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So the system not workin' for you then, I thought Obamacare was supposed to take care of that. We find a single payer system does stop some of those doctors avoiding their responsibilies but when it comes down to specialists, they talk money and you need an insurer to negotiate with themQuote:
Originally Posted by speechlesstx
If expanding the rolls of the Medicaid system that my daughter has to navigate and pushing us all toward that is a solution then we're screwed.Quote:
Originally Posted by paraclete
Hello again, Steve:
The other day you were saying that bad insurance is pretty good. and people should be able to KEEP it if they wanted..
Now that you KNOW someone with bad insurance, you're singing a different tune.
excon
I never, ever said the government run insurance was good, it's you guys trying to blow smoke by saying the new more expensive in every way bad private insurance is better. The point was stop feeding me this crap about not caring about the plight of others, I know it, I live it, I can tell you firsthand about both the private care you're screwing up and the public care that sucks already and you want to expand. You guys really do think we're stupid don't you? Ask yet another Obama supporter that doesn't understand why they can't keep their old, BETTER insurance.Quote:
Originally Posted by excon
$550 a month for their health coverage ? Must be one of them bare bones plans that didn't cover abortion pills .
Or the $4.00 contraceptives Sandra Fluke couldn't find at Target down the street.Quote:
Originally Posted by tomder55
Why Health Insurance Cancellations Shouldn't Be a Surprise - ProPublica
The Affordable Care Act's Most Important Date: Not What You Think - ProPublicaQuote:
Q. Is Medicaid a success story here?
A. Medicaid enrollment data from the states with their own exchanges certainly suggests a surge in Medicaid. It's still early but it appears that the surge is a combination of ACA Medicaid expansion and the woodwork effect – bringing in individuals already eligible but not enrolled. Medicaid rolls will also increase somewhat as individual commercial polices are cancelled, high-risk pools end, and some small and mid-size employers drop coverage.
Today, Medicaid covers about 74 million Americans. Given all the unknowns, including economic conditions, projected Medicaid enrollment by 2020 ranges from 85 million to 102 million. Regardless, the role of Medicaid in the marketplace and impact of Medicaid on federal and state budgets will only grow.
Quote:
What most people remember about the high court's decision is that it upheld the core of the law: an individual mandate that requires practically everyone to buy health insurance or pay a penalty.
But the most consequential part of the ruling, which got less attention at the time, gave states discretion over whether to expand their Medicaid programs for the poor.
The law originally called for each state to expand Medicaid to people making less than 138 percent of the federal poverty level (now $15,856 for a household of one or $32,499 for a household of four). But the court said states could refuse to go along and not risk losing the federal government's contribution to their Medicaid programs.
Why is this so important? Because about half the states have refused the expansion (or haven't approved it yet), putting Medicaid out of reach for millions of their residents. Those states include Texas, Florida and almost all of the south. Here's a map of what each state is doing.
Like I said, if they can't get a doctor who accepts Medicaid what's the use? I know, those greedy doctors expect to get paid.
Yeah we went over that and found out you need a doctor who writes a prescription, and have to have insurance to cover both. Contraceptives are not sold over the counter like aspirin.Quote:
Originally Posted by speechlesstx
Nor is it used strictly for birth control. But you know all that.
Nah ,it's most important date will be when employer mandates goes into effect. Then the sh*t will really hit the fan. If the death spiral doesn't happen by then ,it will.Quote:
Originally Posted by talaniman
Then the death panel will have to decide the patient's fate .Quote:
Originally Posted by speechlesstx
That is a problem, and its not just Medicaid. Finding a doctor or clinic that takes whatever your insurance is has been a HUGE challenge to many of us even with employer based insurance or private insurance. Every freakin' county in Texas does things differently, at least the four I have been to, even in the big cities. Even with a computer.Quote:
Originally Posted by tomder55
I have found that even with great insurance the final word is with the doctor or hospital you want to deal with, even though they have an option to JOIN whatever network you are part of, most don't. It's worse with specialists, much worse. Ask me how I know.
Even Medicare requires TWO insurance companies, if you don't want to be burdened with those out of pocket expenses which will kick your old a$$. Good luck finding a doctor, its expensive and labor intensive I already know. I think we are all finding out what the TRUE cost of health care is, the hard way, and its more than just paying a monthly note.
Personally I hate insurance companies too, and doctors are not that far behind.
Tal don't ever let that one slip in your Dr's office or you might find yourself getting far more prostate exams than are medically necessary.
We have had that conversation, as have all the other doctors I have been to. Been to court numerous times questioning bills and charges. You only stick your finger up my a$$ once a year that I pay for and anything beyond that you better make an offer I can't refuse.
No doctor has taken me up on that yet!
When the whole system comes crashing down ,the choice will be bail out the insurance companies or single payer socialist system... Guess you'll be able to hang that 'Mission Accomplished ' banner then.Quote:
Originally Posted by talaniman
I am willing to bet there are a lot of people that the system has crashed on and sticker shock is nothing new, nor the worst case scenerio, and indeed we are a LONG way from a better fix.
Doing nothing though? Not a good option. And for fact we already run socialists programs quite well in America. SS, Medicare are very popular. Even the TParty loves them.
You can thank you Republican buddies for the system you do have, their ideological objections to cleaning the system up mean you only have a system that is good for the doctors and the insurance companies and it seems the attempt to fix it has produced a camel. You need to think of socialist solutions as common sense. If the trains don't run on time you make them, if you need medical care, medical care is provided, if you need education, education is provided, if you need a job, piant rock whiteQuote:
Originally Posted by talaniman
Our solutions are well known . "Doing Nothing " was never one of them .
Heritage foundation supported it right down to the mandates before they were against it, and truth be told NOTHING had been done about it for decades while the problem got worse. Now after taking what republicans had supported and actually done in MASS. Current republicans have been delay, repeal, and defund, and obstruct everything.
Even in Kentucky where its becoming an example of how it works the two Kentucky senators are still squawking foul. Despite the website glitches the squawkers are still republican governors who have done NOTHING, except make the problem BIGGER.
Start over is not an option, and the people have spoken on the republican alternatives by Ryan and the rest. How long were we supposed to wait for YOU guys to do something? Get off the sidelines and help fix it.
Governor Nikki Haley on Health Care: Part Two | FreedomWorks
Sort of like decrying the stimulus and taking a picture with a big fat check and saying "see what I did".Quote:
Patricia Finley
The following information was already announced in January. Nikki Haley and Tony Keck are just repeating what has already happened. Beginning next year, Medicaid-designated rural hospitals in South Carolina will be fully compensated through the Medicaid Disproportionate Share Hospital (DSH) program for their uncompensated care costs. In this news release it says the following - The DSH program is a taxpayer-supported $461 million Medicaid fund used to compensate hospitals in South Carolina for the unreimbursed costs of providing inpatient and outpatient hospital services to the uninsured and Medicaid eligible individuals. I guess in a around about way the DSH program IS a taxpayer supported program - It is a federally funded program. Apparently Nikki Haley is accepting more federal funds than she wants anyone to know about. In news releases she is conveniently leaving out the fact that many programs that she claims to be funding - is being funded with federal dollars.
I can't speak to what the Heritage Foundation supported ,and they don't speak for me. I'm a 'more choice' type of person when it comes to the market place ,and health care is in the market place . The choice should not be restricted by state lines or mandates . So ,the McCarran-Ferguson Act should be amended to allow interstate competition in health insurance.You like sticking it to the insurance companies.. right ?What better way than take away their anti-trust exemptions.
The choice should also be in types of treatment options ,including alternative.The choice would include keeping your insurance if you like it when you change jobs or move from state to state .
Medicare and Medicaid need reform first... including cracking down on fraud and abuse ,and then we can talk about expansion for those who truly can't afford any other alternative ,or fall through the cracks because of preexisting conditions... although I believe that fewer would fall through the cracks if they were allowed to cater their coverage for their preexisting conditions instead of for BS they don't need ,but are mandated to buy coverage for , like fertility drugs or abortion pills, or aromatherapy and massage treatment . But just to cover those truly in need ,a high risk pool could be subsidized ,or tax credit to help low income individuals buy health insurance .
Tort reform is part of the solution. That would include reasonable financial damages for breaches of clear and identifiable standards and other transgressions.
Ok ,I will address Heritage .Their thought was to mandate catastrophic care . Further their plan was tax incentives to purchase insurance... not mandates to buy or face a penalty . But even then ,Heritage was an outlier. It is hardly true to say conservatives supported it then. It's more accurate to say SOME conservatives did .
You make a great case for single payer, Medicare for all but where we really disagree is making people wait for insurance while we get rid of abuse and fraud. Do 'em both. Be able to buy across state lines put states with higher standards off living at a distinct disadvantage unless every body has the same basic prices. Single payer accomplishes that, and does away with the for profit middleman. Lowering costs for everybody, and no anti trust issues.
All the states have pretty much the same companies as it is or a subsidiary of a larger company.
Currently though, I can see mandating those currently under care with private insurance keeping what they have. It's the insurance companies leaving them high and dry, and NOT honoring the rather broad grandfather clause and saying the devil made me do it. I can leave all that tort reform stuff to a judge myself. A case has merit, or it doesn't.
Well Tal you would think so, but the twist here is the detail which the insurance companies had a hand in writing, you don't think politicians are smart enough to get the detail right, do you, particularly when vested interests are involved. And making it a states issue is a divide and conquer technique. As to Tort, well the insurance companies are pushing the barrow for that and with an election year coming up they just might get it. These things are not about merit but limiting the collateral damageQuote:
Originally Posted by talaniman
I guess one of your solutions wouldn't be having the government get into the private health insurance business.Quote:
Originally Posted by tomder55
No, I didn't think so.
Well of course not, it's a democracy, or is it a republic, I get confused, when is a democracy not a democracy. When it is a republic. What is a republic. One thing for sure, it is not government, by the people, for the people. The people can go to hell
Hence getting rid of the anti-trust exemptions that create state favored monopolies. I don't see how a single payer system enhances competition... it reduces competition and creates a huge monopoly with the power of the law to back it up. The case I made was NOT for the elimination of the private market.Quote:
All the states have pretty much the same companies as it is or a subsidiary of a larger company.
I can make a case where a medical procedure is NOT regulated and mandated that the pricing goes down as doctors compete for the business. A prime example is lasik surgury or other elective surguries .You see the same dynamics where on-line pharmacies have lowered the prices of some drugs,andfewer dispensing errors than conventional pharmacies .
Rubbish the only way doctors reduce their fees is when they are forced to do so. There is no shortage of patients, therefore they can charge what they likeQuote:
Originally Posted by tomder55
Forced to by competition . The facts don't lie. Lasik prices have plummetted . Why ? Because it is an elective procedure not covered by insurance mandates. The doctors who perform it have to compete with ads and best pricing .Quote:
doctors reduce their fees is when they are forced to do so
I think the jury is out on whether the cost of drugs is coming down from global options or patents for drugs expiring and the use of generics has grown widely or a combination of both, but an aging society is also a driver of costs. Speechless has pointed out many times that the shortage of primary doctors especially for less wealthy consumers is greatly underserved and the trend for hospitals to cherry pick doctors and insurance companies in there networks also contributes to higher costs and mark ups of services that leave many with fewer options.
Eliminating the anti trust exemption may well open the market up, but like the law itself, it's only a step in the right direction. States will still have to do their parts and without the frame work of regulation as a bar to meet, an unregulated market can lead to many money making revenue streams being created that don't work, or work badly for consumers.
One of the downsides of reigning in costs is lowering profits, and the free market isn't a good place to do that. Hospitals are already cutting people to keep the bottom line healthy.
As you know ,I'm not opposed to reasonable regulation ,and of course prefer it at the state level . Although I continue to allow myself to be inflicted with the burden of living in blue state hell... it's still my choice . One day I may do a Davey Crockett and say "You go to hell....I'm going to Texas" .Quote:
States will still have to do their parts and without the frame work of regulation as a bar to meet, an unregulated market can lead to many money making revenue streams being created that don't work, or work badly for consumers.
No time like the present, get out see a new world and live among those of like mind
Come on down, it's a whole other world... for now.Quote:
Originally Posted by tomder55
Hello again, Steve:
At least you admit your ideology is dying out.Quote:
Come on down, it's a whole other world... for now.
Go, Wendy, GO!
excon
I bet .they haven't been completely over run with locust... yet
You mean Wendy "I'm totally pro-life if the child makes it out the womb and don't stand snow ball's chance in hell" Davis? Bwa ha ha!Quote:
Originally Posted by excon
Making people have babies and not helping support them is hypocritical. To raise a child the parents have to be raised. That's what she said, no matter how you spin it on the right. But listening is something the right hasn't learned yet. You will though.
Not all conservatives in Texan are right wingers, some are darn good people. :D
Straw man bullsh*t.Quote:
Originally Posted by talaniman
OK, back to the OP. I forgot something from my saga of helping my daughter navigate the pathetic Medicaid system - my dad is in the "care" of another public health system, the VA. He's been in a VA nursing home since June.
Two weeks ago he went downhill suddenly and was admitted to the VA hospital. The diagnosis went from pneumonia, to multiple organ failure due to congestive heart failure to septicemia and pneumonia. Once they determined he had septicemia he went on a broad spectrum antibiotic and over the next week he improved to where he was eating again and doing pretty good considering. Today or tomorrow he should be back at the nursing home.
Here's the kicker, the doctor said we need to take care of him - that we basically can't count on the nursing home staff to do a damn thing to see to his medical well-being - we need to tell them if he's sick.
What the hell? Is that not what the 24 hour care is for? WE have to be the nurse, too?
Again, I'm living government health care, and this disaster unfolding does not instill confidence. No thank you.
Join the party, Many us have to make the very difficult choice of how best to care for our aging parents including going the nursing home route. Its difficult, but have you looked into arranging for a visiting nurse? Is that a viable option?
My mom isn't ready for a nursing home. And I lost faith in them long ago. Even with your constant participation, just finding a GOOD one that's close enough for frequent family visits is extremely labor intensive. Right now family is the best 24/7 care to be had from what I have seen and so far my elders all want to be at home, not isolated with strangers.
You are not alone my friend. Not by a long shot.
No, my dad needs nursing home care, but one would expect them be proactive, not expect us to make sure he's healthy and safe.
Is his NH close enough for daily visits by family?
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