[talaniman]

There is no law to excuse a doctor or care provider from delaying any treatment. Its an easier accommodation than people think. Hospitals and doctors are and have always pushed hard to maximize there own pay agreements and that's where all this in network, and out of network crap started, and where it will end.

The whole point of the law is to expand the networks and bring a uniform standard of payments and cost controls. That's a part of bending the curve down but insurance companies have to compete with each other instead of sticking to their own self controlled territories. I think you had it right with the eliminating the anti trust exemption for insurance companies.

States that didn't take the Medicaid expansion are now hard pressed to come up with a plan to fund those high risk pools and I did provide a link where the Texas hospitals were pushing their own regional cost sharing plans.

[speechlesstx]

Seems to me you previously argued it was the evil insurance companies that brought us all this network stuff. Regardless, Obamacare is shrinking networks, not expanding them.

[tomder55]

bottom line is that in a few weeks critically ill people are going to be denied their doctors and the hospitals where they get life saving treatment . Haven't heard the emperor address this at all.

[tomder55]

you had it right with the eliminating the anti trust exemption for insurance companies.

thanks I think so too . Will you also join me in opposition to the insurance company bailout that was written into the law ( "risk corridor program"),and is set to kick in when they realize they can't enroll enough invincibles ?

[talaniman]

I will admit Tom my concern over this transitional program is who bear the final cost because I think the insurance companies affected should, not the states or the feds. Yeah cuts into profits, but even without young people jumping on board I still see a lot of money being made by the insurance companies and so far I have to admit I am against it as it is written.

Still studying it though. Thoughts?

[paraclete]

Tal the insurers have to accept the changed environment, it's actually called soveriegn risk. They may incurr lower profits but they have a unique opportunity to prosper so they need to take a long term view

now individuals are subject to soveriegn risk too, the government has moved the gaol posts, that is what governments do, it is consequence of electoral outcomes.

[tomder55]

it is the consequences of big statist government thinking it can micromanage an industry .This thing is in it's infancy and still there are more unintended consequences than can be listed .

[paraclete]

There are always unintended consequences Tom when we implemented something similiar, pathology services went mad as the entreprenuer medical practitioner sought to profit. It is a continual battle by government to contain costs from pressures from various service sectors, but you have to have the will to do it despite the various lobbies. I suspect you do not have the will to contain these voracious profit takers

[speechlesstx]

More on how obamacare is "expanding" the provider networks. Did someone say unintended consequences?

Doctors boycotting California's Obamacare exchange | Mobile Washington Examiner

An estimated seven out of every 10 physicians in deep-blue California are rebelling against the state's Obamacare health insurance exchange and won't participate, the head of the state's largest medical association said.

“It doesn't surprise me that there's a high rate of nonparticipation,” said Dr. Richard Thorp, president of theCalifornia Medical Association.

”Thorp has been a primary care doctor for 38 years in a small town 90 miles north of Sacramento. The CMA represents 38,000 of the roughly 104,000 doctors in California.“We need some recognition that we’re doing a service to the community. But we can’t do it for free. And we can’t do it at a loss. No other business would do that,” he said.

California offers one of the lowest government reimbursement rates in the country -- 30 percent lower than federalMedicare payments. And reimbursement rates for some procedures are even lower.

Now you have insurance, shame you don't have a doctor. On the other hand I also heard reported this morning that the exchanges are sharing your personal data so you can be harassed by insurance companies. Yep, this is working out real well.

Next they'll be mandating doctors work for these slave wages to solve the participation rate and quality of care will necessarily skyrocket.

[talaniman]

From what I read this risk corridor has a shelf life of 3 years, and is funded by the insurers through a narrow and defined window. The purpose is to make sure premium prices can be monitored and adjusted, be they too high, or to low as more data trends become available.

http://www.cms.gov/CCIIO/Resources/F...final-rule.pdf

Section 1341 of the Affordable Care Act provides that:
–
A transitional reinsurance program must be established in each State to help stabilize premiums for coverage in the individual market from 2014 through 2016
–
All health insurance issuers and third party administrators on behalf of self-insured group health plans, must make contributions to support reinsurance payments that cover high-cost individuals in non-grandfathered plans in the individual market
•
Reinsurance is a critical element in helping to ensure a stabilized individual market in the first years of Exchange operation.

[talaniman]

Next they'll be mandating doctors work for these slave wages to solve the participation rate and quality of care will necessarily skyrocket.

That's a stretch. More customers, more profits. Prices going down, and we have been needing more doctors anyway.

[speechlesstx]

Talk about a stretch. More customers, fewer providers, lower reimbursements, less interest in making medicine a career (which is odd that you argue for higher wages while thinking lower wages will encourage making it a career) - not sure how your math works.

I thought you libs were big science guys. You know, evidence based? Amazing how you keep dismissing the evidence of a disaster unfolding before our eyes. I think you're more faith based than we are, you govern by wishful thinking.

[excon]

Hello again, Steve:

You know, evidence based? Amazing how you keep dismissing the evidence of a disaster unfolding before our eyes.

Evidence??? I dunno.. Insurance works.. What more evidence do you need? Unfolding disaster??? Nahhh, a few bumps along the way to a kinder and BETTER country.

Take the chart below.. Even if it's off a couple MILLION, it STILL shows that we'd PROSPER under universal health care. What??? Even though you LIKE the old system, it's BANKRUPTING us.

I wonder, when you speak of "evidence", you don't get perplexed at your OWN party's INABILITY or UNWILLINGNESS to offer LEGISLATION encompassing THEIR ideas..

All you're saying is NO, and that AIN'T enough.

[talaniman]

I live by facing challenges, and overcoming obstacles and solving problems. I concede the need for more doctors, and the aging population of doctors and society at large. Your link points out the fact that older doctors want to do less and get paid more and that's understandable for people our age.

Surprised you don't recognize the two tiered compensation structure as its been adapted by MANY private industries as a cost cutting measure separating older workers from newer ones. The free market fills in it's own gaps as you and Tom have so highly touted as the answer.

When it fails government has to step in, and it is has failed. Supply side economics has always failed a large segment of the American population, as well as global economics. Of course it will never be acknowledged by the few beneficiaries of this broken business model.

[speechlesstx]

Hello again, Steve:
Evidence??? I dunno.. Insurance works.. What more evidence do you need? Unfolding disaster??? Nahhh, a few bumps along the way to a kinder and BETTER country.

Take the chart below.. Even if it's off a couple MILLION, it STILL shows that we'd PROSPER under universal health care. What??? Even though you LIKE the old system, it's BANKRUPTING us.

I wonder, when you speak of "evidence", you don't get perplexed at your OWN party's INABILITY or UNWILLINGNESS to offer LEGISLATION encompassing THEIR ideas..

All you're saying is NO, and that AIN'T enough.

Dude, I gave you the list of GOP options pages ago and you still post that drivel? As I was saying about your evidence based thinking...

[excon]

Hello again, Dude:

Dude, I gave you the list of GOP options pages ago

Options are like a$$holes. Writing down your options and PROPOSING them in a bill, is what we pay congressmen to do... If these so called "options" are sooooo good, where the BILL????

Right now, ALL we got, is right wingers flapping their gums. But, we're USED to that.

excon

[talaniman]

I gave you the list of adopted GOP amendments in the ACA, you ignored that fact too!

[speechlesstx]

As I was saying. You both just keep affirming my point.

[talaniman]

If your point is you hate everything liberal, I already got your point.

[speechlesstx]

Nope, just saying you still have an aversion to reality. We both want things fixed, but only one side is acknowledging how much you've made things worse as is typical for big government solutions.