Well, I just got hit with it last night at work.

Our coverage will go from 90/10 to 80/20. Our vision and dental will now be charged extra for both rather than being covered under one umbrella. Rates are going to increase, but we won't find out how much until the Open Enrollment Period from October 7 through November 15.

Not only will our rates increase, but our pay is decreasing. No longer will be get paid time and a half if we are on call and get called in after the beginning of our shift.

AND... I'm in the healthcare business!!

I think it might be time to go on Da Welfare! At least I know I'll make more money that way.

The apologists are now going to blame your employer... just giving you a heads up.

Yes, I've already spoken to some.

We are a huge employer in the Mid-South. Thousands and thousands of employees.

I'm lucky in that this won't make me or break me. Not all are that lucky.

I've seen it coming for a couple of years now in the hospital. All sorts of measures that "cut costs," at the expense of patient safety.

I don't think people outside of the medical scope really understand how this is going to affect their safety, or the safety of their loved ones, when they are hospitalized. Many are looking at it from a different standpoint than I am. I am truly scared for you all if you ever have to be in a hospital. This is putting your health at great risk.

My meeting is next week . But I've already seen the basic numbers .

But as I've already been scolded by Kentucky's Democrat Governor Beshear ,and Excon using the latest favorite Democrat talking point...
"The Affordable Care Act was approved by Congress and sanctioned by the Supreme Court. It is the law of the land. Get over it ... and get out of the way....
http://www.nytimes.com/2013/09/27/opinion/my-state-needs-obamacare-now.html?_r=2&adxnnl=1&adxnnlx=1380374233-BYqMdBngalUieHOpyEz2cw

The difference is, where all of you quote from, the people writing those articles in the NYSlimes, et al is that this is coming from politicians and the like. Not the medical personnel themselves.

There will be a mass exodus of medical professionals in the hospital/rehab/nursing home settings. Our employer has already let go of 36 staff members throughout the system, 6 at our facility. Nurses are leaving by the numbers. Nurse to patient ratio has decreased dramatically, and this has only begun. When one nurse was required to take only 4 patients, she is now required to take 7 (just an example). This places you and yours at risk of a multitude of safety issues. Medication errors, falls, bedsores, neglect, just to name a few.

One of our physicians, who also holds a Juris Doctor, has retired from medicine and has returned to practice med/mal law. Maybe I should go back to my former life as a med/mal researcher.

No, surely not. We've been assured there will be no mass exodus and our options will be unlimited now. And obviously as tom noted it's your employer's fault for not shopping around for a better deal or they're just plain greedy.

Hello J:

If I had my druthers, the insurance companies would NOT have been left in the loop to do these very things.

I've been prescribed a cream for rash. A month or so ago, my co-pay was about $6. A few weeks ago, my co-pay was $23. Last time I bought it, my co-pay was $46.

I'd LIKE to blame somebody, too. How about Ted Cruz?

excon

NJ is already experiencing a shortage of doctors .The ones graduating in the state are making an exodus . What Obamacare does is nationalize the problems so there is no escape. Guess that's what they mean by 'shared sacrifice'. We all suffer .

http://www.nytimes.com/2013/09/27/opinion/my-state-needs-obamacare-now.html?_r=2&adxnnl=1&adxnnlx=1380374233-BYqMdBngalUieHOpyEz2cw This article fails to take into account the decrease in the nursing staff available at hospitals due to a decrease in staffing for cost saving (money making) purposes. While they may be seeking out medical treatment, it also fails to point out the increased risk of medication errors and the like.

If you want to see how this Act is really going to affect you, don't listen to the politicians, don't read the articles. Go to your local hospital and talk to the employees who would be treating you.

If your wife, or your daughter, were in labor for let's say 40 hours. Unable to eat or drink anything but ice chips, and finally delivered her baby at midnight... Are you following me? She's starving and asks for something to eat and a soda. She now gets, if she's lucky, two pieces of bread with a slice of meat in between. Oh, and no soda, only milk, water or apple juice.

If your wife has Alzheimer's and has sundowners syndrome (awake and agitated during the night), she is now strapped to what is called a gerry chair or placed in restraints because there aren't enough nurses or techs to adequately take care of her.

Your ER waiting time has gone from 4 hours to 8 hours unless you are having chest pain, then you get to chew an aspirin and have an EKG from the time of arrival, THEN your wait begins.

I'm not trying to be argumentative. I'm truly concerned. On this board the members quote articles, quote politicians, etc. but I'm actually witnessing it from the ground floor.

We've been assured there will be no mass exodus and our options will be unlimited now

You can never be assured of a mass exodus in health care. It happens all the time. When there is a new Administrator, new nurse manager, policies change, etc. Has nothing to do with my facility, that's the nature of medicine in the hospital setting.

I can appreciate you telling us about it from the actual field instead of all this blowing smoke we get from the true believers.

Hello J:

If I had my druthers, the insurance companies would NOT have been left in the loop to do these very things.

I've been prescribed a cream for rash. A month or so ago, my co-pay was about $6. A few weeks ago, my co-pay was $23. Last time I bought it, my co-pay was $46.

I'd LIKE to blame somebody, too. How about Ted Cruz?

Excon

I am so with you there, but I can't blame Ted Cruz and I'm not saying insurance companies aren't to blame.

While I am concerned about the rising costs of medical care, I am also concerned about the health and wellbeing of patients everywhere. Not just my facility, the entire national hospital system.

The actual point is that the people of this country are going to get substandard care as there will be a shortage of doctors and nurses.


We've been assured there will be no mass exodus and our options will be unlimited now Oh, yes. Be sure to thank your nurses who will be working, the ones who stay with their facilities, for working 85-95 hours a week on crisis pay. Don't forget to ask them what medications they are giving you, and why. You are now responsible for keeping us on our toes due to sleep deprivation.

Sh!t... Did you say you were allergic to morphine? Hey Doc, what is the antidote for morphine in an allergic patient?

I can appreciate you telling us about it from the actual field instead of all this blowing smoke we get from the true believers.

Thank you. While I don't know all of the political jargon that you all do, and I tend to stay away from the Current Events board as I just don't understand it, I do feel that it is necessary to keep people informed from the field rather than from behind the podium.

The actual point is that the people of this country are going to get substandard care as there will be a shortage of doctors and nurses.

It's the same thing with teachers, cops, EMT's, food inspectors, garbage collectors, actually all local services that are forced to cutback due to the high cost of doing business.

It's the same thing with teachers, cops, EMT's, food inspectors, garbage collectors, actually all local services that are forced to cutback due to the high cost of doing business.

Are you going to sue your teachers? Going to sue your garbage collectors? Or are you going to go for the big money and sue the doctors and nurses in a med/mal suit? Sorry Tal, it's not the same. Not only will health care decline, but the court system will be tied up more than it is now. There will be a higher number of med/mal cases awarded to the plaintiff's because there was an actual error in care. This will increase med/mal insurance premiums, yes I carry my own, thus discouraging people from entering the profession.

I don't know of teacher malpractice, or food inspector malpractice, but med/mal is one that can tie the courts up for many years.

I understand you are just focusing on your own issues in areas of your concern, but there are many that are concerned about their issues as well, such as rising energy costs and where to educate their children, AS WELL AS affording a doctor. Private doctors ain't cheap. Neither are emergency rooms.

How about paying a higher water bill on a fixed income? Or paying a higher sanitation bill for flushing your toilet? Or rising food costs or gas? There are many issues that people are facing. There are big issues and health care is but one of them. Hell everything is just to damn high for my paycheck.

And of course the way to help people with those rising costs is to make health-care more expensive and energy costs to "necessarily skyrocket."

Rein in the cost, and give me more money, would be my idea of a fix. What's yours?

Rein in the cost, and give me more money, would be my idea of a fix. What's yours?

That is ALWAYS the typical answer from your side. Hey its broken lets throw more money at it and its solved. What a pantload. Look how come you find it so awkward that what you have been told is now coming to fruition ? You wanted canadian style healthcare and now your getting it. If you have complaints then pray to your god Obama. He is the one make sure you get further behind. He removed food and fuel from the inflationary index and wants to get fuel to $5.00 a gallon and figures your rich enough to absorb the costs. You are aren't you ?

You speak in a vacuum like everything was hunky dory before. Like we haven't had a recession, and are slow to recover. Like problems fix themselves. The question was "What's your solution" Not what's your beeyatch.

You speak in a vacuum like everything was hunky dory before. .
Actually, you are speaking from a vacuum. You are on the outside. Reading bills and the propaganda put out by the liberal media. I'm speaking from the front lines. The actual practice of medicine. I know the "behind the scenes" that is going on.

No, everything was not hunky dory before, but it was a far cry better than it is going to be next year at this time.

You wanted canadian style healthcare and now your getting it.Uh no, it's not at all like our system. Just wanted to make that clear.

I think it is important testimonial that we are hearing from health care providers . But the left is ideologically wed to a state run socialized health care system... I've heard it on these boards ;I heard it from more than one elected official ,including right out of the mouth of my representative... and they are more that willing to destroy ours to get us there.
Listen to Tal .He says "Medicare for all."
J 9 . What would happen if the whole nation were to be thrust into the Medicare system now ? My own observation is that more than one doctor refuses to take on Medicare patients.

Listen to Tal .He says "Medicare for all."
J 9 . What would happen if the whole nation were to be thrust into the Medicare system now ? My own observation is that more than one doctor refuses to take on Medicare patients.

You really do have a small imagination, don't you

No a realistic one not clouded with progressive utopian visions.

progressive utopian visionsstatements like that make it hard to have a discussion.

statements like that make it hard to have a discussion.

That is because it is true.

The thing is that here in NY ,we have been subject to a version of the Obamacare mandates for years (MarioCare ); which means we've been inflicted with the high costs that the rest of the country is about to experience.

The right wing utopian vision is pure free market capitalism and that would be a disaster.

Don't you realise that is what you are experiencing, capitalism gone mad. Your government pours money into the economy so it can be gambled on wall street, creating a share bubble, and now they say they can't stop. Very soon you are going to disappear up your own fundamental orrifice taking the rest of us with you

Don't you realise that is what you are experiencing, capitalism gone mad. your government pours money into the economy so it can be gambled on wall street, creating a share bubble, and now they say they can't stop. Very soon you are going to disappear up your own fundamental orrifice taking the rest of us with you

It is not capitolism gone mad. Its cronyism at its extreme. The current administration claims to be disconnected from everything when in fact he is stealing millions from the economy for his personal friends. He started misusing funds the day he took office and has made sure that the economy never recovers. Until he is gone we will be locked into permanent recession.

Obviously 51% of the voters don't agree with you, or else he would have been gone in the 2012 election.

Its cronyism at its extreme.Totally agree. That and greed. Since the US has set being wealthy as the ultimate goal then you get what you currently have, politicians out to enrich themselves. And who can give then the most money? Companies of course. Until this can be fixed I see no end in sight to your troubles.

Also the Current Events board is a great example of the divisiveness that you've been played into. No one cares about doing something good for the american people, they only want to bring down the other party. Good luck!

Obviously 51% of the voters don't agree with you, or else he would have been gone in the 2012 election.

That wouldn't be the same ones that don't seem to want to be involved in the rocess only vote for someone that tells them what they want to hear without paying attention to what is really going on? The media did its job of creating a messiah and many fell for it. Honestly most of the voters do not have 1/2 of the knowlage that we here do during our discussions nor do they want to. So long as the checks and phones keep coming they will vote them in time and time again.

Also the Current Events board is a great example of the divisiveness that you've been played into. No one cares about doing something good for the american people, they only want to bring down the other party. Good luck!

There are many that truly do care about what's best for the American people. The problem here as well as in other places is the philosophy that goes with the decision making. The main thrust being one wants to care for a persons need by stealing from everyone else and the other side wants to try to create selfsufficiant people that can stand on their own. There is plenty of room for safety nets. Many of us believe that you enslave the people when you give them everything rather then free the people by teaching them the needed skills to live the life they choose.

Hello dad:

So long as the checks and phones keep coming they will vote them in time and time again.Skip to today. The government is going to be shut down. . BOTH Republicans AND Democrats think a WIN here will result in BIG gains in 2014.

So, do you think the Republicans will WIN the Senate as THEY think think they will?? Or, do you think the Democrats will take over the House, as THEY think, they will?

Excon

Don't you realise that is what you are experiencing, capitalism gone mad. Your government pours money into the economy so it can be gambled on wall street, creating a share bubble, and now they say they can't stop. Very soon you are going to disappear up your own fundamental orrifice taking the rest of us with you
Crony socialism gone mad... what you describe is not capitalism... therein lies the problem.

Hello dad:
Skip to today. The government is going to be shut down. . BOTH Republicans AND Democrats think a WIN here will result in BIG gains in 2014.

So, do you think the Republicans will WIN the Senate as THEY think think they will??? Or, do you think the Democrats will take over the House, as THEY think, they will?

excon

My pridiction is that it will be more of the same. It is beyond me when the people keep re-electing the idiots over and over again and expect a different outcome. We truly need a turnover of high magnitude to change things and break the entrenchment process that we see today. It was never meant for a politician to be a lifetime position. Throw them all out in a voter inspired ctrl/alt/delete.

Hello dad:
Skip to today. The government is going to be shut down. . BOTH Republicans AND Democrats think a WIN here will result in BIG gains in 2014.

So, do you think the Republicans will WIN the Senate as THEY think think they will??? Or, do you think the Democrats will take over the House, as THEY think, they will?

excon

What difference will it make if a majority of beltway Repubics win in the Senate? They are Democrat-lite .

That wouldnt be the same ones that dont seem to want to be involved in the rocess only vote for someone that tells them what they want to hear without paying attention to what is really going on? The media did its job of creating a messiah and many fell for it. Honestly most of the voters do not have 1/2 of the knowlage that we here do during our discussions nor do they want to. So long as the checks and phones keep coming they will vote them in time and time again.

I could say the same thing about the TParty distortions and there stated goals to destroy the government and let the rich guys do as they please. I can dig the fear of losing control of YOUR government as it more, and more, becomes our government.

By our I do mean ALL Americans, not just the chosen, lucky few.

I could say the same thing about the TParty distortions and there stated goals to destroy the government and let the rich guys do as they please. I can dig the fear of losing control of YOUR government as it more, and more, becomes our government.

By our I do mean ALL Americans, not just the chosen, lucky few.

Actually you mean nothing of the sort. As we have seen by example over and over again. How can you use the term "our" when the people are against Obamacare and your government seems to be pushing it forward full steam ?

When it is that this administration has told more lies and refuses to come clean when asked to do so by the people? He is giving all the money to the rich right now. I don't see "our" government doing anything to stop it nor do I see them doing anything to derail this permanent recession.

Do you?

QUOTE by cdad;
Actually you mean nothing of the sort. As we have seen by example over and over again. How can you use the term "our" when the people are against Obamacare and your government seems to be pushing it forward full steam ?

FACT is people LIKE what they have seen so far, and you guys know it. Maybe the waters are muddy, but in a few days they can decide for themselves if they like what they are about to see, and keep it or reject it.

Let the people decide.


When it is that this administration has told more lies and refuses to come clean when asked to do so by the people? He is giving all the money to the rich right now. I don't see "our" government doing anything to stop it nor do I see them doing anything to derail this permanent recession.

Do you?

Your side is good at obstruction, delays, and creating obstacles that have prevented a more robust recovery, while shifting blame away from yourselves, and too everybody else. That's what I see.

I mean no disrespect with my comments. I am just wondering why universal health care won't work. Canada does it, not perfectly but we do have it. I will be honest without it I would not be alive as no treatment for my asthma, no treatment for my mental health issues and suicide attempts. Don't forget DBT that would have been not even an option. Hubby also had a heart attack and I am unsure what we would have done for the bills from him being in ICU for 5 days. Then in regular room for 2 more and all the tests that were run.
We do work and pay our bills with not much left over. We are not rich and the only workplace plan we have is through hubby's work. They charge a set amount and don't take into account people's prior medical condition.
I don't see how insurance rates will rise and affect the workplace. Some provinces out here people pay a fee usually every 3 months. I think it is per person and per family depending on what is your situation. Others have it through the provincial sales tax.
What are people's solutions to your health care issues? Let's brainstorm ideas and if any seem valid you can maybe present to your local politician. Don't say they won't listen you never know. It is like when I share a dog that needs to be saved, no one hears me but sometimes the dog gets saved and out of the bad home. If we do nothing than nothing will be done and if we do something maybe things will improve.

FACT is people LIKE what they have seen so far, and you guys know it. Maybe the waters are muddy, but in a few days they can decide for themselves if they like what they are about to see, and keep it or reject it.

I guess you and those people get your "facts" from YouTube.

Obama courts young voters in MTV interview – CNN Political Ticker - CNN.com Blogs (http://politicalticker.blogs.cnn.com/2012/10/26/obama-courts-young-voters-in-mtv-interview/)

I fail to see your point since many younger consumers watch UTube.

FACT is people LIKE what they have seen so far, and you guys know it. Maybe the waters are muddy, but in a few days they can decide for themselves if they like what they are about to see, and keep it or reject it.

Let the people decide..

And again you fail to see the disconnect in saying "let the people decide" when the people didn't want it to begin with and have opposed consistently since it was forced on us.

I mean no disrespect with my comments. I am just wondering why universal health care won't work. Canada does it, not perfectly but we do have it. I will be honest without it I would not be alive as no treatment for my asthma, no treatment for my mental health issues and suicide attempts. Don't forget DBT that would have been not even an option. Hubby also had a heart attack and I am unsure what we would have done for the bills from him being in ICU for 5 days. Then in regular room for 2 more and all the tests that were run.
We do work and pay our bills with not much left over. We are not rich and the only workplace plan we have is through hubby's work. They charge a set amount and don't take into account people's prior medical condition.
I don't see how insurance rates will rise and affect the workplace. Some provinces out here people pay a fee usually every 3 months. I think it is per person and per family depending on what is your situation. Others have it through the provincial sales tax.
What are people's solutions to your health care issues? Let's brainstorm ideas and if any seem valid you can maybe present to your local politician. Don't say they won't listen you never know. It is like when I share a dog that needs to be saved, no one hears me but sometimes the dog gets saved and out of the bad home. If we do nothing than nothing will be done and if we do something maybe things will improve.

I'm glad you are happy with your system. I was happy with what we had.

I mean no disrespect with my comments. I am just wondering why universal health care won't work. Canada does it, not perfectly but we do have it. I will be honest without it I would not be alive as no treatment for my asthma, no treatment for my mental health issues and suicide attempts. Don't forget DBT that would have been not even an option. Hubby also had a heart attack and I am unsure what we would have done for the bills from him being in ICU for 5 days. Then in regular room for 2 more and all the tests that were run.
We do work and pay our bills with not much left over. We are not rich and the only workplace plan we have is through hubby's work. They charge a set amount and don't take into account people's prior medical condition.
I don't see how insurance rates will rise and affect the workplace. Some provinces out here people pay a fee usually every 3 months. I think it is per person and per family depending on what is your situation. Others have it through the provincial sales tax.
What are people's solutions to your health care issues? Let's brainstorm ideas and if any seem valid you can maybe present to your local politician. Don't say they won't listen you never know. It is like when I share a dog that needs to be saved, no one hears me but sometimes the dog gets saved and out of the bad home. If we do nothing than nothing will be done and if we do something maybe things will improve.

The health care they are proposing here is much different than what you have Mogrann. You aren't required to pay for it and if you don't pay for it you aren't penalized. There is no comparison to what you have and what is being forced down our throats.

Hello again, Steve:

the people didn't want it to begin with and have opposed consistently since it was forced on us.This BS is getting old. But, I see that it'll NEVER change.. You just have an aversion to the truth, that'll NEVER change.

But, that's NOT going to stop me from trying... You talk about what "the people" want, as though you know.. But, you don't. You IGNORE the stuff that goes against your argument, like our last election...

Really.. It was an ELECTION... One candidate said his NUMBER ONE job would be to REPEAL Obamacare. He LOST, and he LOST BIG.

The PEOPLE SPOKE!! You don't LIKE it, but they SPOKE loudly and clearly.

Excon

You aren't required to pay for itWell we do through our payroll deduction taxes. But you are correct that the systems are quite different.

2004 the people spoke and voted for the candidate who promised to reform Social Security . He made it clear that was his number 1 agenda for his 2nd term. But a minority in the Senate was able to block the attempt even though The PEOPLE SPOKE!!

The health care they are proposing here is much different than what you have Mogrann. You aren't required to pay for it and if you don't pay for it you aren't penalized. There is no comparison to what you have and what is being forced down our throats.

Interesting article on how Obamacare will "fundamentally change" the fabric of American society .

Will Obamacare hurt job creation and marriage? - Diana Furchtgott-Roth - MarketWatch (http://www.marketwatch.com/story/will-obamacare-hurt-job-creation-and-marriage-2013-09-27?link=mw_home_kiosk)

There are 'disincentives both to hiring and marriage'.

Hello again, tom:

But a minority in the Senate was able to block the attempt even though The PEOPLE SPOKE!! And, THIS time, they weren't. That's how democracy works in this great country of ours. If you have the REPRESENTATIVES in congress, what YOU want, happens. If you don't, what the OTHER guy wants, happens.

You didn't have the votes. That's how democracy works. But, you'd rather squeal, and snivel, and hold the country hostage to GET what you DON'T HAVE THE VOTES TO GET.

It ain't going to work.. Oh, it'll work for ME. You Tea Party dudes will be dispatched.

Excon

Hello again, Steve:
This BS is getting old. But, I see that it'll NEVER change.. You just have an aversion to the truth, that'll NEVER change.

But, that's NOT gonna stop me from trying... You talk about what "the people" want, as though you know.. But, you don't. You IGNORE the stuff that goes against your argument, like our last election...

Really.. It was an ELECTION... One candidate said his NUMBER ONE job would be to REPEAL Obamacare. He LOST, and he LOST BIG.

The PEOPLE SPOKE!!!! You don't LIKE it, but they SPOKE loudly and clearly.

excon

You'll have to point out where the people voted for Obama because they wanted Obamacare so bad, because I thought he got elected because women were afraid Romney would take away their tampons and birth control.

Hello again, Steve:
You'll have to point out where the people voted for Obama because they wanted Obamacare so bad, Let me see. WHEN they voted for Obama, they ALSO voted for a congress who passed the ACA.

That, my right wing friend, is DEMOCRACY at work. That's HOW it happens here, in this great land of ours.

Speaking of democracy, if you WIN the senate, and WIN the presidency, you can REPEAL the whole ball of wax, and I'll be the one squealing...

Excon

Hello again, Steve:Lemme see. WHEN they voted for Obama, they ALSO voted for a congress who passed the ACA.

They voted for a divided executive and legislative branch. That's what they do when the people want to cut back the power of the party in charge, it's certainly not a mandate to do whatever he wants.

Hello again, Steve:

it's certainly not a mandate to do whatever he wants.It ISN'T?? Tell that to the right wing governors who have right wing congress's... They're certainly doing whatever they want, and DAMN what the libs want...

Frankly, I think they're RIGHT. I don't LIKE what they're DOING, but that's DEMOCRACY. When libs take over those states again, as they surly will, they'll REPEAL all the right wing crap.

You ARE going to defend those states rights to run roughshod over their opponents, aren't you?

Excon

Hello again, Steve:
It ISN'T???? Tell that to the right wing governors who have right wing congress's... They're certainly doing whatever they want, and DAMN what the libs want...

Frankly, I think they're RIGHT. I don't LIKE what they're DOING, but that's DEMOCRACY. When libs take over those states again, as they surly will, they'll REPEAL all the right wing crap.

You ARE going to defend those states rights to run roughshod over their opponents, aren't you?

excon

So you admit it isn't about what the people want, it's about running roughshod over Republicans.

Hello again, Steve:

So you admit it isn't about what the people want, it's about running roughshod over Republicans.Nannnn. We're MUCH nicer than you.. And, that's exactly WHY the ACA needs fixing.. Obama didn't run roughshod over anybody.. He DESIGNED the bill to attract Republicans. He certainly didn't let the insurance companies stay IN the mix to placate Democrats... But, that didn't work, did it?? So, the Democrats did their own thing.

You COULD have participated then. You CAN participate NOW, if you only knew how.

Excon

The Repubics were shut out of the process completely by Reid and Pelosi.

Hello again, Steve:
Nannnn. We're MUCH nicer than you..

LOL, that must be why the White House is calling Republicans terrorists and calling Iran instead of them.

Hello again, tom:

the Repubics were shut out of the process completely by Reid and Pelosi.That's the spin, isn't it? The truth is, if Democrats had their way, we'd have single payer.

Excon

No it's the fact . The Repubics were complaining about it as it happened in 2009 . All the negotiations were held in secret in the White House... show me the day that C-Span aired any of them as the emperor promised. 45 Republic amendments were proposed.. All were knocked out without any debate.
Not only that ;but when the Repubics tried to hold hearings on their own to get their ideas out ,this is how they were greeted :

"Top aides to Senate Finance Chairman Max Baucus (D-Mont.) called a last-minute, pre-emptive strike on Wednesday with a group of prominent Democratic lobbyists, warning them to advise their clients not to attend a meeting with Senate Republicans set for Thursday. Russell Sullivan, the top staffer on Finance, and Jon Selib, Baucus' chief of staff, met with a bloc of more than 20 contract lobbyists, including several former Baucus aides. "They said, 'Republicans are having this meeting and you need to let all of your clients know if they have someone there, that will be viewed as a hostile act,'"said a Democratic lobbyist who attended the meeting. "Going to the Republican meeting will say, 'I'm interested in working with Republicans to stop health care reform,'"the lobbyist added."

The fact is that the ONLY reason we don't have that universal cr@p sandwich is because the Dems took over the House in 2006 by recruiting a bunch of blue dog Dems to run.. They had to keep them in line and they would never approve a universal plan. So they passed Obamacare to ensure they got the moderate Dem vote . It had nothing to do with consideration for Republic ideas . None of them were incorporated .

Hello again, tom:

It had nothing to do with consideration for Republic ideas . None of them were incorporated .No?? The whole damn thing was based on a REPUBLICAN (http://www.forbes.com/sites/theapothecary/2011/10/20/how-a-conservative-think-tank-invented-the-individual-mandate/) idea.

Dude!

Let me say again, if the Democrats wanted to shove something down your throat, it would have been single payer.

Excon

Since I'm getting in on this thread fairly late... a lot of us knew this is exactly what was going to happen right after they rammed this through without a vote.

Now everyone else is going to find out about the propaganda they were fed by the lame stream media the last few years.

And they are going to learn it came from the pig farm out back and not the kitchen.

Hello again, smoothy:

they rammed this through without a vote. Without a vote, huh? And, the Supreme Court found it to BE Constitutional??

Dude. Step away from the FOX News channel. It's rotting your brain.

Excon

Hello again, smoothy:
Without a vote, huh? And, the Supreme Court found it to BE Constitutional????

Dude. Step away from the FOX News channel. It's rotting your brain.

excon

What part of it didn't get a vote like it should have is beyond your capacity to iunderstand...

the Repubics were shut out of the process completely by Reid and Pelosi.

No they weren't they were in it all the way until it was time to vote on it for passage. Then they said NO. So we got it passed despite your plot to kill it after you stalled it.

And this last assassination plot is the desperate final chance after 43 other attempts that FAILED. Governing by fear and extortion will FAIL!

Hello again, smoothy
What part of it didn't get a vote like it should have is beyond your capacity to iunderstand... Splain it to me.

Excon

Would it make any difference? You Obamacare prophets isnist its going to save EVERYONE money... and give better care to everyone... despite there being ZERO proof of that. Only Obamas claims that NOBODY else can prove.. not even the CBO.

Incidentally... look it up yourself here's the link...

The Legislative Process · House.gov (http://www.house.gov/content/learn/legislative_process/)


Because this is NOT how it happened...

Introduction and Referral to Committee

Any member in the House of Representatives may introduce a bill at any time while the House is in session by simply placing it in the “hopper” at the side of the Clerk's desk in the House Chamber. The sponsor's signature must appear on the bill. A public bill may have an unlimited number of co-sponsoring members. The bill is assigned its legislative number by the Clerk and referred to the appropriate committee by the Speaker, with the assistance of the Parliamentarian. The bill is then printed in its introduced form, which you can read in Bill Text.

An important phase of the legislative process is the action taken by committees. It is during committee action that the most intense consideration is given to the proposed measures; this is also the time when the people are given the opportunity to be heard. Each piece of legislation is referred to the committee that has jurisdiction over the area affected by the measure.

Consideration by Committee

Public Hearings and Markup Sessions

Usually the first step in this process is a public hearing, where the committee members hear witnesses representing various viewpoints on the measure. Each committee makes public the date, place and subject of any hearing it conducts. The committee meetings scheduled for today are available along with other House Schedules. Public announcements are also published in the Daily Digest portion of the Congressional Record.

A transcript of the testimony taken at a hearing is made available for inspection in the committee office, and frequently the complete transcript is printed and distributed by the committee.

After hearings are completed, the bill is considered in a session that is popularly known as the “mark-up” session. Members of the committee study the viewpoints presented in detail. Amendments may be offered to the bill, and the committee members vote to accept or reject these changes.

This process can take place at either the subcommittee level or the full committee level, or at both. Hearings and markup sessions are status steps noted in the Legislative Action portion of Bill Status.

Committee Action

At the conclusion of deliberation, a vote of committee or subcommittee members is taken to determine what action to take on the measure. It can be reported, with or without amendment, or tabled, which means no further action on it will occur. If the committee has approved extensive amendments, they may decide to report a new bill incorporating all the amendments. This is known as a “clean bill”, which will have a new number. Votes in committee can be found in Committee Votes.
If the committee votes to report a bill, the Committee Report is written. This report describes the purpose and scope of the measure and the reasons for recommended approval. House Report numbers are prefixed with “H.Rpt.” and then a number indicating the Congress (currently 107).

House Floor Consideration

Consideration of a measure by the full House can be a simple or very complex operation. In general a measure is ready for consideration by the full House after it has been reported by a committee. Under certain circumstances, it may be brought to the Floor directly.

The consideration of a measure may be governed by a “rule”. A rule is itself a simple resolution, which must be passed by the House, that sets out the particulars of debate for a specific bill—how much time will be allowed for debate, whether amendments can be offered, and other matters.

Debate time for a measure is normally divided between proponents and opponents. Each side yields time to those members who wish to speak on the bill. When amendments are offered, these are also debated and voted upon. If the House is in session today, you can see a summary of Current House Floor Proceedings.

After all debate is concluded and amendments decided upon, the House is ready to vote on final passage. In some cases, a vote to “recommit” the bill to committee is requested. This is usually an effort by opponents to change some portion or table the measure. If the attempt to recommit fails, a vote on final passage is ordered.

Votes on final passage, as well as all other votes in the House, may be taken by the electronic voting system which registers each individual member's response. These votes are referred to as Yea/Nay votes or recorded votes, and are available in House Votes by bill number, roll call vote number or words describing the reason for the vote.

Votes in the House may also be by voice vote, and no record of individual responses is available.

Senate Action

After a measure passes in the House, it goes to the Senate for consideration. A bill must pass both bodies in the same form before it can be presented to the President for signature into law.

Resolving Differences

If the Senate changes the language of the measure, it must return to the House for concurrence or additional changes. This back-and-forth negotiation may occur on the House floor, with the House accepting or rejecting Senate amendments or complete Senate text. Often a conference committee will be appointed with both House and Senate members. This group will resolve the differences in committee and report the identical measure back to both bodies for a vote. Conference committees also issue reports outlining the final version of the bill.

Consideration by the President

After a measure has been passed in identical form by both the House and Senate, it is considered “enrolled”. It is sent to the President who may sign the measure into law, veto it and return it to Congress, let it become law without signature, or at the end of a session, pocket-veto it.

Hello again, tom:
No?? The whole damn thing was based on a REPUBLICAN (http://www.forbes.com/sites/theapothecary/2011/10/20/how-a-conservative-think-tank-invented-the-individual-mandate/) idea.

Dude!

Let me say again, if the Democrats wanted to shove something down your throat, it would have been single payer.

Excon

A policy paper by Heritage in the early 90's?? That's where you get this idea that the 21st century Republican party endorses it ?
From the Heritage amicus to SCOTUS :

Heritage policy experts never supported an unqualified mandate like that in the PPACA [ObamaCare]. Their prior support for a qualified mandate was limited to catastrophic coverage (true insurance that is precisely what the PPACA forbids), coupled with tax relief for all families and other reforms that are conspicuously absent from the PPACA. Since then, a growing body of research has provided a strong basis to conclude that any government insurance mandate is not only unnecessary, but is a bad policy option. Moreover, Heritage’s legal scholars have been consistent in explaining that the type of mandate in the PPACA is unconstitutional.

I've said it before that the only mandate to insurance polices that states should be required is providing catastrophic insurance. If that is all that was in Obamacare then I would support it too.

So you don't see the need for regular checkups and prevention as something really important to consumers huh, or ones with kids? Or drug coverage for lets say high blood pressure or other medical conditions that can be treated if found early?

Catastrophic is great for car insurance, but people require more than cars do.

So you don't see the need for regular checkups and prevention as something really important to consumers huh, or ones with kids? Or drug coverage for lets say high blood pressure or other medical conditions that can be treated if found early?

Catastrophic is great for car insurance, but people require more than cars do.

I think that's between the individual and the provider as to what degree of coverage they require . Cost would drop like a rock if there was competition and choice in coverage .

You have just described the exchanges Tom, but with a broader minimum to include ALL the population, not just your favored, or acceptable socio-economic, or religious demographic.

Even republican governors are getting with the Medicaid expansion, and so will the rest when they get the bill for uninsured poor people in their states.

But what should I expect from the party that cuts welfare for poor people and gives it to rich people?

You have just described the exchanges Tom, but with a broader minimum to include ALL the population, not just your favored, or acceptable socio-economic, or religious demographic.

Even republican governors are getting with the Medicaid expansion, and so will the rest when they get the bill for uninsured poor people in their states.

But what should I expect from the party that cuts welfare for poor people and gives it to rich people?

Not even close to true . I described a FREE MARKET consumer friendly alternative . Not your statist mandates .

I described a FREE MARKET consumer friendly alternative .It does sound like a republican utopia as a thesis paper, but given the way corporation screw people over I think it would be hell on earth for the citizens.

Now we have apparatchiks in the National Cancer Institute redefining what cancer is for the purpose of cost saving.


By redefining the term “cancer,” the National Cancer Institute hopes to reduce patient anxiety and reduce the risks and expenses associated with supposedly unnecessary medical procedures. In technical terms, the government hopes to reduce “overdiagnosis” and “overtreatment” of cancer.
It is true that some patients wrongly view the word “cancer” as the equivalent of a death sentence and become overly distraught. This can cloud their judgment when they most need their full rational faculties to make sound medical decisions.

But while there are legitimate scientific and medical questions about the proper definition and classification of any disease (including cancer), we must be careful that that any redefinition won't be used for inappropriate political purposes. Given the increasing government control over US health care, how the government defines medical terms can have serious economic and policy implications.


Why The Federal Government Wants To Redefine The Word 'Cancer' - Forbes (http://www.forbes.com/sites/paulhsieh/2013/09/29/why-the-federal-government-wants-to-redefine-the-word-cancer/)

The article goes on to quote Dr. Milton Wolf, a practicing radiologist who cares for patients with DCIS warns against this Orwellian possibility:


Health care rationing takes many insidious forms but perhaps the most immoral is for the government to wage a public relations campaign designed specifically to dissuade patients and doctors from seeking available cures for cancer. They scheme to rename cancer, not to cure it, but to deny it exists. These government rationers have calculated that rather than actually treat patients with cancer, it's cheaper to simply keep them as calm as Hindu cows right up to the very end.

Or as the emperor says... “Maybe you're better off to tell your mother to take a pill"

The free market has had decades to solve problems, they didn't. They have FAILED US!

So out of spite... certain leftist Democrats are insistant on ruining everything for everyone?

That's how insurance companies and doctors make all that money - unnecessary tests and procedures.

Doctors Call Out 90 More Unnecessary Medical Tests, Procedures - Forbes (http://www.forbes.com/sites/brucejapsen/2013/02/21/doctors-call-out-90-more-unnecessary-medical-tests-procedures/)

HealthWatch: Saying 'No' To Unnecessary Medical Tests « CBS San Francisco (http://sanfrancisco.cbslocal.com/2013/04/02/healthwatch-saying-no-to-unnecessary-medical-tests/)

Medical Tests | Unnecessary Medical Tests & Treatments - Consumer Reports (http://www.consumerreports.org/cro/magazine/2012/06/many-common-medical-tests-and-treatments-are-unnecessary/index.htm)

Now we have apparatchiks in the National Cancer Institute redefining what cancer is for the purpose of cost saving.



Why The Federal Government Wants To Redefine The Word 'Cancer' - Forbes (http://www.forbes.com/sites/paulhsieh/2013/09/29/why-the-federal-government-wants-to-redefine-the-word-cancer/)

The article goes on to quote Dr. Milton Wolf, a practicing radiologist who cares for patients with DCIS warns against this Orwellian possibility:


Health care rationing takes many insidious forms but perhaps the most immoral is for the government to wage a public relations campaign designed specifically to dissuade patients and doctors from seeking available cures for cancer. They scheme to rename cancer, not to cure it, but to deny it exists. These government rationers have calculated that rather than actually treat patients with cancer, it’s cheaper to simply keep them as calm as Hindu cows right up to the very end.

Or as the emperor says..... “Maybe you're better off to tell your mother to take a pill"

Or maybe we should be checked early so we don't get to discovering we have a disease when its already in the critical stages. Better outcomes from screening and prevention.

That's how insurance companies and doctors make all that money - unnecessary tests and procedures.

Doctors Call Out 90 More Unnecessary Medical Tests, Procedures - Forbes (http://www.forbes.com/sites/brucejapsen/2013/02/21/doctors-call-out-90-more-unnecessary-medical-tests-procedures/)

HealthWatch: Saying ‘No’ To Unnecessary Medical Tests « CBS San Francisco (http://sanfrancisco.cbslocal.com/2013/04/02/healthwatch-saying-no-to-unnecessary-medical-tests/)

Medical Tests | Unnecessary Medical Tests & Treatments - Consumer Reports (http://www.consumerreports.org/cro/magazine/2012/06/many-common-medical-tests-and-treatments-are-unnecessary/index.htm)

So instead the socialists want the THOUSANDS of new Government employees to be pocketing that instead... while returning no return of investment? YOu don't actually believe the people with the real jobs are going to keep any of it? Its coing to cost a lot more for a lot less coverage... and you have the word of an actual Health care professional proving that's the case...

That's how insurance companies and doctors make all that money - unnecessary tests and procedures.

Doctors Call Out 90 More Unnecessary Medical Tests, Procedures - Forbes (http://www.forbes.com/sites/brucejapsen/2013/02/21/doctors-call-out-90-more-unnecessary-medical-tests-procedures/)

HealthWatch: Saying 'No' To Unnecessary Medical Tests « CBS San Francisco (http://sanfrancisco.cbslocal.com/2013/04/02/healthwatch-saying-no-to-unnecessary-medical-tests/)

Medical Tests | Unnecessary Medical Tests & Treatments - Consumer Reports (http://www.consumerreports.org/cro/magazine/2012/06/many-common-medical-tests-and-treatments-are-unnecessary/index.htm)

Well that ties in nicely with my point about liability and tort reform.the reason extra tests are recommended is CYA

the reason extra tests are recommended is CYA.. and extracting as much money as possible from the client.

..and extracting as much money as possible from the client.

Naw... but that is EXACTLY wha tObamacare accomplishes. Extract much MORE money and deliver far less in return for it.

..and extracting as much money as possible from the client.

Lol
The list was compiled by groups such as the American Academy of Family Physicians; the American Academy of Hospice and Palliative Medicine; the American Academy of Pediatrics; the American College of Obstetrics and Gynecology; the American Urological Association; and the Society of Thoracic Surgeons.

Yes of course all these doctor associations would be compiling a list of unnecessary procedures to extract as much money from their clients. You would think that they would be promoting the benefits of the procedures if it was a money making scheme.

Naw...but that is EXACTLY wha tObamacare accomplishes. Extract much MORE money and deliver far less in return for it.
Far less indeed. Fewer nurses with higher patient census. It's going by numbers now versus how sick the patients are. Seven patients to one nurse may not seem like a lot to you, but it's astronomical when the patient level of acuity is ignored in favor of numbers.

Your ER wait times will increase because the ER will become a clinic for headaches and flus and colds. Why? Because many competent doctors will opt out of taking patients with Islamacare.

Far less indeed. Fewer nurses with higher patient census. It's going by numbers now versus how sick the patients are. Seven patients to one nurse may not seem like a lot to you, but it's astronomical when the patient level of acuity is ignored in favor of numbers.

Your ER wait times will increase because the ER will become a clinic for headaches and flus and colds. Why? Because many competent doctors will opt out of taking patients with Islamacare.

But proponents say it will reduce ER wait times because people will go to their doctor now that they have insurance. So when they can't get off work, can't afford to take time off work, can't get an appointment with their doctor because of his increased case load, etc. etc. where will they go? If you said the ER step to the front of the line.

Visits to ER rise despite health law (http://www.boston.com/news/local/massachusetts/articles/2011/06/07/visits_to_er_rise_despite_health_law/)

Islamacaremaybe Hitlercare? Or GasOvensCare? Or IranCare? Or ScientologyCare? Or Muslimcare?

LOL!

Far less indeed. Fewer nurses with higher patient census. It's going by numbers now versus how sick the patients are. Seven patients to one nurse may not seem like a lot to you, but it's astronomical when the patient level of acuity is ignored in favor of numbers.

Your ER wait times will increase because the ER will become a clinic for headaches and flus and colds. Why? Because many competent doctors will opt out of taking patients with Islamacare.

Washington DC has lost half of its Primary Care Physiicians in the last few years... and I have ZERO doubt its happening many other places as well. At some point the trouble and the cost vs. pay will hit a point its no longer desirable or economically feasible to continue to practice medicine.

I don't think a lot of people actually understand how much it costs to keep even a small medical practice open... much less a hospital... or they must actually believe people are going to attend medical school... and all the costs, time and work involved... (and not just for the Doctors) just to work for free.

Doctors are not required to take patients covered by Islamacare. Therefore, many people covered by this insurance will find themselves with no primary healthcare provider, thus the ER will become their primary healthcare provider.

Here in TN, we have a similar insurance plan, or did until it stopped covering many people, TennCare. I've already seen the damage this kind of insurance can inflict.

That's the way it went down with Romneycare .

To understand how difficult it will be to find a primary care doctor in two years, look no further than Massachusetts. In 2006 the state passed a health care law mandating that everyone obtain insurance (sound familiar?). For those unable to afford the cost, subsidies were made available.

Within weeks, the "uninsurance" rate in Massachusetts dropped precipitously. Commensurate with that was a rise in both the number of "closed" office practices and the length of time it took to get a new patient appointment. Nearly six years after the law passed, more than half of the family practice and internal medicine offices in the state are closed to new patients. According to the Massachusetts Medical Society, the average wait for a new patient to be seen by an internist is 48 days. Turns out insurance doesn't guarantee access after all.

The Doctor Is Out: Young Talent Is Turning Away From Primary Care - John Henning Schumann - The Atlantic (http://www.theatlantic.com/health/archive/2012/03/the-doctor-is-out-young-talent-is-turning-away-from-primary-care/254221/)

Speaking of fact checks, AP finally decided to do some (http://finance.yahoo.com/news/fact-check-slippery-claims-health-law-budget-120756800.html) the day before Zerocare takes effect.


OBAMA: "Knowing you can offer your family the security of health care, that's priceless. Now, you can do it for the cost of your cable bill, probably less than your cellphone bill. Think about that, good health insurance for the price of your cellphone bill or less." — Speech in Largo, Md. on Thursday.

THE FACTS: The family coverage you can get for the cost of a monthly cable or cellphone bill is going to expose you to a hefty share of your medical expenses. Looked at in terms of digital communications, it's more like dial-up Internet than 4G.

The cell-phone analogy has become the talking point of the week for administration officials pitching people on the health care markets opening for business Tuesday. Obama said earlier that of every 10 Americans who are uninsured, "six out of those 10 are going to be able to get covered for less than $100 a month, less than your cellphone bills."

He is referring to the cheapest of four major options offered by the new markets, the "bronze" plan. But, just like with auto insurance, premiums aren't the only potential expense for a consumer. Those who choose bronze will have to pay 40 percent of their medical bills out of pocket through deductibles and copayments. A family's share of medical costs could go as high as $12,700 a year, or $6,350 for individuals, on top of those cell-phone-like premiums.

But I'm sure everyone is just going to LOVE it!


OBAMA: "Premiums are going to be different in different parts of the country depending on how much coverage you buy, but 95 percent of uninsured Americans will see their premiums cost less than was expected." — Largo, Md. speech.

THE FACTS: Less than who expected? Obama is referring to an administration analysis that finds premiums are coming in 16 percent lower than had been estimated by experts at the nonpartisan Congressional Budget Office. Independent analysts find similar results. But it's a stretch to suggest that numbers crunched by CBO's experts would reflect the expectations of regular consumers.

And as has been noted, the increase in prices was less than expected.


REP. KEVIN McCARTHY, R-Calif.: "When we started this health care debate, the president led with a very big promise to the American people: If you like the health care that you have, that you currently have, you can keep it."
...

THE FACTS: McCarthy is correct, Obama said exactly that. It was an empty promise, made repeatedly. Sebelius picks her words more carefully but still offers misleading assurances.

An empty promise for a plan that originated from a throwaway applause line. But it's going to be GREAT!

Doctors are not required to take patients covered by Islamacare. Therefore, many people covered by this insurance will find themselves with no primary healthcare provider, thus the ER will become their primary healthcare provider.

Here in TN, we have a similar insurance plan, or did until it stopped covering many people, TennCare. I've already seen the damage this kind of insurance can inflict.

Are you saying there aren't any doctors who receive payment in cash or have they all become employees of insurance companies

And of course the lefties are only going to be happy if everyone gets screwed... no democrat in recent decades has done anything to actually help someone worthy of help.

Meaning they screw the productive members of society to help the lazy bums who would have starved to death left to their own initiative.

And of course the lefties are only going to be happy if everyone gets screwed.....no democrat in recent decades has done anything to actually help someone worthy of help.

Meaning they screw the productive members of society to help the lazy bums who would have starved to death left to their own initiative.
Are you saying our resident library homeless guy and my friend for 12 years was a lazy bum?

Are you saying our resident library homeless guy and my friend for 12 years was a lazy bum?
Why is he homeless and not working? Obama was bragging about how utterly fantastic the economy is right now compared to 5 years ago about an hour ago... that means either he was spouting Bovine excrement again on TV... or there are plenty of jobs to go around.

Actually being a worthless member of society isn't mutually exclusive with being friendly... A lot of them are very good at that to get things off people, or get people to do stuff for them, I've known more than my share of people that fit that bill in my life. I'm just sick and tired of ever larger portions of my income being taken off me and given to the people who won't work hard enough to improve their own situation.

Get burned by enough of them... and you start seeing it my way.

12 years homeless ?

Why is he homeless and not working?
He worked good jobs, but ended up old (60s) and on the street. He died last year at 73.

12 years homeless ?
More than that.

are you saying there arn't any doctors who receive payment in cash or have they all become employees of insurance comapnies
That's not at all what I said. Did you even read what I wrote? Nah, didn't think so.

Doctors are not required to accept the ACA insurance. They can accept cash or private insurance, thus leaving people with this unaffordable health insurance without primary care physicians, hence they will line up at the local ER for ordinary complaints.

Doctors are not required to accept the ACA insurance.
The "ACA insurance" in Illinois is private companies.

That's not at all what I said. Did you even read what I wrote? Nah, didn't think so.

Doctors are not required to accept the ACA insurance. They can accept cash or private insurance, thus leaving people with this unaffordable health insurance without primary care physicians, hence they will line up at the local ER for ordinary complaints.

Why can't these people pay cash and sort it out with their health care provider later, this is what I haven't understood from your remarks, why must a doctor accept a health care provider?

why can't these peopel pay cash and sort it out with their health care provider later, this is what I haven't understood from your remarks, why must a doctor accept a health care provider?
For years, we have looked for area medical people who accept our insurance plans. If we want a certain doctor and he doesn't accept payment from a certain company, then the insured is considered "out of network" - still covered but not as much.

why can't these peopel pay cash and sort it out with their health care provider later, this is what I haven't understood from your remarks, why must a doctor accept a health care provider?

Because only a rich man can pay the rates a doctor charges. Most of us depend on insurance providers.

For years, we have looked for area medical people who accept our insurance plans. If we want a certain doctor and he doesn't accept payment from a certain company, then the insured is considered "out of network" - still covered but not as much.

This is why single payer works better, where I come from there are various options, we can seek out a doctor paid by the system, we can just go to any doctor pay them and get reimbursed from the local office or we can trot along to the ER who obviously wish we wouldn't but the benefit under the system is always the same irrespective of who the provider is, and for hospitalisation we can have insurance, or use the state hospital or the private hospital system but you wouldn't want to do that without insurance but the beauty of the system is it works no matter where you go in the country

Because only a rich man can pay the rates a doctor charges. Most of us depend on insurance providers.

Another distortion .the truth is that doctors are burdened with all the regulations. Doctors setting up their own practice actually have a hard time practicing their profession . They spend a lot of time being office managers . They needs staffs of clerks to comply with all the paper work ;and their fees(which are controlled by government if they accept Medicaid /Medicare patients ) have to cover all the over head ,including what I mentioned ,buying or renting space ,payroll and human resources ,very expensive liability insurance ,and a decent profit to cover the expense of years of education to obtain their license to practice .

To answer Clete's question... there is a growing movement by some doctors to "opt out " of the whole gig and are setting up cash only practices.


In Wichita, Kan. 32-year old family physician Doug Nunamaker switched to a cash-only basis in 2010 after taking insurance for five years. ("Cash-only" is a loose description. Nunamaker accepts payment by debit or credit card too.)

Under the traditional health insurance system, a large staff was required just to navigate all the paperwork, he said. That resulted in high overhead, forcing doctors like Nunamaker to take on more patients to cover costs. Plus, the amount insurance companies were willing to pay for procedures was declining, leading to a vicious cycle.

"The paperwork, the hassles, it just got to be overwhelming," Nunamaker said. "We knew that we had to find a better way to practice."

So Nunamaker and his partner set up a membership-based practice called Atlas M.D. -- a nod to free-market champion Ayn Rand's book Atlas Shrugged. Under the membership plan -- also known as "concierge" medicine -- each patient pays a flat monthly fee to have unlimited access to the doctors and any service they can provide in the office, such as EKGs or stitches.

The fee varies depending on age. For kids, it's $10 a month. For adults up to age 44, it's $50 a month. Senior citizens pay $100.

The office has negotiated deals for services outside the office. By cutting out the middleman, Nunamaker said he can get a cholesterol test done for $3, versus the $90 the lab company he works with once billed to insurance carriers. An MRI can be had for $400, compared to a typical billed rate of $2,000 or more.

Nunamaker encourages his patients to carry some type of high-deductible health insurance plan in case of an emergency or serious illness. But for the everyday stuff, he said his plan works better for both doctor and patient.

"It would be like if car insurance paid for gas, oil and tires," he said. "It would be very expensive, and you'd have to get pre-approval for a trip out of town."

Most of his clients are self-employed, small business owners, or employed at small firms that have found the monthly fee, combined with a high-deductible plan, a cheaper option than traditional insurance.

Nunamaker now has a patient list totaling 400 to 600, compared to the 2,500 to 4,000 he said a typical family physician usually maintains. He's quite happy with his annual salary of around $200,000.

"My professional life is better than expected, my family life and personal time is better than expected," he said. "This is everything I wanted out of family medicine."
Read the rest .
Cash-only doctors abandon the insurance system - Jun. 11, 2013 (http://money.cnn.com/2013/06/11/news/economy/cash-only-doctors/index.html)
I think it's very affordable ;and in fact ,my wife has gone to a cash only doctor for many years .

Doctors setting up their own practice actually have a hard time practicing their profession . They spend a lot of time being office managers . They needs staffs of clerics to comply with all the paper work ;and their fees(which are controlled by government if they accept Medicaid /Medicare patients ) have to cover all the over head ,including what I mentioned ,buying or renting space ,payroll and human resources ,very expensive liability insurance ,and a decent profit to cover the expense of years of education to obtain their license to practice .
That's been the norm for years. Few doctors practice alone, but become associates and establish group practices in which they share an office manager, clerical staff, PAs, nurses, rent space, buy furniture and medical equipment. Each has his own liability insurance (I had mine as a counselor in a group practice). Licenses were not yet needed for counselors, but we would have had them if they were. We charged a fair market price that people paid out of pocket or through insurance. If we (or a doctor) was too expensive, the patient went elsewhere.

The ACA shouldn't affect that.

A tactic here Clete is to charge you to pay for health services and let you argue how much you get reimbursed for those services with your provider, or bill you the difference (out of pocket expenses).

But some of us got checks back for the provider not spending a fair share of our premium payments for health care.

That's been the norm for years. Few doctors practice alone, but become associates and establish group practices in which they share an office manager, clerical staff, PAs, nurses, rent space, buy furniture and medical equipment. Each has his own liability insurance (I had mine as a counselor in a group practice). Licenses were not yet needed for counselors, but we would have had them if they were. We charged a fair market price that people paid out of pocket or through insurance. If we (or a doctor) was too expensive, the patient went elsewhere.

The ACA shouldn't affect that.

The ACA will not relieve the overhead burden . If anything it will make it worse . That is why these doctors are opting out of the game. Others are just leaving the profession in droves .

Overhead is a slave to whatever the market will bear. Nothing to do with insurance at all. Talk to the real estate guy or power company for overhead concerns.

You just keep piling on the excuses don't cha? Sooner or later you will acknowledge EVERYTHING is too damn EXPENSIVE, and your wages can't keep up.

the ACA will not relieve the overhead burden .
It's not supposed to and has nothing to do with it. Overhead is the cost of doing business. ACA or not, overhead is there.

Why would doctors flee? They're going to get more patients (and thus more money). The same patients who headed for the ER (and the hospital got the Medicaid payment) will now seek out a doctor (and the insurance coverage the patient pays for will pay the doctor).

So the doctors are lying ? From an AARP article on the same subject

Why is this happening?

Physicians and researchers cite three reasons — but all relate to one thing: insurance hassles.

Money: Under the traditional system, most medical practices need a large staff to ensure that they are reimbursed by health insurers. This results in higher overhead — which eats up to 60 percent of a typical practice's revenue — and forces doctors to see more patients in order to cover costs.
Direct Primary Care - Cash Only Doctors Say No to Your Health Insurance - AARP (http://www.aarp.org/health/health-insurance/info-08-2013/direct-primary-care.html)

It's not supposed to and has nothing to do with it. Overhead is the cost of doing business. ACA or not, overhead is there.

Yes it is ,as all compliance with regulation results in added overhead costs

yes it is ,as all compliance with regulation results in added overhead costs
I have no idea what that means. My doctor hasn't changed a thing in his office.

I have no idea what that means. My doctor hasn't changed a thing in his office.

Unless the doctor is administering care to the patient ;everything else that goes on in the doctor's office is overhead. If the law requires more staffing ,more hours to comply with the paperwork for added mandates then overhead costs have to go up . You can't make the statement you made until you know the details . Perhaps your doctor compensates by taking a reduced salary . Anyway ,Obamacare tries to regulate the details with the HHS " Medical Loss Ratio Regulations”. That effort will fail ,and more than one provider is betting that their overhead will be too high to continue their practice. That is why J-9 mentioned that many are opting to work out of hospitals as paid staff .

If the law requires more staffing ,more hours to comply with the paperwork for added mandates then overhead costs have to go up
Does the law mandate that -- or does the increased patient load mandate that? Seems like it's a win-win situation.

I really hope everyone who voted for Obama ends up with $10,000 deductible plans...

Then tell us how much you are saving from your old plan when you pay twice as much to begin with.

No changes in the plan we have. Or in my son's private pay.

ACA is for those who have NO insurance.

I gave 2 links including the Obamacare friendly AARP. Guess the doctors are lying .

Here's another :

Many doctors — particularly those nearing the end of their careers — will simply hang up their scrubs instead of spending heavily to comply with ObamaCare. According to Dr. Jeff Cain, president of the American Academy of Family Physicians, "Almost a third of family doctors in rural America are thinking about retiring in the next five years."

A 2013 Deloitte survey of physicians found that six in 10 doctors believe that many in their profession "will retire earlier than planned in the next one to three years."

Those who can't afford to retire may look to partner with hospitals in order to offload increases in overhead fueled by ObamaCare. That's bad news for physicians, hospitals and patients alike.
Dysfunctional ObamaCare Is Making Our Doctor Shortage Crisis Worse - Investors.com (http://news.investors.com/ibd-editorials-perspective/092413-672319-obamacare-medicaid-expansion-worsens-doctor-shortage.htm#ixzz2gQQZdxIa)

It's not supposed to and has nothing to do with it. Overhead is the cost of doing business. ACA or not, overhead is there.

Why would doctors flee? They're going to get more patients (and thus more money). The same patients who headed for the ER (and the hospital got the Medicaid payment) will now seek out a doctor (and the insurance coverage the patient pays for will pay the doctor).

You really don't have a clue WG. Not a clue. Maybe you should go to your library and do some more research.

No changes in the plan we have. Or in my son's private pay.

ACA is for those who have NO insurance.

No changes yet. They are coming, I assure you. Unless you are on Medicare.

ACA has nothing to do with those of us who already have insurance.

WRONG, WrOng, WRoNG! Mine is changing. I have Aetna. Aetna has already pulled out of a number of states. I hope my state is not next.

WRONG, WrOng, WRoNG! Mine is changing. I have Aetna. Aetna has already pulled out of a number of states. I hope my state is not next.
But that's for the NOT insured. Aetna won't be in those states' marketplaces for the NOT insured.

Originally Posted by Wondergirl
ACA has nothing to do with those of us who already have insurance.

You do live in a pretty little bubble don't you? You think that this will not affect those of us with private insurance? You really need to do some more research. It will affect us greatly. Our costs will increase, your coverage will decrease. It's already affected me.

I used Aetna as an example only.

Physicians will stop accepting new patients. There will be a waiting list months long at the physicians' offices that DO accept ACA. You think they will make more money? That's incorrect as well. They will be under the watchful eye of the government officials who will be the watchdogs. They will get paid LESS for services rendered if they don't conform to specific tests that may be needless. As a matter of fact, they may get paid NOTHING if they don't conform.

Again, I speak from the front lines. We've had meetings, classes, etc. that are telling us what the changes will be in order for our physicians and our doctor's to get reimbursed. Vanderbilt Hospital just let go of 1,000 necessary employees. This site says that it will be by the end of the year. My nurse friend who works there told me different today.

http://www.tennessean.com/article/20130918/BUSINESS05/309180127/Vanderbilt-University-Medical-Center-cutting-several-hundred-more-jobs

You do live in a pretty little bubble don't you?
The insult wasn't necessary.

Change is scary. People don't understand this scary ACA thing which does need tweaking and will be tweaked as it goes along.

If anything, this will be a great time to be in healthcare. More patients, who will become private-pay insureds, will be looking for doctors (not ERs and Medicaid), thanks to ACA.

United Health Care has opted out of IL marketplaces, but we've had it for years and will be able to keep it. No change in premiums so far. My older son has BC/BS and no changes for him either. It IS one of IL's marketplace choices, so if anything, premiums will eventually go down (or at least stay the same) as currently uninsured people sign on.

It wasn't an insult. You are living in a bubble, that's simply the truth. You don't have a clue what is going on! If you were still in the counseling field accepting insurance, maybe you would understand better.

No, this is not a good time to be in healthcare, nor is it a good time to be a patient.

If this was a good time to be in healthcare, why did Vanderbilt let go of 1,300 employees thus far? Why has my company let go of 63, thus far?

I'm sorry Carol, but you really don't have a clue how this is going to affect you. They don't even need to let you know until January 2014.

My older son has BC/BS and no changes for him either

Not yet.

Not yet.
We shall see, we shall see. The way everyone is panicking, I would think the changes would have been proclaimed by now.

Many of the changes have been proclaimed, but not to you. We, on the inside of the healthcare system, have been holding classes, courses, etc. for over two years now. I'm just speaking out because we don't have any other medical professionals on this site to speak as well.

You can read all of the propaganda you want, but that doesn't equal the facts from the epicenter. The fallout is going to be astronomical.

The fallout is going to be astronomical.
Okay.

Hello again, J:

What do you think about Medicare?

excon

So if I get this right from the complaints registered here the ACA is going to cause the next great depression, is that mental depression or economic depression or both? Extinction of all life as we or is that you know it?

If you were still in the counseling field accepting insurance, maybe you would understand better.
I have a RN niece, several RN friends, and friends who are still counselors. All are looking forward to the jump within the next year in supplying medical/mental health care to people previously uninsured.

Yes that does seem to have been forgotten in the explosion of self doesn't it

I was at one doctor (a specialist) several months ago... that is in the process of closing up his practice, yes all his staff will be laid off... I got it from them and they said there will be a lot more practices doing the same because of Obamacare and what's in it..

Hello again, J:

What do you think about Medicare?

Excon

It needs a complete overhaul as well. My mother is on it and it stinks. However, she had a knee replacement last month. Her doctor advised her to have it before this ACA took place to save her some money.

My mother-in-law is on it as well and was informed by her cardiologists to have her open heart surgery done prior to the roll-out of the ACA, for cost savings as well.

This will end up as though all persons covered will be covered similar to Medicare. Facilities, physicians, groups, etc. will follow specific guidelines or they will not be paid for services.

Now, what if a patient requires that certain tests be run that are not covered? Should the physician run those tests knowing he/she isn't going to be paid, or should the physician follow the guidelines, regardless of the patient's health requirements, so that he/she DOES get paid?

So J the new system will stink the old system stunk, so as a insider what's your fix? Would you rather have a voucher for your elders? What's the alternative to uninsured people besides emergency rooms?

The roles of the uninsured is going to swell. People previously covered will make the economic calculation to drop out ;pay the fines ,knowing they can enrole any time they want because the pre-condition provisions have been dropped .

This is only the option in the first year, but the purpose of insurance is to provide against catastrophy. If you didn't have the cash before you don't have the cash now, so fines are stupid until they are so large that it's cheaper to be insured

This is only the option in the first year,

And then what ? The fines increase at a similar rate of increase for insurance coverage . Without a tremendous amt of subsidies ,the young (who's enrollment is key in the calculations to make the fantasy work) will continue to opt out .

Hello again, wingers:

Let me ask you this. Even if you HATE Obamacare, and you HATE how it's paid for, aren't you happy that the poor family down the street can buy insurance?

excon

Remember the Stupak–Pitts Amendment that conned the blue dog dems into voting for Obamacare ? Well so much for that deception.
Obama administration: Lawmakers, staff can get abortion coverage - Washington Times (http://www.washingtontimes.com/news/2013/sep/30/white-house-lawmakers-staff-get-abortion-coverage/)
Don't know how many blue dogs are left in Congress since the Dems have been purging anyone who isn't far radical left from their ranks . But they must been feeling stupid .

This what you get when you are not paying attention to the detail

This is what you get when you have an emperor who decides which laws he chooses to enforce/ ignore .

Hello again, wingers:

Lemme ask you this. Even if you HATE Obamacare, and you HATE how it's paid for, aren't you happy that the poor family down the street can buy insurance?

excon

That poor family down the street could have had Medicaid.

Hello again, wingers:

Lemme ask you this. Even if you HATE Obamacare, and you HATE how it's paid for, aren't you happy that the poor family down the street can buy insurance?

excon

It depends on how you define poor. Poor working family or lazy family living off food stamps, welfare, and the free phone they were given?

Not unless your governor okays the Medicaid expansion. One million Texans are excluded from Medicaid because he hasn't.

Hello again, J:

Of those poor families, what percentage do you believe are "working poor", or scammers?

excon

If they're "poor" they could have gotten Medicaid before Zerocare. Instead, you guys had to totally remake healthcare for everyone and quite frankly a lot of us resent that. The "poor" had a safety net but you think everyone needs a government nanny and quite frankly, a lot of us resent that. In typical liberal/progressive fashion you refuse to do things that will lift others up so we can all prosper, you have to bring others down and "level the playing field" whatever that means.

And meanwhile, the elite you pretend to hate just get richer and more powerful. They will still get whatever care they want while the rest of us deal with fewer options, fewer providers, and long waits.

Oh, believe me. I see them all. In my location there are more living off the system than working poor. If it didn't violate HIPAA I have stories that would shock you.

Stablize, give pills for pain and symptoms, and get told to go see a doctor, is the safety net you think is adequate? If they could afford to see a doctor they wouldn't be in the emergency room of the county hospital. That's where the poor elderly get shuffled in Texas. Don't know about Tennessee or Oklahoma, where a lot of hollering about losing their present system of state run health care safety nets, but so far, I am finding the same general plan for those lazy poor people who run to emergency rooms for their doctor needs.

Seems to come down to how well the states have been tackling the problem, and how well they prepared for the changes the law represents.

I found these points to be of interest,

Obamacare and why the Cleveland Clinic is really cutting jobs - Dave Ross Blog - MyNorthwest.com (http://mynorthwest.com/813/2363289/Obamacare-and-why-the-Cleveland-Clinic-is-really-cutting-jobs)


But in fact, this is one of those examples of the government actually spending less money.

When the government spends less, yeah, jobs get cut.

You kind of have to choose which side of the seesaw you want to be on.

If you hate government spending, you should be happy the government is spending less on Medicaid and Medicare, and that the Cleveland Clinic is making a 5 percent cut in its budget to get ready for that.

When you cut costs as the clinic is doing, and as it's supposed to do, if we're going to save money on health care, what has to happen? Some people have to lose their jobs.

Like when people clamored for the government to cut spending, and then say, "Will you look at that, unemployment is up!" Well, how do you think you cut spending? You cut salaries or fire people.

Wait until they add the sequester to the mix, and those government contractors start laying off. LOL, and repubs expect everything to work, without paying for anything.

http://images.sodahead.com/polls/001748671/327489119_12_15_10_keep_your_own_doctor_Obama_laug hing_answer_103_xlarge.jpeg

Stablize, give pills for pain and symptoms, and get told to go see a doctor, is the safety net you think is adequate? If they could afford to see a doctor they wouldn't be in the emergency room of the county hospital. That's where the poor elderly get shuffled in Texas. Don't know about Tennessee or Oklahoma, where a lot of hollering about losing their present system of state run health care safety nets, but so far, I am finding the same general plan for those lazy poor people who run to emergency rooms for their doctor needs.

I guess you missed where ER visits increased after Romneycare and why that might be? You think they're going to decrease after Obamacare? Bwa ha ha!!

http://www.mass.gov/chia/docs/r/pubs/10/preventable-avoidable-ed-use-2004-2008.ppt


Findings:
Community Health Network Areas (CHNA) with the highest per capita rates of preventable/avoidable ED use had rates that were 3 to 5 times the CHNAs with the lowest rates. This could signal that there are substantial disparities among communities in primary care access and treatment.
Designated medically underserved populations (low income) consistently exhibited higher rates of preventable or avoidable ED visits compared to the state average. For some, Fall River, North Berkshire and Springfield, the rates were more than double the state average. This may indicate that socio-economic factors play a role in access to primary care. Only one area (Lowell) designated as a medically underserved population had a lower than average rate of preventable/avoidable ED visits. This is consistent with a lower rate found for the Greater Lowell Community Health Network Area.
Geographic areas designated as health professional shortage areas showed mixed results. Unlike socio-economic barriers (medically-underserved populations above), geographic barriers measured by distance from the nearest primary care provider alone may not be a significant driver of preventable or avoidable ED visits. pp26


The preventable/avoidable ED visit data can also contribute to a set of measurable outcomes to evaluate progress towards improved health in the CHNA. It should be recognized, however, that socio-economic factors in each region play a significant role. pp27

These were pre recession numbers to be sure, but one other factor is apparent, no primary physician, the whole key to accessing reasonable Health Care for anyone.

If you have a link for more recent data please provide it.

http://images.sodahead.com/polls/001748671/327489119_12_15_10_keep_your_own_doctor_Obama_laug hing_answer_103_xlarge.jpeg

Thanks A Lot, Mr. President! My Health Premium Is Up 114% - Forbes (http://www.forbes.com/sites/georgeanders/2013/09/27/thanks-a-lot-mr-president-my-health-premium-is-up-114/)

This is something I found out today while doing some more research...

A 40% tax on "Cadillac Health Care Plans" starting in 2018. Those whose employers pay for all, or most, of comprehensive healthcare plans (costing $10,200 for an individual, or $27,500 for families) will have to pay a 40% tax on the amount their employer pays. The 2018 start date is said to have been a gift to unions, which often have comprehensive plans. Americans for Tax Reform (http://www.atr.org)

I pay approximately $3,200 per year for my insurance, now I'm going to be taxed an additional $1,280? Where am I going to get this money from? I can't work 24 hours a day 7 days a week!

This is something I found out today while doing some more research...

A 40% tax on "Cadillac Health Care Plans" starting in 2018. Those whose employers pay for all, or most, of comprehensive healthcare plans (costing $10,200 for an individual, or $27,500 for families) will have to pay a 40% tax on the amount their employer pays. The 2018 start date is said to have been a gift to unions, which often have comprehensive plans. Americans for Tax Reform (http://www.atr.org)

I pay approximately $3,200 per year for my insurance, now I'm going to be taxed an additional $1,280? Where am I going to get this money from? I can't work 24 hours a day 7 days a week!

Yep, that's liberal logic - penalize you for having good insurance, penalize you for having no insurance, exempt themselves from it all.

Yep, that's liberal logic - penalize you for having good insurance, penalize you for having no insurance, exempt themselves from it all.

I bet if this was ever challenged under the equal protection clause... it would not stand.

Subjecting one goup to one thing while specifically exempting another... fill in rich/poor, black/white... etc... Polititions/peons...

I bet if this was ever challenged under the equal protection clause....it would not stand.

Subjecting one goup to one thing while specifically exempting another....fill in rich/poor, black/white.....etc....Polititions/peons.....
But won't this get people off Medicaid (our tax dollars at work) and make them responsible for their own health care? Isn't that want Republics especially want -- individual responsibility?

No it won't . In NY Medicaid gets expanded . Same in Illionois .

But won't this get people off Medicaid (our tax dollars at work) and make them responsible for their own health care? Isn't that want Republics especially want -- individual responsibility?

Individual responsibility is also not having six kids if you can only support one on your income.

And stories like this don't help your tax dollars --

"Congressional committee releases letters stating that Marra's pharmacy in Cohoes, NY, and Total Town Nutrition Inc in Manhattan overcharged Medicaid by millions of dollars by using political connections; letters, demanding release of related documents and emails, are part of broadening corruption inquiry." Medicaid - Health - The New York Times (http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/medicaid/index.html)

Maybe get rid of the cheating and corruption, and the Medicaid won't look so bad.

And stories like this don't help your tax dollars --

"Congressional committee releases letters stating that Marra's pharmacy in Cohoes, NY, and Total Town Nutrition Inc in Manhattan overcharged Medicaid by millions of dollars by using political connections; letters, demanding release of related documents and emails, are part of broadening corruption inquiry." Medicaid - Health - The New York Times (http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/medicaid/index.html)

Maybe get rid of the cheating and corruption, and the Medicaid won't look so bad.

Getting rid of the lower level medicare cheats as well... many of these higher level cheats do it with the help of other lower level cheats in exchange for a few bucks.

Individual responsibility is also not having six kids if you can only support one on your income.
Not everyone applying has six kids or even any kids.

Not everyone applying has six kids or even any kids.

Most of them do... if they have one kid... thats one too many. '

Look at the breeeding rates of Welfare recipients... they get paid to have more kids. Nobody with a job gets a pay raise for every kid they have.

Look at the breeeding rates of Welfare recipients....they get paid to have more kids. Nobody with a job gets a pay raise for every kid they have.
Where are your stats?

I bet if this was ever challenged under the equal protection clause....it would not stand.

Subjecting one goup to one thing while specifically exempting another....fill in rich/poor, black/white.....etc....Polititions/peons.....

Most exempts and grandfathering will go to groups that already have good health care plans in place that meet the minimum requirements of the law and that's most employee based insurance for bigger corporations.

Where are your stats?

Reality... every child of a welfare recipient gets an allotment... more kids=more money... its not limited to X dollars per household.

And stories like this don't help your tax dollars --

"Congressional committee releases letters stating that Marra's pharmacy in Cohoes, NY, and Total Town Nutrition Inc in Manhattan overcharged Medicaid by millions of dollars by using political connections; letters, demanding release of related documents and emails, are part of broadening corruption inquiry." Medicaid - Health - The New York Times (http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/medicaid/index.html)

Maybe get rid of the cheating and corruption, and the Medicaid won't look so bad.

And in turn Medicaid screws doctors and hospitals and other providers with their reimbursement rates .
In NY Medicaid pays doctors 71 percent less than insurance companies. As a result, many doctors refuse to take Medicaid patients . Still the system will be expanded under Obamacare (Obamacaid ?) .

Most exempts and grandfathering will go to groups that already have good health care plans in place that meet the minimum requirements of the law and that's most employee based insurance for bigger corporations.

Until the Cadillac Insurance plan tax kicks in... then see how many employers dump the good plans...

Congress, and the rest of the Political establishment of course get to keep their Gold plated and diamond encrusted plans tax free because they exempted themselves from the legislation.

Reality...every child of a welfare recipient gets an allotment...more kids=more money.....its not limited to X dollars per household.
And what percentage of people using Medicaid are in that boat?

And what percentage of people using Medicaid are in that boat?

All the Welfare people... despite the fact with all their freebies... they end up with more than many working families who have to pay for the same stuff..

http://www.zerohedge.com/article/entitlement-america-head-household-making-minimum-wage-has-more-disposable-income-family-mak

THis one REALLY goes into it.

http://www.cato.org/publications/white-paper/work-versus-welfare-trade

Until the Cadillac Insurance plan tax kicks in....then see how many employers dump the good plans.....

Congress, and the rest of the Political establishment of course get to keep their Gold plated and diamond encrusted plans tax free because they exempted themselves from the legislation.
Do you have health insurance and figure you will lose it?

All the Welfare people....despite the fact with all their reebies....they end up with more than many working families.
How many welfare people have six kids, or even kids at all?

From an economics point of view, Medicare’s below-market reimbursements create cost-shifting onto private payers where hospitals raise private payer fees to compensate for lower payments from government programs. In a 2006 Health Affairs study, researchers focused on this phenomenon by studying data from California private hospitals. The authors discovered a statistically significant inverse relationship between Medicare fee changes and private payer fee changes.

The research revealed that a 1 percent decrease in average Medicare price correlated with a .17 percent increase in private payer price, and that a 1 percent decrease in the Medicaid rate was associated with a .04 percent increase. From 1997 to 2001, Medicare and Medicaid cost-shifting accounted for 12.3 percent of increases in private payer prices.

From a clinical perspective, Medicare’s underpayments result in diminished access and compromised quality care. The most widely cited effect is the difficulty that Medicare and Medicaid patients encounter trying to find a physician. This problem is increasing. The American Academy of Family Physicians discovered 13 percent of doctors surveyed did not partake in Medicare in 2009, up significantly from 6 percent in 2004.

According to the American Osteopathic Association, 15 percent of members don’t take Medicare and 19 percent don’t take new patients with Medicare. In New York state, approximately 1,100 physicians have stopped participating in Medicare.According to a 2009 New York Times article, at New York Presbyterian Hospital, only 37 of the 93 affiliated internists accept Medicare. Even fewer doctors are taking Medicaid, with its lower reimbursements and administrative burden.
The New Health Law: Bad for Doctors, Awful for Patients | The Institute for HealthCare Consumerism (http://www.theihcc.com/en/communities/policy_legislation/the-new-health-law-bad-for-doctors-awful-for-patie_gn17y01k.html)

My daughter is on Medicaid and SSI, she has no kids. She also has to see a clinic doctor who can't even schedule an appointment on the days the doc is in and they have 2 walk-in days. So if she can't see wait to be sick on the day of her appt or a walk-in day she still has to go to the ER. Obamacare did nothing for her and it has nothing to do with whether Texas expands Medicaid, it's the availability of providers who accept Medicaid.

Plus, not only does our son have to buy insurance he can't afford or pay a penalty, his wife who is a permanent resident from the UK is also subject to the individual mandate. At least here she may not have to face hospitals that are hazardous to her health (http://rt.com/news/hospital-cover-up-uk-190/) for a while.

What hypocrites you guys are. You want the government spending cut, entitlements cut and then beeyatch because you don't get enough money from the government any more. My gosh that's what YOU wanted!

Do you have health insurance and figure you will lose it?

I have have one of those "Cadillac" Union medical policies... thats going to get me bent over a table "Deliverance style" when that tax kicks in.

What hypocrites you guys are. You want the government spending cut, entitlements cut and then beeyatch because you don't get enough money from the government any more. My gosh that's what YOU wanted! what are you talking about ? Why don't you want doctors who take government plan patients to get fair compensation for their services? Do you think it's good for the patient for the doctor to get screwed ? Then the Slimes has the cahones to point out places that over charge knowing their reimbursement is going to be slashed ? It's the government program itself that breeds this type of corruption.

How many welfare people have six kids, or even kids at all?

THere are many with 10 or more kids... some by just as many different fathers.

THere are many with 10 or more kids.....
How do you know this? Where do these people live?

How do you know this? Where do these people live?

Public housing... where else.

Ask anyone that has ever workied in the Head Start program... they will back it up. That's why so many quit.

Public housing...where else.
Where?

Hello again, Steve:

Obamacare did nothing for her and it has nothing to do with whether Texas expands Medicaid,So, closing the government IS doing something for her? What?

Excon

Where?

THe projects... section 8 housing vouchers... any number of places where they don't have to pay market rate for rent like anyone with a job.

THe projects....section 8 housing vouchers....any number of places where they don't have to pay market rate for rent like anyone with a job.
And they don''t have jobs because they are shiftless and lazy?

What hypocrites you guys are. You want the government spending cut, entitlements cut and then beeyatch because you don't get enough money from the government any more. My gosh that's what YOU wanted!!

You must be talking to someone else because I didn't ask for a penny, I'm just telling you what it's like for someone who truly needs assistance. It sucks, and you guys want us all to have what she has.

Hello again, Steve:
So, closing the government IS doing something for her? What?

excon

She gets the same crappy treatment if the government is open or not.

And they don''t have jobs because they are shiftless and lazy?

Most of them... yes. Particularly if their parents and grandparents were on welfare as well.

I can understand people in very remote and rural areas not having opportunity... but it's a lame excuse for those who live in a major city.

Most of them...yes. Particularly if their parents and grandparents were on welfare as well.
What's the excuse if their parents are well-to-do?

What's the excuse if their parents are well-to-do?

Lazy...

Lazy.....
How about disabled or mentally ill?

How about disabled or mentally ill?

If they are mentally ill... why are they not in an institution?

As far as disabled... I see some seriously disabled people making it to work every morning... several in fact.. Don't know them personally... but I've seen thatm comig to work for over 10 years... barely able to operate a joystick controlled electric wheelchair. They work within a block of my office for different employers.

If there were all that disabled why are they on welfare and not SSI Disability?

If they are mentally ill... why are they not in an institution?
All mentally ill should be in institutions?

As far as disabled... I see some seriously disabled people making it to work every morning... several in fact.. Don't know them personally... but I've seen thatm comig to work for over 10 years... barely able to operate a joystick controlled electric wheelchair. They work within a block of my office for different employers.
You have jobs for the ones who can't find one?

All mentally ill should be in institutions?

You have jobs for the ones who can't find one?If they have such a severe mental illness they can't hold a job or take care of themselves because it can't be sufficiently treated or controlled.. then yeah... they should.

There are jobs out there... they have to find them... I don't employ anyone myself... I work for a large corporation. And I haven't done what would be considered an entry level position (in my specific fielt) in over 30 years... You won't even get an interview for a job like I do unless you have 10+ years doing this work someplace else. And even then it would be another 10+ years after you got it to do what I do.

If they have such a severe mental illness they can't hold a job or take care of themselves because it can't be sufficiently treated or controlled.. then yeah... they should.
With meds, they can manage to live at home, but can't keep a job for various reasons.

There are jobs out there... they have to find them... I don't employ anyone myself... I work for a large corporation.
They have to find them... Um, factory work was sent overseas. That would have been perfect! Corporate jobs are not available or appropriate for everyone.

With meds, they can manage to live at home, but can't keep a job for various reasons.

They have to find them.... Um, factory work was sent overseas. That would have been perfect! Corporate jobs are not available or appropriate for everyone.

There are a LOT of jobs that aren't paper pusher jobs of various types, and aren't factory jobs... I don't have a desk, I've got a console that's L shaped got 20 feet of counter top... and rises 6 feet full of computer momitors, equipment and manuals. Used and shared by nobody else.

As per that individual in question... what happens to them when the parents die that they have been living with? And that day will come at some point.

There are a LOT of jobs that aren't paper pusher jobs of various types... I don't have a desk, I've got a console that's L shaped got 20 feet of counter top... and rises 6 feet full of computer momitors, equipment and manuals.
That's why I often suggest checking out the public library, nursing homes, hospitals, and other sites that offer entry-level jobs. I have a friend who lost his low-wage job, recently totaled his truck, and now has no transportation -- and lives in the middle of nowhere.

As per that individual in question... what happens to them when the parents die that they have been living with? And that day will come at some point.
Yup. I've got an adult autistic son that I will have to start thinking about. State funding for group homes has disappeared, family members are often few and far between, so what's the parent of a disabled child to do?

That's why I often suggest checking out the public library, nursing homes, hospitals, and other sites that offer entry-level jobs. I have a friend who lost his low-wage job, recently totaled his truck, and now has no transportation -- and lives in the middle of nowhere.

Yup. I've got an adult autistic son that I will have to start thinking about. State funding for group homes has disappeared, family members are often few and far between, so what's the parent of a disabled child to do?

I figured it was your son... but I wanted to leave it up to you if you wanted to reveal that or not.

In many places MOST of the people living on the streets fit the mentally ill description...

If they have family willing and able to care for them... great... but what happens if they don't... there are no institutions any more unless they are proven to be a danger, and that's usually AFTER something happens... so they end up on the streets where it does nobody any good.

Hello again, smoothy:

Individual responsibility is also not having six kids if you can only support one on your income.

Killing a fetus is murder...


Don't believe me... assault a pregnant woman... and see how you get charged if she loses the baby.

I figured it was your son... but I wanted to leave it up to you if you wanted to reveal that or not.
We'll work out something for him. His grandmother left money for him and his brother.


In many places MOST of the people living on the streets fit the mentally ill description...

If they have family willing and able to care for them... great... but what happens if they don't... there are no institutions any more unless they are proven to be a danger, and that's usually AFTER something happens... so they end up on the streets where it does nobody any good.
We had our usual homeless crowd at the library every day. Some were medicated, and others were not. All were well behaved (except for the woman who would strip naked in the ladies washroom to sponge bathe). Some went to shelters at night (where your stuff could get stolen), and others hung out at all-night fast-food places. As long as they ordered something and behaved, they could sit there and even nod off. Most had no families, or at least families who wanted nothing to do with them. I remember only one who got any government assistance (he had to somehow get to an office to pick up his check, had no residence to send it to). The rest depended on handouts.

Hello again, smoothy:

Still playing that merit-less nonsense I see.

Hello again, Steve:

Still playing that merit-less nonsense I see.Well, I'm bored, and he IS an easy target, after all.

Excon

Kalifornia had problems with its exchanges - just like everyone else. It's just all those darn people so excited to sign up their servers couldn't handle the traffic you know.


California exchange overstated its Web traffic for Obamacare launch
(http://www.latimes.com/business/money/la-fi-mo-california-health-exchange-glitches-20131001,0,7108713.story)
California's health insurance exchange vastly overstated the number of online hits it received Tuesday during the rollout of Obamacare.

State officials said the Covered California website got 645,000 hits during the first day of enrollment, far fewer than the 5 million it reported Tuesday.

The state exchange had cited the 5 million figure as a sign of strong consumer interest and a major reason people had so much difficulty using its $313-million online enrollment system.

5 million - 645,000, numbers are difficult things.

Numbers are difficult aren't they. Well we know you guys don't have the numbers to repeal, or stop the ACA. And if the full house voted, you probably don't have the votes to keep the government shut down.

How many welfare people have six kids, or even kids at all?

I'm going to admit that I didn't go back and read it all, but this one just made my chin drop. I think I broke it and will need to go to the ER.

Let's see, without violating HIPAA... I know of one gal who is on welfare and she has 9 children by 5 different men. Another who is mentally disabled currently has 4. During her last labor her Aunt was talking with other family members about who they could get to father her next child so that they could get another check. Since the mother is disabled and gets a disability check, so does that child. Multiply that check by how many children she has. Don't forget to increase the value of the monthly food stamps.

Another comes to the hospital about 45 minutes after each shift change at least 5 times a week, sometimes 2 or 3 times in a 24-hour period. Usually by ambulance with an entourage of about 20 people following in their own vehicles. Typically it's because she got into a fight with the father of her baby and wants the attention.

Who pays those bills? We do, of course. If these people had to pay for the ambulance or, at minimum, a co-pay of, say, $5 - $20 per visit, then we would see less of them.

Another from the ER is 16 and has visited us 120 times this year alone. Yes, I said 120 times and it's only October 3. She claims to have seizures, yet none are documented. EEG (Electroencephalographs are negative for seizure disorder, CT scans are negative) and her visit always occurs during, or after, an argument with her mother.

I could go on and on and on. The guy with the Hep C who get's blood transfusions in the ER because he refuses to quit drinking and has no primary care physician. Oh, speaking of PCP's. Do you have a clue how many PCP's have stopped admitting to hospitals and are now giving their patients over to hospitalists? Not a promising trend.

Now, if we held these people accountable, maybe we would see a decrease in hospitalizations, whether it be inpatient, observation, or labor and delivery. The problem with the system is that we ALLOW this to happen without any consequences.

Now I will go over and read back.

How do you know this? Where do these people live?

I know this because I live it. I see it every time I go to work. Read my post above.

Where do they live? Usually in the urban settings. Inner cities, but even in rural towns like mine. Just delivered a woman's 17th child, she never worked a day in her life and her husband had "meth mouth."

If they are mentally ill... why are they not in an institution? Now that one just pi$$ed me off to no end. My father was mentally ill and took 25 pills a day, but lived a stable life. He even had electric shock therapy some 25+ years before he died. Why should he be in an "institution?" He wasn't a blithering idiot who shat his pants to get attention. He was a depressed person caused by a childhood of mental, emotional and physical abuse.

My brother-in-law is mentally challenged. He's 53 years old, has the memory of an elephant but will argue with my 11 year old. Should he be institutionalized? We aren't living in the dark ages, Smoothy.

The Obamacare national hotline number is 1-800-318-2596. Leave out the 1 which has no letter value and this is what you get.

1-800-3(F) 8(U) 2(C) 5(K) 9(Y) 6(O).

why are they not in an institution?

Back to institutions. There are few state run institutions these days. Most are for-profit only. They will not accept people who do not have private insurance and they will not accept people who have medical illnesses along with mental illness. If you are medically unstable they will not accept you. If you don't have private insurance, they will not accept you. Co-morbidity is not cohesive with mental illness these days.

Did I miss it or did anyone bring up the 28th Amendment to the Constitution?

J-9 are you talking about the proposed one that says Congress can't exempt the members of the Federal government from the laws they pass ? Sign me up.
You may want to read Mark Levin's new book... 'The Liberty Amendments ' . He proposes many such amendments to restore the nation to a constitutional republic.

Hello J:

The 28th?? Nahhh.. Nobody brought it up. What does it say, if anything?

excon

Gimme a break here. Been up over 24 hours, but this is what I found.


"Congress shall make no law that applies to the citizens of the United States that does not apply equally to the Senators and Representatives; and, Congress shall make no law that applies to the Senators and Representatives that does not apply equally to the citizens of the United States".

Hello J:

Well, it AIN'T an amendment, but if it was, I'd vote for it.

excon

Hello again, Steve:

1-800-3(F) 8(U) 2(C) 5(K) 9(Y) 6(O).If they'd do that, they'd put death panels in there...

You're silly.

Excon

You may want to read Mark Levin's new book

I've got it on order for Hubby's birthday. I've never been into politics until my hours at work went from 48 per week to 24 and I am the sole provider in a household of 4 paying for a college tuition for 1.

Not only are my hours decreasing, but the cost of my benefits are increasing. I was breaking even, last year.

Well, it AIN'T an amendment, but if it was, I'd vote for it.


Looking back it is a PROPOSED amendment. It should be an amendment. The adage comes into play... "What is good for the goose is good for the gander." If it's not good enough for the house, senate, president, etc. it's not good enough for the common person.

Hello again, Steve:
If they'd do that, they'd put death panels in there...

You're silly.

excon

It's true, I'm just the messenger.

Single payer for all regardless of who. Sounds unanimous to me.

I have a question. I don't want sources quoted, if possible.

With these cutbacks, if you or a loved one were hospitalized, how would you expect the care given to them. Now, remember that we are being cut back, as is the government. I am given 7 patients to care for versus the 4 patients before. I can't answer the call lights as quickly, nor can I give the medications as directed. I am over worked and underpaid.

Would you complain? If so, to whom?

If your loved one died because I was expected to care for more patients than I am capable of, would you blame me or would you blame the system? Would you sue? Would you make me lose my license because I am conforming to the new system?

I reiterate that those of you outside of the medical community expect more than what we are capable of under the ACA. We are going to see a drop in the applications of medical students. Our nursing is already saturated. Vanderbilt has just let go of 1,000 necessary personnel.

Rather than seeing a higher number of health benefits, as a nurse, I see a higher number of medical malpractice cases.

I'm not saying that the ACA is wrong, per se, I'm seeing that it hasn't been tried out. There are positives to it, but there are negatives as well. Why not give certain states the option to try it out and see how well it works? Tweek it where it is needed. Give the general population a voice as to how it works and how it doesn't. This would take time, but it would be well worth it.

The ACA was modeled after the successful experiments of the states, Massachuessetts, and the other ones who had exchange programs of their own, some very good and have transitioned easily so far, and some bad ones that will get kicked to the curb. Every state has a guideline to build on and tweak.

I also think we recognize that more trained bodies are needed, but there are also millions of unemployed. And yes it will take time, that's a given and it's unreasonable to expect instant success. You are right, the public will indeed judge the results of THIS program in due time, and tweak as necessary.


Would you complain? If so, to whom?

If you answer to the boss as an individual, he fires you if you cannot perform his instruction, dumb or unreasonable as you think they are, but as a collective group that sticks together, you have a lot more leverage. No nurses union?

Speaking as someone who is a consumer of Healthcare... I don't want someone that couldn't get a real job anywhere else... playing doctor... nurse... or anything else.

Not everyone has the mindset.. intelligence or the aptitude to be working in the medical field. Heck... not even all the Doctors that actually manage to graduate from medical school should be practicing.

You just can't make this s**t up... Does anyone actually THINK in the Democrat party?

http://dailycaller.com/2013/10/03/need-health-care-coverage-just-dial-1-800-yo-to-reach-obamacares-national-hotline/

You just can't make this s**t up....Does anyone actually THINK in the Democrat party?

http://dailycaller.com/2013/10/03/need-health-care-coverage-just-dial-1-800-yo-to-reach-obamacares-national-hotline/

Yes you guys CAN make this crap up. I've seen you do it many times and have to admit you are damn good at it.

Yes you guys CAN make this crap up. I've seen you do it many times and have to admit you are damn good at it.

Really... try calling it then... it really does go there. A Coworker just tried it and that IS where it goes.

That means an Obama administration person did it... not some Republican...

Did you know 'smoothy' is an anagram of 'homo sty'?

Amazing where your mind goes do you know an anagram of your name includes the word nerd

Did you know 'smoothy' is an anagram of 'homo sty'?

Ever notice that "Need Karma" literally means you want something bad to happen to you?

Ever notice that "Need Karma" literally means you want something bad to happen to you?
Or something good.

Obamacare quote of the day (http://www.mercurynews.com/nation-world/ci_24248486/obamacares-winners-and-losers-bay-area), "I was laughing at Boehner -- until the mail came today."


But people with no pre-existing conditions like Vinson, a 60-year-old retired teacher, and Waschura, a 52-year-old self-employed engineer, are making up the difference.

"I was laughing at Boehner -- until the mail came today,"

"I really don't like the Republican tactics, but at least now I can understand why they are so pissed about this. When you take $10,000 out of my family's pocket each year, that's otherwise disposable income or retirement savings that will not be going into our local economy[/B]."

Ya think? Apparently forcing someone to cough up an extra 10 grand every year is no big deal to all those wealthy libs. So much for enjoying the fruits of one's labor in America.

There has never existed a more compelling reason to work off the books than there is now.

I hear Maryland managed to sign up 326 people so far, woo hoo! I wonder though, are they really signed up?


Insurers Getting Faulty Data From U.S. Health Exchanges
(http://www.bloomberg.com/news/2013-10-08/insurers-getting-faulty-data-from-u-s-health-exchanges.html)
Insurers are getting faulty and incomplete data from the new U.S.-run health exchange, which may mean some Americans won’t be covered even after they sign up for an insurance plan.

While it’s not clear how widespread the problem is, the reports from industry consultants are the first hint that the technical troubles faced by consumers trying to enroll in health plans under the Affordable Care Act may also be hitting the insurers. The companies are receiving electronic files that can’t open or have so much missing information on new enrollees they’re unusable, the consultants said.

Some insurers have been forced to fix entries by hand, said Bob Laszewski, an insurance-industry consultant based in Arlington, Virginia.

“If we don’t see substantial improvement by the end of this week, then I would throw up the yellow flag,” said Dan Schuyler, a consultant advising states and insurers on the exchanges. “If we don’t see it in the next two to three weeks, it’s time for red flags. The concern is some people could get to Jan. 1, and not have coverage.”

Since the exchanges opened on Oct. 1, consumers have struggled to access the online marketplaces, which have been overwhelmed by millions of visitors.

While capacity was added this past weekend to a system meant to serve people in 36 states, the federal website continued yesterday to deliver error messages to potential customers trying to create accounts and shop for health plans.

State Exchanges

At the same time, most of the 14 state exchanges yesterday reported performing with fewer troubles.

Maybe they should hire more people from Amazon. Maybe the insurance companies will need more techs. Maybe the states need more techs.

Some states seem better than others working their glitches out.

AFFORDABLE CARE ACT: Program offers six-month enrollment | Amarillo Globe-News (http://amarillo.com/news/local-news/2013-10-05/affordable-care-act-program-offers-six-month-enrollment)

That's one way to run up costs and prices even higher than they already are... a few hundred thousand more people to pay.

At what point woud there be fewer people NOT working for Obamacare than actually are?

Maybe they should hire more people from Amazon. Maybe the insurance companies will need more techs. Maybe the states need more techs.

Some states seem better than others working their glitches out.

AFFORDABLE CARE ACT: Program offers six-month enrollment | Amarillo Globe-News (http://amarillo.com/news/local-news/2013-10-05/affordable-care-act-program-offers-six-month-enrollment)

They already spent a fortune of our tax money to program this dog already . But by all appearance the programing of the software is fundamentally flawed.
HHS thinks shutting it down on weekends is all they need to fix it... lol

For instance, when a user tries to create an account on HealthCare.gov, which serves insurance exchanges in 36 states, it prompts the computer to load an unusually large amount of files and software, overwhelming the browser, experts said.

If they are right, then just bringing more servers online, as officials say they are doing, will not fix the site.

"Adding capacity sounds great until you realize that if you didn't design it right that won't help," said Bill Curtis, chief scientist at CAST, a software quality analysis firm, and director of the Consortium for IT Software Quality. "The architecture of the software may limit how much you can add on to it. I suspect they'll have to reconfigure a lot of it."
Analysis: IT experts question architecture of Obamacare website | Reuters (http://www.reuters.com/article/2013/10/05/us-usa-healthcare-technology-analysis-idUSBRE99407T20131005)

You never know until you try it.

You never know until you try it.

Maybe its just all lies and its working just fine right?

UPDATED: Obamacare Poster Boy Chad Henderson and His Dad Didn't Really Buy Insurance - Reason.com (http://reason.com/archives/2013/10/04/obamacare-chad-henderson-father)

That he can shop and weigh his options is the goal since the deadline to actually enroll is December 15th to have coverage January 1st.

To shop you have to have an account, like many of the retail sites online, but I guess some will see the glass half empty no matter what.

Help me here (please). Why the screaming about increased costs because there will be more Medicaid coverage? Wouldn't that eventually become LESS of a drain on taxpayers as more and more uninsured poor (who used to hang out at the ER with Medicaid paying for ALL of the costs) now buy insurance? And yes, there will be Medicaid still working into that (depending on what choices the state made for funding the ACA), but wouldn't it be less than the full coverage it is now?

Help me here (please). Why the screaming about increased costs because there will be more Medicaid coverage? Wouldn't that eventually become LESS of a drain on taxpayers as more and more uninsured poor (who used to hang out at the ER with Medicaid paying for ALL of the costs) now buy insurance? And yes, there will be Medicaid still working into that (depending on what choices the state made for funding the ACA), but wouldn't it be less than the full coverage it is now?

There you go wasting logic on the party of scream. Before they started hollering years ago, they were against paying for those lazy poor people who go to the emergency room.

Help me here (please). Why the screaming about increased costs because there will be more Medicaid coverage? Wouldn't that eventually become LESS of a drain on taxpayers as more and more uninsured poor (who used to hang out at the ER with Medicaid paying for ALL of the costs) now buy insurance? And yes, there will be Medicaid still working into that (depending on what choices the state made for funding the ACA), but wouldn't it be less than the full coverage it is now?

Who exactly is going to be paying these HUGE medicaid increases... we already know Obamacare is going to cost more than triple what Obama promised (big surprise there)... and the CBO says it will bankrupt the country.


Oh right, those of us trying to put enough to retire on because SSI won't be there because its been going to people who never worked or paid much into the system... so the have nots expect to take what little we have left off us.

Maybe if they had worked harder and made better choices they would have more themselves.

And I've been paying more in SSI that won't be there to collect than I can set aside to survive on the last 34 years.

Who exactly is going to be paying these HUGE medicaid increases
Why are they going to be huge?

Why are they going to be huge?

Simply do the math... If you expand coverage then the costs have to expand at least that much.. though usually even more because of greater overhead. You can't double the number of covered people without at least doubling all the costs... if those people are all high cost and high risk... increase the costs by orders of magnitude.

Can't get something for nothing.

Simply do the math.....If you expand coverage then the costs have to expand at least that much
But that's not what that means.

But that's not what that means.

It does... you can't offer more to more people and NOT have it not cost a lot more. More people equals more payouts... you think all these newly covered people are going to NOT use it?

Unless you make them all pay $20,000 annual deductibles.

It does...you can't offer more to more people and NOT have it not cost a lot more. More people equals more payouts...you think all these newly covered people are going to NOT use it?

Unless you make them all pay $20,000 annual deductibles.
Think of it this way --

NOW: 20 people have no health insurance. They all go to an ER. The cost is $100 (just to keep this simple). All end up getting the $100 charge paid by Medicare = $2000.

WITH ACA: Those 20 people are eligible for and apply for a health care plan from their states' marketplace, and are then covered. 10 of those people are able to pay the premiums out of pocket, but the other 10 are even poorer, can't pay the total premium out of pocket, but are qualified to receive additional assistance, so Medicaid steps in and pays part. Thus, Medicare costs will be a much less total payout for those 20 people.

Now, think of the savings when we consider 40+ million people who could end up in the ER under ACA as opposed to NOW.