Don G. Dinsdale Loc: El Cajon, CA (San Diego County)

ObamaCare Is Still a Disaster
Nov. 3, 2014
Those who believe healthcare is a right, along with those who believe having access to health insurance equals access to health care itself, are in for a nasty surprise. A survey conducted by the American Action Forum (AAF) reveals that as many as 214,524 American doctors “will not be participating in any ACA exchange products.” According to the Kaiser Family Foundation, there are 425,032 primary care physicians and 468,819 specialist physicians, totaling 893,851 physicians in the entire country. Thus a whopping 23.9%, or nearly one-in-four doctors, are opting out of participating in ObamaCare. If you like your doctor…

The number of non-participants will exacerbate an already precarious doctor shortage expected to reach 45,000 in six short years. And despite all the happy talk about how ObamaCare is working, courtesy of l*****t cheerleaders like The New York Times, this is where the proverbial rubber meets the road.

And it’s a road that may get bumpier still. The AAF survey was conducted last May, and it appears the list of disgruntled doctors is growing. California, a.k.a. the epicenter of l*****t pipe dreams, is already hard-hit: As of January, a staggering 70% of CA’s 104,000 physicians were not participating in Covered California, the state’s insurance exchange. The LA Times disputes that total, insisting that 80,000 CA physicians will be participating in 2015. But even they are forced to admit that health insurers “are sticking with their often-criticized narrow networks of doctors, and in some cases they are cutting the number of physicians even more,” even as those insurers “prepare to enroll hundreds of thousands of new patients.”

The real k**ler in California? Many consumers have been hit with huge medical bills because insurers won’t cover the costs of doctors deemed “out of network” – even as they continue to narrow those networks to make insurance more affordable. Thus many Californians will be faced with the same “choice” as millions of other Americans: having access to a doctor who may be unaffordable, or no access to a doctor at all.

Why are doctors opting out of ObamaCare? The AAF cites three big reasons. First, they note ObamaCare’s big selling point was the idea that insurers would have to compete with each other for enrollees purchasing subsidized insurance. Insurers made their premium prices competitive by lowering reimbursement rates to providers. Providers were supposed to make up the difference with an increased patient load that resulted from narrowing the networks.

Yet those pay cuts are too dramatic. “It is estimated that where private plans pay $1.00 for a service, Medicare pays $0.80, and ACA exchange plans are now paying about $0.60,” the AAF explains. What about increasing the patient load to make up the difference? “Primary care providers … are already overburdened and have too many patients as it is, so the increase in volume will do nothing to offset their losses.” Just as troubling, physicians believe patients signing up for ObamaCare will be sicker than average, requiring more of a primary doctor’s time at much lower rates.

Second, high-deductible insurance plans are equally problematic for physicians because enrollees – many of whom have no understanding of what a deductible is – may accumulate thousands of dollars in charges that have to be paid in order to meet that deductible. Physicians fear that low-income patents racking up unaffordable costs will fail to pay their bills, even as insurance companies continue to collect premiums.

Yet the third reason physicians are opting out, and the one they cite as the most onerous reality, is a virtual paean to l*****t pie-in-the-sky sensibilities. ObamaCare gives enrollees a 90-day grace period to pay their insurance premiums. Thus a patient can continue to claim he or she is insured, even without paying the premium for three months. After a 30-day delinquency, insurers change the patient’s status to “pending,” and any charges accumulated by the patient will be paid by the insurance company – if the overdue premium is paid within the 90-day grace period.

If not? The insurer is required only to pick up the first 30 days of charges. The remaining 60 days of charges must be chased down by the health care provider, who will remain uncompensated if patients can’t or won’t pay their bills. The AAF notes that nearly one million Americans “enrolled” in exchange plans had failed to pay their premiums as of May.

Doctors are also dealing with the issue of chaotic bureaucracy that has been ObamaCare’s hallmark from the beginning. For example, doctors rightly want to know if the insurance card being presented by a patient is connected to an ObamaCare plan so they can verify benefits eligibility. A 2014 Medical Group Management Association (MGMA) survey of 40,000 physicians reveals that 62% considered it “moderately to extremely difficult” to identify a patient that has ObamaCare coverage, rather than traditional commercial coverage.

So doctors have it bad – but the public may have it worse. The latest study by Health Pocket, a health plan comparison and research site, compared premium price data from 2013 pre-ObamaCare polices with 2014 ObamaCare policies from exchanges in metro areas of all 50 states. Three age groups – 23, 30 and 63 year-olds – were used to collate the comparisons. The calculations were made minus the subsidies that make insurance cheaper, but only because the taxpayer is picking up the difference.

Every group got hammered with substantial increases. Costs for 23-year-old women and men increased 44.9% and 78.2% respectively. For 30-year-olds, increases came in at 73.4% for men and 35.1% for women. For 63-year-olds the increase was 37.5% for women and 22.7% for men.

Incredibly, there’s even more bad news on the horizon. All of the non-compliant insurance plans that were supposed to be canceled last year are now ending. They were extended for a year unilaterally (and illegally) by Barack Obama due to the enormous political fallout eng****red by his infamous promise – or more accurately Politifact’s 2013 “Lie of the Year” – that if Americans liked their health insurance, they could keep their health insurance. That year is up.

Most of those policies are in the individual market, and hundreds of thousands of Americans have been, and will be, receiving cancellation notices.

They won’t be lonely. As many as 40 million Americans whose insurance is in small-group plans provided by their small business employer will be required to have ObamaCare-compliant insurance beginning in 2015 – precipitating another tidal wave of cancellations. Thus the president’s “promise” will be broken yet again.

One more thing: For insurance policies going into effect in 2014, the open enrollment period began on Oct. 1, 2013. New year, same set-up, right? Wrong. This year the open enrollment period for a 2015 insurance policy begins on Nov. 15 – 11 days after the mid-term e******n.

The Obama administration would like Americans to believe one has nothing to do with the other. It’s exactly that kind of contempt for the public, coupled with the overall chaos of ObamaCare, that has seen many Democrats up for e******n running away from the health care law.
The very same law their party passed without a single Republican v**e. On E******n Day, Americans should make it clear to those Democrats that an old cliché still applies: You can run, but you can’t hide.

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Republicans need to be held accountable as well... Don D.

W8_4_It

Yep JMHO,

I noticed they aren't starting enrollment until after the e******n.

I guess Preznut Obama got tired of playing "hide the sausage" with "Reggie Love" and decided to play "Hide the ZeroCare Sticker Shock" instead.

You are correct we need to hold some "R" feet to the fire over this too.

lpnmajor Loc: Arkansas

I wouldn't pay too much attention to what Doctors say, they're afraid for their money. No one was putting cost restraints on health care providers, so they were free to charge what they like. There was no competition, so free market effects were absent. Capitalism had no place in the health care industry - they had absolute authority to set prices - regardless of what the rest of the economy was doing.

The failures of the ACA must be addressed - the biggest of which - is the absence of any cost constraints on health care COSTS - just insurance. Good insurance still has co-pays and co-insurance, so a $100,000 appendectomy - will still destroy a family of four's ability to survive beyond the health care insurance they've paid for.

W8_4_It

Best way to address "ZeroCare" is to dismantle it completely and put it where it belongs, in the dustbin of history.

Rufus Loc: Deep South

:thumbup:

Brian Devon

***********
To be replaced with MEDICARE FOR ALL, regardless of age.

It's called real deal NATIONAL HEALTH CARE. It's what first world developed nations do.....in spite of what the AMA, Big Pharma, the D.C. lobbyists and congressional bagmen would tell you.

Don G. Dinsdale Loc: El Cajon, CA (San Diego County)

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Sent to W8, but for everyone...

Question:

Seems like about 70% - 90% (depending on the poll) of "We the People" want some type of Standard Socialized Med. Care...

So, why didn't we go North and ask Canada for some direction, or England, or Hell Romneycare...

All seem to be better than O-Care... Don D.

W8_4_It

Anything the government gets involved in is a fiasco.

The only thing the government should be doing is National Defense and protecting our borders, International trade, treaties and such.

We see how well they protect the southern border.

Why would you think they would do any better on healthcare Don?

Rufus Loc: Deep South

Before Obamacare America was considered to have the overall best healthcare in the world. Anyone was allowed to walk into an emergency room. We had many systems in place to help provide for the poor and disadvantaged, including many Christian organizations. I think most Americans always want to improve healthcare for everyone, but lets do it responsibly with doctors, economics, business people, etc. sitting at the table. Let's not do it in the middle of the night behind closed doors with no republican input. Let's also read what we come up with first instead of passing it only to discover it is a nightmare.

Don G. Dinsdale Loc: El Cajon, CA (San Diego County)

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It's not what I think...

It's what the majority of citizens seem to want, so the question... Don D.

Don G. Dinsdale Loc: El Cajon, CA (San Diego County)

~~~~~~~~~~~~~~

It's not what I think...

It's what the majority of citizens seem to want, so the question... Don D.

Don G. Dinsdale Loc: El Cajon, CA (San Diego County)

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Here's the answer to the question, thanks, some times can't see the forest for the tree's...

Good Job... Don D.

Brian Devon

[quote=Rufus]Before Obamacare America was considered to have the overall best healthcare in the world...





*******
By who Rufus? The A.M.A. and P****r? I guess your definition of best health care is being #38 in medical outcomes and #1 in costs.

Oh joy...

Rufus Loc: Deep South

[quote=Brian Devon]

Overall. Obviously you have not spent much time in third world countries or countries where socialized medicine is the norm. All of us want to work to improve healthcare but let us work together in a responsible way so that it truly benefits those who need it.

Workinman Loc: Bayou Pigeon

Dr. Bens take on Health Care:



Ben Carson on Health Care



ObamaCare is the worst thing since s***ery
Q: Let me just raise this issue about ObamaCare, because I want to come back to that. One of the issues is that for conservatives, this has been such a huge issue, even though the law's been passed and upheld by the court, they still argue, "No, there's a basis to really try to make it better, to replace it, to get rid of it." And then you had Dr. Ben Carson; this is what he said on Friday:

(VIDEO) BEN CARSON: I have to tell you, ObamaCare is really, I think, the worst thing that has happened in this nation since s***ery. And it is in a way, it is s***ery in a way.(END VIDEO)

Sen. ROB PORTMAN: Well, he's a doctor who feels passionately about this issue, obviously.
Source: Meet the Press 2013 interviews: 2014 p**********l hopefuls , Oct 13, 2013

Health savings account from birth; teach poor responsibility
Carson's idea for health-care reform is Washingtonian. Instead of the technocratic behemoth of Obamacare, empower the individual. "When a person is born, give him a birth certificate, an electronic medical record, and a health-savings account to which money can be contributed--pretax--from the time you're born till the time you die. If you die, you can pass it on to your family members . . . and there's nobody talking about death panels."

The beauty of Carson's argument exceeds its simplicity, particularly as even economist Paul Krugman now concedes that something like death panels are inevitable if we stay on our current path. Taxpayers, the rich, or charities can contribute extra money to the accounts of the poor (with everyone's account seeded at birth), but at the same time, Carson says, the poor will "have some control over their own health care. And very quickly they're going to learn how to be responsible."
Source: 2013 Conservative Political Action Conf. in National Review , Feb 13, 2013

Two-tiered system ok as long as care is adequate
Our 1st child, Murray, was born in Australia. The health-care system in Australia provides substantial benefits for its citizens, and when a baby is born, the family receives a "baby bonus." Although it was a two-tiered system, I did not witness much resentment by those receiving their basic care free of charge against those who could afford private insurance. There may be some substantial lessons that we can learn from such a system.

Everyone has different needs and we do not have to have a one-size-fits-all system. Because one person drives a Chevrolet and another drives a Mercedes, it doesn't automatically mean that the Chevrolet driver is deprived or needs some supplement. The fact is, he can get to the same place as a Mercedes driver with perhaps slightly less comfort. People have different medical needs and some can afford the Chevrolet plan while others can afford the Mercedes plan. We should leave it at that and not try to micromanage people's lives as long as the care is adequate
Source: America the Beautiful, by Ben Carson, p.143-144 , Jan 24, 2012

Saudi Arabian solution: stiff penalties for medical fraud
Insurance companies would almost certainly object that some unscrupulous doctors would simply submit "evidence" that they had done two appendectomies instead of one.

There are very few physicians who would engage in fraud, but there certainly are some. However, the solution for dealing with those few is not to create a gigantic and expensive bureaucracy, but rather to apply what I term the "Saudi Arabian solution." Why don't people steal very often in Saudi Arabia? Because the punishment is amputation of one or more fingers. I would not advocate chopping off people's limbs, but there would be some very stiff penalties for this kind of fraud, such as loss of one's medical license for life, no less than 10 years in prison, and a loss of all of one's personal possessions. Not only would this be a gigantic deterrent to fraud, but to protect themselves every physician in practice would check every single bill quite thoroughly before submitting it, which would not be that difficult to do and document.
Source: America the Beautiful, by Ben Carson, p.145-146 , Jan 24, 2012

Regulate insurance companies as non-profit services
Today, insurance companies call the shots on what they want to pay, to whom, and when. Consequently, even busy doctors operate with a very slim profit of margin.

This is an ideal place for the intervention of government regulators who, with the help of medical professionals, could establish fair and consistent remuneration. To accomplish this, essentially all of the insurance companies would have to become non-profit service organizations with standardized, regulated profit margins.

This is not the paradigm that I see for all businesses, [but] is uniquely appropriate for the health-insurance industry, which deals with people's lives and quality of existence. That may sound radical, but is it as radical as allowing a company to increase its profits by denying care to sick individuals? In the long run this would also be good for the insurance companies, who could then concentrate on providing good service, rather than focusing on undercutting their competitors and increasing their profit margin.
Source: America the Beautiful, by Ben Carson, p.147-148 , Jan 24, 2012

Government responsibility for catastrophic coverage
There was a time when premature babies or babies with significant birth defects simply died, which cost the insurance company very little. Now, however, thanks to developments in medical technology, we're able to put such babies in incubators and treat them, usually saving their lives--but then we hand the insurance company a bill for $1 million. This kind of scenario, repeated on a regular basis, drove insurance companies to drastically increase their premiums.

One solution would be to remove from the insurance companies the responsibility for catastrophic health-care coverage, making it a government responsibility [like FEMA insures against hurricanes]. Clearly, if the health-care insurance companies did not have to cover catastrophic health care, it would be relatively easy by analyzing actuarial tables to determine how much money they are likely to be liable for each year. With this information at our disposal, health insurance companies could be regulated just as utilities are regulated.
Source: America the Beautiful, by Ben Carson, p.149-150 , Jan 24, 2012

Let paralyzed quadriplegics choose to die if they wish it
We are facing a time when we have to be pragmatic, while at the same time exercising compassion.

I remember a case of a prominent individual who had been in an automobile accident and was rendered a C-1 quadriplegic, which means not only was he paralyzed from the neck down, but he could not breathe without assistance. We could have made the decision to keep him alive at all costs, but through a unique system of communication that we were able to work out with him, he indicated that he wanted to die. After much debate, we yielded to his wishes and withdrew ventilator support. In the long run, I think our course of action was both compassionate and pragmatic. If we integrate compassion and logic into our decision-making processes, I am convinced that we will deal with newly emerging ethical dilemmas appropriately.
Source: America the Beautiful, by Ben Carson, p.151 , Jan 24, 2012

Suffered research cancer injection and prostate cancer
One day in the lab years ago, in the process of injecting cancer into a rabbit's brain, my hand slipped & I accidentally inoculated my own finger with the VX2 carcinoma. Within days, modules began to form on that finger, and another lesion began growing in my throat.

I happened to be reading "Back to Eden" about natural healing remedies and the medicinal properties of red clover tea. VX2 was a xenograph, from another species, so my own i****e s****m would attack it, so anything that boosted my natural i****e s****m might have been enough to do the job.

In the summer of 2002, I had my PSAs checked. I had prostate cancer; a very malignant and aggressive form. The various medical options were laid out; what caught my attention were glycol-proteins. Within a week my symptoms were completely resolved. But urologist [recommended immediate] surgery anyway, [which I did]. It turned out that the cancer was within one millimeter of metastasizing. If we had waited it would have been too late.
Source: Take the Risk, by Ben Carson, p.164-172 , Dec 25, 2007