Benefit Package: $28,723
Pretax Wage Equivalent: $26,200
After Tax Income: $28,722

Remember, it's not what you make but what you keep. By the time you deduct federal, state, local, social security and insurance deductions you are lucky to see 1/2 of your gross income.

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238Sensible(118 comments)posted 11 months, 2 weeks ago

Wow,
Has this thread been hijacked!

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239southsidedave(4784 comments)posted 11 months, 2 weeks ago

For the most part, I think people want to work. My problem with the welfare system is that it "rewards" recipients for having more children, but it is the children who suffer the most.

Who can realistically live on the dollar amount of food stamps that are allotted each month?

It is easy to judge others who collect public assistance if you have never walked in their shoes.

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240HappyBob(285 comments)posted 11 months, 2 weeks ago

This thread has been hijacked !

What does eivo's obsession have to do with Medicare and Obamacare?

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241Sensible(118 comments)posted 11 months, 2 weeks ago

evio is concerned that some of the 900,000 veterans that are getting food stamps are not looking for jobs.

Or that folks who are eligible for medicare are happy with the government being in the health business.

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242HappyBob(285 comments)posted 11 months, 2 weeks ago

In Internet slang, a troll (/ˈtroʊl/, /ˈtrɒl/) is a person who ... posting extraneous, or off-topic messages in an online forum, with the deliberate intent of otherwise disrupting normal on-topic discussion.

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24376Ytown(1254 comments)posted 11 months, 2 weeks ago

SlapHappy...it was "Fool" that changed the topic of the thread to the working poor.

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244dontbeafool(951 comments)posted 11 months, 2 weeks ago

@76, but it was in the context of Obamacare and the link to the artical that I attached. The one nobody would read because it dealt with the religious view of helping those in need. It wasn't from Hannity or Rush either, so it wasn't worth reading apparently.

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24576Ytown(1254 comments)posted 11 months, 2 weeks ago

dontbeafool: Did we kiss an make up? I guess so because we are back to talking.

I read the article about the coverage gap, the poor and churches. Churches have always been able to take care of the poor a lot more efficiently than the government. I do know firsthand that at Andy Stanley's church in GA last year, he challenged his church to raise $1.5 million. In the TWO DAY campaign, they exceeded their expectations raising $5.2 million. The church in turn gave all of it away to other charities who most able to help those in need.

"In late 2012, North Point Ministries' five churches and 17 strategic partners raised over $5 million in just two Sundays through their "Be Rich" campaign, with all of the money going directly to 92 different local charities. These nonprofit organizations – which are tackling a wide range of challenges from foster care and inner city education to homelessness and sex trafficking – were carefully selected based on their specific needs, impact in their communities, and potential for church members to volunteer with their projects on a long-term basis."
http://www.christianpost.com/news/and...

As far as Obamacare. no matter how much they encourage people to buy insurance they'll still have people that won't. Some can't afford it, some...just irresponsible, and some will buy but won't be able to pay the OOP expenses. Subsidizing premiums instead of lowering costs is not the answer.

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246dontbeafool(951 comments)posted 11 months, 2 weeks ago

@eivo, how did you know if it was off topic, when your refused to even read it? You seen CNN and you didn't bother reading it. It is called being closed minded. @76, if your handle isn't your age, I will consider kissing and making up. Churches do give to charities, well understood, but they will come nowhere close to providing coverage for uninsured medical costs. I just find it funny that some of these mega church frauds live in multi million dollar homes, and live lavish lifestyles as a pastor, but won't as much comment on the topic because they are afraid of losing followers, AKA money.

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247HappyBob(285 comments)posted 11 months, 2 weeks ago

See evio's first post to this thread at #30. That was 3 weeks five days ago.
"The freeloaders won again"

This has been evio's recurrent/obsessive topic.

As to "lefties" getting their story straight, as I recall in post #203, evio was claiming that don't- be- a- fool and I were the same person agreeing with one another.

I'm interested in discussing how health care costs and HC insurance premiums are able to be held in check or possibly reduced. I'm interested in hearing about Obamacare (pros and cons) and if it is possible that 10 years from now Insurance exchanges and standardized policies will be as acceptable as Medicare is today.

76 has forced me to do some research by having brought up subjects and ideas. While I might not agree with everything that 76 has brought up, her contributions have been substantive.

Evio, not so much.

Can you get over your "freeloaders" and "loafers" obsession, or at least disclose to the rest of us how you would eliminate those folks from using healthcare dollars?

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248HappyBob(285 comments)posted 11 months, 2 weeks ago

The hospitals contend that the users of the ER, be they able bodied or not, are a huge contributing factor to overall costs.
The ER is a monumentally expensive department to equip and staff, regardless of the employment status of the patients.

(see I was able to discuss my comment without resorting to name-calling).. it wasn't painful)

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249HappyBob(285 comments)posted 11 months, 2 weeks ago

Hospitals have long contended that if everyone coming to the ER was fully insured (or had the ability to actually pay the bill) that they could lower charges.

Their charges are based on the cost to operate plus the burden of covering costs for those who do not or will not pay.

There is no significant argument (Rs & Ds) that a key element to getting control is reducing the number of uninsured. The republicans (seen from their proposals) appear to acknowledge that governmental intervention is going to be necessary, because private business has not (and perhaps can not) do it.

So whether you are talking about the "legions" of federal bureaucrats from Obamacare or (what would have been) Romneycare it's pretty much the same thing, the government is going to have to wrestle to control healthcare costs.

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25076Ytown(1254 comments)posted 11 months, 2 weeks ago

The fastest way to lower ER costs is to steer people in the direction of urgent care centers if they can't visit their doctor. Urgent care centers are popping up drug stores and stand alone centers.

People don't consider the cost when they end up at the door to an ER. They only think about the fact that 1. It's open in the middle of the night or weekends. 2. They don't have to wait for a dr's appointment. 3. They can't be turned away. 4. Someone else will pay for it.

Convenience is not a legitimate reason. By the time you walk in the door of the ER, you've run up a $1000 bill. vs the doctor's office of less than $100.

We all need to become better consumers whether you have health insurance or not. Insurance plans have a separate co-pay for ER visits that you won't incur if you go to urgent care. High deductible health plans mean you pay out of your pocket so it's in your best interest to control costs

No doubt, some situations require emergency care but treatment but for stitches, sprain/strain, flu, stomach ache, headache and toothache you could be seen by a doctor somewhere other than the ER.

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251dontbeafool(951 comments)posted 11 months, 2 weeks ago

Did you know that from 2008 to 2013, premiums rose by an average of 5.8 percent per year. But between 1999 and 2008, premiums rose by an average of 13.2 percent a year -- in other words, twice as fast as premiums rose under Obama. This is according to Politifact.com. Where were Republicans and their great plan to reduce costs? All they did was make generalized statements but with no specifics. The main reason Obama was elected the first time was because of the enormous expense of healthcare at the time, and people wanted reform. That was the Rebublicans time to shine, but they offered no solutions.

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252jojuggie(1294 comments)posted 11 months, 2 weeks ago


Remarks as they will be found in the history books..

Nixon
I am not a crook.

Clinton
I did not have sex with that woman.

Bush,Sr.
Read my lips.

Obama
I will have the most transparent administration.

I have shovel ready jobs.

The IRS is not targeting anyone.

It was about a movie.

If I had a son.

I will put an end to the type of politics that breeds division, conflict and cynicism.

You didn't build that.

I will restore trust in government.

The cops acted stupidly.

I am not after your guns.

The public will have 5 days to look at every bill that lands on my desk.

It's not my red line it is the world’s red line.

Whistle blowers will be protected.

We got back every dime we used to rescue the banks, with interest.

I will close Gitmo.

I am not spying on American citizens.

ObamaCare will be good for America.

You can keep your family doctor.

Premiums will be lowered by $2500 a year---every year.

You can keep your current healthcare plan.

I, Barrack Hussein Obama pledge to preserve, protect and defend the Constitution of the United States of America.

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25376Ytown(1254 comments)posted 11 months, 2 weeks ago

Did you know that 2008 is about the time that high deductible health plans gained in popularity? The rates for these plans dramatically dropped the premiums to a fraction of what they were with a traditional health plan. The higher the deductible the higher the premium savings because they shifted the risk from the insurance company to the insured.

You have to compare PPO to PPO or HDHP to HDPH to know the rate of increase which is why I dislike "averages".

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254HappyBob(285 comments)posted 11 months, 2 weeks ago

eivo,
Post 281. Annenburg makes the same point, you know the factcheck.org that Dick Chaney liked to quote.

76Ytown,
I agree with the averages comment, it may be detailed but you got to know if like things are being averaged.

I personally did not see anything other than an increase in premiums in the 2008-2009-2010 era. Were those reductions you mentioned limited to a segment of the HC insurance market?
Do you have a link for that info?

76Ytown, you raise an valid discussion point about urgent care centers. I've not read the whole item yet, but here is an interesting link:

http://www.debt.org/medical/emergency...

I've no doubt that Urgent care utilization can save $ for the consumer; and your right that becoming a better consumer is something that we all need to practice.

But a real distinction exists between UC and ER. Prima Healthcare operates three UC (called Express Care) here in the area. None of them is open after 5pm to 8am, none are open on Sunday, and holidays are closed as well. They will take most insurance (their website spells out the insurance they won't accept), and if you are private pay there is a 85$ charge to be paid in advance of care.

They have every right to turn away anyone they don't want to serve. As different from the Hospital ERs, they are not required by law to provide care.

All that aside, if the fraction of current Hospital ER patrons divert to UC, leaving a larger proportion of uncovered patrons to go to Emergency Rooms does that improve the financial situation at the ER?

" Even with its high costs, however, the percentage of the country’s total health care spending on emergency care is actually very small. According to the Agency for Healthcare Research and Quality, in 2008, when the nation’s total health care expenditures was approximately $2.4 trillion, all services provided in American EDs, including physician services, was $47.3 billion –barely 2 percent of the overall amount."

and
"It is estimated that more than $18 billion could be saved annually if those patients whose medical problems are considered “avoidable” or “non-urgent” were to take advantage of primary or preventive health care and not rely on ERs for their medical needs."

Lastly, I'd be wary of an urgent care center "popping up" at my local drug store.

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25576Ytown(1254 comments)posted 11 months, 2 weeks ago

Premium increases are tied to health care costs and as long as costs continue to rise....well. We should be looking at the COST of health care instead of premiums. A drop in averages from 13.2% to 5.8% just shows that the shift to HDHPs slowed the increases in premium cost.

~2011 "Among workers offered health benefits, 17 percent are enrolled in a high-deductible health plan with a savings option, an increase from 13 percent in 2010 and 8 percent in 2009, researchers found."
http://www.bloomberg.com/news/2011-09...

HappyBob,
~The urgent care link is very good info. Something that can be easily fixed is to add after hours/weekend access to urgent care doctors.

~The argument that diverting paying patients to urgent care would cost the hospital doesn't float. People without insurance who can actually pay are able to negotiate discounts with urgent care centers, and are also better off avoiding the high cost of ERs. The only uninsured segment that would be a drain on the hospital are those that can't pay at all... that's when the hospital takes their write-offs.

~ "In 2008, ER costs were only $47.3 billion, 2% of overall healthcare costs." So it doesn't matter that there is waste in that area? If $18 billion is saved, that's a pretty impressive number compared to the original cost of $47.3 billion.

~If you could be seen by a licensed practitioner at a clinic, why not go there for minor emergencies like cuts, sprains, fever, sore throat, bronchitis, earache, flu, insect bites and stomach aches when your doc's office is closed or they can't fit you in. You don't have to go to the ER for a broken bone, stitches or any of the above.

~ There's a Minute Clinic at CVS on Market Street
Clinic Hours:
Mon – Fri 9am to 8pm
Sat 9am to 5:30pm
Sun 10am to 5:30pm

Practitioners take a daily required lunch break from approximately 1:30 to 2:30pm Mon – Fri and 1 to 1:30pm Sat – Sun.

ValleyCare Urgent Care, Austintown
20 Ohltown Road
Austintown, Ohio 44515
330-884-1500
7 a.m.-7 p.m. - Everyday

dontbeafool...it means reconcile differences. And no, not old enough for medicare either.

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256dontbeafool(951 comments)posted 11 months, 1 week ago

The percentage facts were brought up because the GOP's lastest fact that they are throwing out is that healthcare has risen 29% under Obama. The Politifact numbers I gave was in response to.. Ok 76, you are President, lower health care COSTS. What is your detailed plan? Tort reform? Let us hear it. And I know that it means reconcile differences, it was a funny, ha ha, a joke, a little sarcasm.

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257HappyBob(285 comments)posted 11 months, 1 week ago

76Ytown,
Your last post #283...

My perspective is that overall healthcare costs are the sum of the actual costs for services and supplies to direct providers plus profit.

My cost for healthcare is the sum of the bills I pay to direct providers plus the premiums I pay for HC insurance. If my healthcare insurance provider is obligated to pay out at least 85% of premiums collected to medical care providers, or return the difference to me, than I have saved some money and my healthcare costs are lower. A step in the right direction to be sure.
*******
The effect of doubling the enrollment in HDHC-employer plans no doubt contributed towards a slowdown in the increase in AVERAGE employer based premiums. Although I not thoroughly convinced that the enrollment was elective on the part of the employee. One of my western relatives says that their family coverage was changed (by employer) last year to a 5,000 per person deductable plan. That was the only plan available through their employer. Since there was some subsidy for that they accepted it.... but not happily.

HDHC with HSA maybe a good option for some folks and overall may be another good step toward reducing the individual's healthcare costs.

***Notice that so far we haven't discussed reducing the cost of healthcare at the provider level, we've just played with insurance.***

So enter now the tort reform suggestion. Providers have argued that a massive portion of their business cost is paying for malpractice insurance. They say that if their malpractice insurance premium were reduced they could cut their patient's charges. Several states have experimented (for several years) with tort reform and none have achieved the desired effect, reduction in patient's bills.
(also notice how the issue loops around to the insurance industry again)

I don't know if we should give up on the malpractice insurance issue, possibly have the government take over the malpractice business. Interesting but not a likely scenario.

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258dontbeafool(951 comments)posted 11 months, 1 week ago

and of course, all savings for the doctors and insurance companies will be directly passed on to you and I, the patient. All that will happen is more profit will go into their pockets. It is the free market that you love so much. Cost savings equals larger profits, regardless of how you get the savings. Lets do tort reform so if a doctor is negligent and kills someone, or amputates the wrong limb, then the person suing has to settle for a capped amount. What happened to letting the legal system decide cases. What is the proper amount to award you if the Doc neglectfully kills your wife? 100k, 500K? I think Doctors would be more negligent knowing that it would be harder for people to sue. Yes there are a lot of people who sue to try to get some easy money, but the last time I looked, they needed to prove their claim in a court of law. The only thing I would possibly change with that, is if the law suit is frivilous, then the plantiff must pay fees or a penalty steep enough to discourage frivilous suits.

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259HappyBob(285 comments)posted 11 months, 1 week ago

Urgent Care facilities are like any other business- they are in business to make money. If there were no profit incentive to be open overnight or on weekends, it won't happen. And I doubt that the State or Federal government would/could order them to be open.

Perhaps I didn't develop the discussion about diversion of insured and fully self-pay patrons into UC centers from the point of view of the Hospital ER. Where do you suppose that the hospitals get the cash to cover the write-off? Don't you think that the write-offs are covered by inflating bills for everyone else (just as they are today)?

I'm not suggesting that UC utilization is bad, not at all. Just that increasing UC utilization may not have an anticipated positive impact on hospital ERs

Even if the overall savings are less than eight tenths of one percent, "if those patients whose medical problems are considered “avoidable” or “non-urgent” were to take advantage of primary or preventive health care and not rely on ERs for their medical needs.", isnt that worth capturing?

That is a prescription for not only UC centers, but for regular primary care visits and preventative care.
Regular primary care visits and preventative care (incuding diet and exercise), things that most americans try to avoid like the plague, but when they do get sick we demand the fastest ambulance and the utmost in care.

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260jojuggie(1294 comments)posted 11 months, 1 week ago

Remember Obama's cash-for-clunkers program..?

The person who calculated this information is now, and has been, a professor at the

University of West Virginia in Morgantown for the last forty-some years:

A clunker that travels 12,000 miles a year at 15 mpg uses 800 gallons of gas a year.

A new vehicle that travels 12,000 miles a year at 25 mpg uses 480 gallons of gas a year.

So, the average cash-for-clunkers transaction reduced gasoline consumption by 320 gallons per year.

The government claims 700,000 clunkers were replaced, so that is 224 million gallons saved per year.

That equates to a bit over 5 million barrels of oil. 5 million barrels is about 5 hours worth of US consumption. More importantly, 5 million barrels of oil at $90 per barrel costs about $450 million dollars.

So, the government paid $3 billion of our tax dollars to save $450 million. They spent $6.67 for every $1.00 they saved.

We've been assured, though, that they will do a much better job with our health care.

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261jojuggie(1294 comments)posted 11 months, 1 week ago

The Obamacare girl - SHE'S NOT A CITIZEN.
Can those Dems do anything right?

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262dontbeafool(951 comments)posted 11 months, 1 week ago

what's that have to do with the ACA eivo? The gov shutdown was just great for the economy, est $28 billion lost. How is that for being fiscally responsible? And for what purpose, besides to throw a temper tantrum. And the debt ceiling was raised 5 times under Bush with bipartisan support and no demands attached to it. You can't even approve a judge without having a filibuster. I guess none of the 20 some respected judges aren't good enough. Try GOVERNING and get something done instead of just being a roadblock.

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263HappyBob(285 comments)posted 11 months, 1 week ago

Here's a couple of interesting facts from KFF 2013 survey of employer sponsored HC plans.

2013 - 20% of the employer plans are HDHP with savings. While that is significant growth since 2008 (at 8%), the growth of employer sponsored HDHP with savings has leveled off in the past two years (2012 was 19%, 2011 was 17%)

The 2013 HDHP with savings premium average for single coverage is 5.884 with employers contributing 83% so the net premium was about 75/mo

The 2013 HDHP with savings premium average for family coverage is 15,227 with employers contributing 76% so the net premium was about 304/mo.

"Most employer plans (PPO,HMO,POS, and HDHP) limit the amount of cost
sharing workers must pay each year, generally referred to as an out-of-pocket
maximum. Even in plans with a specified out-ofpocket limit, not all spending is counted towards meeting the limit. For example,among workers in PPOs with an out-ofpocket maximum, 76% are in plans that do not count towards physician office visit copayments, 34% are in plans that do not count towards spending on the general annual deductible, and 84% are in plans that do not count towards prescription drug spending when determining if an enrollee has reached the out-of-pocket limit. The ACA will require that all nongrandfathered plans have an out-of-pocket maximum that counts ALL COST SHARING TOWARDS THE LIMIT." (emphasis is mine).

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26476Ytown(1254 comments)posted 11 months, 1 week ago

Don't see any reason for UCC's would not profit by fulfilling a need to be open weekends and after hours. They may consider positioning their center close to a hospital. Should they be required to take all patients? Are doctors?

Can't claim to have the answers re: hospital write offs. Whether some of it is absorbed by higher fees to patients or by tax deductions, it still comes down to coming out of our pocket. http://www.modernhealthcare.com/artic...

Bottom line, healthcare cost will continue to rise. Years ago before all the advances in technology an illnesss or injury claim was for an office charge, maybe some labs or even an X-ray. Now we expect to get a battery of tests, forget the X-ray... We want an MRI. Now the cost has gone up from $30 for an office visit plus $15 for labs which when billed to our insurance co would be paid at 80% after our $100 deductible. Now it will be $30 co-pay at the office, $130 ov billed to the ins, negotiated down to $60, applied to a high deductible. The MRI... another charge for hundreds plus the fee for reading. We demand the best care but it comes with a cost. And don't forget the dr's order some tests and RXs to C.Y.A.

So much for supply and demand lowering costs!

As people become more involved in preventive care whether voluntarily or forced by employers they'll possibly keep costs down as they stay healthier longer.

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26576Ytown(1254 comments)posted 11 months, 1 week ago

Tort reform as a cost savings is somewhat dubious.

In 1975 in California, malpractice laws were enacted with a maximum of $250,000 that could be paid out. It doesn't matter if a jury awards $5 million, the claimant is limited to receive $250,000. This amount has never been adjusted for inflation. Supposedly, this keeps the cost of malpractice insurance down. Since this amount is not adjusted for inflation, there are times factoring attorney costs, you cannot even get an attorney to take the case. Besides, just try to sue a hospital or doctor. Nearly impossible.

Sure, there are plenty of frivolous lawsuits out there. Ever listen to daytime TV commercials? "So and so got me $1 million for my accident claim". I'm not saying that there are times that people need to be compensated for their injuries.

So if we implement tort reform, who wins? Doctors because their malpractice insurance premiums go down? Has anyone really ever seen premiums go down for any insurance coverage? You may see a reduction in healthcare or auto insurance premiums by having a higher deductible. You may see a reduction in premiums after you remove your teenager from your auto insurance. LOL

Side note...recently, I called to cancel comprehensive on a pickup truck since the vehicle was not worth much if it was ever in an accident and it was rarely used. The policy showed a yearly cost of $300 for collision. After the call, the amount of savings was only slightly less than what I was paying because now I didn't have as many options on my plan and didn't get as high a discount for the other options after cancelling collision coverage. It went from thinking I'd save $300 by removing the coverage to only saving $100. I left it on the plan.

Back to tort reform. A ceiling on the limits hurts those who are truly injured. Maybe the limits should be on attorney fees? How can they substantiate 40% of the award? Is the time they spend in defending the claimant justly in line with their compensation?

Should we implement laws that require the claimant to pay costs associated with the suit if they loose? That would definitely scare a lot of people into thinking twice about suing their doctor or hospital even when they have a legitimate case.

What percentage of cases fall with the definition of frivolous lawsuits? Should we just say that to err is human and we should look the other way if someone misread your x-ray or didn't diagnose you symptoms correctly? We're not talking about suing for hot coffee that you spilled in your lap.

All rhetorical questions.

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266dontbeafool(951 comments)posted 11 months, 1 week ago

Now that we are officially off topic, I did do more research, and you are correct about the appointed/nominated judges, although both parties are guilty of obstructing, political games I guess. I also read that the Senate committee (the Gang of 14) also agreed not to use the filibuster against nominees except for "extraordinary circumstances". I don't know what their extraordinary circumstances in this case are, but again, it is politics as usual. But I can admit when you make a valid point in this particular case. I won't hold my breath waiting for the same from you. Now back to the medical issues....

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267HappyBob(285 comments)posted 11 months, 1 week ago

@eivo,
Return to your post at #285, have anything more to support your tort reform suggestion?

I'll try to get some references, but I think that there has been specific legislation the "criminalizes" the drug industry / prescribers sweetheart deals.
Regarding nurse practs and PAs, my personal experience with my primary care physician is this: when seen by nurse practice the charge is about ten dollars less. After write-off , then determination of my co-insurance, the difference in my final bill is about one dollar or less..
No doubt more certified nurse practitioners and PAs would relieve a shortage of MDs and ODs, but I' m not certain it would have as much impact on costs. Do you have anything to the contrary?

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268Sanjay1976(37 comments)posted 11 months, 1 week ago

to eivo,
So that's all you have to offer?

Opinion but nothing to back up.
Concepts but no support.

How shallow is that?

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26976Ytown(1254 comments)posted 11 months, 1 week ago

Nurse practicioners bill @ 85% of the doctors fee if billing on their own or if they work with the doctor it's billed as the doctor's fee. Not a savings to have them but they fill a gap in provider shortages.

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270jojuggie(1294 comments)posted 11 months, 1 week ago

During the government shutdown, Barack Obama held fast, heroically refusing to give an inch to the hostage-taking, barbaric orcs of the Tea Party who insisted on delaying Obamacare. It was a triumph for the master strategist in the White House, who finally maneuvered the Republicans into revealing their extremism. But we didn’t know something back then: Obama desperately needed a delay of Healthcare.gov. In his arrogance, though, he couldn’t bring himself to admit it. The other possibility is that he is such an incompetent manager, who has cultivated such a culture of yes-men, that he was completely in the dark about the problems. That’s the reigning storyline right now from the White House. Obama was betrayed. “If I had known,” he told his staff, “we could have delayed the website.”

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271HappyBob(285 comments)posted 11 months, 1 week ago

@76Ytown,
Seems like we are in general agreement that tort reform and increasing the number of nurse practictioners will not significantly impact healthcare costs.

@eivo, As I'm sure most people will explain to you, belief that the sun will rise is based on more than just a few years of experience.
Your beliefs that tort reform and nurse practitioners will control costs has no experience to rely on.

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272HappyBob(285 comments)posted 11 months, 1 week ago

@76Ytown,
In the lead up to today's news conference I was listening to several news sources. One of the things I heard was that the non-ACA compliant plans are illegal, so were required to be cancelled.

I really wondered about that, so I did a quick google search and it appears that insurer's cancelled policies voluntarily, not because they were "illegal".

See the following:
"Insurers are allowed to continue to offer grandfathered (non-ACA compliant) health plans, but that doesn't mean they have to.".

(http://www.businessinsider.com/why-yo...)

The second reason is legal rather than economic. As a strict matter of fact, the ACA does not render any existing insurance plans illegal. Not all pre-ACA individual plans satisfy the bronze-level coverage requirement of the ACA, but it remains perfectly legal to buy and sell them, either by paying the ACA penalty and having a "non-compliant" plan.
(http://hyperplanes.blogspot.com/2013/...)

In your research on ACA, have you found anything that makes these non-compliant policies illegal (or makes it illegal to sell or buy them).

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273Elf2(75 comments)posted 11 months, 1 week ago

I would be a relief if you would hold your breath till April 2015.

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274SheDevil(120 comments)posted 11 months, 1 week ago

Yup, way too much hot air coming from that eivo

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275dontbeafool(951 comments)posted 11 months, 1 week ago

You two agreed, now eivo is going to accuse you two of being the same person. Or you must be left wing loonies.

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276dontbeafool(951 comments)posted 11 months, 1 week ago

Obama said, "It is on me", which at least I can respect that. The previous administration would never take ownership on anything. And to say, "I'm sorry", never would you ever hear that from a Republican leader, with the exception of maybe Christie. I can at least respect Christie for telling it how it is and GOVERNING without playing games. When the President did a good job during the hurricane, he had the ballz to say he did a good job, despite what his party thought. That was refreshing. This is a program on a MEGA scale, it will have problems when it is launched, anyone who thought it would be a smooth transition is nuts. And when you have the biggest do nothing congress in history doing everything they can to destroy it before it starts, you can expect it to be even a bumpier launch. Defund/delay is all they do, not improve/fix. Please fail so we can get elected next term is all they think!!!

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27776Ytown(1254 comments)posted 11 months, 1 week ago

HappyBob: The key word is "grandfathered" plans. They were purchase and effective prior to 5/23/10. They may not have complied, but were not subject to the ACA. Plans AFTER 5/23/10 are subject to all of the 10 essential benefits of the ACA. If they didn't comply, they were being cancelled. A new rate was offered effective 1/1/14 to include all of the 10 essential benefits. Maybe not "illegal", more like not in "compliance" therefore can't be sold.
http://www.kaiserhealthnews.org/Stori...

The "fix" will only postpone the issue. It didn't make it go away. Also, the final decision is at the state level. Insurance commissioners will have to decide. Stay tuned.

It's called back-peddling, not an apology folks!

Obamacare is a massive failure which we are only beginning to see.

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27876Ytown(1254 comments)posted 11 months, 1 week ago

Obamacare's success is dependent on the individual market. The plan all along was to bring those people into the exchange to offset the cost of the coverage for people entering the exchange who could not afford coverage. Individual plans tend to have younger, healthier people which would balance those who couldn't get coverage because of pre-existing conditions or who will be getting the Medicaid subsidy.

The "fix" says insurance companies can decide if they will allow the individuals to continue their plans. It doesn't say at what cost which means, guess what? If the cost is "unaffordable" then they will have no choice but to go into the exchange. Again, the middle class is screwed.

Obama is a sly guy. He's saying those bad insurance companies dropped all those people. Actually, if the insurance companies didn't have to follow the Obamacare rules in the first place, they wouldn't have dropped the plans. People were happy with the coverages they bought. Obama can't blame the insurance companies because the very fact that he's undoing the rules points the finger back at him.

Once again, folks they've kicked the can down the road instead of fixing anything.

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27976Ytown(1254 comments)posted 11 months, 1 week ago

HappyBob, Having trouble following your comment #291. Are you saying single coverage averages only $75 per month and family coverage average only $304 per month after employer subsidy?

Next, IRS regulates the HDHP plans and HSAs (always has). The variable here as with all insurance plans lower your out of pocket costs (ded, ect) the higher your premium and vice versa.

2013 IRS Limits:
Annual contribution limits (premiums)
(EE Only): $3,250
(Family, or more than EE-Only): $6,450

Minimum deductible:
EE Only: $1,250
Family, or more than EE: $2,500

Out-Of-Pocket (OOP) Max:
(EE Only): (including deductibles, co-pays and co-insurance — but not premiums): $6,250
(Family, or more than EE-Only): $12,500 — up $400 from 2012’s limit.

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280HappyBob(285 comments)posted 11 months, 1 week ago

In May 2013, KFF surveyed 2948 businesses that employed 3 or more persons. 2,067 businesses reported that they had some sort of employee health plan and were willing to complete the survey.

Among the findings of the survey 20% percent of the covered workers were enrolled in HDHP/SO (high deductable health plan with savings option)

(my note: This does not mean that 20% of the businesses had HDHP/SO offered , but rather that 20% of all employees were covered by HDHP/SO plans)

KFF goes on to say that among the single employee covered by a HDHP/SO plan the average premium was 5,306/year. The average company contribution to that premium was 4419/year and the employee made up the difference of 887/year. ( I divided that by 12 to get about 75/month)

Simalrily, among the employees covered by a family HDHP/SO plan the average premium was 15,227/year. The average company contribution to that premium was 11,578/year and the employee made up the difference of 3,649/year. ( I divided that by 12 to get about 304/month)

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281HappyBob(285 comments)posted 11 months, 1 week ago

76,

I think I see where the confusion lays.

The IRS does not regulate the premiums for coverage, it regulates the amount that is deductable for the savings option.

"
SECTION 2. 2013 INFLATION ADJUSTED ITEMS
Annual contribution limitation. For calendar year 2013, the annual limitation on deductions under § 223(b)(2)(A) for an individual with self-only coverage under a high deductible health plan is $3,250. For calendar year 2013, the annual limitation on deductions under § 223(b)(2)(B) for an individual with family coverage under a high deductible health plan is $6,450."
(http://www.irs.gov/pub/irs-drop/rp-12...)

I guess that you could put more into the savings, but you'd only be permitted to deduct up to the max of 3250 or 6450 depending on EE or family.

You've just mistaken the contribution limits for premiums.

Let me say that I appreciate our discussion here, while we might disagree on an overall approach, we can still share information and insight without being disagreeable or resort to personal attacks. Thanks.

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282HappyBob(285 comments)posted 11 months, 1 week ago

Slight correction to post 317,

I guess that you could try to put more into the HSA, but the trustee would probably not permit it (because the HSA is intended to be deductible from one's regular income.

And another note on the OOP max... Those limits also do not to out-of-network expenses

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28376Ytown(1254 comments)posted 11 months, 1 week ago

HappyBob: Yes, typo about the contribution limits. These are not premiums but instead the maximum you can put into your HSA. The IRS regulates the max you can put in each year just as they regulate the max you can put into a 401k or IRA. You can also add a catch-up amount of $1000 yr to your HSA if you are over 55.

As with anything the IRS regulates, there are so many rules to the HSA including:
- You must be covered under a HDHP
- You have no other health coverage
- You are not enrolled in Medicare.
- You cannot be claimed as a dependent on someone else's tax return.
http://www.irs.gov/publications/p969/...

The HDHP premiums are really low, and as long as you put your savings over the traditional plan option into an HSA it is a good option. Compare your traditional plan premium to to the HSA. Generally, the savings is enough to make up the difference in out of pocket. Another benefit to employees is that the premiums are deducted pre-tax.

Since the amount left over in your HSA can roll over from year to year, it can possibly grow to a substantial amount over your lifetime. The HSA follows you if you leave your employer and is not dependent on payroll deductions although you have to have a HDHP in order to contribute. HDHPs and HSA are available in the individual market as well.

Many employers also add an amount to the employees HSA each week as an incentive to join...sometimes $1000 yr. or more. The fact that premiums are lower for the employed also means they are lower for the employer and the savings is passed on.

~ #318 "Those limits also do not to out-of-network expenses". Actually, out of network expenses have their own deductibles, coinsurance and OOP max. The plans say that you can go outside the network for treatment but you incur a higher cost. They want you to stay within the providers they contract in the network for a lower cost. You're free to use the money in your HSA to pay for the expense. Also important to note is the the OOP only applies to "eligible expenses" No, that cosmetic surgery is not part of it and an HSA has it's own rules as to eligible disbursements.

The Obamacare plans that have lower premiums also have higher deductibles and OOPs but don't leave much room for contributing to and HSA. The idea of having a HDHP is to shift the risk from the insurance co to the patient. Sure, the first year can be a scary step since your HSA isn't yet built up if you have medical expenses you drain it as fast as you build it, but for the majority of people, we don't incur major medical expenses every year.

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284jojuggie(1294 comments)posted 11 months, 1 week ago

That crazy Ted Cruz. The Texas freshman Senator (R-Tea Party) tried to defund Obamacare, then accepted a one-year delay in the individual mandate as a compromise position. But you can't govern from one House of Congress, and the one he's in is one the Republicans don't govern anyway. Obama and the Democrats held all the cards. So Cruz caved--it was only a matter of time, right?--and Republicans got blamed for everything.
Fast-forward a few weeks. President Barack Obama is trying to delay parts of Obamacare by administrative fiat. Democrats are rushing for the exits, ready to sign onto a bill that will essentially gut the entire policy by letting people keep their insurance (as promised). The website has not been fixed, and will not be fixed by the end of November. The media, Obama's core constituents, are wavering. Suddenly he looks desperate.

What wouldn't Barack Obama give to be able to wind back the clock to late September and accept Ted Cruz's offer of a one-year delay--in exchange, say, for a promise not to block immigration reform? That would have been a trade worthy of Lyndon Johnson, who knew how to give a little to get what he wanted. It also would have saved Obama the hideous--and global--embarrassment of Obamacare's failure--for a while, anyway.

Yes, Cruz's strategy was flawed because defunding seemed nearly impossible, and because he struggled to unite the GOP (not least because he occasionally attacked would-be allies). But he made it absolutely clear that Republicans had zero ownership of Obamacare--a fact that would not have been as obvious had the GOP meekly funded the program. He set down a bright marker. And was mocked. When does he get his apology?

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285HappyBob(285 comments)posted 11 months, 1 week ago

Re #318
What I should have said is:
"Maximum annual deductible and other out-of-pocket expenses:
This limit does not apply to deductibles and expenses for out-of-network services if the plan uses a network of providers. Instead, only deductibles and out-of-pocket expenses for services within the network should be used to figure whether the limit applies" (IRS pub 969)

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286HappyBob(285 comments)posted 11 months, 1 week ago

On HDHP/SOs
I was wondering if people are really using their HSA account to accumulate wealth (as you suggested to build up a reserve) According to findings from the 2011 EBRI/MGA CEHCS, there was $12.4 billion in HSAs and HRAs in 2011, spread across 8.4 million accounts. From that very broad perspective the average HSA balance is only about 1474 dollars per account, and that would include accounts that have been in existence (rolling) since 2004.

Employee Benefit Research Institute: " The 2012 EBRI/MGA Consumer Engagement in Health Care Survey (CEHCS) found while (HSA) account balances increased regardless of income level, in 2012, the average (HSA) account balance was $1,246 among individuals with less than $50,000 in household income; $1,359 among individuals with $50,000−$99,999, and $1,957 among those with $100,000 or more." (http://www.ebri.org/pdf/FF.240.HSAs.1...)

Blue Cross Blue Shield Association in 2005 to 2007 found that 42 to 49 percent of HSA-eligible plan enrollees did not open HSAs in those years. (http://en.wikipedia.org/wiki/Health_s...)
I have not found updated info on the number of HSA-eligible persons who have not opened an account. But apparently in the 2005-2007 era, a substantial number were not bothering to worry about deductibles or bills less than their OOP.

Consumer-driven healthcare costs are a great selling point for HDHP/SO plans, but "the expectation that cost-conscious decision making would lead to higher account balances was not borne out by the data." In fact when the patient asked question about cost (presumably to lead to a more cost-effective treatment or drug), those patients tended to spend more of their account dollars, leading to a lower account balance.
(http://www.ebri.org/pdf/briefspdf/EBR...)

Interesting data.....

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28776Ytown(1254 comments)posted 11 months, 1 week ago

OK Mr.Bob, Let's put this into perspective. People are given free will when it comes to their benefit choices. Unfortunately, not all companies have the time, staff or even expertise to advise the employees of the necessity to participate in these plans. If you choose a HDHP and don't put money into an HSA or don't take advantage of your company's 401k you are loosing out.

HSAs are not meant to be a wealth builder. They are a means to pay for your health costs through your savings but they can build to a tidy sum if you don't need to use it over a period of years and can be used for anything after age 65. As for health insurance, you can either give an insurance company an amount in premiums each year to cover the risk, or you can assume the risk with lower premiums. Some people are reluctant to go with a HDHP because they feel more secure with the insurance co taking the risk. And some people only see the premium savings of a HDHP but don't fund an HSA. Any wealth that is created would be by being able to keep the amount you don't use in any given year instead of letting the ins co keep it. I'll bet you would agree that most years you may not use your health insurance at all, and then there will be a year or two where it's good to have coverage. I have only once met my OOP max.

Employers are finally requiring new hires to participate in 401Ks. In the past, many people did not take advantage of these plans or when they did, they took loans on the money they built up. Both HSAs and 401Ks and IRAs etc are not meant to be raided.

The same participation statistics can be said about Flexible Savings Accounts. You can put the money into an account pre-tax but you have to be careful that the amount you save will be for expenses that you are expecting to be OOP otherwise the money left in the account after the plan year will be lost. Too many people didn't take advantage of FSA's because of the "use it or loose it rule" so they lost out on the tax savings.

I always say, once you know better, you do better.

Here's an article from the Society for Human Resource Management regarding different employee savings styles. I think it shows that once people understand the concept they are much more likely to participate. http://www.shrm.org/hrdisciplines/ben...

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28876Ytown(1254 comments)posted 11 months, 1 week ago

If only they taught some simple wealth building concepts to kids at the high school level. Here is something that every young person should be doing from their very first paycheck:

http://www.daveramsey.com/article/how...

In this example, the person that started saving at age 19 and stopped at age 27. But the person who waited till age 27 had to continue to save all the way to age 65 and yet still did not have as much in their account as the younger saver.

Parents or grand parents, just think about how powerful it would be to save an amount from a child's birth to give them at adult age to be used as a retirement head start.

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289southsidedave(4784 comments)posted 11 months, 1 week ago

You cant; save if your'e not earning

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29076Ytown(1254 comments)posted 11 months, 1 week ago

SoSdD and eivo: Yep and Yep. And this slide into socialism is only making it harder for people to live the American Dream.

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291Jerryl(105 comments)posted 11 months, 1 week ago

The same argument used to oppose Medicare.
How has that worked out?

Think that Medicare will be abandoned anytime soon?

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292Sanjay1976(37 comments)posted 11 months, 1 week ago

76Ytown,
you said " people are given free will when it comes to their benefit choices" , then you said " employerrs are finally requiring new hires to participate in 401Ks"

Do you see the inconsistancy between these statements?

I think that you have misrepresented the auto-enrollment with required participation.

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29376Ytown(1254 comments)posted 11 months, 1 week ago

Sanjay, You still have free will. You are given the option to opt out anytime you choose. I used the word "requiring" when I should have said "automatically" enrolling, and the amount is generally only 3% of pay or lower. For that misrepresentation I stand corrected.

401Ks are deducted pre-tax. Employers sometimes match as much as 50%. You benefit by not having to pay taxes on that amount and get free money to boot!

Let's say that you earn $10 per hour, 40 hours per week = $400.
3% deduction is $12.00.
That is deducted pre-tax saving $2 or $3 in that bracket.
Your employer may match your deduction and add as much as 50% to your account. ($6)
Now you have $18 in your account that only felt like a $9 or $10 deduction from your paycheck because of the tax savings.
That money invested, grows over time and it's yours. If you leave the company after you are vested, that money is yours to keep too.

It's your option to participate, but too many don't.

You can only hand-hold so much LOL!

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294thinkthentalk(265 comments)posted 11 months, 1 week ago

You two (76 and evio) wouldnt know what socialism is if it bit you in the butt.

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295Sanjay1976(37 comments)posted 11 months, 1 week ago

All I was saying was that your statements were inconsistant...

I didn't need a lesson on how 401ks work.

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296HappyBob(285 comments)posted 11 months, 1 week ago

76,
OK perhaps I over emphasized your point about HSAs accumulation (that was one of your support points) . However the average data on HSA users doesn't show much in accumulation.

If your situation is an outlier (ie, you put away the maximum each year and spending is low) then I'd say possible. But the data seems to indicate that it's not typically utilized that way.

***********
While we can speculate that someone who is self-pay (up to OOP in a HDHP plan) might be expected to shop for lower cost doctors, lower cost treatments, lower cost meds, there does not seem to be any evidence that that behavior is generally or typically true.

Do you have anything beyond expectations that measurably supports that.

BTW, you posts are becoming a bit condescending.

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297jojuggie(1294 comments)posted 11 months, 1 week ago

.

President Obama has been given so much slack by an enabling Washington D.C. media, that Obama is now hanging onto the rope to avoid falling into the abyss. The fawning media who placed all their political bets on his success, is unwilling to admit publicly (and perhaps even privately) what they know in their brains but unwilling to let their heart in on: Obama is and always was a phony.

He’s a phony who has deceived, lied and broken his solemn oath taken when he swore to uphold the Constitution. But for his followers to accept these facts is to accept what many conservatives predicted from the beginning; and that thought also keeps them from acknowledging the obvious.

The official process of Impeachment must be initiated immediately.

We, you, have no other choice.

Democrats who have blindly and whole-heartedly supported this president have no choice either. They quickly labeled and accepted as partisan, charges by conservatives regarding issues such as Benghazi, IRS targeting, Fast and Furious gun running, Executive Orders altering existing law, secret Iranian deals, labeling Muslim terrorism as workplace violence, routinely using Air Force One as a campaign asset; each transgression is clearly a violation in its own right, but when added together make for an astounding consistency of impeachable evidence. It has all been hidden in plain sight.

Impeachment is simply the only rational action, with resignation a better alternative for the good of the nation.

So, John Boehner, Speaker of the House, the body responsible for initiating Impeachment proceedings: When are you going to take your responsibility for this nation

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298HappyBob(285 comments)posted 11 months, 1 week ago

And eivo is off and running after the freeloaders again

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29976Ytown(1254 comments)posted 11 months, 1 week ago

All,
Didn't mean to offend anyone with my simplistic explanation. My point is that some people don't take full advantage of their benefits either because someone did not take the time to explain or they listen they listen their friends, or they procrastinate. If you are a young person just starting out in the work world, understanding the concepts of pre-tax, risk, time and compound interest can be powerful and the longer you wait the more expensive it becomes to try to catch up.

One more HDHP/HSA comment and then I'll try to stay out of it.

Consider this scenario: You have a traditional health plan with family payroll deductions of $250 pay period. The ins co takes all the risk. If you get sick, they reimburse after your deductible. At the end of the year, you've paid $6500 in premiums to the ins co plus ded if you incur claims. If you have a good year and don't get sick, the ins co is ahead.

Now, you're offered a HDHP with a premium of $75 pp / $1950 yr. The plan has a high deductible. Over traditional plan, you save $4550 per year in payroll deductions. If you do get sick, you will have to pay out of your pocket to meet the high deductible. If you have a good year and don't get sick, you are ahead.

Next, you can choose to deduct only $75 per pay period and keep the $175 difference in premiums in your pocket. You assume the risk, but if you have any claims you need to come up with the amount up to the high deductible with after tax dollars. Also, your premiums would be lower, but the extra you take home is taxable income so it won't feel like $175 more in your check.

Or, you can choose to enroll in an HSA, park the amount that you saved in payroll deductions of $175 pp / $4450 yr to be used if you incur claims. In a good year, you keep the money and it rolls over to the next year or if you need it it's there...it's your money. There are no guarantees the you won't need the money so if there is any left over, it's better in your pocket than the ins co's pocket.

In addition, some employers also give you an amount toward your HSA. You should compare plans to see how much you would be out of pocket in both scenarios. The HDHP premium savings plus employer contribution may equal the higher deductible. You won't feel like you are deducting any more from your check if you keep the HDHP /HSA at the same amount as it would have been with the traditional plan..

.

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300HappyBob(285 comments)posted 11 months, 1 week ago

76,
Its not the example that is off-putting, it's the style. You are coming off (perhaps unintentionaly) as being teachy and talking down to us.

While eivo may only be concerned with freeloaders, there are still some of us (maybe sanj, a couple of others and myself) that are still willing to fully examine the pros and cons of HDHP versus "traditional" healthcare Insurance.

Since you example uses an employer based based example, we could use the information from the KFF survey I cited earlier
http://kaiserfamilyfoundation.files.w...

On Page 2 , Exhibit B you will find data that compares the employee cost for a traditional family plan compared with a family HDHP plan.

The monthly deduction difference (PPO to HDHP, family, employee cost) is 78/mo. Your theoretical scenerio starts with an difference of 379.00/mo!

(I suggest that PPO is the appropriate catagory to compare because almost 60% of all employees covered are enrolled in PPO, see page 4 Exhibit E)

So can we begin with the average background to begin to run the scenerio ?

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301Jerryl(105 comments)posted 11 months, 1 week ago

I'm still here and interested....

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302dontbeafool(951 comments)posted 11 months, 1 week ago

@jerry. I'm not.

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303Sanjay1976(37 comments)posted 11 months, 1 week ago

I don't agree that HDHP is the way to go!
I've carefully tracked my healthcare cost for the past 8 years, and with only one year exception my total costs have been less with traditional PPO and FSA. Even in that year, the difference was less than 100 dollars.
HDHP may work for some people, but for all.

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304Sane1(24 comments)posted 11 months, 1 week ago

I was in a high deductable plan in 2010, and putting money away in savings. Midway through the year they found out that I had a scare with cancer (that later proved to be a mis-diagnosis), that did not stop them from dropping me from all coverage in the middle of the year.

When I applied for copverage elsewhere i was rejected because I had been denied by another company. TOTALLY SCREWED.

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30576Ytown(1254 comments)posted 11 months, 1 week ago

HappyBob,
I'd be happy to do a high-level discussion of benefits but I'm thinking there are people following this discussion that may benefit from the basics. As I've said before, I wish they'd teach some of this in high school.

Sanjay, True when you have a chronic health condition and incur claims every year you may not be ahead with a HDHP / HSA. My personal experience has been that in most years we have very few doctor visits or other services and for that I'm grateful. But, I did have 2 years with major expenses and only one where we met our OOP.

It's really hard to give examples because of so many variables. My best advice (from the heart) is to take the options you currently have and compare what you would spend for both plans to reach the point that they start reimbursing claims after your deductible.

Add up the traditional plan's premiums plus the deductible, compare that to the HDHP's. If your employer gives you money to fund your HSA, include that plus the difference in premiums to know what will be available in your HSA.

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306dontbeafool(951 comments)posted 11 months, 1 week ago

@sane, according to some of these people on this site, too bad. You have to take care of yourself. You should have saved up money starting in your childhood in case this happened. Insurance companies are heartless! I watched my mom work for 15 years as a manager at a convenient store working 6 days a week, 12 hours a day on salary, getting guns stuck in her face, all because of my dad's chronic health. She couldn't get another job because no other insurance company would accept her because of his pre existing condition. Some of the people on here have never been faced with such hardship or have lived below the poverty line, you can hear it in their comments.

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307HappyBob(285 comments)posted 11 months, 1 week ago

@76Ytown,

Will you get back to me after you've looked at the link in post 338 and considered the question at the end of that post?

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30876Ytown(1254 comments)posted 11 months, 1 week ago

HappyBob,

The link in 338 compares average premium contributions but it's still too general for us to use to compare, they are only about $1,000 apart for the yearly amount based on an average. I don't like averages. The scenario I gave is an a true example. Premiums for family coverage went from $250 pp to $75 pp with the HDHP.

If anyone here can give some quick input we can crunch the numbers. We'll need the PPO and HDHP pp or monthly cost for employee and family, at a local company and the calendar year deductible for each.

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309HappyBob(285 comments)posted 11 months, 1 week ago

@76Ytown,
Can you be more specific when you say "they are only about $1,000 apart for the yearly amount based on an average"?

I assume that you are comparing the employee premiums for the employee family plan under traditional PPO (4587/yr) versus the employee premiums for the employee family plan under HDHP/SO (3649/yr).

I calculate the difference is 78/mo.

Do you have information that contradicts the idea that the premium difference might be that small?

The average is a useful tool to get us to the notion of what might be typical, but I appreciate your caution about using averages blindly.

However your suggestion to get information about a local company actually more likely to stray from describing the typical situation.

So, let's look at what is being marketed today. (Yes, we have to shift gears into the private versus the ESI market ) but the differences between HDHP and traditional PPO will stlll hold up.

For private purchase single 29 year old with no subsidy the premium from Summacare is 154/mo for HDHP. The Summacare premium for the same individual under a traditional (bronze) PPO is 207. Difference is 54/mo

Anthem, same comparison, difference is 33/mo.

MedMutual, same comparison, difference is 50/mo

My cousin, in Indiana as a new employee, was just given the traditional PPO (single) and HDHP(single) offerings. The difference was 68/mo.

Your "savings of 4550/year" appears to be unrealistic.

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31076Ytown(1254 comments)posted 11 months, 1 week ago

HappyBob:

~ We're on the same page. $78 mo / $937 yr. for the Trad vs HDHP. Both are actually PPOs. Difference being the deductible. We'll guess that the HDHP ded is at least $1200 (min per law) but we don't know what the Trad plan ded is.

~ In my example, the ded went from $250 pp / $500 fam Trad plan to $3800 pp $5k fam. The higher the deductible the lower the risk to the ins co & lower premiums.

~ In your examples in the individual market, we still need to know what the deductibles are to be able to consider the savings. The IRS defines HDHP as having at least a $1250 ded per person / $2500 family.

~ The employer paid portion of premiums is much higher for employee only coverage, and the employee pays the greater portion of family premiums.

Our missing link is the deductible with all of these plans.

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311HappyBob(285 comments)posted 11 months, 1 week ago

The KFF data on the annual deductibles is given in the full report (228 pages) which can be found here:
http://kaiserfamilyfoundation.files.w...

In the technical report that accompanies, it provides the variation from the average as standard error. The standard error in these numbers is rather low, indicating that spread of the survey is acceptably tight.

Anyway, to answer your question. For employees with single coverage HDHP the deductable for HDHP was 2002 dollars (standard error 74)

For employees with single coverage traditional PPO the deductable 799 dollars (standard error 41).

The family plan deductables are also given, but for simplicity sake try to run a scenerio with the single employee.

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31276Ytown(1254 comments)posted 11 months, 1 week ago

I'm rounding. $2000 ded HDHP, $800 PPO.
~ HDHP difference $1200

~ Premium savings of $78 mo / $937 yr.

~ Take $937 premium savings & put it into an HSA. Add employer match $1000 est. You now have $1937 to use as you incur expenses.

~ Plan to fund the maximum into your HSA for the year if you can to be used for other expenses like you would have done with your FSA.

Note, since the account rolls over from yr to yr, you can decide if you want to draw from HSA savings to pay for small expenses like co-pays or RX charges or pay out of your pocket and leave the money in the HSA.

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313HappyBob(285 comments)posted 11 months, 1 week ago

Ok, I accept your rounding on deductibles.

So let's say we are working with a 30 year old single insured ESI. Can we also agree (for purposes of comparison) that the gap between the deductible and OOP is covered by co-insurance and co-pay cost of 25%. We can use that for both the HDHP and the traditional plan.

The next, critical step is to estimate the annual healthcare expenditures for this person. For that I'm going to send you to:

http://www.healthcostinstitute.org/20...

here you will find (on page 5) that the healthcare costs for our 30 year old is 4123/year.

Using that as a starting point, and with our previous conditions we see that the HDHP participant has to have 285/mo to pay the bills.
(74 for premium, 167 for deductible and 44 for co-insurance&copay)

Our traditional participant has to have 220/mo to pay the bills.
(85 for premium, 66 for deductible and 69 for co-insurance and copay)

But then I here you say..... lets let the total expenses be only 2000/year. OK, in that case it looks like the HDHP cost per month would only be 241 as compared with the traditional insurer's cost of 251/mo.

Not much difference in that scenerio.

Where the difference become more meaningfully tilted towards the HDHP are when the total expenditures are very low, like less than half the annual expected expenditures.

So people maybe able to achieve that by being exceeding lucly or blessed with "good genes" and have a natural ability to avoid accidents. But typically most are us don't fall into that catagory.

And that's why we have insurance.

I urge you to read the expediture report carefully, and take note that it is based on the actual amounts paid out by either the insured and the actual amounts paid out by insurers . They have access to some 6 billion claims for pre-65 employees). The expenditures DO NOT include the premiums paid.

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314HappyBob(285 comments)posted 11 months, 1 week ago

One last thought for now, do you have some reference that the typical employer contribution towards HSA is 1000/year?

I realize that some employers provide either a contribution towards , or a percentage match; I've just never seen
1000 being suggested as a typical contribution. (particularily after they have already contributed 83% of the premium).

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31576Ytown(1254 comments)posted 11 months, 1 week ago

HappyBob, I do appreciate the link highlighting the slowdown in health care costs observed for people under age 65 over the past several years but those numbers are irrelevant to the difference in cost between a trad plan and a HDHP. What you want to look at is a side by side of how much it will cost to get from point A to point B. Point A being what you in pay in ins premiums and B being what it costs you to get to the point that the insurance starts to reimburse you for your expenses. I wish we could post a graph here and I haven't found a simple one online. The ones I found compare tax savings which we're not even getting into here. I'll keep looking.

~ You said "people maybe able to achieve that by being exceeding lucky or blessed with "good genes" and have a natural ability to avoid accidents. But typically most are us don't fall into that category."

Studies say 20 - 25% of the population incur 75 - 80% of the medical claims. A fairly healthy or generally healthy family will typically have some good years and some bad. Younger people tend to be healthiest. All of this is considered by insurance companies actuarially to determine premium rates where the premium is equal to the expected payout of the insurance provider. The concept of a "pool" is having a mix of adverse selection and healthy individuals all insured at the same time to minimize risk.

~ Please ask your cousin what his employer's contribution to the HSA will be. I think that is a much more fair example rather than using an average. Consider the fact that the employer spends less for an employee that chooses a HDHP over a trad plan, that savings is passed on by helping to fund their HSA whether it be an incentive or good will.

~ I think that what we are finding in this research is that there are many differences in what employees pay for their health insurance. Larger companies can offer benefits at a lower cost to the employee. Cost sharing for employee and family premiums vary. Deductibles vary...an on and on.

~ HDHP / HSAs are not for all but they offer a choice. If you are healthy, you may see a HSA as a way to build a savings to pay for those expenses that you may incur, and over time if you don't spend the money in your savings account get to keep the money you would have paid to the insurance company with the traditional plan. Others may find that paying a higher premium every month is worth it to have the ins co pay for expenses after reaching a smaller deductible if they incur claims.

Auto ins works the same way. You can have a $100 deductible and pay a much higher rate, or you can have a $1000 deductible and bring your cost down. You are taking the risk that if you cause an accident, you have to pay $1000 out of your pocket before the ins pays anything on your claim. If you never have an accident, you pocket a big savings in premiums every year.

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316HappyBob(285 comments)posted 11 months, 1 week ago

I can give you an answer right away about my cousin, as she faxed her enrollment options to me.

There is no employer contribution to HSA if HDHP is the chosen program.
The deductable is 3000 and the OOP is 6500. There is 30% co-insurance on most (but not all) types of coverage, and a 25 to 50 dollar copay on some (but not all visits).

There are 337 people employed with her company. The information is interesting, but not particularly useful because it may not be representative of the typical.

All I can conclude from this is that SOME employers do not offer a HSA account contribution. That's why I asked if you have some source that suggests that typically companies contribute $1000.

Be back later.....

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317Jerryl(105 comments)posted 11 months, 1 week ago

Ah, an interesting, informative and adult conversation. How refreshing!

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31876Ytown(1254 comments)posted 11 months, 1 week ago

HappyBob; So let's just throw out our other scenarios and start from scratch. Let's use your cousin's real life benefit options to do a side-by-side. We'll need the following info.
* Is she currently on the trad PPO plan (2013)
* What is her 2013 plan cost
* Single or Family
* PPO plan cost 2014
* HDHP plan cost 2014
* PPO and HDHP deds

Did she fund an FSA last year? Did she meet her deductible last year?

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319HappyBob(285 comments)posted 11 months, 1 week ago

76Ytown,
No, that is the wrong approach b/c it develops a protocol for just her.

What I thought we were trying to get to was a more analysis of the typical, so a close examination of a specific case actually doesn't help.

But actually there is another reason that is specific in her case. She was (and is) covered under her parents policy for 2013, so her historical insurance information is mixed up with her parents.

In point of fact she is not presently covered by any plan, having turned 27. But she is a new hire and is being offered plans that will start as soon as she meets her eligibility date. The offers are the 2014 plan for that company.

I know that she had some gynecological issues, but I am not going to be asking her or her Dad how much money she or "her" insurer paid out.

The only way to use her information would be to declare that she is representative of the typical 27 year female and that her new employer is representative of the typical employer.

I can not make a case to satisfactorily establish any of those conditions.

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320HappyBob(285 comments)posted 11 months, 1 week ago

I would not have any great disagreement with the statement '20-25% of population incurring 75% of medical expenses' as it stands, however I think those studies include the population above 65. AHRQ.gov has studied this extensively.

There is one statement that AHRQ has made that is concerning. They state "Half the population spends little or nothing on healthcare". On one hand, that's good from a total healthcare cost standpoint, but I ask myself " is that healthy". Is half the population that healthy that they have no need for medical care, or are they staying away from medical care because of it's inaffordability. The answer is probably somewhere in between.

Your last bullet point "~HDHP / HSAs are not for all, but they offer a choice" I AGREE 100% !!. You may have thought that I was against HDHP programs, and you'd be wrong.
Rather what I am pushing back on is the notion that HDHPs are "the way to go" to effect healthcare cost reform.

I'm not convinced that having everyone insured is the magic bullet to throttle down the medical expenditures rate. I'm not entirely convinced that the consumer-driven healthcare advocacy will do it alone either.

Of one thing I am convinced: something(s) must be done, and that is going to have to come from our government(s). -------- BECAUSE private enterprise governance just ain't working.

Have a good Thanksgiving

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32176Ytown(1254 comments)posted 11 months, 1 week ago

HappyBob; The reason I brought the 2013 premium into the the calculation is because it's probably a given that the cost to stay in the same plan is going up in 2014 and you want to consider that even if you stayed in your current plan, you'll pay x amount more next year.

I think it's safe to say that her data is anonymous enough to use as an example. If she has a chronic condition, I would to advise her to put money into either a Flex account (FSA) or an HSA.

I don't think using averages was getting us anywhere. Again, so many variables. Anyone else out there that would like to give an example so that we can crunch some numbers?

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32276Ytown(1254 comments)posted 11 months, 1 week ago

HappyBob: Healthy people get their checkups and find problems before they become big expenses. Preventive benefits have been around for a long time, not just with the ACA and that's all good. Finding out that you have a lower stage of cancer with a routine mammogram is much better than waiting and finding out that you're now at at the point that it has spread.

I'm glad we agree that HDHPs have their place! If it works for you it can be a sensible way to spend your healthcare dollars. We'll never be able to have a one-size fits all and government healthcare for all is not the answer.

My take on the whole mess... fix certain problems that exist. 1. Prohibit pre-x limitations except for a waiting period in your new plan. Charges considered pre-x to be insured by the govt much like a re-insurance plan. Not all people with a pre-x condition are still in treatment or have major expenses. 2. Provide better access to health care for the poor. ER visits seem to be the only easy access but a very expensive option. Urgent care centers or neighborhood health clinics would contain costs. 3. Rather than government subsidies to the insurance companies for ins co premiums being the answer to all health care costs, go to the root of the problem...the actual COST of health care.

Interesting article today "Out of touch’ unionized public employees strike over 14.5 percent raise" http://watchdog.org/116705/touch-unio... Private sector could only dream of such benefits!

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323dontbeafool(951 comments)posted 11 months, 1 week ago

Insurance companies are the private sector, so are doctors and hospitals, so I guess they can determine the COST of health care. They set the prices of what procedures, tests, and treatments costs. That is free enterprise right? Unless you want government to step in and regulate them. I see it all the time, doc walks past the hospital room, bam....there is a $500 Dr visit. If certain people would spend the same amount of time and energy trying to fix problems as they do trying to make something fail, we would have a lot better place to live.

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324HappyBob(285 comments)posted 11 months, 1 week ago

@76Ytown,
just a quick thought, cuz I gotta run.

Would you repeal the ACA recission rule?

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32576Ytown(1254 comments)posted 11 months, 1 week ago

HappyBob;

The rescission rule? For pre-x? Don't know about repea,l but for certain we need to fix the problem regardless of whether we keep the entire ACA or defund and start over.

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326HappyBob(285 comments)posted 11 months, 1 week ago

The pre-existing condition fix that is being phased in right now under ACA provides that insurers can not deny new coverage for a pre-existing condition (Consequently there should be no questions on an enrollment application about the applicant's health)

The recission rule, which came about immediately after ACA was adopted in 2010, prohibited insurers from retroactively cancelling insurance after a claim was filed. This was a mechanism that some insurers used to avoid paying on claims. Perhaps because it was three years ago we tend to forget that the ACA outlawed that practice.

Two different things.

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327HappyBob(285 comments)posted 11 months, 1 week ago


76Ytown,
Your point #2 in post 365 about the "poor" and my concern about "50% of the population spends little or nothing on healthcare".....

Reminds me of some experiences I've had in the past few years. For the years I worked with rural folks in southern Kentucky and extreme western parts of Virginia, I came in contact with an amazing number of folks who were very proud of the fact that they had not seen a doctor or a dentist.

In particular two of these folks had similar end-of-life experiences.

A forty-four year father of three that I had known over several years expressed pride that he hadn't need of medical care, nor would he want (allow) any of his family to get care.

His teeth had rotted so badly and he had an abscess, the infection got into his blood stream and he became septic. His children found him delirious and called for 911. He was taken to the local hospital where he was in a coma in intensive care for 7-8 days and eventually passed away.

Of course he had no insurance, and wasn't on medicaid (I ain't taken no welfare, he had told me). The hospital billed his family for 213,000 dollars. They were already effectively bankrupt, so the hospital had to eat the bill (redistribute it to others).

The man felt he had his rights and freedoms, specifically to refuse to get medical care. But his family, when faced with his sudden illness, called 911 rather than let him die in their backyard. And of course, because he was comatose, he couldn't refuse being treated

In the span of three years I've witnessed this similar scenario played out twice.

Maybe some people can not be in charge of their own healthcare, and how many of them are in that 50% of the population that spend little or nothing on healthcare.

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32876Ytown(1254 comments)posted 11 months, 1 week ago

Group plans are not as affected by the rescission rule as individual policies such as life or health. The policy is underwritten after the person applying for coverage completes the application and certifies that the information provided is correct. If there is fraud or a misrepresentation or omission of medical history the insurance company has the right to cancel coverage and refund premiums. This is only for the period of the first 2 years. It doesn't pay to lie on an insurance application.

Group insurance can rescind the coverage if for example your are no longer eligible for coverage but through a clerical error were not taken off the plan. If you paid for coverage you weren't entitled to they can just cancel the coverage not retroactively.

PPACA will eliminate medical underwriting in 2014 but will still include the medical questionnaire in the application.

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329HappyBob(285 comments)posted 11 months, 1 week ago

Are you sure about the medical questionaire in the future?

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330HappyBob(285 comments)posted 11 months, 1 week ago

Johanna M. Novak
Foster Swift Employment, Labor & Benefits Quarterly
Fall 2010
"Thousands of Americans lose health care coverage each year due to rescissions. According to the House Energy and Commerce Committee, some health insurance companies wait until expensive claims are submitted and then investigate enrollment materials to try to locate some discrepancy or omission in those materials that could justify a rescission of coverage and denial of the expensive claims, even if the discrepancy or omission was unintentional and unrelated to the medical condition for which the patient sought care.

To end this practice, the Patient Protection and Affordable Care Act ("PPACA") included language to ensure that individuals would no longer unjustly lose health coverage by rescission. Effective for the first plan year beginning on or after September 23, 2010, a group health plan or health insurance issuer cannot rescind coverage with respect to an individual once the individual is covered under a plan or policy unless the individual performs an act, practice, or omission that constitutes fraud or an intentional misrepresentation of material fact, as prohibited by the terms of the plan or coverage. A group health plan or health insurance issuer must provide at least 30 days advance written notice to each participant who would be affected before coverage can be rescinded, regardless of whether the coverage is self-funded or fully-insured. These regulations apply to both grandfathered and non-grandfathered health plans"
.

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331HappyBob(285 comments)posted 11 months, 1 week ago

The Health Lawyer
Hilary Rowen, Esq.
Sedgwick, Detert, Moran & Arnold
San Francisco, CA
"Starting in 2014, price differences based on health status and medical history will not be allowed, with the exception of lower premiums for employee participation in wellness programs.8 In addition to banning medical underwriting, PPACA also provides that individual and small group premiums can be determined based only on:
• Family Structure. Whether coverage is provided only to an individual or for a family. The price differential is not capped, but families of two (i.e. spouses or partners) and families of eight (adults plus children) will pay the same premium.9
• Geographic Region. The permitted geographic regions are to be estab¬lished by each state, subject to review by the Department of Health & Human Services (“HHS”).10 This factor is not capped under PPACA. The geographic region rating factor captures differences in the cost of healthcare services in different parts of a state (most typically, cost differ¬ences between urban and rural areas).
• Age. Price differences based on age are limited to a 3-to-1 difference between the lowest and the highest priced age groups.11 HHS is to spec¬ify permitted age bands by regulation prior to 2014. On average, people in their fifties and early sixties have sig¬nificantly higher medical and hospital costs than people in their 20s. The effect of the 3-to-1 ratio cap is likely to shift costs from younger insureds (especially males, in states that currently allow insur¬ers to use sex as a rating factor) to older insureds.
• Tobacco Use. Tobacco use is lim¬ited to a 1.5-to-1 difference in premiums between tobacco users and non-users.12 This rate differen¬tial is significantly smaller than the actual difference in costs (especially for older smokers who have reached the ages where tobacco-related ail¬ments tend to manifest)." http://www.sdma.com/files/Publication...

So what is the point of medical questionaires for new policies??

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33276Ytown(1254 comments)posted 11 months, 1 week ago

"Thousands of Americans lose health care coverage each year due to rescissions"

Let's say you apply but intentionally omit the fact that you have just been diagnosed with cancer in the 6 months before obtaining coverage. (pre-x). That constitutes fraud. You will still be rescinded under the new laws. I don't know of a company that willy-nilly denied coverage for people who submit claims but there apparently have been examples.

The applications will still include questions such as your tobacco use.

With the addition of PPACA, the laws and interpretations are about as complicated as IRS tax law! In the immortal words of Nancy Pelosi "But we just have to sign it to find out what's in it".... Despicable!

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333HappyBob(285 comments)posted 11 months, 1 week ago

Mcgraw Wentworth LLC - Employee Group Benefits Consultants

"Guaranteed Availability and Renewability of Coverage

In 2014, individual and small group health insurance carriers will be prohibited from medically underwriting applicants for non-grandfathered coverage. Small groups will be defined as groups with up to 50 employees in 2014 and 2015. In 2016 that number will rise to groups with up to 100 employees. Although states can use the 100-employee threshold in 2014 and 2015, it appears that few will. In 2017, states may allow large group health coverage to be offered through the Exchange.
Carriers will be unable to deny coverage based on pre-existing medical conditions or any other factors. This requirement could potentially cause a problem if people decide not to purchase health insurance until they have an actual need to use it. Several health care reform provisions will protect insurance carriers against this adverse selection. "
http://www.mcgrawwentworth.com/Reform...

Where did you get your information that a medical questionaire will still be required?

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33476Ytown(1254 comments)posted 11 months, 1 week ago

HappyBob; Did we finish our discussion about HDHP / HSAs because this is going to take us in an entirely different direction.

Like I said in post 376: "With the addition of PPACA, the laws and interpretations are about as complicated as IRS tax law! In the immortal words of Nancy Pelosi "But we just have to sign it to find out what's in it".... Despicable!"

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335commoncitizen(961 comments)posted 11 months ago

Obama is now trying to blame the Repubs. for HIS lack of follow up on HIS prize Obamacare. When is he going to stop blaming OTHER people for HIS mistakes????
Are all of you Obama fans STILL happy?

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33676Ytown(1254 comments)posted 11 months ago

HappyBob: Your post #371 makes me wonder what will happen to those people who decide to forgo the insurance and pay the penalty but now need to go to the hospital for care. Will they still be able to receive treatment since they willfully declined to get coverage?

If you don't sign up during the open enrollment period, you have to wait till the next enrollment to apply, so it won't be like you show up at the ER and just pay a month's premium to join unless you qualify for Medicaid.

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33776Ytown(1254 comments)posted 11 months ago

eivo: If next year's cancellations will be for Jan 1, 2015, they may be able to time the notices to be sent right after the elections. This administration has a way of timing things to their advantage.

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33876Ytown(1254 comments)posted 11 months ago

Mid-term elections: Vote out every incumbent that followed Pelosi when she said " We have to pass the bill (healthcare) to see what's in it" Despicable!

One thing Obama didn't lie about "I'm going to fundamentally transform the United States Of America"

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33976Ytown(1254 comments)posted 11 months ago

Where is my friend Bob?

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340HappyBob(285 comments)posted 11 months ago

On Vacation........

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34176Ytown(1254 comments)posted 11 months ago

Enjoy!

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342HappyBob(285 comments)posted 11 months ago

Thanks.
You may have noticed, or not, but I'm just not interested in trash talk at the expense of any party.
Have a nice thanksgiving.

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343Jerryl(105 comments)posted 10 months, 4 weeks ago

Eivo,
How about some source for your assertions. Or are you trying to tell us that you personally know these millions, or these record numbers of doctors?

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34476Ytown(1254 comments)posted 10 months, 4 weeks ago

I'm one of the millions who've had ins cancelled and a second wave is coming affecting 50 - 100 million Americans. http://townhall.com/tipsheet/guybenso...

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345commoncitizen(961 comments)posted 10 months, 4 weeks ago

Jerry must have his head in the sand if he hasn't heard (thru most of the news reports) that Obama was not honest when he said that you could keep your ins or your doctor. If it isn't true then why are a lot of the Dems not backing Obamacare?
Jerry must belong to a large union that thinks they will get "favorable" treatment from Obama because they (unions) backed him in the last election --WRONG!!

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34676Ytown(1254 comments)posted 10 months, 4 weeks ago

Sen. John Thune (R-SD), the chairman of the Senate GOP conference, has discovered that President Barack Obama’s administration has decided to grant an exemption to labor unions from Obamacare’s reinsurance tax.

http://www.breitbart.com/Big-Governme...

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347Jerryl(105 comments)posted 10 months, 4 weeks ago

@ytown,
You said your old policy was canceled and replaced with a 1100/ mo policy.
What will a policy thru the exchange cost you for a family of 3?

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348Sanjay1976(37 comments)posted 10 months, 4 weeks ago

Faux News.... now I understand!

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34976Ytown(1254 comments)posted 10 months, 4 weeks ago

Jerry, The latest KFF.org calculation shows premiums of $15,132 per yr for the Silver plan with a max OOP of $12,700 added to the premium cost in my case. That is before subsidies. In other words, the government is willing to pay as much as $15,132 per year to subsidize the premiums a person pays for health insurance up to 400% of poverty level. Plus subsidies for the OOP up to 250% of poverty level.

Now, compare that to my current plan. $508 mo / $6096 yr., $5500 ded per person / $11,000 per family. Eff 1/1/14, because of the ACA, coverage will be $1098 per mo / $13,176 yr. with the same ded. Plan pays 100% after ded is met.

Can't you all see that this is just a massive subsidy to the insurance companies. They did not save anyone any money nor did they make health coverage affordable. If the problem was taking care of 48 million uninsured Americans, they could have subsidized that group alone for less than the cost of this massive subsidy for all.

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350Sanjay1976(37 comments)posted 10 months, 3 weeks ago

@ evivo,
Are you saying that is not true?

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351dontbeafool(951 comments)posted 10 months, 3 weeks ago

RUSH said it Sanjay. That is Eivo's Bible.

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352Sanjay1976(37 comments)posted 10 months, 3 weeks ago

@eivo,
A 2013 policy that had pre-existing conditions excluded can not be offered in 2014.

A 2013 policy that had pre-existing conditions excluded cost less that the same policy that had no pre-existing conditions excluded.

Is there some reason that would not also hold true for 2014?

So, where do you find fault with the "spin" ?

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35376Ytown(1254 comments)posted 10 months, 3 weeks ago

It's not that we paid too little in the past. We simply paid for the benefits we received. Every time you add extras, you'll pay more. Actuarially, you spread the risk over the entire group.

A recent Vindy article said "As many as 45 percent of motor vehicle operators in the city drive without licenses or insurance," http://www.vindy.com/news/2013/sep/08...

If we look at the problem of uninsured drivers the same as health insurance, we'd run into the same thing. There will be people who don't carry towing or car rental insurance or even comprehensive on their current plans that would see an increase in rates if it was required for all. By bringing into the pool those who have bad driving records or DUIs, the rate will go up to even out the cost for all.

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354Sanjay1976(37 comments)posted 10 months, 3 weeks ago

Exactly correct 76.
Eivo, like it or not that's the way insurance works.

Let us know when you find an insurance pool of only healthy people without genetic flaws.

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355Jerryl(105 comments)posted 10 months, 3 weeks ago

@76ytown,
The implication of an annual premium of 15,100 is that the average age of your family unit of 3 is approximately 51.

If that is somewhat accurate, your's is a unique family unit.

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35676Ytown(1254 comments)posted 10 months, 3 weeks ago

Jerry: Not sure how you come up with avg age 51 and that we're unique, but I can tell you we're certainly an average family.

Sanj: Actually Evio's post #410 is correct. He said this was the latest "spin". "The reason the cost of your health insurance is going up is that you have been paying artificially low premiums in the past because the system did not cover people with pre-existing conditions"

That reminds me of another "spin" that people with individual plans had "substandard" health plans. LOL!

Supporters need to realize that group plans don't exclude individuals with pre-x and individual plans may didn't automatically exclude coverage. If you have a pre-x condition, you may have a waiting period of up to one year with can be offset by a certificate of creditable coverage from your previous carrier.

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357Jerryl(105 comments)posted 10 months, 3 weeks ago

@76Ytown,
Using the KFF calculator I come up with a silver plan as you described with 3 adults aged 56,54 and 33.
There are other combinations such as 60,60 and less than 21.

I sincerely ment no offense by suggesting unique, but the 15,132 you said exactly fit the 3 adults case. If that were the situation, the third adult would have to be a dependent.

If your family situation is not even close to the above, I think you might want to check back with KFF for a new estimate.

###########

Sanjay can speak for himself, but I think what he was objecting to was eivo's implication that this "spin" is a gross distortion of the truth.

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35876Ytown(1254 comments)posted 10 months, 3 weeks ago

Again, can't you all see that this is just a massive subsidy to the insurance companies.

They did not save anyone any money nor did they make health coverage affordable.

If the problem was taking care of 48 million uninsured Americans, they could have subsidized that group alone for less than the cost of this massive subsidy for all.

Interesting... http://www.gao.gov/new.items/d11662.pdf

The Government appropriated $5 billion toward the creation of a temporary federal
high-risk pool, known as the Pre-Existing Condition Insurance Plan (PCIP) program.

The Congressional Budget Office estimated the program could cover an average of 200,000 individuals each year with the $5 billion appropriation.

The Office of the Actuary within the Centers for Medicare & Medicaid Services (CMS) projected enrollment of 375,000 by the end of 2010 and that funding would be exhausted by 2011 or 2012.

States and HHS Spent about 2 Percent of Total Program Funding by March 2011

They cancelled this plan eff 1/1/14 due to the ACA going into effect.

If a major problem with the uninsured is pre-existing conditions and the above program was so cost effective, spending only 2% of the allocation, why can we not continue with such a program rather than subsidize premium cost for just about everyone in America? The ACA projected cost of trillions of dollars vs $5 billion. No brainer!

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359HappyBob(285 comments)posted 10 months, 3 weeks ago

@76Ytown,
Didn't you have this discussion before. You argue that the insurance industry is the receipient of a massve subsidy. For this, they should be thrilled and be doing everything to make ACA successful.

And yet we hear that the Insurance companies are not happy, that some major insurers are not participating.

Can you figure how to reconcile those two positions?

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360HappyBob(285 comments)posted 10 months, 3 weeks ago

@76Ytown,
I come up with the same numbers that Jerry did. Your family of 3 would consist of a 56 year old, a 54 year old spouse and a 33 year old dependant.

The assertion that you are putting forward, that the government is willing to subsidize you up to 15,321 per year assumes that none of the none of the adults in your family is working.

You said above (#409) that ACA did not make health coverage affordable, there are hundreds of thousands that would disagree.

I'm beginning to get the sense that your biggest issue with ACA is that low income folks may be able to have insurance coverage.

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361kurtw(876 comments)posted 10 months, 3 weeks ago

Nobody seems to like the current healthcare system- either because of excessive government involvement or because the government isn't involved enough- what is the answer?

Why can't fixing our bodies- health care- be like fixing our motor vehicles? Shop around, get the best deal- check the ads, clip coupons- and then go in an get that open heart surgery and you'll know you're getting the best deal.

What I'm trying to say is that if health care providers were subjected to ordinary market pressures- the ones that control every other part of the economy- cost would have to go down and costs would stay realistically pegged to the law of supply and demand.

Employer provided health insurance, in a way, has corrupted the system and led to the present crisis- where nobody thinks about the costs of the goods and services- medical care- they are consuming because somebody else is paying for them. That's insane- and it's a recipe for disaster- as we now see.

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362Jerryl(105 comments)posted 10 months, 3 weeks ago

Conservatives GREATEST fear:

In rural Kentucky, health-care debate takes back seat as the long-uninsured line up

“Soon, Ronald Hudson walked in (to the clinic)

“Okay,” Lively began. “What Hudsons are you kin to?”

“R.T., Uncle Lenny . . .” said Hudson, a skinny 35-year-old who worked as an assistant director at the senior center and had just been released from the hospital after a blood-sugar spike.

He’d never had insurance before and said his hospital bills were up to $23,000 at this point.

“Good night,” Lively said, tapping in his information.

Kids: five. Salary: about $14,000 before taxes.

“You’re going to qualify for a medical card,” she told Hudson.

“Well, thank God,” Hudson said, laughing. “I believe I’m going to be a Democrat.” “

(from article about Breathitt County Kentucky)
www.washingtonpost.com/national/in-ru...

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36376Ytown(1254 comments)posted 10 months, 3 weeks ago

HappyBob: #422 "Can you figure how to reconcile those two positions?"

1. The exchange is only a data hub designed to collect your info and share with 7 other govt agencies. The insurance companies authorized by the government to participate are given subsidies to offset premium cost. They set the premium cost...the government subsidizes.

2. http://www.bloomberg.com/news/2013-10...

Bob&Jerry...you're putting way too much energy into guessing my age! LOL BTW you're not even close. You can fill in the blanks with any individual or family for an example of the amount of premiums the government would be willing to subsidize. The subsidy goes down of course as the income goes up, but they will subsidize up to 400% of the federal poverty level.

Kaiser Foundations says the average Among the approximately half of current enrollees who will be eligible for tax credits, the average subsidy would be $5,548 per family, which would reduce their premium for the second-lowest-cost silver premium by an average of 66%.

http://kff.org/health-reform/issue-br...

I do not have an issue with providing health insurance for the uninsured, I have an issue with the cost of subsidizing premiums. As I've said before, we need affordable health care COST, not health care premiums.

My post #421 mentions a program that was scrapped this year which covered pre-existing conditions. They funded $5 million, only spent 2%? The ACA is expected to cost over a Trillion $s...that's more cost effective?

kurtw: You're right, people have no clue as to what health care COSTS. Consumer driven health plans put the patient in the driver's seat just like you say in your post.

Driving people to Medicaid (BTW...already broke) is not going to save health care COST. Medicaid has all kinds of benefits not covered by Medicare or other health care plans. Vision, dental and hearing aids just for starters.

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364andersonathan(669 comments)posted 10 months, 3 weeks ago

Just convert to Islam, become a Muslim and file for a exemption it will take about 9 months to get it.

OR

do not sign up do not visit the sight it is nothing but a information power grab right now by a corrupt system. They have a long time to set this failure up i can think of a air ship and sea vessel that crashed in the end but at least flew and sailed for a bit. Now is the time to drive the Obama Care and supporters out of office for good, unless we can deport them then that would be nice.

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365Sanjay1976(37 comments)posted 10 months, 3 weeks ago

Faux News...... Brought to you by eivo

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366HappyBob(285 comments)posted 10 months, 3 weeks ago

@ eivo,
You say the the insurance companies don't like ACA, but 76ytown says that the ACA is a big benefit to the insurance companies.

Sounds inconsistent

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367Jerryl(105 comments)posted 10 months, 3 weeks ago

The nightmare scenerio:

The newly insured under Obamacare become democrats.

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368Jerryl(105 comments)posted 10 months, 3 weeks ago

@kurtw,

Are you proposing the end of healthcare insurers?

Or that insurers should allow the policyholders to go to any provider (eliminate networks or preferred provider discounts)?

Regarding government involvement, should the government stop regulating who can practice medicine?

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369HappyBob(285 comments)posted 10 months, 3 weeks ago

@76Ytown,

You said: "I do not have an issue with providing health insurance for the uninsured, I have an issue with the cost of subsidizing premiums."

Is your objection to cost or subsidizing?

How would you "provide" health insurance to the uninsured and uninsurable without cost?

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370Jerryl(105 comments)posted 10 months, 3 weeks ago

76, You chose to use your family as an example.

Using that information It takes practically no time to determine that the configuration of your family of three adults are persons aged 56 and 54 and 33.

For the sake of discussion if your total family income is 30,000 (each person working at a 10,000/yr job) you would still not get a 15,132 subsidy (as you claim would be possible).

Either you have miscalculated your family plan, or it's not a family plan at all, or you just made up some numbers. Or, the last possibility is that your family has no income.

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37176Ytown(1254 comments)posted 10 months, 3 weeks ago

Regardless of the scenario we present, we're finding that the government is willing to give all of us free money (subsidies) to cover the cost of our insurance premiums paid for by our Federal Taxes. We currently have a national debt of over 17 trillion, 206 billion dollars. This is borrowed money that we pay interest at the lowest rates in history. Loans that are short term and when renewed are not guaranteed at these low rates. Before O took office in 2008 he criticized Bush for adding $4.9 trillion to the debt in 8 years. When Bush left office our debt was10 trillion 700 billion dollars. We now owe over 17 trillion, 206 billion dollars. That's $7.5 trillion added to our debt in 5 years and since October, the debt ceiling was eliminated so it's a free for all.

A solution to our health care problems of uninsured and pre-x could have been addressed in a way that did not involve this massive overhaul of our entire health care system as we know it. Re-read my post # 421 and the link to a program for people with pre-x conditions that allocated $5 million but only used 2% before it was scrapped. "Spending was also lower than projected—about 2 percent of total program funding had been spent, or about $78 million by state-run PCIPs and $26 million for the federally run PCIP. " http://www.gao.gov/new.items/d11662.pdf

The money to fund subsidies up to 400% of poverty level could have gone directly to fund the uninsured through programs such Medicaid. Obamacare is expected to cost over a trillion dollars. The exchange website has already spent far more than projected. If people do not sign up and pay premiums into the exchange, the cost for those enrolled goes up.

Medicaid is free health care for those under the state poverty line. Medicaid is broke, the USPS is broke, We have unfunded liabilities in Social Security and Medicare, and the list goes on.

Government needs to stay out of healthcare. Allowing the free market to insure individuals and providing a safety net for those that have a pre-x or cannot afford the cost would have cost far less than where this is taking us. This is nothing other than a power grab to control 1/5 of our GDP.

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37276Ytown(1254 comments)posted 10 months, 3 weeks ago

"Government big enough to supply everything you need is big enough to take everything you have. The course of history shows us that as a government grows, liberty decreases." -

Thomas Jefferson

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373dontbeafool(951 comments)posted 10 months, 3 weeks ago

You act like he is the first politician to not tell the truth. Lie about evidence to go into a war that cost human lives and billions of dollars (that was kept off of the national budget no less) is okay. Go from the red to the black financially. Great job. Create Homeland Security and the Patriot Act that enabled all of this spying in the first place. Do away with SS and just put your money into the stock market! Great idea until it crashes. Healthcare skyrockets out of control so lets do absolutely nothing about it. But all that is acceptable. I hope a Republican wins the POTUS this time, and I hope the Dems take the house and senate and block every single proposal that your President wants to do. Can't wait. Let's go for another do nothing 4 years.

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374dontbeafool(951 comments)posted 10 months, 3 weeks ago

What does cash for clunkers, cell phones, and free houses have to do with health care? Ummm NOTHING. Phony hypocrite just like your pill popping idol Rush.

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375kurtw(876 comments)posted 10 months, 3 weeks ago

There's no way to get around the fact that all this is leading up to "single payer" government run health care European and Canadian style- does anyone think there is any other alternative?

Do you remember the story of "Humpty Dumpty" :
"Humpty Dumpty sat on a wall,
Humpty Dumpty had a great fall,
All the kings Horses and all the Kings Men,
Couldn't put Humpty back together again."

That's the American Health Care System- Humpty Dumpty- Broken- and there's no going back- much as I hate to say it.

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376kurtw(876 comments)posted 10 months, 3 weeks ago

Another Point: There's three reasons American Health Care Cost are going through the roof, they are:

One: Obesity and lack of exercise among 70% of the population.

Two: Tobacco Addiction

Three: Shyster Lawyers who sue doctors
at the drop of a hat to make
money.

Now I don't know what to do about Number One; But Number two is easy- ban tobacco as a consumer product- it should be treated as a toxin and regulated by the FDA- like Cocaine and Heroin (the only reason that hasn't been done yet is because of the political clout of Southern Democrats- the good people who care about you- people like Bill Clinton, Jimmy Carter, and Al Gore, right!- the same good people who gave us Slavery and Jim Crow).

As far as the Shysters are concerned: Tort Reform! Do you know how much it costs a physician to defend himself against a frivolous law suit? Change the law and if you sue somebody and lose the case- you pay costs for both sides. That's the way it is in Europe and Canada. Over here, I get flyers all the time (I'm sure we all have) from some Shyster who wants me to sue somebody because: "No risk to you. Fees deferred until you settle" Right. In other words they want you to gamble- "What have you got to lose?" Well, doctors and hospitals- and Insurance Companies know that and- guess what- they practice "Defensive Medicine"- order tests that otherwise wouldn't be needed just to cover their butts- and it pushes premiums through the roof- which ordinary people have a hard time affording (the shysters and politicians seem to do pretty well, don't they?)

And all that- taken together- is why American Health (disease) care is as expensive as it is.

P.S. I saw a great bumper sticker the other day, it said:

"If you need a Doctor, Call a Lawyer!" Amen to that (or "Politician", it's more or less the same thing).

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377HappyBob(285 comments)posted 10 months, 3 weeks ago

@76Ytown,
"Already, the Congressional Budget Office has quietly erased hundreds of billions of dollars from its projections. It now estimates that Medicare spending in 2020 will be $137 billion lower than it thought in 2010, a drop of 15 percent; Medicaid spending will be $85 billion, or 16 percent, lower; and private health insurance premiums are expected to be about 9 percent lower."
- NYT. 12/2/13

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378Jerryl(105 comments)posted 10 months, 3 weeks ago

@kurtw,
I realize that you are late to this thread, but the issue of tort reform as an effective means to control health care cost has already debunked.

Ban Tobacco - like prohibition of alcohol????- how did that work out?
Incidentally, Tobacco use in Europe is significantly higher than in the US, and their health care costs are lower. (go figure)

BTW your linking Clinton, Gore and Carter with Jim Crow laws and slavery is slightly inflamatory. Having lived in the tobacco growing South, Republicans are just as responsible for protecting the tobacco industry.

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379HappyBob(285 comments)posted 10 months, 3 weeks ago

Decererating Health Care costs:

http://www.nytimes.com/2013/12/03/bus...

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380dontbeafool(951 comments)posted 10 months, 3 weeks ago

yes Happy, you need a Fair and Balanced source, or something with the phrase "mega dittos" in it, or otherwise Chicken Little won't believe it. Chicken Little, for those who don't know, is the one who constantly ran around yelling "the sky is falling" because she thought the world was ending.

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381HappyBob(285 comments)posted 10 months, 3 weeks ago

According to the Kaiser Family Foundation—widely regarded as an honest, non-partisan broker when it comes to healthcare issues and analysis—the declining increases in the cost of healthcare is 75 percent the result of economic factors and 25 percent a benefit of the cost cutting measures in the ACA that do, in fact, appear to be working.
- Forbes 12/3/13

In its most recent baseline projections, CBO reduced its estimates of spending for the Medicare and Medicaid programs compared with its estimates in the August 2012 baseline. For the 2013–2022 period, projected spending for those programs is now $382 billion (or 3½ percent) below the agency’s estimates in August 2012
http://www.cbo.gov/publication/43947

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382dontbeafool(951 comments)posted 10 months, 3 weeks ago

that won't be good enough either Happy. Nothing will.

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38376Ytown(1254 comments)posted 10 months, 3 weeks ago

HappyBob: Provide us with the Forbes link, would love to know how they define 75% economic factors.

Project all you want. The CBO estimates show that they will spend less than what they estimated. What the heck does that prove? So they estimated high and they look good if they come in low?

Look at the bottom line. Medicare spending in 2012 $494 billion, vs 2022 $899 billion. Medicaid spending in 2012 $267 billion, vs 2022 $592 billion. Don't think the Medicaid expansion will affect spending?

This reminds me of the change in how our unemployment numbers our calculated. They no longer count the under and unemployed, they only count people who are actually collecting unemployment benefits making the numbers shrink as the long term unemployed drop off the rolls or people accept part time jobs. The number of workers in the labor force has fallen to 63.6%. http://data.bls.gov/timeseries/LNS113...

The real numbers are:
"official" unemployment: 11,178,194
actual unemployment: 21,405,443
http://www.usdebtclock.org/index.html

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38476Ytown(1254 comments)posted 10 months, 3 weeks ago

Sorry, HappyBob, I didn't read your previous post (449) before I asked you about the economic factors. That article says:

"Economists broadly agree that the sluggish economy remains the main reason that health spending has grown so slowly for the last half-decade."

"other changes, like rising deductibles and copays that discourage some people from seeking extra services, play a bigger role, analysts say. Still, the Kaiser Family Foundation, a nonprofit research group, estimates that the weak economy accounts for as much as three-quarters of the slowdown in the growth of spending on health care."

"But those are responsible for only a tiny portion of the slowing rise of health care costs; other changes, like rising deductibles and copays that discourage some people from seeking extra services, play a bigger role, analysts say. Still, the Kaiser Family Foundation, a nonprofit research group, estimates that the weak economy accounts for as much as three-quarters of the slowdown in the growth of spending on health care. "

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38576Ytown(1254 comments)posted 10 months, 3 weeks ago

Kurtw: "There's no way to get around the fact that all this is leading up to "single payer" government run health care European and Canadian style- does anyone think there is any other alternative?"

Obama always wanted a single payer health system but says it will take a transition. http://www.youtube.com/watch?v=Kvg8qV...

and a viewpoint of "designed to fail"
http://communities.washingtontimes.co...

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386dontbeafool(951 comments)posted 10 months, 3 weeks ago

Myth: Canada's health care system is a cumbersome bureaucracy.

The U.S. has the most bureaucratic health care system in the world. More than 31 percent of every dollar spent on health care in the U.S. goes to paperwork, overhead, CEO salaries, profits, etc. The provincial single-payer system in Canada operates with just a 1 percent overhead. Think about it. It is not necessary to spend a huge amount of money to decide who gets care and who doesn't when everybody is covered.

Myth: The Canadian system is significantly more expensive than that of the U.S.Ten percent of Canada's GDP is spent on health care for 100 percent of the population. The U.S. spends 17 percent of its GDP but 15 percent of its population has no coverage whatsoever and millions of others have inadequate coverage. In essence, the U.S. system is considerably more expensive than Canada's. Part of the reason for this is uninsured and underinsured people in the U.S. still get sick and eventually seek care. People who cannot afford care wait until advanced stages of an illness to see a doctor and then do so through emergency rooms, which cost considerably more than primary care services.

What the American taxpayer may not realize is that such care costs about $45 billion per year, and someone has to pay it. This is why insurance premiums increase every year for insured patients while co-pays and deductibles also rise rapidly.

Read more: Debunking Canadian health care myths - The Denver Post http://www.denverpost.com/recommended...

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387ytowntomg(26 comments)posted 10 months, 3 weeks ago

If you have enough cash, you will always get great health care in this country. If you have to get obomocare, you will be standing in lines longer than the NY Turnpike. My friends twisted her ankle in Canada and was at the emergency room for 11.5 hours before she said f'it and left. That's where we're headed kiddees.

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388ytowntomg(26 comments)posted 10 months, 3 weeks ago

And let's all sit around the fire and sing kumbaya with 'dontbeafool'. She is a true believer. I can almost hear the music when I read her words. It's all gonna be just great. Ahhhhhhhhhhhh.

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389dontbeafool(951 comments)posted 10 months, 3 weeks ago

kumbaya, no, but I learned not to listen to scare tactics from people like Chicken Little aka eivo and his idol Rush. The sky is falling....is all you hear from the extreme right. You guys will be on the next season on Doomsday Preppers soon.

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390Jerryl(105 comments)posted 10 months, 3 weeks ago

Here's a quote from Ytownomg:
" I'm all for helping those who cannot work. I'm all for taking care of the young and the elderly. I'm all for giving people a chance to get back on their feet."

Except when it comes to Obamacare.

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391dontbeafool(951 comments)posted 10 months, 3 weeks ago

I wonder why?

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392James_S(268 comments)posted 10 months, 3 weeks ago

Harry Reid has just exempted some of his Congressional staff from Obamacare.

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393HappyBob(285 comments)posted 10 months, 3 weeks ago

@76Ytown,
Re: In its most recent baseline projections, CBO reduced its estimates of spending for the Medicare and Medicaid programs compared with its estimates in the August 2012 baseline.
http://www.cbo.gov/publication/43947

Is there some reason that you are unwilling to accept any good news?

It seems like when the CBO announces something that supports the party philosophy, the information is taken as gospel.

But when a CBO release runs counter to party philosophy then they are accused of cooking the books or incompetence.

Considering your concern over government spending, you should be celebrating estimated spending reductions.

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394dontbeafool(951 comments)posted 10 months, 3 weeks ago

@happy.... AMEN! They don't want to hear any good news!

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39576Ytown(1254 comments)posted 10 months, 3 weeks ago

HappyBob:

I'm really excited about the estimates of lower spending, but it still shows costs to nearly double in the next 10 years. Are they including the Medicaid expansion in the projections? Medicaid is already broke.

I'm just not a fan of estimates or averages since they are relative.

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396kurtw(876 comments)posted 10 months, 3 weeks ago

My linking Southern Democrats to Slavery, Jim Crow and bending over backwards to support Big Tobacco- "Inflammatory"- Maybe. True- Yes.

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397dontbeafool(951 comments)posted 10 months, 3 weeks ago

Irrelevant- absolutely.

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398kurtw(876 comments)posted 10 months, 3 weeks ago

Not really- when you consider the huge expense of treating the consequences of tobacco addiction and the burden it imposes on an already over strained system. Ironically, the South, the home of Big Tobacco, also has some of the unhealthiest dietary choices you can think of- everything is "deep fried" down there- add that to a sedentary lifestyle and what do you get:

A lot of health problems which are "self created" by bad life-style choices. And then, add the predatory shysters always ready to shift the blame away from the individual to the "system" and when you thing about all that- it goes a long way to explaining- "runaway health care costs".

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399dontbeafool(951 comments)posted 10 months, 3 weeks ago

Those points about unhealthy choices okay, but that is the entire US, not just the south. The irrelevant part is about the southern Dems and slavery and tobacco, really? The entire south is primarily republican controlled, do you think that they are going to let the tobacco industry fail. Tobacco isn't going anywhere. Besides, they make too much tax revenue from it.

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400Jerryl(105 comments)posted 10 months, 2 weeks ago

@kurtw:
your words: " Bill Clinton, Jimmy Carter, and Al Gore, right!- the same good people who gave us Slavery and Jim Crow)."

You are insisting that Clinton, Carter and Gore gave us Slavery and Jim Crow (laws)?????

What alternate universe are you living in?

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401Cosmo19(53 comments)posted 10 months, 2 weeks ago

He's living in the tea party cup with Sara

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402dontbeafool(951 comments)posted 10 months, 2 weeks ago

Maybe after 500+ comments on this thread, it might be a good idea for all to go back and read the article at hand, which was written by a Doctor. This same scenario happened back when Medicare was introduced. Doctors hated it, bad mouthed it, people hated it, and there were problems launching it. Over time, those same people learned to like and appreciate it. It is going to be worse this time around with the ACA because of the political opposition of the other party involved. Instead of obstructing and fear mongering, accept it and try to make it better as problems arise. Is the ACA perfect, NO. Is everything going as hoped, NO. It is a major program and it will take years to tweak and run efficiently.

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403dontbeafool(951 comments)posted 10 months, 2 weeks ago

Thanks for that wonderful insight Chicken Little. I thought that you would be in a better mood, since there are more freeloaders suffering since SNAP was cut this last Friday. Not even that made you happy? Oh btw, on a 50K income, you pay around $42 towards SNAP and other help programs. On that same 50k salary you pay 6k towards Corporate Welfare. Now go back to the couch with your lap top.

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404dontbeafool(951 comments)posted 10 months, 2 weeks ago

YES, there is one, CORPORATE WELFARE TO BIG BUSINESSES. Is there a poor, sick, or non white person that you don't hate? My parents were working poor growing up, and there was a period of a couple months after the loss of my Dad's job that food stamps put food on the table until he landed another job. We were embarrassed to use them, but I was thankful for that program. I always found it funny the the "Conservative" groups always preach about morals, values, and family, but they are the first to object when someone in need gets some assistance. That is because their money tends to be more important than the down and out person's needs. And I'm not stupid Chicken Little. I know that there are plenty of people who abuse the assistance, and they are wrong in doing so. And more measures need to be put in place to stop it.

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405dontbeafool(951 comments)posted 10 months, 2 weeks ago

Those are some good people that you see on tv. And there are no corporate welfare going on to companies donating to Republican politicians? You neither hate or like the sick or poor, you just can't stand seeing them receive any kind of help. Your true colors are shining strong my friend.

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406HappyBob(285 comments)posted 10 months, 2 weeks ago

"I was among the many docs who went around their local communities badmouthing Medicare and praising the AMA’s anemic substitute, which was called Eldercare. We predicted doom and disaster if the Medicare bill passed, just as some doctors are doing today with regard to the Affordable Care Act....None of the predicted horrors came to pass. As time went on older patients came to appreciate their ability to get medical services without risking bankruptcy, and doctors found their incomes rising rather than crashing."
- Dr Robert Gillette

eivo, you said you'd try to stay on topic. Tell us why this healthcare reform differs.

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407dontbeafool(951 comments)posted 10 months, 2 weeks ago

Very good question Happy. I will be awaiting to see what kind of answer he has, other than bashing Obama. Switch over to the other thread, and look at his health care plan that he would initiate. Call me stupid, but I didn't realize that Happy was the author of this article. lol.

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408dontbeafool(951 comments)posted 10 months, 2 weeks ago

@Happy, btw, I am glad to see that someone can say that their previous views were wrong. Some people cannot admit when they were wrong. I thank you for your views from a Doctors standpoint.

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409dontbeafool(951 comments)posted 10 months, 2 weeks ago

@Happy. I guess he can't answer it. At least not without the help of ytown76.

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410dontbeafool(951 comments)posted 10 months, 2 weeks ago

you didn't even answer the question eivo! The question was can you tell us how does the implementing of this Healthcare reform differ from the healthcare reform in the 1960s (Medicare)
Try to follow along.

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411dontbeafool(951 comments)posted 10 months, 2 weeks ago

We will see if that satisfied Bob's question. You answered some question, but not the one he asked. Maybe reading comprehension isn't your strong suit. 1 Billion. What could we have done with 24 Billion that was lost from the gov shutdown duo of Cruz and Boehner? I know....... that was all Obama's fault too.

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412dontbeafool(951 comments)posted 10 months, 2 weeks ago

The hell it didn't. Then reopen the government, and pay all of the workers that they made stay home! Makes perfect sense!

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413HappyBob(285 comments)posted 10 months, 2 weeks ago

Anyway you could be enticed to discuss Obamacare?

Tried the healthcare website, fast and efficient and gives lots of details about plans, including downloadable descriptions and brochures from the insurers.

76Ytown should try it now.

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414dontbeafool(951 comments)posted 10 months, 2 weeks ago

Eivo, sign up and get u some Obamacare, get an eye appointment (I know, u will have to wait in line for 6 months) and get some glasses. Post 376 is your post.

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41576Ytown(1254 comments)posted 10 months, 2 weeks ago

dontbeafool...time for bi-focals or cataract surgery? Post 376 is mine.

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41676Ytown(1254 comments)posted 10 months, 2 weeks ago

HappyBob: I must say this site is an improvement but once again, the estimates I got were different.

There isn't a plan that compares apples to apples (current ded/OOP) to my current plan but the closest I get is with a gold plan but my rates will triple. In fairness, that plan has a lower deductible before reimbursement but the OOP max is the same.

If I drop down to a bronze plan, the rate is double my current rate, the deductible is the same, but has a higher OOP max.

FYI, my current plan is $5500 ded, then 100%. Allows 3 office visits and preventive care at 100% not subject to the deductible. Cost $508 per month.

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417dontbeafool(951 comments)posted 10 months, 2 weeks ago

The sky is falling! The sky is falling!

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418HappyBob(285 comments)posted 10 months, 2 weeks ago

Is misquoting excusable?

Here is the Fox transcript:

EMANUEL: The president never said you were going to have unlimited choice of any doctor in the country you want to go to.

WALLACE: Wait, no. He asked a question. "If you like your doctor, you can keep your doctor." Did he not say that, sir?

EMANUEL: He didn't say you could have unlimited choice.

WALLACE: It's a simple yes or no question. Didn't he say, "If you like your doctor, you can keep your doctor"?

EMANUEL: Yes. If you want to pay more for an insurance company that covers your doctor, you can do that. This is a matter of choice.

We know in all sorts of places, you pay more for certain -- for a wider range of choices or wider range of benefits.

The issue isn't the selective networks. People keep saying, oh, the problem is you're going to have a selective network.
(END of TRANSCRIPT)

Anyone with a half-brain understood that "you can keep your doctor" was NOT some guarantee with no exceptions. If your doctor dies, sorry can't keep him. If your doctor moves away, sorry, if you want to keep him you may have to move. If your doctor leaves the insurance network, sorry you'll have to join his new network. If your doctor wants to charge you more, sorry if you want to keep him, you'll have to pay more. If your doctor goes boutique, if you want to keep him you'll just have to go boutique also.

To portray "you can keep your doctor" as a lie only serves to indict the listener as a lacking in common sense.

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419HappyBob(285 comments)posted 10 months, 2 weeks ago

I don't care for cigars....

There are multiple ways that you can lose your doctor, and one of them is that your insurance plan is cancelled.

As you yourself stated: "Then you either lose your doctor or PAY MORE for the same doctor you had before." --- Your choice!

And that is exactly what Emanuel was saying...it's all about choice and the freedom to choose.

If you choose to stay with the same doctor and his conditions (or contract/network changes), when you would choose to accept the consequences of those changes.

What's so hard to understand?

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420HappyBob(285 comments)posted 10 months, 2 weeks ago

BTW, can you sure that you will pay MORE to see the same doctor under a new policy? --

The correct answer is : Not really, it all depends

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421Ytown76(32 comments)posted 10 months, 2 weeks ago

When the Supreme Court decides the favor of companies like Hobby Lobby, Chick-fil-A and the Catholic Church you will hear:

"If you like your birth control, you can keep your birth control."

Same difference. You can keep your doctor or you can keep your birth control. You will just pay for it out of your pocket.

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422HappyBob(285 comments)posted 10 months, 2 weeks ago

@76Ytown,

Why did you abandon the discussion (and abandon your login name) ?

76Ytown = Ytown76, ???

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423Ytown76(32 comments)posted 10 months, 2 weeks ago

I didn't abandon my friends, I've been banned for some reason since last week. Nothing I post shows up. Still waiting for answers from Vindy after 2 requests. I hope that I did not offend anyone. : (

Made up a temp login name. Notice none of my previous 500 + 76Ytown posts appear in any of the Vindy discussions. No warning. No explanation. Quite the mystery!

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424HappyBob(285 comments)posted 10 months, 2 weeks ago

Noticed that as well (missing posts)

Do you suppose that explains why there are supposed to be 564 posts on this topic but the last published above is 396?

Some several months ago I had a similar thing happen when without warning my login name wouldn't work and when I went to old threads my posts were missing. Then, months later, the posts reappeared! and the login was working!!!

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42576Ytown(1254 comments)posted 10 months, 2 weeks ago

Would be nice if they'd communicate the reason. Had it happen to me a few months ago too.

Wow 150 missing posts. Was I that active on this thread?

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426dontbeafool(951 comments)posted 10 months, 2 weeks ago

I asked vindy why some threads show 100 posts but there are actually less. They responded that SPAM is counted as a comment, but it is not posted. I'm sure eivo is glad to see you back, he struggled without you.

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427HappyBob(285 comments)posted 10 months, 2 weeks ago

Spam...interesting explanation

So they are saying that spam senders have established a login identity and password.

either someone made a mistake on 76's account or they considered her posts as spam.

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42876Ytown(1254 comments)posted 10 months, 2 weeks ago

Dontbeafool:

I'm baaaaack! I see you missed me!

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42976Ytown(1254 comments)posted 10 months, 2 weeks ago

Here's why you can't keep your doctor under the Owebama plan. Insurance COs contract with doctors for negotiated rates of reimbursement. The smaller the network of docs you have to choose from the more patients the doctors will have in exchange for their lower reimbursement.

HMOs are very limiting to what doctors you choose but the cost is the least of PPOs and POS. Doctors have the freedom to accept or not accept to join a network and we're finding that the exchanges don't offer a lot of choices even though they're calling it a PPO.

Also important to look into are covered prescriptions under the plans before you choose. Not all drugs are covered and unlike traditional health plans which still pay a percentage of other drugs, the exchange doesn't pay at all and your cost doesn't go toward your OOP max.

Be prepared for higher premiums, higher deductibles, higher OOPs, fewer providers and limited choices under these plans.

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43076Ytown(1254 comments)posted 10 months, 2 weeks ago

Thank you Vindy for your reply: "Your account was flagged as spam. We removed the flag. Avoid using links in your comments."

Must be an automated flagging system since the links I've provided to substantiate my claim don't sell viagra or tell you that I make millions of dollars working from home on my computer.

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431dontbeafool(951 comments)posted 10 months, 2 weeks ago

I don't know if that is why 76 was locked out, I just know that spam messages is what elevates the number of comments showing. I can see how they could mistake her comments as spam though. I did miss you 76, I have been having trouble sleeping lately. I usually read one of your 2 thousand word essays to knock me out.

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43276Ytown(1254 comments)posted 10 months, 2 weeks ago

dontbeafool: Sorry to hear that you're having trouble sleeping. Owebamacare is enough to keep anyone up and when you do fall asleep it will give you nightmares!

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433dontbeafool(951 comments)posted 10 months, 2 weeks ago

Don't worry, now that you are back on, I can sleep like a baby. Once a rich, white, corporate,bible thumping man is back in the White House, you can sleep well again too.

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434dontbeafool(951 comments)posted 10 months, 2 weeks ago

I think Chicken Little, what you are trying to say is, "THE SKY IS FALLING!"

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435dontbeafool(951 comments)posted 10 months, 2 weeks ago

I am happy. I don't think that the world is ending because a Democrat is in office.

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436Jerryl(105 comments)posted 10 months, 2 weeks ago

eivo,
your post #527
Apparently you missed it, but Obama is not running again, so your concern about him not getting any votes is kind of misplaced.

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437HappyBob(285 comments)posted 10 months, 2 weeks ago

@76Ytown,

Although we disagree on many things, glad your back.

You have alluded to, if not said outright, that the real issue confronting Americans is the cost of healthcare.

I've not finished reading this 5 part series, but would recommend it to you:

http://www.nytimes.com/2013/06/02/hea...

While I'm hopeful that ACA will have SOMEe impact on the cost of healthcare, I fairly convinced that is by no means a "cure". IMO what this series of articles lays out is that changes must occur in the way in which healthcare is charged and paid.

The problems are systemic, and insurers are only a fraction of the layers and layers of "costs".

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438dontbeafool(951 comments)posted 10 months, 2 weeks ago

@Jerry. Man, you ruined it and told him Obama isn't running again. You are no fun. He was afraid that Obama was going to be the first president to win a third term. LOL

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439dontbeafool(951 comments)posted 10 months, 2 weeks ago

???

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44076Ytown(1254 comments)posted 10 months, 2 weeks ago

HappyBob: Good link. The problem with cost is it's also opportunistic. Many surgery centers are owned by doctors and most people don't shop around to find cheaper lab & x-ray and prescriptions or they'll go to the ER just for the convenience.

I don't agree that the ACA will have an impact on lowering cost. We've seen premiums, deductibles and OOP costs go through the roof. What is surfacing is that the exchanges will offer even less freedom of choice of doctors, hospitals, prescriptions and services. The middle class is being CRUSHED. We're seeing costs rise in numbers not like 3% or 5% but more like 100% or 200% or more.

It's no wonder that medical tourism is taking off. People are going to places like India or Thailand for surgery where the cost is $1,600.00 vs $106,000 in the US for heart bypass surgery. There was a program on TV the other night covering just that. A man said he needed bypass surgery but didn't have insurance although his life savings would cover the procedure in the US. He was willing to forgo the surgery in the US if it meant that he'd have no money to survive after the surgery. He decided to have the procedure done in India for a fraction of the cost, is now healthy, and still has his savings. The doctors treating him in India had been trained in the US. The care he received was 1st class. He had a private duty nurse and private room with no urgency to be discharged right after surgery.

There is a

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44176Ytown(1254 comments)posted 10 months, 2 weeks ago

To put our medical cost in prospective...

There is an organization that a friend of mine is very active. She goes on medical missions throughout the world to provide surgery to children who need cleft palate or orthopedic surgeries. In the US, surgery for cleft palate can cost $10 - $20,000 but this organization is able to provide the surgery to children in need throughout the world for less than $100 and open heart surgery for $350. How heartwarming to know that you can donate $100 to pay for a life changing surgery. I could tell you stories that would break your heart but the outcomes would restore your faith in humanity.

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442HappyBob(285 comments)posted 10 months, 2 weeks ago

76,
Have you read all five of the series? The last one specifically addresses ERs.

Are you suggesting that a solution to the high cost of surgery in the US is to go overseas? If everyone needing bypass went to India, and everyone needing angioplasty went to Thailand, and everyone needed knee or hip replacements went to Germany or France, minor health problems, like dental work could be done in Canada and of course prescriptions could be filled in Guatemala or Haiti.

One of the problems is the American's desire for on-demand services. We don't want to wait for services, we want our angioplasty NOW !!!

Read the rest of the articles, if you haven't already.

With respect to your friend..... been there done that.

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44376Ytown(1254 comments)posted 10 months, 2 weeks ago

HappyBob:

I'm not suggesting outsourcing of surgery in US. Just using that as a comparison of cost and alternatives.

The series is informative. The link to colonoscopies doesn't give the drop down at the top of the page to access the other articles so it took a bit of digging. Try starting here (part 5): http://www.nytimes.com/2013/12/03/hea...

"been there done that"... makes our problems seem trivial doesn't it?

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444Jerryl(105 comments)posted 10 months, 2 weeks ago

76Ytown:

OPPORTUNISTIC ???

Do you mean an industry that takes advantage of people when they are ill, injured, or hurting. When they are most needy.

There is no excuse to charge 30 dollars for a Tylenol pill. Pure and simple it's gouging.

Without the opportunistic, there would be less concern about insurance and no need for ACA.

The blood suckers are the root problem

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445dontbeafool(951 comments)posted 10 months, 2 weeks ago

amen Jerryl. All these conservatives preach free market, free enterprise. Well when you let the pharmacutical companies, doctors, and insurance companies decide the prices, gouging is what happens. Healthcare is a necessity or you die, so ill people have no choice but to pay their demands. We have all seen how SOME Doctors make rounds at the hospitals. 5 min visit if the patient is lucky. How much does that cost? It is sickening.

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446Truth4Life(33 comments)posted 10 months, 2 weeks ago

Someone above posted the following link as "proof" that Obamacare doesn't work:

http://religion.blogs.cnn.com/2013/11...

Evidently, they failed to read their own link as it proves that it is the state's failures to comply with the law that is causing the problem:

"The coverage gap was created when 25 states refused to accept the expansion of Medicaid under Obamacare. The people who fall into this gap make too much money to qualify for Medicaid and not enough to qualify for Obamacare subsidies in their state insurance exchanges. If they lived elsewhere, they would probably get insurance. But because they live in a state that refused the new health care law, they likely will remain among the nation’s uninsured poor after Obamacare coverage kicks in come January."

Therefore, please blame the states, not President Obama.

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447Truth4Life(33 comments)posted 10 months, 2 weeks ago

In reply to:

southsidedave:

"It is a shame that the U.S. has taken so long to provide healthcare for its citizens particularly when compared to Canada and the United Kingdom"

Significantly, when the Republican party dictated the new constitutions to Iraq and Afghanistan, BOTH featured provisions that included universal health care for their citizens. GREAT irony when you think about it.

Perhaps even more significant is how American taxpayers have financed Israel's health care for the past 60 years just as we did for Europe's health care under the Marshall Plan. Evidently, many right wing Americans are perfectly happy to finance "socialist" health care for foreigners but not for poor Americans. Oh, and by the way, wealthy Americans who work for the Fortune 500 companies have gotten their health care financed by taxpayers as well since these companies deduct the costs of health insurance on their 1120 tax forms. Thus, foreigners and domestic wealthy elites have been subsidized by taxpayers all these years without objection. But once poor Americans got subsidized under Obamacare then it became a problem for many of these right wingers.

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448Jerryl(105 comments)posted 10 months, 2 weeks ago

and eivo is off any running again on "freeloaders".......

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449dontbeafool(951 comments)posted 10 months, 2 weeks ago

Good points truth... Great rebuttal from the wise conservative Eivo. How about something with some substance in return instead of everybody get a job. (Even though he doesn't have one)

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450Sensible(118 comments)posted 10 months, 2 weeks ago

At Eivo. your post 546.

you should have cited your quotation. In case you forgot it's from Tea Party.org.

South Carolina, the great state that gave us Strom Thurmond, a life-long racist that the good folks from SC sent to Washington for almost 50 years. If ever there was any doubt that the South is still fighting the Civil War, meet the electorate from SC.

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45176Ytown(1254 comments)posted 10 months, 2 weeks ago

I could give you a long list of why Owebamacare won't work but the shorter list is what they could have done to solve the problem of the uninsured.

1. Reduce the COST of health care at the source. Americans are being gauged by the prices charged by hospitals and other providers of care.. The cost of health CARE is directly tied to the cost of health insurance premiums. Reducing health insurance premiums allow more employers to offer coverage.
2. Allow the Medicaid expansion for those under a certain income level.
3. Fix the pre-x problem by creating a safety net for those with pre-x conditions much like the one they just scrapped. https://www.pcip.gov/
4. Prohibit individual plans from excluding pre-x conditions. Apply a one year waiting period for the pre-x condition, all other conditions would be covered by the plan.
5. Allow individual plans to pool nationwide vs only the state, giving greater actuary results.
6. Create HSAs to fund OOP health expenses.
7. Allow options for catastrophic coverage vs one size fits all.
8. Create outpatient stand alone clinics as alternatives to ER visits.
9 Bring down prescription drug costs. The mark up on RXs can be 400% - 20,000 %.
10. The elephant in the room that no one likes to talk about and that the ACA won't solve is the uninsured illegal immigrants.

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45276Ytown(1254 comments)posted 10 months, 2 weeks ago

LOL: You're right. And the middle class is rapidly shrinking from the top down and the bottom up all the while thinking that it will be the rich that will pay for the subsidies and taxes.

The have nots have already outgrown the haves. The value of the benefits a welfare mother of 3 is equal to a single person earning $60K per year.

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453Truth4Life(33 comments)posted 10 months, 2 weeks ago

Reply to the wise conservative Eivo,

First, I'm not a leftist extremist.

Second, as for government handouts, sure, there are a few I'd get rid of:

1) the tax deduction Fortune 500 companies have enjoyed on their 1120 corporate tax forms all these years

2) the subsidization of Israel's health care that American taxpayers have financed for the past 60 years

3) the freebie medical coverage given to politicians like Florida's Rubio who condemned Obamacare but just signed up for it

4) multiple billions in corporate welfare given to the military industrial complex and other corporations

5) and most important of all, an end to the foreign tax shelters in which wealthy elites have put over $30 trillion thereby circumventing tax payments

All this welfare for the rich should have been ended a long time ago. For the record, President Obama called for an end to foreign tax shelters but Republicans in Congress would have none of it.

Let's see if the wise conservative makes a shout end to end all corporate freeloading.

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45476Ytown(1254 comments)posted 10 months, 2 weeks ago

Rubio said: "But in the interim, I'm going to follow whatever law that applies to everybody else. I don't think members of Congress should be able to have laws separate from the laws that everybody else has to live under."

http://www.foxnews.com/on-air/the-kel...

Truth4Life: Which do you want? Congress to be part of the exchange or Congress to have their own Cadillac taxpayer funded plan?

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45576Ytown(1254 comments)posted 10 months, 2 weeks ago

eivo: "After reading points 1 thru 5, whether or not you want to admit it, you are a raging left wing extremist. I mean, you have all the left wing extremist talking points down pat."

Touche buddy!

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456HappyBob(285 comments)posted 10 months, 2 weeks ago

@76Ytown,

Regarding your post 548,

Do we agree the US healthcare costs are jeopardizing the US economy - thus the need to take some corrective action?

In post 548 you state: "what they could have done to solve the problem of the uninsured..."

I submit that this is not a problem that is isolated to the uninsured, but rather impacts all Americans and the country's fiscal future.

So your first suggestion as to what they could have done was "reduce the cost at the source". To this suggestion, we are in agreement. Where we might have disagreement is HOW to do that. More specifically how to control costs and still have a free marketplace.

The general consensus is that US healthcare costs about 2.7 trillion per year. Comparatively, US citizens spend 2-3 times more on healthcare than is spent in all other developed countries. Does that suggest that we ought be spending 1.4 trillion? Should that be the goal?

I'd be interested in hearing your ideas on how to reduce source costs without (or with minimal) governmental intervention. I'd also like to hear your thoughts about what the annual US healthcare cost should be? (if we don't know what the goal is, how can we tell if we have moved closer to that goal)

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457Elf2(75 comments)posted 10 months, 2 weeks ago

@eivo....

I always thought that "the freebie medical coverage given to politicians" was a TEA Party talking point.

76:
Tell us what are the provisions of the mythical "Cadillac taxpayer funded (insurance) plan is. --

Rubio is accurate in his response to Megan Kelly about subsidy.

Full text:
"KELLY: And so, already some of your critics are saying, well, that's hypocritical of you to enroll and take the federal subsidy since you have been critical of this law. To them, you say, what?

RUBIO: Well, first of all, we are supposed to live under the same laws everybody else is. So, if everyone else is being force to go on ObamaCare, why shouldn't members of Congress be forced to be on it as well? I didn't vote for the law. I wasn't here when it passed. But I don't think I should go back to Florida and tell people that I got an insurance plan that they don't have. As far as the subsidy, it's not a federal subsidy. It's the employer contribution made by the Senate. "

ACA requires Members of Congress to use the exchange unless they are otherwise insured (like Cruz, through his wife's Goldman Sacks policy) or not qualified (like medicare or military).

The "subsidy" that Kelley is trying to get people up in arms about is an employer contribution (just like everyone else's employer contribution).

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458Truth4Life(33 comments)posted 10 months, 2 weeks ago

Evidently members of the deluded far right in this forum love corporate welfare and want to see these wealthy elites get your dollars into their pockets.

Their far right elitist heroes pocket trillions of dollars tax free, a SOCIALIST country like Israel gets subsidized medical care at YOUR expense, and warmongers profit at the cost of your blood and tax dollars. Thus, these radical extremist Tea Baggers claim they hate welfare and free loaders - but free loading is perfectly OK so long as it is done by wealthy elitists and the socialist government in Tel Aviv.

Hypocrisy at its worse.

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45976Ytown(1254 comments)posted 10 months, 2 weeks ago

Truth4Life: What you are witnessing with this administration is the crushing of the middle class from the top down and eroding from the bottom up. There will be no more middle class when this is over. If you are one of the bottom feeders, you wouldn't have a clue. All you care is what's in it for me.

BTW, your hateful spew just proves that when you point a finger at someone, there are 3 others pointing back at you.

And one last thing...you probably don't want to use the term tea bagger. It is more offensive than you realize.

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460IslandMike(757 comments)posted 10 months, 2 weeks ago

Neo-Cons need to pass The Affordable Dental Plan, because Obama just kicked their teeth down their throat.
The stock market is up, unemployment is down, Obama killed Osama and they can't quit crying on the FIXED NOISE CHANNEL.
OBAMA RULES!!!!!!!

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46176Ytown(1254 comments)posted 10 months, 2 weeks ago

HappyBob: #557

There's a commercial on TV "When banks compete, you win".

We, as consumers need to become better educated. Our parents generation went to the doctor and did whatever he said. Our generation partners with our doctor. If the doctor you need to get an MRI at the hospital, the first thing we should say is can I get it done at the a local imaging center, saving half the cost? If the doctor gives you a prescription you could run to the closest drug store, or you could call around and find that Sam's club (no membership needed for prescriptions) could fill that order for a fraction of the cost.

Doctors feel the need to write a prescription or send you for further testing more often than not, because they need to cover their butt. How many times have you been given a 30 day supply of prescription pain pills for something minor that could be helped with over the counter Advil? You don't have to accept if the alternative over the counter would work just as well. But we don't think about it because our insurance usually covers it. All we pay is our co-pay.

You wouldn't pay full sticker price for a new car. You'd shop around and negotiate. Believe it or not, you can negotiate rates with providers too if you're willing to be a cash payer.

Once they realize that we have choices, the market should adjust. Providers should also be held to posting their charges. This is insane how they get away with charging everyone something different. Just because I have x-y-z insurance and the other guy has medicare or whatever, the hospital shouldn't be allowed to charge me more to supplement someone else.

I couldn't begin to tell you what annual healthcare costs in the US should be, except they should be less. What I do know is that our out of pocket costs have skyrocketed in recent years. Not long ago, insurance plans offered $100- $200 deductibles and once met, paid 80%, you paid 20%. Recently, High deductible Health Plans with deductibles of $3000, $5000 or higher allowed you to get lower premiums so you could park the difference in an HSA. Problem with the ACA plans is they they follow the HDHP deductibles but the premiums don't allow room for HSA savings.

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46276Ytown(1254 comments)posted 10 months, 2 weeks ago

IslandMike: "The stock market is up, unemployment is down"

First, the stock market lost 50% of it's value. If you had 100k and lost 50%, you then had $50k. The market is up 100% so your $50K doubled. You now have $100k. You're going to tell me that's good. We're basically right where we were when it crashed.

Second, unemployment numbers are no longer measured by the actual people who are unemployed or underemployed (part-time). The U3 report measures the number of people collecting unemployment. The rosy picture is that as the long term unemployed or the underemployed drop off the rolls, the numbers go down.

According to the US Bureau of Labor Statistics U3 report:

Official unemployed: 10,866,715
The actual unemployed:20,432.538
http://www.usdebtclock.org/index.html#

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463HappyBob(285 comments)posted 10 months, 2 weeks ago

76,

This is not a trick question, I really want to know if we can agree that the cost of healthcare is jeopardizing the US economy.

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46476Ytown(1254 comments)posted 10 months, 2 weeks ago

Elf2: #558
About the subsidies:

Congress will now buy their healthcare plans through the exchange. They will received a subsidy like they would as an employee of a company, however, private industry cannot subsidize their employees benefit plans purchased on the exchange.

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46576Ytown(1254 comments)posted 10 months, 2 weeks ago

HappyBob: Owebamacare is jeopardizing the economy by squeezing every last dime out of anyone who works by way of fewer hours, higher insurance premiums and OOP expenses.

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466HappyBob(285 comments)posted 10 months, 2 weeks ago

76, the point is that if we Americans continue to expend almost 18% of our GDP on healthcare, while the rest of the developed nations expends half that, we are setting our economy to fail.

http://www.pbs.org/newshour/rundown/2...

If you and I can't agree on that basic idea, then the rest of the discussion about healthcare, ACA, HSAs, health insurance etc. is just worthless chit-chat.

I have read your thoughts expressed in #566 and wil wait to hear about how serious you feel the healthcare COST might be.

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46776Ytown(1254 comments)posted 10 months, 2 weeks ago

HappyBob: I thought I answered your question. We become better educated savvy consumers driving the free market to lower cost.

Interesting comparisons of the cost of an MRI..http://health.costhelper.com/mri.html

Also read patient comments, especially this one:

MRI no insurance, Self Pay
Amount: $500.00 not covered by insurance
Posted by: Al in DFW in Dallas, TX. Posted: October 18th, 2011 03:10PM
Medical Center: Gateway Imaging in Dallas Insurance: none
No Insurance, Self pay. $500. MRI of my brain for pituitary gland tumor. You have to shop around and not use major medical centers. MRI through hospital would of been $7500.
http://health.costhelper.com/mri.html

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468HappyBob(285 comments)posted 10 months, 2 weeks ago

76,

I intended to say 'how serious you feel the healthcare COSTs problem might be'.

Set Obamacare aside for a minute, in 2008 Americans were spending (one way or another) an average of 8000 dollars a year on healthcare. Other countries seem to be able to do it with less, much less. In fact 36 other developed countries have better overall healthcare than the US.

We seem to expend far more with poorer results. And since we are talking about one-fifth of our economy, even if we stop the rate of cost growth (just keep it where it is) we are in trouble.

This problem existed long long long before Obamacare.

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469Elf2(75 comments)posted 10 months, 2 weeks ago

@76Ytown,
Could you provide sourcing for your "private industry cannot subsidize their employees"

Are you suggesting that employers are prohibited from making changes in benefits packages?

I believe that TacoBell announced a month or so ago that they would be providing a 500 dollar cash benefit to their employees who needed to purchase through the exchange.

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47076Ytown(1254 comments)posted 10 months, 2 weeks ago

HappyBob: How serious is the healthcare COST problem?

The example of the cost of an MRI shows how serious our COST problem is. $3,460 for a basic shoulder MRI – but a little shopping around can cut that cost to $450.

http://www.cpt12.org/news/index.php/p...

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471dontbeafool(951 comments)posted 10 months, 1 week ago

Eivo, you are like a mini Rush with your EXTREME RIGHT gobblely goo. Since you don't have a job now, maybe you could get a job on his staff pouring his coffee or something. If you didn't know a President couldn't serve a third consecutive turn, maybe you should stick to other topics like sports or weather.

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472Truth4Life(33 comments)posted 10 months, 1 week ago

76ytown,

You failed to realize that spiteful hate was directed at me but you failed to condemn that. Why the double standard??

If you troubled yourself to read the news you would know that the Pope was voted Person of the Year by Times magazine. Did you see why? And did you see how right wing radical Rush Limbaugh immediately branded him a "Marxist"? All of Limbaugh's hate was directed at him for merely quoting Jesus Christ who had compassion for the poor and who taught that the rich must give of their wealth to the poor. This isn't Marxism - it is Christianity which is evidently something neither you nor evio know anything about.

Prior to Obamacare 45,000 Americans died every year from lack of health care according to a Harvard University study. This is the most prestigious institution of higher education in the USA so that its findings are respected by everyone. They would not publish this truth unless it was backed up with solid evidence. Today, thousands of lives are being saved thanks to Obamacare or more correctly the ACA.

Anyone who is patriotic will endorse the saving of Americans lives. Unpatriotic haters who despise the poor cry over this news. They applaud subsidized health care for corporations under the tax law. But condemn similar subsidization for all else.

Lastly, the term "Tea Bagger" is not offensive. If you bother to read National Review you will see that it (the USA's number one conservative publication) agrees the right wing created the term and that it is here to stay. This is the price you pay for your extremism and your ignorance.

Don't wish to be labelled as such? OK. Let's make a deal - do not use the term "left wing extremist" on me or anyone else. Keep it nice & polite and you will be treated as such in return. Deal?

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473Sane1(24 comments)posted 10 months, 1 week ago

Eivo,
you said: "I certainly agree with 76 that there are a lot of costs that could be taken out of the health care system if only it were a free market system"

Are you delusional? Free market is what has brought you today's healthcare costs.

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474Truth4Life(33 comments)posted 10 months, 1 week ago

This is the type of headlines all truly patriotic Americans love to see:

"‘I Just Instantly Burst Into Tears’: Uninsured Florida Woman Gets $3.19 Obamacare Policy!"

https://aattp.org/i-just-instantly-bu...

"60 year-old JoAnn Smith made waves today as the newest Obamacare success story. Smith expressed her overwhelmingly gracious emotions to NBC News after she successfully enrolled yesterday for a health insurance plan that will cost her just $3.19 a month through an Affordable Care Act exchange. Smith, who has been uninsured for years since her employer does not currently offer coverage, described her new plan as “totally mind-blowing.”

To me, all American lives are precious. Nobody should die because of lack of health care. We as a nation have the resources to protect every American.

Ironically, many members of the right wing (note that I did not use any offensive term, here) put value only on dollars saved, not on lives saved. I put more value (FAR more value) on the lives saved. And note further that, as people like her are treated for illness and go back to work, money is recovered in terms of tax revenue generated and increased productivity. Therefore, money invested in protecting and in improving American lives are recaptured. Bottom line is that ACA is an INVESTMENT in improved and preserved American lives. All patriotic Americans should rejoice at this.

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47576Ytown(1254 comments)posted 10 months, 1 week ago

How many people die each year with health insurance?

How many people were without insurance before Obamacare?

How many people are without insurance after Obamacare?

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47676Ytown(1254 comments)posted 10 months, 1 week ago

Truth4Life: I too burst into tears when I saw what my premiums would be under Obamacare. Fortunately we'll be moving into an employer sponsored plan on the 1st after losing our individual plan this year.

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477HappyBob(285 comments)posted 10 months, 1 week ago

76,
Re your 576 post...

from your source "Currently in Colorado, the only way to compare prices is to call the provider directly. Yet many are reluctant – and even refuse – to disclose their prices for services."

How can providers be required to disclose their prices???

##########################

I've gotten to the point of considering abandoning any though of having a rational, intelligent discussion with you.... not because of you.... but because of eivo, who has decided to flood the discussion with cut-and-paste crap.

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478Elf2(75 comments)posted 10 months, 1 week ago

@76Ytown,
Could you provide sourcing for your "private industry cannot subsidize their employees" (your #570)

Are you suggesting that employers are prohibited from making changes in benefits packages?

I believe that TacoBell announced a month or so ago that they would be providing a 500 dollar cash benefit to their employees who needed to purchase through the exchange

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479dontbeafool(951 comments)posted 10 months, 1 week ago

Eivo and 76, the study I am sure implies that the deaths occurred could have been prevented if caught early through checkups and preventive tests that people didn't do because they had no insurance. I expected eivo not to comprehend that, but 76? And to say "how many people die with insurance" is pure stupidity. Surely you aren't suggesting you have a better chance of not dying without health insurance/healthcare. And 76, you mean you will be moving to your HUSBAND's employer based insurance, don't you....

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480Truth4Life(33 comments)posted 10 months, 1 week ago

For those who hate freeloaders, especially the privileged elitists:

http://vimeo.com/ondemand/werenotbrok...

You pay, they profit while laughing at those who both love and condemn them for their greed.

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481Truth4Life(33 comments)posted 10 months, 1 week ago

quoting evio,

" the preposterous claim that 45,000 people die each year because of lack of health care, yet some will cite it because it supports their own left wing extremist idealogy. Not even 1 person has ever been turned away for health care at the emergency room"

In his anger and hate, he fails to realize that the medical profession endorsed this finding and has always been the primary institution in the USA that called for health care reform.

People have been turned away from health care for lack of financial means. And it is acknowledged that more people have gone broke from excessive medical bills than from any other cause. Now with ACA we have seen a drop in this and will see many more.

By the way, there is a claim that 5 million people have lost coverage due to Obamacare. But no one has provided evidence from the government that this is a fact. All they do is to quote and re-quote right wing sources none of which have any credibility. So where's the proof for this preposterous claim??

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482dontbeafool(951 comments)posted 10 months, 1 week ago

@truth, it is the conservative right wing that bashes the people who live under the poverty line for receiving any assistance, but if you are a billionaire suit and tie, they don't have a problem with it. Not only do the Repubs don't want any tax increases, they don't want to even close any of these tax loop holes for these greedy bast@rds. I would love to throw some of these congressmen into public housing and give them food stamps (the reduced rate) and tell them good luck.

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48376Ytown(1254 comments)posted 10 months, 1 week ago

HappyBob: "How can providers be required to disclose their prices???"

Easy. When we consumers demand that they disclose their price or... we go to someone else. Next.

Bob... don't shoot the messenger when it comes to eivo, I thought you were better than to follow the crowd. His/her dry sense of humor is not always understood but the message is factual. Flex spending limits were reduced to $2500 this year. (another tax)

fool... Yes. I would suggest that no one take their job for granted in this economy. After a long 11 months out of work, re-entering the workforce although under employed.

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48476Ytown(1254 comments)posted 10 months, 1 week ago

Truth4Life: "there is a claim that 5 million people have lost coverage due to Obamacare. But no one has provided evidence from the government that this is a fact."

~ Do you trust that the government is going to provide you with the facts? If you've been following this thread you would see that insurance is a very complicated issue. You only need to google to do your own research but I would suggest you stick to reputable sites. The rules under the ACA are affecting individual plans, small groups, and will affect 10's of millions of no longer grandfathered.people in the next wave to affect group plans.

~ Your claim that claim that 45,000 people die each year because of lack of health care relative to the total number of deaths per year: 2,468,435. Did they die solely because they did not seek treatment or because they could not afford treatment?

A study done at Harvard University indicates that medical expenses are the biggest cause of bankruptcy, representing 62% of all personal bankruptcies. One of the interesting caveats of this study shows that 78% of filers had some form of health insurance, thus bucking the myth that medical bills affect only the uninsured.

Rare or serious diseases or injuries can easily result in hundreds of thousands of dollars in medical bills - bills that can quickly wipe out savings and retirement accounts, college education funds and home equity. Once these have been exhausted, bankruptcy may be the only shelter left, regardless of whether the patient or his or her family was able to apply health coverage to a portion of the bill or not."

~ The ACA sets out of pocket limits to protect $6,350 for an individual plan and $12,700 for a family plan. This does not include your premiums, deductibles or not covered expenses. A deductible of $2,000 - $6,000 per person plus monthly premiums added to the OOP max is enough to cause hardship to any family.

~ The term tea bagger has multiple meanings. You may want to "google" that. I find it offensive.

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485IslandMike(757 comments)posted 10 months, 1 week ago

The economy is better now than when Bush was there, Obama killed Osama, the US is out of Iraq. Unemployment is down and Obama passed universal health care. The republicans did NOTHING when they had Bush in the White House and the numbers in Congress. Now that Obama has passed a HC bill they whine and cry. Republicans and their buddies on the FIXED NOISE CHANNEL are a bunch of whining LOSERS.

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486Elf2(75 comments)posted 10 months, 1 week ago

@76Ytown,

Could you provide sourcing for your "private industry cannot subsidize their employees"

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487Elf2(75 comments)posted 10 months, 1 week ago

@eivo

You: "make all of those congressman that voted for Obamacare take Obamacare"

Your wish is already in the ACA law.

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488dontbeafool(951 comments)posted 10 months, 1 week ago

@island. They are STILL doing NOTHING, except for obstructing and whining. Eivo, glad that you are caught up to speed now that Congressmen do have to sign up, and that Obama can run again in 16.

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489dontbeafool(951 comments)posted 10 months, 1 week ago

*can't run again....in my previous. I don't want to confuse certain people more than they already are..

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490Elf2(75 comments)posted 10 months, 1 week ago

76Ytown,

You said @ post 750 "private industry cannot subsidize their employees benefit plans purchased on the exchange"

I have asked you repeatedly to provide a source.

Do you have a credible source, or is this something eivo has told you?

As I pointed out Taco Bell announced that they would give their part-time employees, who get coverage from the exchange, 500 dollars as a subsidy.

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491Elf2(75 comments)posted 10 months, 1 week ago

76Ytown,
Correction that was post 570....

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492HappyBob(285 comments)posted 10 months, 1 week ago

@76Ytown,
Re post 600...
regarding eivo, sometimes I think that he wants to just see his name appear, seems like all he does is regurgitate Rush or newsbusters or some other cry baby. I feel like I have to wade through all his crap to continue a conversation with you.
As for being factual, apparently he didn't realize that MoCs are required to use the exchange if they can qualify. And he only tells half the story on the FSAs. What he doesn't tell is that you can now carry over some of your FSA account into the next year.

- you need not respond to this post, as it is just an explanation

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493HappyBob(285 comments)posted 10 months, 1 week ago

76Ytown,
My first reaction to your "Easy...." answer in #600, was that you were just being flippant.

But I think I've now got a clearer impression of what you (and eivo) want to do with the healthcare industry. Eivo put it more bluntly weeks ago with the "government has no business in healthcare". What you really want is the libertarian solution: Turn healthcare over to the free market.

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494HappyBob(285 comments)posted 10 months, 1 week ago

So here's the process to turn Healthcare over to free market and end government involvement:

- Providers: 1) End medical licensing of healthcare providers (doctors, hospitals, nursing homes, nurses, caretakers), 2) End medical college requirements

-Insurance: 1) End medicare, medicaid, VA Health and Indian Health Service, 2) End all regulation of healthcare insurance industry

-Taxes: 1)End all medical deductions, thereby ending HSA, FSA, MSA etc. 2) End tax subsidy of employers to provide healthcare insurance

-Drugs: 1) End FDA approvals, 2) End labeling requirements, 3) End requirements for prescribing drugs

-Other: End regulation of tissue and organ sales and or donations.

-Legal: no caps on malpractice settlements

-Bureaus: 1)Close CDC, 2)End Joint Accrediation Committees, 3) Close HHS.

Legislative: Constitutional amendment prohibiting state, county or local government enactment of any healthcare regulations.

That's just my fast list, I'm sure there are more, but if you enact these, I'm sure that you will be on you way to letting the free market control healthcare costs.

(I acknowledge that many of these action items were originally proposed by the CATO institute and supported by Ron Paul)

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49576Ytown(1254 comments)posted 10 months, 1 week ago

I'm determined to call for pricing on an MRI in the Yo area on Monday. I will let you know my findings. My point is that as we become proactive consumers the COST of health care can will down. As long as you just take your script to the nearest hospital to have a test done without any thought as to who is actually paying for this, our costs will continue to rise. I already gave you links to examples in #576 of how different the charge can be.

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496IslandMike(757 comments)posted 10 months, 1 week ago

Sarah Palin was right on the money when she warned of Death Panels. Just look at the Tea Party!!

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497HappyBob(285 comments)posted 10 months, 1 week ago

Eivo:

#615 is a left wing extremist rant.- Really????

These are all ideas put forth by CATO and Ron Paul.... and you call them left-wing extremist?

Don't you have that backwards? Or do you just call everything left-wing

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49876Ytown(1254 comments)posted 10 months, 1 week ago

Elf2: Don't you have work to do this time of year?

"In spite of Senate Majority Leader Harry Reid (D-NV) being one of the Affordable Care Act’s most vocal supporters in Congress, he is the only top congressional leader to exempt some members of his staff from having to purchase insurance through the ACA’s insurance exchanges. House Minority Leader Nancy Pelosi (D-CA), Speaker John Boehner (R-OH) and Senate Minority Leader Mitch McConnell (R-KY) have all informed their staffs that they will have to comply with the ACA mandates.

This decision represents a shift in Reid’s stated plans. He told reporters in September that he believed that all congressional staffers would, and should, have to comply with the law’s requirements for American citizens."

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499HappyBob(285 comments)posted 10 months, 1 week ago

76,
Good luck.
They MAY give you a charge price, but since we know that they will accept less, what you really want to know is your (or your insurance's) negotiated price.

Since you are on catastrophic, you would probably need to know their self-pay price.

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500Elf2(75 comments)posted 10 months, 1 week ago

@76Ytown,

Don't know why your presenting me with this info, I have been asking (again and again) about your post 570 where you say""private industry cannot subsidize their employees benefit plans purchased on the exchange".

Have you found a source for that?

BTW, since you brought it up, evio is wrong thinking that congressmen don't have to participate in the Obamacare exchange.
Reid maybe able to exempt his STAFFERS (because the ACA does not explicitly require them to enroll), but he (Reid) and the rest of Congress is required to participate in the exchange unless they are excluded.
I suspect that Reid may be excluded because he is probably getting medicare.

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50176Ytown(1254 comments)posted 10 months, 1 week ago

Why is there one standard for Congress and one standard for everyone else?

Does it not bother you that companies are allowed to cancel employee insurance coverage plans, pay a penalty and dump you into the exchange. If your income is up to 400% of the federal poverty level you may receive a subsidy from the federal government. Where do these dollars come from?

Tell me about these subsidies. How can a company subsidize someone receiving benefits through the exchange? Wouldn't that exclude them from getting a government subsidy? You can't have your cake and eat it too.

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50276Ytown(1254 comments)posted 10 months, 1 week ago

HappyBob: "Since you are on catastrophic, you would probably need to know their self-pay price." What do you consider to be catastrophic?

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503dontbeafool(951 comments)posted 10 months, 1 week ago

Happy is the one who hit it right on the head. By doing away with gov involvement or regulations in health care, it would be total chaos. The problem with "free market" is eventually the big players of the field squash everyone else, then they get together and fix prices. Then the rich get richer, and well, you know the rest. Even when you present eivo with some stuff from Ron Paul and company, if he doesn't like it or doesn't have a response, he always goes to the left winger response.

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504HappyBob(285 comments)posted 10 months, 1 week ago

You described your current policy thusly: ", I pay 100% (co-insurance) till I meet my deductible ($5500) then, plan pays 100% for the remainder of the calendar year."

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505Truth4Life(33 comments)posted 10 months, 1 week ago

Initially, Kentucky rejected ACA. Now, they are taking their fill of it:

http://blogs.courier-journal.com/poli...

"Enrollments for health care coverage under the federal Affordable Care Act have risen sharply in Kentucky since the Thanksgiving holiday and now exceed 84,400, officials said Friday.

The Beshear administration reported that 64,471 people have now enrolled in Medicaid and 20,951 have enrolled in a qualified health plan through the state’s health benefit exchange, kynect.

That represents a 40 percent jump since Thanksgiving and a 17 percent increase since last week ..."

Good for those folks who will now enjoy the same coverage corporatists who work for Fortune 500 companies get at taxpayer expense.

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506Truth4Life(33 comments)posted 10 months, 1 week ago

Pope answers those critics who called him a "Marxist":

http://www.theguardian.com/world/2013...

"Defending his criticism of the "trickle-down" theory of economics, he added: "There was the promise that once the glass had become full it would overflow and the poor would benefit. But what happens is that when it's full to the brim, the glass magically grows, and thus nothing ever comes out for the poor ... I repeat: I did not talk as a specialist but according to the social doctrine of the church. And this does not mean being a Marxist."

In the 95-minute interview, conducted last Tuesday by the newspaper's Vatican correspondent, Andrea Tornielli, but published on Sunday, Francis touched on many of the issues that have dominated his first nine months as head of the Catholic church, such as the suffering of the poor and his reform agenda."

Right wingers on this forum believe that such thoughts constitute communism and radical leftism. Obviously none of them have ever read the Bible and know nothing of true Christianity. The Bible calls such people antichrists and warns of eternal perdition that will happen to people like them.

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507HappyBob(285 comments)posted 10 months, 1 week ago

eivo,
You are the one that said the a truly free market would bring down healthcare costs.
You are the one that said the the government has no business in healthcare.

Post #615 is all about executing what YOU said You wanted. If that vision is leftist, Marxist, liberitarian, Tea Party, whatever is no matter.

Why don't you give YOUR proposal to "get government out of healthcare"

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508dontbeafool(951 comments)posted 10 months, 1 week ago

Eivo I specifically looked up some of your cut and paste crap to see what the source was. I know several pieces of info, or better put would be propaganda, came from the mouth of Rush. It scares me that you don't even know what you are copying!

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509HappyBob(285 comments)posted 10 months, 1 week ago

You say you have given your proposal several times.

Ok, don't repeat it, just point to the number of your 'several' posts that "gets the government out of the healthcare business"

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510dontbeafool(951 comments)posted 10 months, 1 week ago

Can't wait for the doc to pick apart Eivo's genius plan. If the President approval rating is down, you should be happy. Let the voters speak in 16, that is how it works. *** reminder, Obama can't run again eivo, but maybe you can at least get a extreme right candidate in.

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51176Ytown(1254 comments)posted 10 months, 1 week ago

HappyBob: Your post # 626. Have you looked at the health plan options being offered by the exchange? Healthcare.gov say catastrophic plans are only available to people under age 30, but the bronze plans seem to be the same. Do people realize that they are enrolling in catastrophic plans? Thttps://www.healthcare.gov/can-i-buy-a-catastrophic-plan/

Also, go to "see plans now". Enter a single 21 year old and you'll get options which show that the catastrophic plans and a $31,000 yearly salary (about $15 hr), won't qualify you for a subsidy.

The lowest premiums are:
$109 mo, $6,350 ded - catastrophic
$162 mo, $6,350 ded - Bronze PPO/HSA

They sound the same to me except the catastrophic one which costs less allows a $20 co-pay for your PCP and you don't need to meet your deductible!

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51276Ytown(1254 comments)posted 10 months, 1 week ago

eivo: Or fund their HSA with $14,000.

The state of Oregon spent more than $300 million for their exchange and has signed up only 44 people. How about those numbers!!!
http://washingtonexaminer.com/oregon-...

Well, at least it doesn't cost as much as the American Recovery Reinvestment Act AARA. That "shovel-ready" program that cost us $278,000 per job.

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513KSUgrad(144 comments)posted 10 months, 1 week ago

@anyone:

I tried to research the source of the "Taxpayers Shell Out $14,000 per Obamacare “Enrollee” story that appears above at # 638.

I can't find any credible source. The closest is American's for Tax Reform -- but they are not known for their honest reporting. Even Fox News hasn't touched i, since it was released by ATR last Wednesday.

Does anyone have verification of this, or a credible source?

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514KSUgrad(144 comments)posted 10 months, 1 week ago

@anyone,

While I'm thinking about it.

Has anyone been able to verify or provide a source for the claim that "private industry cannot subsidize their employees benefit plans purchased on the exchange." ??

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51576Ytown(1254 comments)posted 10 months, 1 week ago

HappyBob; As promised, I took a proactively called to find the cost of a MRI of the brain in the Yo area. The following are quotes from the 3 providers I called:
1. $2873
2. $1425.20 but will apply a 35% self pay discount plus a 20% prompt pay bringing it down to $741.10
3. $650

Insurance companies negotiate their fees with providers and there's a whole different range for that. You see that on your EOB. Cost $XXXX approved amount $XXX. As a you can see above, the cost of healthcare COST can be controlled by shopping around. Yoe don't have to accept the highest price. In the free market competition will drive down prices.

Economics 101

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51676Ytown(1254 comments)posted 10 months, 1 week ago

Obamacare in WA reports of money deducted from their accounts twice, others being billed before the date they had selected, creating significant cash flow problems, especially before Christmas.

http://reclaimourrepublic.wordpress.c...

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51776Ytown(1254 comments)posted 10 months, 1 week ago

KSU & Elf...

II think Elf is busy this time of year.

Why is there one standard for Congress and one standard for everyone else?

Does it not bother you that companies are allowed to cancel employee insurance coverage plans, pay a penalty and dump you into the exchange. If your income is up to 400% of the federal poverty level you may receive a subsidy from the federal government. Where do these dollars come from?

Tell me about these subsidies. How can a company subsidize someone receiving benefits through the exchange? Wouldn't that exclude them from getting a government subsidy? You can't have your cake and eat it too.

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51876Ytown(1254 comments)posted 10 months, 1 week ago

KSUGrad: "I tried to research the source of the "Taxpayers Shell Out $14,000 per Obamacare “Enrollee” story that appears above at # 638.

I can't find any credible source."

Eivo gave the breakdown in post # 638. The costs are as reported by Sebelius.

$14,000 per enrollee is provided those "enrolled" actually pay for the coverage. Just because they shopped, doesn't mean they'll buy.

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519HappyBob(285 comments)posted 10 months, 1 week ago

76Ytown,
In reference to your question about the two plans in your post #692.

There are a couple of minor differences and one major one.

Minor: the catastropic has a $20 PCP copay and is not eligible for subsidy.

Major: the catastrophic ploicy (109/mo) is NOT elgible for HSA, the Bronze (162/mo) is eligible for HSA.

That didn't seem right to me, but I confirmed it with Coventry Health.

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52076Ytown(1254 comments)posted 10 months, 1 week ago

eivo: That's just for an MRI. You can do the same for x-rays, prescriptions and medical supplies. Imagine having the tables turned and healthcare competing for our business.

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521HappyBob(285 comments)posted 10 months, 1 week ago

@76Ytown,
you either misspoke or were trying to be sarcastic with your " Or fund their HSA with $14,000."

The contribution limit for HSA is $ 3300/year .....

#####################################

I surprised (and pleased) that you were able to get price quotes on your MRI. Did you have any providers say that they could or would not give price quotes?

More to the point, what providers were cooperative?

It would be helpful for all of us to know who to call.

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52276Ytown(1254 comments)posted 10 months, 1 week ago

HappyBob: Interesting info.

So you'd have to figure out which option would be better for you.

If you go with the $162 plan, the government may subsidize your premiums (unless you make more than $15 hr). So you could look at it like...so what...the extra $53 per month is not going to come out of my pocket. But, then what is the subsidy? If you get a subsidy of $53 per month or less, you're not ahead. And with this plan, if you need to go to the doctor, it won't be paid till after you meet your deductible.

Or, you could take the $109 mo plan and If you need to go to the doctor with this one, you could see your PCP for only $20 vs paying for the entire amount with the other plan. You could set up your own health savings plan. Of course it may not have pre-tax benefits, but it could be an account set aside to pay for out of pocket xpenses.

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52376Ytown(1254 comments)posted 10 months, 1 week ago

HappyBob: The first person I spoke to at the freestanding MRI centers gave me the info. When I called the hospital, I was transferred to their billing department.

You're right about the HSA funding unless they added more for catch up contributions for those over age 55...still wouldn't be able to give each enrollee the whole $14k!

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524KSUgrad(144 comments)posted 10 months, 1 week ago

@anyone,

Still interested in the "private industry cannot subsidize their employees benefit plans purchased on the exchange." --- I think came from 76Ytown....

@eivo:
I didn't mean to suggest that ATR was dishonest. Biased would have been a better adjective. But to the point, the 677 million obligated was what Sebelius said on 12/11/13.
What I want to know is where the 4.5 billion number came from.

I would have expected Fox and others to be all over that, but so far nothing.

So where did you get this information?

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525Sanjay1976(37 comments)posted 10 months, 1 week ago

76YTOWN.

So who were the three providers?

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526Sensible(118 comments)posted 10 months, 1 week ago

You might want to try this:

http://www.newchoicehealth.com/Direct...)

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52776Ytown(1254 comments)posted 10 months, 1 week ago

Sanjay: A major hospital and 2 major stand alone radiology centers.

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528Sanjay1976(37 comments)posted 10 months, 1 week ago

76YTOWN,
I was expecting that you would provide names.
Do you consider this privileged information?

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529Truth4Life(33 comments)posted 10 months, 1 week ago

quote from dontbeafool,

" it is the conservative right wing that bashes the people who live under the poverty line "

So very true. There's a great irony to this as delusional right wingers all claim to be Christian and observers of the Messianic law. Anyone who has actually read the New Testament knows that Jesus taught one must have compassion for the poor and give of their wealth to them. That it will be "easier for a camel to fit through the eye of a needle" than for a rich man to enter the Divine Kingdom. In his days, Jesus criticized the Pharisees, that is the religious hypocrites, for preaching a seemingly good sermon and acting holier-than-thou while living lives of sin and dissipation. If Jesus was around today, he would be similarly attacking those religious and political hypocrites of the right wing as their conduct is today the same as that of their predecessors in New Testament times.

Case in point: look at how the right wingers attacked the Pope for his kind words just a few days ago. I would venture to guess that if the Pope, or if Jesus for that matter, walked around without protection, these right wingers would physically attack both of them thereby guaranteeing eternal perdition for their endless sins.

Society's many problems can be corrected. Using the model taught by Jesus and by the Pope will go a long way towards solving much of those problems. Using the antichrist "trickle down" nonsense spewed by Reagan and Ayn Rand (who called Jesus a fraud) aggravates society's problems. When society finally awakens to the fraudulence of these right wingers then society will evolve into a better one for all.

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53076Ytown(1254 comments)posted 10 months, 1 week ago

Sanjay, not privileged but you are welcome to do your own survey. The CPT code I used was 70553. In fact, if you're willing, maybe you do a survey of a popular drug. Let's hear what you find when you call 2 pharmacies and either Wal-Mart or Sams.

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53176Ytown(1254 comments)posted 10 months, 1 week ago

Truth4Life: There's an old Chinese proverb that says "Give a man a fish and he will eat for a day, teach a man to fish and he will eat for life" The problem with so many programs today is that they create dependence and studies have proved that the dependency becomes generational. It is good to take care of those who cannot take care of themselves but when a welfare mom can make more on welfare than a teacher, what is the incentive to go to work?

Would you rather have a hand-out or a hand-up?

You say "Society's many problems can be corrected." How do you propose doing that?

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532dontbeafool(951 comments)posted 10 months, 1 week ago

@truth, it always amazed me when I attended church that almost all the members were Republicans. I understand the pro life aspect, but there was almost a hatred for any assistance programs. I would think that they should be in favor of BOTH. And btw, you did not spin the bible, you accurately quoted it.

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533dontbeafool(951 comments)posted 10 months, 1 week ago

Your comment is irrelevant and makes no sense as usual.

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53476Ytown(1254 comments)posted 10 months, 1 week ago

http://www.american.com/archive/2008/...

Truth4life & dontbeafool: Better question might be who gives more liberals or conservatives?

"it turns out the conservatives give about thirty percent more per conservative-headed family than per liberal-headed family. And incidentally, conservative-headed families make slightly less money."

Read more: http://newsbusters.org/node/9323#ixzz...

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535HappyBob(285 comments)posted 10 months, 1 week ago

@76Ytown,

There are 18 facilities in the Youngstown area that perform MRIs of the head.
You could have made Sanjay's survey a little less difficult by identifying what facilities you have already spoken with.
It wouldn't be hard to imagine that a provider who charges 75% less for a Brain Scan with and without contrast (two views) would probably charge less for other scans. Your answer to him...'do your own survey' was dismissive and not very helpful to the rest of us.

BTW, Sorry to hear that you need a Brain Scan, hope that whatever problem you are having can be resolved with ease.

On the same subject, I had asked you if all the providers were cooperative or if some would not or "could not" provide pricing.

You and others may want to checkout this page:
(http://www.newchoicehealth.com/Direct...)

These folks claim to provide price quotes for MRIs in the area. You need a CPT:
(http://patient.rad.msu.edu/documents/...)

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536HappyBob(285 comments)posted 10 months, 1 week ago

I guess the difference is that I'm interested in information and facts, while you seem to be focused on being aggressively argumentative.

If I knew where to get a service at a discounted price, I would be happen to share that information with you.

In regard to your post 649, there are more circumstances where patients are NOT in a position to shop for prices, then there are to have that luxury to shop around. While there are folks like 76 who have an elective MRI, there are thousands who have stat MRIs. They don't get to shop.

I would encourage folks to shop, but it's not always possible to do so.


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537KSUgrad(144 comments)posted 10 months, 1 week ago

anyone:

I'm still trying to verify the claim that 76Ytown made that:
"private industry cannot subsidize their employees benefit plans purchased on the exchange"

I can't find any corroboration for that.. 76Ytown, do you want to explain that further?

############################################

@ eivo (or anyone else), where did the figure 4.5 billion come from that eivo is using for his calculation in post 638

#############################################

@76, Can you expound on your " why is there one standard for Congress and one standard for everyone else"? Are you implying that Congress does not have to comply with PPACA? And if so, in what specific way?

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538GailsMom(16 comments)posted 10 months, 1 week ago

@Ksugrad,
Don't bother with evio, he just makes stuff up or repeats whatever he read on lunacyoutpost.com.

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539HappyBob(285 comments)posted 10 months, 1 week ago

Use 76Ytown's example. She surveyed 16% of the market, if she were really looking for the best price would she stop there?

It's unlikely, but she might find a provider who will only cost $450.

Most folks do not have an HSA, most folks are not eligible to have a HSA.

You can't possibly be suggesting that the government intervene and require everyone to have an HSA.

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54076Ytown(1254 comments)posted 10 months, 1 week ago

HappyBob: Wow, is there some disbelief here that it is possible to have such wide differences in prices?

Please re-read my answer to Sanjay in post # 662.

I really don't think the providers would appreciate a survey being published in the Vindicator. I will tell you that one was on the north side, one on the west side and the other on the south side of town. I would encourage you to pick one of your own examples and shop around. Each call took only minutes and every person I spoke to did not hesitate to give the pricing. I chose to call only 3 places for this example.

There is no hidden agenda here. I chose the same procedure as example in my post # 573.

BTW: Of the 18 facilities, you will find that many are satellite offices of the same. I chose to call only 3 for my survey. Did I need to call all of them? Should I expand to neighboring cities, states? I think we had enough data to show that there are differences in charges.

HappyBob, please read my answer to Sanjay. I was not dismissive. "Your answer to him...'do your own survey' was dismissive and not very helpful to the rest of us" My answer was: "you are welcome to do your own survey" means just that. If you do not believe me, you are welcome to do your own survey. I also challenged him...or anyone else to do a survey of a popular prescription drug. Name a prescription if you like and I will do the survey. It's not a big deal.

Yes, it is probably helpful to have the CPT code when calling and maybe the reason I sounded more creditable when I made the calls. Generally, people would be shopping because their doctor order a specific procedure.

Bob, your newchoicehealth link doesn't work.

Lastly, your post above # 673 says I'm argumentative. No, I'm not trying withhold information. I called 3 places and anyone else could do the same. My best advice would be to just ask. If your doctor recommends something, have the conversation with him. You and your doctor are a team. He's not God. It's your body...and your money! If you're being told to have an diagnostic test, know that you have options.

Bob, I don't think MRIs are ever elective but I do understand what you mean. Sometimes we can't stop and take the time to shop around but when we can....

Why would I stop with 16% of the market? Because I'm not a patient with a need. But if I were, and I was paying for this or even if my insurance stood to save money by my calls, you bet I'd finish the list.

Are you being critical because you want debunk the notion that a free market, economics 101, supply and demand, proactive consumers might bring down the cost of healthcare? Or do you believe that only the government is capable of telling us what we should pay and where we should go?

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541Jerryl(105 comments)posted 10 months, 1 week ago

I'd encourage people to shop, but you'd better stay in network if you have insurance.

Also: It might be a great "deal" to get your xrays or mri at 75% off, but how do you evaluate the quality and reliability?

Do you really want your health in the hands of the low bidder?

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54276Ytown(1254 comments)posted 10 months, 1 week ago

KSUGrad: Here's my full post: Why is there one standard for Congress and one standard for everyone else?

Does it not bother you that companies are allowed to cancel employee insurance coverage plans, pay a penalty and dump you into the exchange. If your income is up to 400% of the federal poverty level you may receive a subsidy from the federal government. Where do these dollars come from?

Tell me about these subsidies. How can a company subsidize someone receiving benefits through the exchange? Wouldn't that exclude them from getting a government subsidy? You can't have your cake and eat it too.

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54376Ytown(1254 comments)posted 10 months, 1 week ago

Jerry: If you have an insurance plan it is important to check to see if that facility is in network. Although you may want to take it one step further. If 50% of an out of network provider will be a better benefit than 80% of an in network provider you may want to consider using them.

High deductible health plans are becoming common. This means you must first meet your deductible before claims are paid. If that means you have to cough up the first couple thousand dollars, I'll bet you'd be willing to shop around.

I have never heard of an outpatient imaging center being substandard to a hospital. I'm sure that they all require accreditation.

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544HappyBob(285 comments)posted 10 months, 1 week ago

I just wrote a response to your 679, then lost it!

But before retiring tonight, I want to dispel any notion that you might have that I am in disbelief of the wide difference you have seen !!

You are actually much more fortunate that this reporter fron Kaiser: "How Much For An MRI? $500? $5,000? A Reporter Struggles To Find Out"

http://www.kaiserhealthnews.org/stori...

It is imperative to have the cpts, there are 7 main codes for head scans, and several variants. Without the proper code, you will probably not get the info you want.

Argumentative???? Sorry, that response was directed to the author of 672. My apologies for not properly addressing it.

I'll comment on your last para later, and get the site link.

I have early hours tomorrow., so I gotta get some rest

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545KSUgrad(144 comments)posted 10 months, 1 week ago

76Ytown:

Your original post was addressed to two people, so I thought you were addressing several different things.

The first paragraph seems to be related to Congress; while the second seemed to be related to where funds come from for medicaid subsidy;
and the third seems to be related to how a company can subsidize an employee( who has purchased on the exchange).

When you said previously that "private industry cannot subsidize their employees benefit plans purchased on the exchange" - you did not mention anything about the employee being given a subsidy., if that's what you intended to say..

Could you clarify, perhaps by example, of a circumstance where you think that a employer would be prohibited from changing an employee's compensation based on exchange participation. I can't imagine a situation like that, but apparently you can.

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54676Ytown(1254 comments)posted 10 months, 1 week ago

KSUGrad: You or someone else said some companies are dropping their employees from their existing health plans so that they can get on the exchange. They're tossing them a few crumbs to make it sound like they're compensating them for their loss. So if you are one of these employees who signs up through the exchange, will you be able to collect both the health allowance through your employer and the subsidy through the government? I just don't know what the rules may be in this case. I would think that when the company gave the allowance it would have disqualified them from getting the subsidy.

I don't think they can collect both but please correct me if I'm wrong. And how much is that allowance? $500...that sure won't go far in paying health plan premiums.

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547Jerryl(105 comments)posted 10 months, 1 week ago

76Ytown,

in your survey, you asked for pricing without insurance, right?

To have an HSA you must have a qualified health insurance plan- right?

If you elect the self-pay (no insurance) route you can't use that payment towards your deductable or out-of-pocket max. I confirmed this with representatives from Anthem and MedMutual.

So, short of a major catastrophy, if you self pay for all your healthcare, then the only reason to have insurance is to be able to have a HSA.

If you pay for insurance, and choose not to use it in order to get lower prices, all you've done is put more money into the insurer's pocket.

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548Cosmo19(53 comments)posted 10 months, 1 week ago

eivo, ASTOUNDING !

So you really are contradicting your prior position that "government has no business in healthcare"

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549Cosmo19(53 comments)posted 10 months, 1 week ago

evio,
Do you think that MacDonalds, etc are going to voluntarily do this?

Still violates your desire of no government involvement.

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55076Ytown(1254 comments)posted 10 months, 1 week ago

Jerry, I think the clarification here is that in order to qualify for an HSA, you must be covered by a HDHP.

The self pay option works just like if you went out of network except the expenses will be covered based on the in network negotiated charge up to the amount billed. As with any health plan, you need to submit an itemized bill for reimbursement of services.

If you have money in your HSA, you could use that to pay the expense at the time of service. You can then decide whether you want to submit the bill to your health plan until you have enough to meet the deductible under your health plan. Although providers must submit charges to the insurance company within a short time frame, you have over 2 years to submit your paid claims for reimbursement.

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551dontbeafool(951 comments)posted 10 months, 1 week ago

I think I am not visiting this thread anymore and read something more interesting. Maybe like an instruction manual for constructing a book shelf.

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552dontbeafool(951 comments)posted 10 months, 1 week ago

I hope that ticking is coming from the device that you are holding. With that, I am gone folks. I can't take Eivo's insanity any longer. Good luck spewing your two sided, hypocritical, garbage!

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55376Ytown(1254 comments)posted 10 months, 1 week ago

Read the attached fact sheet from the state of Ohio.

Premiums for Ohio consumers purchasing on federal exchange to increase in 2014 due to the ACA.

http://www.insurance.ohio.gov/Newsroo...

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55476Ytown(1254 comments)posted 10 months, 1 week ago

eivo, FYI: Just like COBRA, the government allow you to elect coverage but pay retroactively.

Federal regulations give patients in health insurance exchange plans three months to pay their premiums. For the first 30 days of patients' coverage, the insurers are required to pay claims under the federal regulations and accept the government advance tax credit as payment of the premium. However, for the last 60 days of the grace period, there is no such mandate. If the insured person does not pay his or her premiums within the grace period, the law does not require the insurer to cover any services the physician provided during months two and three. - See more at: http://www.texmed.org/Template.aspx?i...

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55576Ytown(1254 comments)posted 10 months, 1 week ago

eivo: Bucket of crabs mentality prevails. Some don't want to raise above, familiar is more comfortable. Not sure if it's apathy or ignorance.

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556KSUgrad(144 comments)posted 10 months, 1 week ago

@76Ytown,

Let's review your post 692....(to be sure I understand what you are stating)

1) you must have a HSA eligible healthcare insurance plan - understood

-2) if you negotiate your own charge for a service by saying you are not insured and want to self pay, you can then submit that itemized receipt to your insurer for credit to your deductible or payment.

Is this what you are saying?

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557Jerryl(105 comments)posted 10 months, 1 week ago

76 & KSU,

That's what I thought she was proposing.

Brokers from Coventry (HealthAmerica) and MedMutual both told me that that plan is flawed and will most likely not get her credit towards her deductible.

It may be particularly problematic at the provider verification stage (insurer asks provider to verify that the services were rendered and that the bill was paid) when the provider realizes that the patient lied.

Don't shoot me, I'm just passing along the information.

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55876Ytown(1254 comments)posted 10 months, 1 week ago

KSUgrad: Self pay does not mean uninsured. You pay for the service and submit the itemized bill to your insurance carrier.

Jerry: In order to get the correct information from the carrier, you'll need to speak to a claims person. Enrollers have limited information.

Your insurance carrier will pay for eligible expenses. Typically your provider will bill your insurance for you and accept assignment. You have the option to pay the charges and submit the bill directly. The exception would be for a HMO plan which is an whole 'nother animal.

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559dontbeafool(951 comments)posted 10 months, 1 week ago

@76, my last one is to you. I assume post 699 is directed to me? That is your problem, you think that you are better than thou, and all you do is talk down to people like it is your duty to educate the dumb people who are less superior to you. Good for you that you can sit at home all day, surf websites, and call around and conduct surveys, just so eivo can kiss your arse and say "good point". Meanwhile, ther rest of us go to work. Why don't the two of you just exchange emails and spare the rest of us from the crap.

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560KSUgrad(144 comments)posted 10 months, 1 week ago

76Ytown,
Re your 703 post. It may be buried somewhere in this thread, I just can't find it.

Regardless, when you spoke with your providers did you tell them that you are insured but wanted a self-pay price?

Did you also tell them that you intend to file a claim with the self-pay reciept so that your payment could be credited toward your deductible?

***********************************************************

Other pending questions:
1) you still haven't sourced your claim that "private industry cannot subsidize their employees benefit plans purchased on the exchange" - is post 685 your explanation?

2) What are referring to with your "Why is there one standard for Congress and one standard for everyone else?" -- can you be more specific?

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561dontbeafool(951 comments)posted 10 months, 1 week ago

nice, it must have been a 3 hour shift because your last post was 3 hours and some change ago. Hard worker. I work midnights btw.

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562dontbeafool(951 comments)posted 10 months, 1 week ago

That is hard to believe, that I work shift work? I noticed you didn't explain your 3 hour shift. Let me guess, your self employed too.

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56376Ytown(1254 comments)posted 10 months, 1 week ago

KSUgrad: All I said was "Can you tell me what the cost for an MRI procedure code 70553, brain MRI with and without contrast would be as a cash or self payee. No need to explain whether you have insurance or not because you're not asking them to bill your insurance directly. If you have insurance, they'll need to know the details of your plan before they can quote prices if in network and the negotiated rate. Out of network providers are paid based on usual and customary charges but the PPO rate may be even better than self pay.

I wonder if we are straying from the purpose of the survey? We wanted to find out the difference in cost for the various facilities and found that yes, there is a huge difference.

The provider can give you an itemized bill after you have the procedure done and after you pay so that you can submit to your insurance.

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56476Ytown(1254 comments)posted 10 months, 1 week ago

dontbeafool: Here we go again. We're no longer talking.

#699 was not directed to you but if the shoe fits. I was speaking to eivo about the fact that so many are critical of the info posted.

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56576Ytown(1254 comments)posted 10 months, 1 week ago

KSUgrad: See #685. My answers are based on the confusion of how Congress can have one rule and private industry others. Does the fact that Congress can go into the exchange and still receive subsidies mean that every employer can ask employees to do the same. Think about the amount of money they stand to save. Self funded health plans pay for all of our expenses while we pay a portion by way of payroll deduction. They'll no longer have to fund the health plan, only give a subsidy to each employee so that they can go through the exchange. Or, maybe they'll just chose to pay a penalty for not offering health coverage which still saves them money but the employees again are left to fend for themselves?

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566dontbeafool(951 comments)posted 10 months, 1 week ago

@76, you are right Cinderella. If the shoe fits wear it.
@eivo, still haven't justified your 2-3 hour work shift. I wonder why? As I go lay down for a couple hours, try to make up something in the way of a job. Snow blowing your driveway doesn't constitute working late, you have to get paid. Hey, maybe a snow plow truck operator. It did snow a little last evening, and you rarely see one working on the roads. That would be a good made up job you could use.
I was going to stay off of this thread, but I think I would miss exposing hypocrites too much.

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567Jerryl(105 comments)posted 10 months, 1 week ago

76Ytown,

your comment about substandard in post 682.

This from clearhealthcosts.com (website dedicated to finding best health costs):
"Do you get more if you pay more for an MRI? The answer is complicated: maybe, but not necessarily. There can be differences in image quality from different machines, though the most expensive ones are not necessarily the best.
In addition, the MRI is only as good as the radiologist interpreting the images. Some places that charge more (like hospitals) may have more experienced, expert radiologists. If your doctor orders an MRI, ask him or her to recommend some facilities with the best radiologists — that way you’ll get the most from your MRI."

No one is suggesting that lower cost services are "substandard" - just that the costs may be a result of many factors, some of which may not be transparent to the patient.

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568dontbeafool(951 comments)posted 10 months, 1 week ago

Just because you got busted Eivo, don't try to twist it and say that I don't have a job. This is twice now that you can't explain what job possibly has a 2-3 hour shift. You don't address it because you don't have one. You just simply ignore it and make another statement. Sort of like a politician who is asked one question, and gives an answer to an entirely different question, simply because he doesn't have the answer to the question asked.

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569Jerryl(105 comments)posted 10 months, 1 week ago

76Ytown,
followup on your 703:
I was talking with licensed brokers, not "enrollers", but today called a couple of claims agents. I got about the same story from them.

While no will "guarantee" it, the procedure you are suggesting, getting a self-pay discount and filing a claim later to credit your deductible, will not work to your advantage.

Firstly they say that the insurers have already negotiated a discount that is deeper than the facility's self-pay discount. Secondly they say that, to prevent people from trying this, they will refuse to credit your deductible.

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570dontbeafool(951 comments)posted 10 months, 1 week ago

@jerry.... sounds like having your cake and eating it too, doesn't it.

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571KSUgrad(144 comments)posted 10 months, 1 week ago

76Ytown,

Reference your 713 post:
You had said previously that employers were prohibited from subsidizing employees who purchase on the exchange.

I don't recall if I said it or someone else, but Trader Joes is sending all those part- time employees who have to purchase on the exchange a check in January to help them pay for their own (exchange purchased healthcare policy.

In the next post I'll quote their letter (see below).

What you have been saying is that they are not permitted to do this. I'd like you to explain how you determined this.

If it's just your intuitition, OK. But they way you came across with your statement was it's like a matter of settled law.

"Additionally, it’s also untrue to suggest that employees are getting anything here that ordinary Americans wouldn’t be entitled to as well since there is nothing in the PPACA that bars private employers from providing a subsidy, in the form of additional salary, for employees that are being forced to go onto the health insurance exchanges." - www.outsidethebeltway .

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57276Ytown(1254 comments)posted 10 months, 1 week ago

Jerry: Two points to consider.

1. Your insurance routinely reimburses expenses for which you may have self paid. Think about when you travel either out of the country or just simply go out of network. Granted, out of network has a higher deductible than in network but my point is that they will reimburse the charge with an itemized bill.

2. In my above post 711, I said "the PPO rate may be even better than self pay". Although the negotiated rate may be better, we were only doing a survey, so we were didn't use a specific example but if you were the patient who needed a certain procedure you could ask all of those questions.

Since brokers are not claims examiners, and unless the claims agents you called are the folks who process claims, you still may get a no guarantee answer. I called Aetna and got through to the claims area. They confirmed that the charges would apply to deductible.

I would not hesitate in the least to go to a stand alone radiology center.

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573KSUgrad(144 comments)posted 10 months, 1 week ago

76Ytown, continued about Trader Joe:

"After providing health care coverage to many of its part-time employees for years, Trader Joe's has told workers who log fewer than 30 hours a week that they will need to find insurance on the Obamacare exchanges next year.

In the memo to staff dated Aug. 30, Trader Joe's CEO Dan Bane said the company will cut part-timers a check for $500 in January and help guide them toward finding a new plan under the Affordable Care Act. The company will continue to offer health coverage to workers who carry 30 hours or more on average".

Trader Joe' HR dept later sent this:

"Perhaps an example will help. A Crew Member called in the other day and was quite unhappy that she was being dropped from our coverage unless she worked more hours. She is a single mom with one child who makes $18 per hour and works about 25 hours per week. We ran the numbers for her. She currently pays $166.50 per month for her coverage with Trader Joe's. Because of the tax credits under the ACA she can go to an exchange and purchase insurance that is almost identical to our plan for $69.59 per month. Accordingly, by going to the exchange she will save $1,175 each year ... and that is before counting the $500 we will give her in January.
While we understand her fear of change, at her income level this is a big benefit that we will help her achieve.
Clearly, there are others who will go to the exchanges and will be required to pay more. That is usually because they have other income and typically a spouse who had a job with no benefits and they do not qualify for the subsidies under the ACA.
One example of that we had yesterday was the male Crew Member who worked an average of 20 hours per week but had a spouse who is a contract consultant who makes more than $200,000 per year. The Crew Member worked for the medical benefits and unfortunately for them they are likely to have to pay more because of their real income. We understand how important healthcare coverage is to our Crew Members and we are pleased to be able to provide and support this program."

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57476Ytown(1254 comments)posted 10 months, 1 week ago

KSUgrad. What are the chances that you'll work for $18 hr if your spouse makes $200k yr.? In that tax bracket they're taking home less than 1/2 their income.

What about the other full time or even part time folks working two jobs who now have to go on the exchange? @ $36k what kind of subsidy will they get.

All of these subsidies are paid for by us and with $17 trillion debt. . Corporate welfare at its best.

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575dontbeafool(951 comments)posted 10 months, 1 week ago

Corporate welfare at its best is when the 5 largest oil companies who made 118 billion in profit, receive up to 41 billion in subsidies. All while we pay record high gas prices. Who loves big oil? Ironically they just slashed 40 mil from Snap. How would those oil execs make it without those subsidies?

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576KSUgrad(144 comments)posted 10 months, 1 week ago

76Ytown,
You've done everything possible to avoid answering the original question, which I would remind you is: what is your source for you claim that employers are prohibited to subsidize employees who have to purchase from the exchange?".

Since you can't, I'm left to assume that you made it up.

Care to try again?

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577KSUgrad(144 comments)posted 10 months, 1 week ago

We've already concluded that eivo made up the claim "CMS has shoveled $4.5 billion of taxpayer money to promote Obamacare".

Is this a trend for the anti-obamacare crowd?

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578Cosmo19(53 comments)posted 10 months, 1 week ago

@Ksu..
OUCH, being a little hard on 76

But I agree that she still doesn't have an answer.

Maybe she can do better with her " one standard for Congress and one standard for everyone else", with regard to obamacare.

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579Jerryl(105 comments)posted 10 months, 1 week ago

76Ytown,

I agreed before that their were wide variances in pricing and that patients should shop.

I did some of my own research today by calling DXMI, Star Imaging, St E's, Southwoods for pricing of a 74183 MRI (abdominal with and without contrast).

I told each that I have insurance with a high deductible and wanted a price for self pay to compare with what their negotiated rate was with Anthem. (all were in Anthem's PPO)

The charges varied from 6863 to 1525, much as you and I suspected.

However, in three of the four providers, the self pay fee more than the negotiated fee.

DXMI was the least expensive of all four with a CHARGE of 1525 (including radiologist professional fee).

They also told me that they would accept 762.50 as payment in full if paid at the time of service as a self pay.

However, they also advised me that their negotiated rate was 425 to insurance. They helpfully went on to explain that how that 425 was divided up between myself and the insurance companies payment was dependent on my policy. Bottom line was that DXMI would be getting 425 dollars from someone.

The self pay vs. insurance allowable fees at the other facilities were:
2743 vs. 1600
3774 vs 2402
845 vs 870.

In two cases the providers said that they would refuse to verify a claim made after the fact (the procedure you are espousing), because their self pay discount is based on the premise that the patient is uninsured.

In a third case the provider insisted that it was illegal, because they are contractually bound to process claims through the patient's insurance first. If they were aware that the patient was trying to take advantage of their self-pay discount and then intended to submit a claim to insurance (for whatever purpose) they would refuse service.

So, with regard to your Aetna claims agent, you'd better be really sure that your game will work.

As one of the insurance reps told me, 'if we refuse to credit a self-pay claim when the client should have used our negotiated rate, they can sue us.' Good luck with that!

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58076Ytown(1254 comments)posted 10 months, 1 week ago

KSUgrad: I've answered your question in a number of posts and in a number of ways since you keep going back to the same question. I'm sorry that you do not understand. I asked you how is it possible that companies can throw employees into the exchange and then subsidize premiums. How will you feel when your company cancels their health plan and you're left to get coverage under the exchange?

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58176Ytown(1254 comments)posted 10 months, 1 week ago

KSUgrad: "We've already concluded that eivo made up the claim "CMS has shoveled $4.5 billion of taxpayer money to promote Obamacare".

~The following link states:

According to public data compiled by Americans for Tax Reform, the Obama administration has spent a minimum of $4.5 billion in federal taxpayer dollars on state Obamacare websites. The money was funneled through the Centers for Medicare & Medicaid Services (CMS), a division of the Kathleen Sebelius-run Department of Health and Human Services (HHS).

CMS distributed the taxpayer dollars to states in several waves of grants. According to CMS data, federal taxpayer funds were shoveled to states for a variety of vague purposes:

http://www.atr.org/obama-administrati...

Once in the article you can click on each source which links you directly to the CMS (Center for Medicare & Medicaid Services.gov) website.

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582KSUgrad(144 comments)posted 10 months, 1 week ago

76Ytown, Ok, I'll look into it (I'm just not going to take ATR word for it, just I would not expect you to take Al Sharptons) .

On the other matter, however.... you've given your opinion but not been able to cite any law or regulation that prohibits an employer from doing what Trader Joe is doing.

ergo, no useful answer from you

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583dontbeafool(951 comments)posted 10 months, 1 week ago

Eivo has been gone for 4 hours. He must be working a double at his imaginary job.
@ksu, they won't believe something if it is from CNN, but everything from ATR. Head scratch

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58476Ytown(1254 comments)posted 10 months, 1 week ago

KSUgrad: I guess we're at a stand-off since you can't seem to accept my opinion which I back up with my reasons and you've yet to answer my questions.

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58576Ytown(1254 comments)posted 10 months, 1 week ago

I realize there are too many words in my post to keep dontbeafool's attention, but the last paragraph reads: "Once in the article you can click on each source which links you directly to the CMS (Center for Medicare & Medicaid Services.gov) website"

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586KSUgrad(144 comments)posted 10 months, 1 week ago

76Ytown,
As I said, I'd look into your link.
At first glance I can see that ATR is implying that a grant authority is equivalent to actual expenditures.

That helps explain why other news services haven't picked this up. I will find out what the outlays are actually.

#######

Regarding the other..... I am willing to accept this as your opinion, but you have been saying this as if it were a fact.

That's what I've been asking all along, if it is a fact
Tell us where it can be verified.

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587GailsMom(16 comments)posted 10 months, 1 week ago

that a common illness with conservatives, can't tell the difference between a fact and an opinion.

They seem to think they are the same.

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588dontbeafool(951 comments)posted 10 months, 1 week ago

a common theme with conservatives is to sit at home all day and gripe about free loaders, when they themselves don't have a job.

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589dontbeafool(951 comments)posted 10 months, 1 week ago

and still no answer as to what profession has three hour shifts eivo. Even part timers get 4.

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590HappyBob(285 comments)posted 10 months, 1 week ago

76Ytown,

For some reason I've not been able to login to comment for the past few days. I've got no idea why, then suddenly I can login again...

I'll try to catch up on our conversation. First the link that didn't work:
http://newchoicehealth.com/Directory/...

The other that I promised was a response to your last paragraph in 679..." are you being critical because..."

I believe that the most effective solution is somewhere between the two opposing ideologies. An exclusively free market approach will result in chaos (as I sarcastically prescribed above), and an exclusively government approach will undermine our desire for freedom.

What I would hope for is that citizens and politicians listen to one another, explore the possibilities, debate the pros and cons, recognize the flaws in each others arguments and find ways to come together to solve a common problem.

I know that you are very concerned about the national debt, and it is a huge problem that sets the stage to bring America to it's knees. If the US could somehow bring it's healthcare spending in line with the rest of the world, we could make a big dent in the national debt.

I think that you'd agree that's a worthy goal!

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591Jerryl(105 comments)posted 10 months, 1 week ago

@76Ytown,

As you experience recently, I was also locked out of posting and my posts removed. But the guys at Vindy waved a magic wand and I'm now restored.

I will repost a message that I had put up almost 24 hours ago, because I think it makes two vital points:

1) self-pay may not yield the results that you think.

2) Given that insurance companies can be slippery little devils, it might be a good idea to get "in writing" an assurance that a self-paid fee will be credited to one's deductible. I understand the analogy that you are reasoning, but I've now talked with several more claims agents that have said that their procedure is to not permit what you are suggesting.

My repost follows below:

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592Jerryl(105 comments)posted 10 months, 1 week ago

76Ytown,

I agreed before that there are wide variances in pricing and that patients should shop.

I did some of my own research today by calling DXMI, Star Imaging, St E's, Southwoods for pricing of a 74183 MRI (abdominal with and without contrast).

I told each that I have insurance with a high deductible and wanted a price for self pay to compare with what their negotiated rate was with Anthem. (all were in Anthem's PPO)

The charges varied from 6863 to 1525, much as you and I suspected.

However, in three of the four providers, the self pay fee more than the negotiated fee.

DXMI was the least expensive of all four with a CHARGE of 1525 (including radiologist professional fee).

They also told me that they would accept 762.50 as payment in full if paid at the time of service as a self pay.

However, they also advised me that their negotiated rate was 425 to insurance. They helpfully went on to explain that how that 425 was divided up between myself and the insurance companies payment was dependent on my policy. Bottom line was that DXMI would be getting 425 dollars from someone.

The self pay vs. insurance allowable fees at the other facilities were:
2743 vs. 1600
3774 vs 2402
845 vs 870.

In two cases the providers said that they would refuse to verify a claim made after the fact (the procedure you are espousing), because their self pay discount is based on the premise that the patient is uninsured.

In a third case the provider insisted that it was illegal, because they are contractually bound to process claims through the patient's insurance first. If they were aware that the patient was trying to take advantage of their self-pay discount and then intended to submit a claim to insurance (for whatever purpose) they would refuse service.

So, with regard to your Aetna claims agent, you'd better be really sure that your game will work.

As one of the insurance reps told me, 'if we refuse to credit a self-pay claim when the client should have used our negotiated rate, they can sue us.' Good luck with that!

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593dontbeafool(951 comments)posted 10 months, 1 week ago

very good info Jerry, and you broke it down well. I like how you explained it without talking down to her without having a "know it all" attitude.

@Bob, just ignore him.

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594dontbeafool(951 comments)posted 10 months, 1 week ago

@jerry, in addition, it was nice how you listed the specific places you called by name. It adds credibility to your statements.

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595Cosmo19(53 comments)posted 10 months, 1 week ago

Jerry,
Sounds like when you are shopping you just have to be 'upfront and honest' to get the best information.

If you have the luxury of time to shop around, you should certainly do so. But don't anticipate that you are going to get a better discount than the insurance company.

As to the 'illegal' remark, well that's questionable. On the other hand, it wouldn't surprise me that a provider might be bound by contract such that they can not offer a self-pay fee less than the insurance negotiated fee.

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59676Ytown(1254 comments)posted 10 months, 1 week ago

Jerry: Let's circle back to where this all started. We were talking about healthcare COST and brought up the difference in charges for an MRI in an article from Colorado. Next, I offered to show that YO also had differences in prices. In our discussion I also said (post #711) "If you have insurance, they'll need to know the details of your plan before they can quote prices if in network and the negotiated rate. Out of network providers are paid based on usual and customary charges but the PPO rate may be even better than self pay."
I also said:
"I wonder if we are straying from the purpose of the survey? We wanted to find out the difference in cost for the various facilities and found that yes, there is a huge difference."

I can tell you that the negotiated prices for each provider will vary across private plans PPO, Medicare, and Medicaid, etc.

Cosmo, you are right, the provider is bound by contract to not offer cash pay for lower than Medicare which drives a lot of the laws and regulations. Keep in mind that even the negotiated price will vary from provider to provider so going to the least expensive facility will also lower your cost.

Again, too much information, but insurance is getting to be as complicated as the IRS. Oh wait...it is a complicated because even Nancy Pelosi doesn't know what's in it!

The take-away here is that provider costs vary from place to place. As a wise consumer, we can lower our healthcare costs by shopping around.

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597Cosmo19(53 comments)posted 10 months ago

76,
Just to correct the record, what I said was that a provider MIGHT be contractually bound.

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59876Ytown(1254 comments)posted 10 months ago

So now we have a hardship exemption. Gee wiz...didn't anyone think this owebamacare program through? Let's just make up the rules as we go along. That's about 30 changes to the law since it started?

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599Sensible(118 comments)posted 10 months ago

@76Ytown & Jerry,

I don't dispute that some money can be saved by shopping .
Personally I'm not sure that the lowest price would necessarily be my criteria to select a surgeon to replace my knee -- but that's just me.

On a global scale, does that mean that other nations (all of them) tend to better shoppers than US consumers?

If so, I wonder why and if that tendency (to overspend) can be broken. Or are there some systemic differences between the US and other developed countries that contribute?

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600Sensible(118 comments)posted 10 months ago

@eivo,

Is that your answer? community organizers cause Americans to overspend on healthcare ???

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601Sensible(118 comments)posted 10 months ago

what gives?

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60276Ytown(1254 comments)posted 10 months ago

Sensible: re: 763...Let's go with the assumption that you have insurance and your primary care doctor recommends surgery. Your number one priority should be to go to the doctor who can provide you with the best care. Your insurance negotiated amount will dictate what will be paid. But, before the surgery, you'll have the freedom to choose who you go to for your x-rays, whether you have the procedure done at the hospital or an out-patient surgery center, where you buy your prescriptions and where you get your durable medical equipment if needed. By being a proactive consumer you can help keep costs down which ties in to lower cost for your employer's self funded health plan, which means lower premiums at the end of the year if we can reverse the trend in cost.

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603Sensible(118 comments)posted 10 months ago

@76,
Generally speaking (for a total knee) your PCP will recommend a surgeon, possibly more than one.

You will choose one, based on what you think will be the best care.

Your surgeon will tell you where he will operate (you may be lucky to have a choice among hospitals) and I can practically guarantee that out-patient centers do not do total knee replacements

The hospital will tell you where and when to have your pre-admit, most hospitals will require it be done by at their facility. (because they don't want to accept the liability of an outside error).

Your surgeon will choose the manufacturer of the implant, the hospital will choose your anestheslogist, the hospital will provide any medicines while in their facility, your surgeon will choose who to ask for consults, your surgeon and doctor will decide when you can be discharged.

You probably will be able to choose where to go for rehab, but once there they will provide any medicines.

The point is that the patient is not nearly as free to decide on provider's costs as you seem to think.

My family has had some experience with total knee replacements, having had 5 done in the past 3 years.

The surgery center (hospital or

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604Cosmo19(53 comments)posted 10 months ago

Interesting question posed by Sensible;

Why ARE healthcare consumers in other countries better shoppers? Or are they? What do they know, or do, that we don't?

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60576Ytown(1254 comments)posted 10 months ago

Sensible: I beg to differ. You have a number of choices in that scenario. Starting with the hospital, doctors have privileges at more than one hospital. Physical therapy does not need to be done at the hospital and pre-admission lab tests can be ordered through your doctor.

Of course the hospital would like to be your provider of choice, they stand to make the most money!

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606dontbeafool(951 comments)posted 10 months ago

The reason we pay what we pay for healthcare, is because we can afford it. They will charge as much as possible, until they reach the point where people can no longer pay what they demand. Why are cost cheaper in India? Because they charge what the citizens can pay, which is not as much as us. I'm sure some of these third world countries aren't as compassionate as the US is. If you can't pay, then no service. Go back to your shack on the garbage heap, sorry.

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60776Ytown(1254 comments)posted 10 months ago

Sensible and Cosmos: Good question..."On a global scale, does that mean that other nations (all of them) tend to better shoppers than US consumers?

If so, I wonder why and if that tendency (to overspend) can be broken. Or are there some systemic differences between the US and other developed countries that contribute?"

Maybe we can get the answers when we compare the price of food globally:

http://www.dailyfinance.com/photos/fo...

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608dontbeafool(951 comments)posted 10 months ago

I also agree with sensible. Some smaller things you can shop around on, but for the most part, the surgeon is going to control most of the options. It is almost like going to Sweeney Chevy, and trying to buy a car off of the lot. I want that one, but I can get tires cheaper from Firestone, so switch those. How much are the manufacturer's brakes and rotors??? I can save 100 bucks if I go to auto zone, so put those on instead. And so on, and so on......Good luck with that, see how that works out for you.

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60976Ytown(1254 comments)posted 10 months ago

I actually know of someone who, a few years ago actually drove off the lot with a brand new car in which he paid full sticker price.

Pretty dumb, huh?

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610dontbeafool(951 comments)posted 10 months ago

Yeah, nobody should pay sticker price, obviously there is wiggle room. I always ask to see the dealers invoice to see what they paid for it. But my point 76, is that 98% of the consumers out there just follow their Doctor's recommendations because they trust their Doctor. They are the healthcare professional, and for generations they have been told to follow doctor's orders. Plus, the common Joe, unless employed in the healthcare profession, doesn't understand the complicated world of medicine/insurance regulations. It is egotistical and unrealistic of you to think, that by reading your posts, that you are going to change healthcare costs as we know it in this country.

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611Sensible(118 comments)posted 10 months ago

76Ytown,

To perform a TKR, generally an orthopedic surgeon is only going to have privileges at one of the two in patient hospitals in Youngstown. That's been my experience -

In any event, the TKR patient is going to be in-patient, there is really no way to avoid that.

I agree that patients should be aware of pricing, but I don't agree that least expensive is the goal.

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612Jerryl(105 comments)posted 10 months ago

@76,
You mentioned durable medical goods, which reminded me of my attempt to be a cost conscious consumer a few years ago.

I was prescribed a CPAP (breathing) machine for sleep apnea. My doctor sent my script to Boardman Medical. The cost of a Respironics machine was $1300. My insurance would cover 80%.

I looked for an alternate supplier locally and they were all about the same price. I did find a national distributor who would only charge $ 478 for the same product, but direct self-pay.

So I thought, why not ask Boardman to try to match that. Boardman then told me that it would still cost less dealing with them, because their negotiated price for Anthem was 700 of which I was responsible for only 20 percent. (Anthem would pay 560 and I would pay 140)

So I called my insurance company and asked if I could file a claim like it had been self-pay with the other supplier. Sure, they said but I would have to pay 50% instead of 20%.

I work for a Fortune 500 company and my employer was self-insured, it would cost my company more to use my company insurance, but it would cost me less if I purchased with insurance.

Using insurance with purchase:
My cost =140, My company’s cost= 560

Self Pay and self-filing:
My cost = 239, My company’s cost = 239

I called my corporate HR, explained the situation, eventually ending up with a vice-president. Their basic response was that they didn’t care if it would cost them more, firstly because that was the system that the insurance company required and secondly because those costs that the company paid were actually deductions against their corporate income.

So, I spent a lot of time chasing down a cost conscious solution, only to find out that I’m the only one who cared.

I took the more costly deal, because it cost ME less.

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613GailsMom(16 comments)posted 10 months ago

If I think that my husband is having a stroke, I'm calling 911.
The ambulance will not be taking him to Walgreens clinic, they will take him to the hospital.

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614Jerryl(105 comments)posted 10 months ago

@76,

I actually had an FSA.

The cost of the purchase was 700 (purchase with insurance) versus
the cost of the purchase would have been 478 (self-pay with insurance followup claim)

MY cost was 140 (purchase with insurance) versus
my cost would have been 239 (self-pay with insurance follow up)

Whether MY costs were paid from a HSA or an FSA has nothing to do with it. (Making the assumption that I wasn't being given "free" money into a HSA or FSA by my employer)

If I had purchased without insurance involvement at all MY cost would have been 478 dollars.

I'm not understanding what you are comparing to get a 50% reduction. Please explain.

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61576Ytown(1254 comments)posted 10 months ago

Jerry: Your story is EXACTLY why we are in the crazy mess when it comes to excess health care costs. You did the right thing, tried to save money not just for yourself but for the insurance company, but in the end had to throw up your hands and go with the more expensive route because it would hurt your bottom line. From the HR standpoint, I would disagree with the answer you got Shame on them for their apathy. As a self funded plan, they had the option to make an exception to approve, but that takes time on their part. Higher healthcare costs directly affect all of us especially in a self funded plan.

As you stated in your last line, "I took the more costly deal, because it cost ME less:" this unfortunately is the reason (not blaming you...again you tried) that our healthcare costs are so high. Going to the ER instead of the doctor or clinic for a non-emergency, buying a prescription at one place when another charges less, etc.

Insurance has changed over the years from not having to think about where to go for treatment, pay your $100 deductible and insurance pays 80/20. New we have to know about PPOs, HMOs, EOPs, POS, in network, out of network, approved, not approved, etc.etc, etc. We will have to get used to consumer driven health plans as this is what it will take to lower cost.

GailsMom: The insurance plans answer to the high cost of ER treatment has been to have a separate higher deductible. If you are having a stroke you go to the ER...that's just common sense. But if you broke your toe, you have a choice to go somewhere for less cost.

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616Jerryl(105 comments)posted 10 months ago

@76,
Yes I was selfish, MY bottom line was more important to me.

But the reason I engaged the HR dept was because as a stockholder (admittedly tiny stockholder), they were wasting MY investment. That made me upset. True or not, I had to take their word for it that the deductions that they could take from their corporate balance sheet for "overpaying" was more significant than the overpayment itself.

Are you a HR person? How do you know that they could have made an exception to the insurance company. Actually, when I asked them, they emphatically denied the possibility.

By the way, this all happened in 2006, so I can't blame any of this on Obama (but I'm not blaming Bush or any other president either).

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61776Ytown(1254 comments)posted 10 months ago

Jerry: Good for you to have an FSA. The amount of tax savings per year depends on your tax bracket, but yes...it puts more money in your pocket at the end of the day! A little saved here and a little saved there adds up.

eivo mentioned the 50% savings by point of service but as you pointed out 80% reimbursement of the higher cost vs 50% of the lower cost was better for you. If your deductible had not been met that decision may have been different the actual out of pocket cost to you would have been different. So many variables!

Even though the claims are administered by a third party, the claims are funded by the company and they always have the final say and yes, HR.

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618dontbeafool(951 comments)posted 10 months ago

Interesting read on steps India uses to reduce health care costs.
http://blogs.hbr.org/2013/10/indias-s...

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619Jerryl(105 comments)posted 10 months ago

76Ytown,
Deductible was 300, so it had been met earlier in the year. I was into co-insurance phase.

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620HappyBob(285 comments)posted 10 months ago

1) Is an employer required to contribute to an employee's HSA?

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621handymandave(515 comments)posted 10 months ago

There are two undisputed underlying facts to the problems facing this entire issue

1.) O'bama has been a major failure as a
president.

2.)-O'bamacare doesn't have a prayer of EVER
becoming a workable project, it was started
by an idiot.

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62276Ytown(1254 comments)posted 10 months ago

HappyBob: Since HSA's reduce the premium cost for both the employee and employer, many companies fund an amount into the HSA. but they're not required. HSA's are employee owned so the money in the account goes with you if you leave.

HRA's follow different rules. The money in the account is funded by and owned by the employer so you don't get to keep it when you leave.

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623Truth4Life(33 comments)posted 10 months ago

Week 12 Obamacare enrollments - including Medicaid Expansion - now exceeeds 5.2 million

Pulling together numbers on Obamacare enrollments is a complicated business because of different sources and different methodologies and different definitions of 'enrollment'. Actual enrollment into an insurance plan doesn't happen until the first premium is paid and given that benefits wouldn't start until January 1st 2014 there is little incentive to pay before December 15th. The enrollment numbers of people who have completed all of the steps, including paying the first premium, won't be available until January and have to come from the insurance companies themselves.

The most consistent, careful and trustworthy compilation of people that have gone through the process and qualified for enrollment appears to be done by a blogger by the name of Brainwrap.

He/she has been posting a weekly update and has links to each states numbers.

It is possible that there is some duplication of numbers but it is certain that many of the numbers haven't been updated during the time when people going through the improved website has undergone significant increase in volume.

His latest numbers:

Private Enrollments 1,389,000

Medicaid Expansion/SCHIP 3,888,000

Total 5,277,000

His spreadsheet with links to his source material here:

Affordable Care Act (aka Obamacare) Health Insurance Signup Chart

http://obamacaresignups.net/

OVER FIVE MILLION AMERICANS HAVE SIGNED UP - A VICTORY FOR THE PATRIOTS WHO FAVOR ACA!!!

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624Truth4Life(33 comments)posted 10 months ago

GailsMom-posted 4 days, 23 hours ago

quote:

''that a common illness with conservatives, can't tell the difference between a fact and an opinion.

They seem to think they are the same.''

The problem with the delusionals of the far right is that they believe only their opinions matter. That these opinions constitute incontrovertible "facts" and God help anyone who dares to question them. McCarthy and the like always feel that way. But in the end they are always proven wrong.

These delusionals in their twisted mindlessness all said Americans would reject ACA. Well, the signups now exceed five million and the number grows by leaps and bounds every day. Just imagine if the right wingers hadn't obstructed the effort to sign up - the numbers would be well over 10 million by now. All those sign ups are a victory for America whether these far right delusionals like it or not. That is not my opinion, it is FACT.

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625HappyBob(285 comments)posted 10 months ago

The rejection of medicaid expansion by (mostly) red states is a real travesty. It seems like a concerted effort to "keep them po folk down"

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626dontbeafool(951 comments)posted 10 months ago

You had 8 years in office under Bush to do ANYTHING about soaring health care cost, but chose to do nothing. He was too busy looking under his desk for WMD's. So embrace the suck.

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627dontbeafool(951 comments)posted 10 months ago

Nope! He or the Republican party had NOTHING TO DO WITH ANY HEALTH CARE REFORM. They did what they are doing in the house now.....NOTHING. They wouldn't touch it for another 20 years until it started to affect the upper class.

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628dontbeafool(951 comments)posted 10 months ago

The Pope preached Love and Forgiveness today at mass, and then he went to local hospitals to spread Christmas cheer to all of the sick kids. Right wing translation before Fox News gets a hold of this tragedy = The too liberal, Marxist Pope launches a war on healthy kids. He is redistributing Christmas cheer to sick kids. Merry Christmas to all, even you Eivo.

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629dontbeafool(951 comments)posted 10 months ago

Couldn't stay away from making a freeloader comment even on Christmas. Even though you don't work yourself.

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630dontbeafool(951 comments)posted 10 months ago

I figured you were going to hear it on Fox or Rush anyway..... But at least I didn't insult the unemployed on Christmas, when, the person insulting doesn't work either.

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631dontbeafool(951 comments)posted 10 months ago

another nice cut and paste job. First you gripe that nobody is signing up, now it is a problem if too many people sign up for insurance.... What are the doctors doing now with all of these patients that they are caring for with NO COVERAGE AT ALL? They are managing. I think that they will survive.

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632dontbeafool(951 comments)posted 9 months, 4 weeks ago

here you go Eivo. It is from the Vindy, not CNN, so maybe you will read it.

RALEIGH, N.C. (AP) — A month after President Barack Obama announced people could keep insurance policies slated for cancellation under the federal health overhaul, the reversal has gotten a mixed response from insurers, state regulators and consumers.

Many consumers complained in October and November after insurers notified them that their individual policies were being canceled because they did not cover pre-existing conditions, hospitalization, prescription drugs or seven other basic benefits required under the law.

In pitching the overhaul, Obama had long promised that people who liked their policies could keep them.

Then Obama announced Nov. 14 that companies could continue existing policies that don't meet the minimum requirements if state regulators approved.

Reporting by The Associated Press shows that older policies are being allowed to continue in 36 states, either because officials allowed it after Obama's announcement, decided not to intervene in any way or had made a decision earlier in the year to extend noncompliant policies for a period of time.

Even so, insurers were given a choice of whether to continue the policies, and some declined to do so.

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633dontbeafool(951 comments)posted 9 months, 4 weeks ago

putting words in mouth again. Never said Obabma care was Bush's fault. I stated that Bush absolutely did nothing to seriously address skyrocketing health care costs. Obama mis spoke about the "if you like your current insurance, you can keep it", and that was a big mistake on his part. But at least he is trying to fix it to make his comment right, as shown in the last paragraph of the last article.

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634SheDevil(120 comments)posted 9 months, 4 weeks ago

Dr. Gillette's letter is just as true today as it was almost three months ago.

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63576Ytown(1254 comments)posted 9 months, 4 weeks ago

Insurance "fix" is just a one year temporary fix. All the delays will come to a head next year...but not till after elections if Obama's timing plan works.

The insurance companies do not have the final say to extend coverage. Insurance is regulated at the state level, it's up to the commissioners to permit the extensions.

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63676Ytown(1254 comments)posted 9 months, 4 weeks ago

Dr. Gillette: Unfortunately, the predicted horrors of Obamacare are coming to pass.

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637SheDevil(120 comments)posted 9 months, 4 weeks ago

@76Ytown:
Do you have any measures, or are you just referring to your fears?

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638Elusiveman(4 comments)posted 9 months, 3 weeks ago

The fear is what you get when you put too much Faux in the Tea (Bag)

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639SeriouslyNow(192 comments)posted 9 months, 3 weeks ago

Dr Gillette's 427 word letter has generated tens of thousands of words in response, comment, enlightenment and disagreement; after almost three months of discussion the thrust of his letter remains valid.

He wrote: "We [doctors] predicted doom and disaster if the Medicare bill passed", and yet "None of those predicted horrors came to pass".
He also wrote " The 1965 Medicare startup was messy, and this year's [PPACA] will probably be worse", but "eventually the dust will settle and American's will see the new system's long term benefits."

Lastly, " No medical system is perfect, but as other industrialized nations learned long ago, a national program is essential to providing high quality healthcare to all citizens at a reasonable cost"

Thank you , Dr Gillette, for the perspective of one who has been there and done that.

PPACA (Obamacare) is the law, the Supreme Court has upheld it, the detractors have been unable to repeal or defund it. It is time for Americans to work together to accomplish the goal of high quality healthcare at a reasonable cost.

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640HappyBob(285 comments)posted 9 months, 3 weeks ago

Your loathing isn't really about post 823.

Your real venom is directed at those who you perceive as "freeloaders".

What have YOU committed to do about ferreting out these freeloaders?

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641SheDevil(120 comments)posted 9 months, 3 weeks ago

@Bob,

You miss e's point. In his world all Americans don't deserve healthcare.

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642SheDevil(120 comments)posted 9 months, 3 weeks ago

BTW, Seriously
Thanks for reminding us what this thread was all about.

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643HappyBob(285 comments)posted 9 months, 3 weeks ago

Then would you propose eliminating all unemployment compensation, foodstamps, medicaid, etc. to stop freeloading?

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644SheDevil(120 comments)posted 9 months, 3 weeks ago

Quote evio : "foodstamps, medicaid should be limited to those who are unable to work due to physical disability."

Quote Fox News (12/24/13): "“For active-duty troops and veterans, making financial ends meet has gotten increasingly difficult in the past four years, according to the Center on Budget and Policy Priorities, a non-profit think tank, which estimates nearly 340,000 veterans receive public money for housing and 900,000 veterans live on food stamps. (additionally) 5,000 active-duty troops are currently receiving SNAP, or food stamp assistance.”

'Thank you for your service to your country, but unless you are disabled, no food stamps for you and your family' -

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64576Ytown(1254 comments)posted 9 months, 3 weeks ago

"The shame on America’s U.S. Senate should be pressing on the heart and spirits of every single U.S. Democrat Senator during the nation’s Christmas season. This is due to a so-called joint budget agreement between the Senate and the House of Representatives that left nearly one million American vet heroes stripped of cost of living veteran’s pension benefits. The cut amounts to $6.2 billion. Yet, when Republicans in the senate moved to correct the problem, Senate Democrats blocked the move and instead allowed illegal aliens to continue to receive illegal welfare benefits to the tune of $4.2 billion annually.

http://www.examiner.com/article/natio...

" there were howls of protests raised by many senate republicans such as Alabama Senator Jeff Sessions. He demanded that the immoral veteran benefits cuts be restored. Yet the smugness displayed by Senate Majority Leader Harry Reid, (D-Nev.) at Senator Sessions offer to correct the problem was totally dismissed.

The fact that even one solitary soldier has to sign up for food stamps while illegal aliens continue to illegally enjoy the fruits and benefits bestowed upon citizens should ignite a whirlwind of protest. In, fact, to add insult to injury, according to the Internal Revenue Service watchdog an estimated $4.2 billion in refundable credits will end up in the pockets of illegal aliens. Over $42 billion will be handed out to illegal aliens over a ten year period is itself criminal.

Of course there was not a peep out of the White House from Obama, who would rather defend the imagined rights of illegal aliens to receive American jobs, educational benefits, college education and other privileges."

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646SheDevil(120 comments)posted 9 months, 3 weeks ago

@76,

We were discussing evio's proposal to get freeloaders out of the system.

He proposes limiting foodstamps and Medicaid to those who can not work due to physical disability.

This is HIS proposal. HE would cut foodstamps to veterans and their families.

Indignation over what the Congress may or may not have done is a distraction to avoid evio from reconciling his proposal.

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647dontbeafool(951 comments)posted 9 months, 3 weeks ago

SHAME on war hungry Republicans who send our young men and women into harm's way over MADE UP WARS. Repubs didn't reduce benefits, they justcost thousands of deaths and injuries to our military members so their businesses in the private sector could rake in the cash.... like Haliburton's no bid contracts! All in exchange for soldier's blood. And Rebubs want across the board spending, but as soon as it happens, then they bit@h about this person getting cut, or this program getting cut You can't have it both ways. And as soon as Eivo GETS A JOB, he can harp on freeloaders.

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648dontbeafool(951 comments)posted 9 months, 3 weeks ago

And my New Year's resolution is to just ignore Eivo completely. As much as I would like to comment on his absurd comments, I now realize that I shouldn't feed into his baiting. I should already know that 99.9% of the readers on here know that he is irrational anyway, so why give him what he desires.......which is attention. To all, Happy New Year, be smart and be safe.

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649dontbeafool(951 comments)posted 9 months, 3 weeks ago

So now Catholic groups/employers can sign, exempting themselves and employees from the birth control portion of the ACA, but they don't want to sign. They were going to be given what they wanted, and all they have to do is sign to exempt that portion of the health coverage, but no. So what is their real agenda???

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650dontbeafool(951 comments)posted 9 months, 2 weeks ago

Romney? Oh yeah, the guy who lost terribly in the election.

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651SheDevil(120 comments)posted 9 months, 2 weeks ago

Romney said WHAT about 70 year olds??????

Either Romney is just blowing smoke, or he is counting on listeners being stupid..

70 year-olds are on Medicare, not Obamacare.!!!!

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652SeriouslyNow(192 comments)posted 9 months, 2 weeks ago

Troll.... “ a person who sows discord on the Internet by starting arguments or upsetting people, by posting inflammatory, extraneous, or off-topic… in an online community either accidentally or with the deliberate intent of provoking readers into an emotional response…” (Wikipedia)

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653SeriouslyNow(192 comments)posted 9 months, 2 weeks ago

Troll.... “ a person who sows discord on the Internet by starting arguments or upsetting people, by posting inflammatory, extraneous, or off-topic… in an online community either accidentally or with the deliberate intent of provoking readers into an emotional response…” (Wikipedia)

By their actions you shall be able to recognize them.

evio: Gee, did you think I was referring to you ???

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654SansArmes(17 comments)posted 9 months, 2 weeks ago

No doubt, evio is trolling to evoke a response with post 845.

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655dontbeafool(951 comments)posted 9 months, 2 weeks ago

For every scare tactic from the right, there is a real success story.
Story of a man who originally thought he couldn't get insurance, then found his perfect plan.

Last week Dan called back again.

"I'm the AIDS patient in Michigan who lost his insurance," he reminded me. "I was panicked I was going to lose all my meds. I take back every word I threw at you. I found insurance. It's better. It's cheap. And I'm keeping my doctor and my plan. I can't believe it."

Dan said he just kept looking until he found his perfect policy on the Michigan exchange.

"The problem is that there's so many policies to go through and compare that it takes you a while to find the one that suits your personal situation," he explained. "But I did find it. It is there. And what the right wing is saying, about, 'You lose your doctor, it's more expensive, you're being canceled,' I have to take it all back. If you get the help, and you talk to people -- because then I called live, a live person to confirm it -- and it is out there."

Dan was paying $1,485 per month for his old plan with the $1,000 deductible. His new plan under Obamacare, which includes coverage not only for all his prescriptions but for dental and vision -- which his old plan did not -- is costing him over $500 less per month, at a total cost of $914, with the same deductible. That's not to mention that he got it with the pre-existing condition of HIV. I don't want to downplay or obscure what are some real problems that some people with HIV are reporting regarding getting drugs fully covered under Obamacare, or what other people are reporting about higher deductibles in the new plans. But Dan's story obviously shows that a lot of people have been swept up in the hysteria when there is indeed great health insurance out there for them.

"Dental and vision!" Dan exclaimed. "Yes, the deductible is all tax-exempt. It's a health-savings plan. So it's all tax-exempt. It's a wonderful plan."

Dan apologized and said he wanted to "rectify the damage" he'd done by calling the show and "scaring people away" from Obamacare.

"I want to say to all your listeners: I was terribly wrong," he said. "Now I'm going to push myself as a huge Obamacare success story. I'm bragging it to everyone."

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656dontbeafool(951 comments)posted 9 months, 2 weeks ago

Here is a great article about Eivo's poor nuns. Enjoy.
http://www.cnn.com/2014/01/08/opinion...

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657dontbeafool(951 comments)posted 9 months, 2 weeks ago

SIGN THE FORM! That is all they have to do to be exempt. I suppose they will get whatever anyone else would get.

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658Truth4Life(33 comments)posted 9 months, 2 weeks ago

More bad news for the enraged and hate filled right wingers who love to see the poor rot to death in poverty due to lack of health care:

Millions of People Have Health Insurance Thanks to Obamacare

At least 9 million people are getting coverage under the health care law

http://www.usnews.com/opinion/article...

quote:

"The big number in the news this week was 1.1 million – the number of people who signed up for health insurance through Obamacare's federal insurance marketplace this year. This is an important figure, especially given the fact that it stood at little more than 100,000 at the end of November.


Nevertheless, that 1.1 million figure dramatically understates what the Affordable Care Act has already accomplished. The number we should be talking about is at least 9 million and could be 14 MILLION people who are currently getting coverage under the law."

The numbers are growing by leaps and bounds every day. And as people return to work because their ailments are treated, this will increase tax revenues and social productivity. Everyone (except for Republicans) wins with ACA!!

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65976Ytown(1254 comments)posted 9 months, 2 weeks ago

The problem with Obamacare is that it is not health insurance, it is a tax on the American people and a data hub to gather and share information between at least 7 different government agencies.

Had the government wanted to provide medical coverage for uninsured Americans, they could have simply expanded the Medicaid program and more widely advertised the pre-existing safety net program already in place. Laws could have been put in place to help those with pre-existing conditions at a cost far less than this behemoth of a plan which inflated the cost of coverage and provides subsidies for all.

30 million Americans without insurance before Obamacare, 30 million without insurance after. Just redistributed. Those who had health care plans who liked their policies are now without, and those who didn't have medicaid are now covered.

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660SeriouslyNow(192 comments)posted 9 months, 2 weeks ago

76,
Your last sentence above (860).
1) Do you have a problem with "those who didn't have medicaid are now covered"? Is that good, or bad, or does it make no difference?

2) As I recall, you seemed to "like" your health insurance policyand were distressed when it was cancelled. Did you get a new policy? Are you one of those who "liked their policy and are now without" coverage?

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66176Ytown(1254 comments)posted 9 months, 2 weeks ago

1. As I said in my 2nd paragraph, had the govt wanted to provide medical for the uninsured they could have expanded Medicaid in the 1st place and that would be good.

2. My individual plan was cancelled a few months ago. Yes I liked that plan. It suited my needs at that time but I now have group insurance.

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66276Ytown(1254 comments)posted 9 months, 2 weeks ago

5 million individual health plan cancellations in 2013 and 80 million small business cancellations to hit later this year after the one year extension expires.

Businesses with less than 50 full time employees are not required to offer coverage but if they do, they need to comply with the ACA. Businesses with more than 50 full-time workers are required to offer health coverage so they are reducing hours to part time to avoid hitting the threshold.

If you work for a company and haven't been affected by Obamacare yet, chances are you will be by the end of this year.

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663dontbeafool(951 comments)posted 9 months, 2 weeks ago

Now, the GOP is concentrating on anti abortion laws. It hasn't been overturned in decades under any administration. You would think that maybe the economy, or jobs would make better sense, since that is obtainable. And they wonder why.......

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664dontbeafool(951 comments)posted 9 months, 2 weeks ago

The American Cancer Society praises Obamacare. I figure I will post it since the haters won't.
http://www.huffingtonpost.com/2014/01...

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665SeriouslyNow(192 comments)posted 9 months, 2 weeks ago

76,your post 862:
Ok on the medicaid question. That's what I thought your position was, but then the last sentence seemed to erode that thought. Anyway, you clarified it, thanks. (unfortunate that a whole lot of republican governors didn't like the medicaid expansion, but they may come around in due course)

It was interested in the computations of the 30 million redistributed.

Before Obamacare I suggest that the characteristics of the uninsured were: a) those who feel that they don't want or need HC insurance, b) those who were uninsurable due to prior conditions, c) those who wanted HC insurance but felt they could not afford it,and d) ????? (put other suggestions here)

After Obamacare I suggest that the number of "a" group probably didn't change much, the number of the "b" group is diminished by the policy standards, and the number in the "c" group is diminished by the medicaid enrollees and those that that are taking advantage of subsidies.

So to come up with 30 million before and after would suggest that number of new medicaid enrollees and previously uninsurable is equal to the number of folks who now can't afford HC insurance even with a subsidy.

Do you have any source data on that score?

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666HonestAbe(274 comments)posted 9 months, 1 week ago

ummm.. @formerdemliberal about your comment #5. gotta admire anyone in Y-Town who gets his propaganda fed to them by the Koch-fed Heritage Foundation. You must make a few billion a year to support their line.

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66776Ytown(1254 comments)posted 9 months ago

Another "just sign it so we can find out what's in it" moment:

States can seize assets to recoup Medicaid costs.

http://m.washingtonpost.com/national/...

Subsidies increased to up to 133% of the Federal Poverty level in some states based on income, not assets.

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668dontbeafool(951 comments)posted 8 months, 4 weeks ago

Are you having fun conversing with yourself eivo. You are most likely the only one listening.

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66976Ytown(1254 comments)posted 8 months, 3 weeks ago

Evio: Your biggest follower is dontbeafool.

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670dontbeafool(951 comments)posted 8 months, 3 weeks ago

I'm his only follower.... I just like getting a good laugh at insane comments.

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671Truth4Life(33 comments)posted 7 months ago

Contrary to the incessant lies from the hate filled and emotional far right, ACA is working:

'' A government report released yesterday detailed how the U.S. economy is already benefiting from the law: by driving up personal income and consumer spending. Between Medicaid expanding to cover millions more low-income people, and families who bought private insurance on the exchange and took advantage of the law’s generous tax credits, the ACA contributed a $33.9 billion jump in personal income for January alone.

Think about that for a second — a $33.9 billion jump in personal income in the first month of the law’s full implementation.

The report also found a bigger than expected increase in consumer spending as well — about $45.2 billion total for the month. The Wall Street Journal looked at the report and said that about three-quarters of this surprisingly positive growth came from those benefiting from the ACA.''

http://thinkprogress.org/progress-rep...

Billions more into the economy and thousands of lives saved -- Thank you President Obama!

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672Truth4Life(33 comments)posted 6 months, 3 weeks ago

''Obama: 'There Are Still No Death Panels. Armageddon Has Not Arrived.' 'Time To Get Over It'''

"There are still no death panels. Armageddon has not arrived," Obama said. "The debate over repealing this law is over. The Affordable Care Act is here to stay."

Obama Tells GOP: Time To Get Over Obamacare
Touting the news that Obamacare had reached 7 million sign-ups, an almost unthinkable achievement so soon after the law's disastrous October launch, President Barack Obama sent a direct message Tuesday to Republicans and their efforts to stymie the law: Get over it.

"The debate over repealing this law is over. The Affordable Care Act is here to stay," Obama said Tuesday in the White House Rose Garden. "In the end, history is not kind to those who deny Americans basic economic security. Nobody remembers well those who stand in the way of America's progress or our people. That's what the Affordable Care Act represents."

The president's remarks followed an unprecedented flurry of good news this week for the law and its supporters. Enrollment beat the Congressional Budget Office's original projection, which had been revised down after HealthCare.gov website flopped in the fall. The Los Angeles Times estimated that 9.5 million previously uninsured people had been covered. A Washington Post-ABC News poll found that support for Obamacare broke even for the first time.

...

"This law is doing what it's supposed to do. It's working. It's helping people from coast to coast. All of which makes the lengths to which critics have gone to scare people, or undermine the law, or repeal the law... so hard to understand," Obama said. "I don't get it. Why are folks working so hard for people not to have health insurance? Why are they so mad about the idea of folks having health insurance?"

http://talkingpointsmemo.com/dc/obama...

ACA = Savings BILLIONS of dollars and thousands of lives.

Thank you President Obama!

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673Truth4Life(33 comments)posted 4 months ago

Insurers join in on ACA:

http://www.nytimes.com/2014/05/26/you...

Health care as a human right:

http://www.dailykos.com/story/2014/05...

Think Obamacare's not working? Think again:

http://www.dailykos.com/story/2014/06...

" the claim that the Affordable Care Act is a job killer flies in the face of reality, as Dan Diamond at Forbes reports: Since the law was signed in March 2010, the economy has added 7.7 million jobs, 982,300 of which are in the healthcare field.

The best estimate of total ACA enrollments continues to come from Charles Gaba (brainwrap) at ACAsignups.net, who estimates a range from 23.6 to 28.2 million gross enrollments."

Obamacare: A complete VICTORY for America. All true patriots agree.

Thank you President Obama!

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