[talaniman]

Governing 50 states is a huge challenge. We have states bigger than countries. It's a huge country.

[speechlesstx]

One you can't micromanage to your liking.

[paraclete]

Governing 50 states is a huge challenge. We have states bigger than countries. Its a huge country.

Yes it is, having less states and less politicians would be more productive. The states formed long before the efficient communications, etc we have today and that local government was necessary then but superflous now, in fact you are over governed at a local level and this means you have 50 different approaches to a common problem, subtle differences maybe but it makes for problems. We solved this by our government insisting on uniform legislation in return for government funding. you want to suck at the government teat you play by the government rules

[tomder55]

The best hospitals in the country are being excluded by plans on the exchanges
New Affordable Care US health plans will exclude top hospitals - FT.com
Can't get the best cancer treatments ..... But at least contraceptives are now covered.

[excon]

Hello again, tom:

You link wouldn't let me read the article unless I REGISTERED.. It seems to be a right wing site. If I COULD have read the article, I'd probably tell them to SHOW ME THE MONEY instead of FLAPPING their gums.

excon

[talaniman]

I read your article, and the bean counters are arguing over how much money they can charge, and how much they will pay. Let 'em argue. There should be one network in the US any way.

So what's really been changed by the new law? Insurers and providers have always dictated who was in or out of their network. Its always been a deal cut between the two, and quiet as its kept, any doctor or hospital can still cut a deal and be IN network.

Hell the first thing all hospitals do is call your insurance company before they do anything else. All of them do that. Even the emergency rooms if you are conscious.

[speechlesstx]

You keep saying that as if it's a sin to get paid for your services after spending thousand upon thousands for years to learn your very specialized trade, pay for very expensive equipment needed to run your practice and paying exorbitant malpractice insurance, all while demanding people who squirt industrial mayo on a bun be paid $15.00 and hour. The disconnect is amazing.

But nice spin anyway. as the article said the best hospitals are expensive because of what they do, innovative treatments for the sickest of the sick.

P.S. Obamacare architect and brother of Rahmbo had this to say yesterday:

The president never said you were going to have unlimited choice of any doctor in the country you want… But look, if you want to pay more for an insurance company that covers your doctor, you can do that. It's a matter of choice. … The issue isn't the selective networks… People are going to have a choice of whether they want to pay a certain amount for a selective network, or pay more for a broader network. They get that choice.

Amazing the shameless lying and spin taking place to excuse thie crap sandwich called Obamacare, a term which even Obama has distanced himself from. What he did say was this and it's unequivocal:

So let me begin by saying this: I know that there are millions of Americans who are content with their health care coverage – they like their plan and they value their relationship with their doctor. And that means that no matter how we reform health care, we will keep this promise: If you like your doctor, you will be able to keep your doctor. Period. If you like your health care plan, you will be able to keep your health care plan. Period. No one will take it away. No matter what.

[excon]

Hello again, Steve:

The disconnect is amazing.

I'm a capitalist. I make as much as I can... The reason has NOTHING to do with how much I spent learning HOW to BE a capitalist. If THAT was the barometer, I spent NOTHING. I'm a high school dropout...

Nahhh... Liberals use a different measure.

When does somebody making as much as he can, DAMAGE society??? As a committed right winger, you'd probably say NEVER. I don't even think you ADMIT that health care costs are BANKRUPTING the entire nation.

Liberals, of course, don't HAVE that aversion to reality. The health care INDUSTRY is bankrupting us, and it WON'T stop until the government STOPS it.

So, we're trying.

excon

[tomder55]

Hello again, tom:

You link wouldn't let me read the article unless I REGISTERED.. It seems to be a right wing site. If I COULD have read the article, I'd probably tell them to SHOW ME THE MONEY instead of FLAPPING their gums.

excon

see below

New Affordable Care US health plans will exclude top hospitals

By Stephanie Kirchgaessner in Washington

Americans who are buying insurance plans over online exchanges, under what is known as Obamacare, will have limited access to some of the nation's leading hospitals, including two world-renowned cancer centres.

Amid a drive by insurers to limit costs, the majority of insurance plans being sold on the new healthcare exchanges in New York, Texas, and California, for example, will not offer patients' access to Memorial Sloan Kettering in Manhattan or MD Anderson Cancer Center in Houston, two top cancer centres, or Cedars-Sinai in Los Angeles, one of the top research and teaching hospitals in the country.


Experts say the move by insurers to limit consumers' choices and steer them away from hospitals that are considered too expensive, or even “inefficient”, reflects the new competitive landscape in the insurance industry since the passage of the Affordable Care Act, Barack Obama's 2010 healthcare law.

It could become another source of political controversy for the Obama administration next year, when the plans take effect. Frustrated consumers could then begin to realise what is not always evident when buying a product as complicated as healthcare insurance: that their new plans do not cover many facilities or doctors “in network”. In other words, the facilities and doctors are not among the list of approved providers in a certain plan.

Under some US health insurance plans, consumers can elect to visit medical facilities that are “out of network”, but they would probably incur high out of pocket costs and may need referrals to prove that such care is medically necessary.

The development is worrying some hospital administrators who see the change as an unintended consequence of the ACA.

“We're very concerned. [Insurers] know patients that are sick come to places like ours. What this is trying to do is redirect those patients elsewhere, but there is a reason why they come here. These patients need what it is that we are capable of providing,” says Thomas Priselac, president and chief executive officer of Cedars-Sinai Health System in California.

One of the biggest goals of “Obamacare” was to make subsidised healthcare plans that are being sold on the new exchanges as affordable as possible, while also mandating that certain benefits, like maternity care, were covered and that people with pre-existing medical conditions could not be denied access.

Amid these new regulatory restrictions, says Tim Jost, a health policy expert, insurance companies have had to come up with new ways to cut the cost of their products. In this new era, limiting the availability of certain facilities that are seen as too expensive – in part because they may attract the sickest patients or offer the most cutting edge medical care – is seen as the best way to control costs.

“It's like buying a Mercedes-Benz or a Chevy. You have to decide whether you want to pay for the highest product out there, which is probably pretty good quality, or the less expensive product,” Mr Jost says. “Everyone is in favour of competition until they see what it looks like. Then they think, maybe it's better for someone else just to pay for the whole thing.”

Kathleen Harrington, who heads government relations for the Mayo Clinic in Minnesota, says that access to the famous clinic was initially limited in the Rochester, Minnesota area until officials at the healthcare exchange board in the state encouraged insurers to expand their network options.

While the Mayo Clinic will now be available on seven different plans offered by two different insurance carriers in Rochester, Ms Harrington says the long-term concern for the hospital is that intense focus on bringing down costs will hurt “centres of excellence” like Mayo that attract the most complicated medical cases in the country.

“I don't think there is any doubt that a significant portion of the Mayo base are very sick patients. You don't come here for primary care. We do treat the sickest of the sick. We do experimental treatment. This is where you come for innovative treatments for life threatening illnesses,” she says.

“If healthcare, the full spectrum from primary to top speciality care, becomes commoditised, it becomes a concern for the American healthcare system,” she adds.

When the Obama administration was asked whether the new healthcare exchanges were offering adequate network options to new consumers, a spokeswoman for the Department of Health and Human Services (HHS) emphasised that the new exchanges would “vastly increase” the access to medical providers to millions of uninsured Americans.

“Decisions about which private health insurance plans cover which doctors is a decision currently made by insurers and providers and will continue that way,” said an HHS spokeswoman.

The top lobby group for US health insurance plans, America's Health Insurance Plans, said the new healthcare law brought “new costs” to the industry and that selecting hospitals and physicians that meet “quality standards” was one way of making health plans more affordable for consumers.

But Mr Priselac at Cedars-Sinai in Los Angeles says the creation of ever more narrow provider networks by insurers is being driven by price alone, and not by quality. He says the hospitals that are being excluded are leaders in innovation, which saves billions of dollars for the healthcare system in the long run.

“There is confusion between price and efficiency,” he says. “The major teaching and research hospitals are more expensive not because they are inefficient but because of what they do.”

Btw ,'Financial Times' is one of the leading economic publications in the world.

[speechlesstx]

Hello again, Steve:
I'm a capitalist. I make as much as I can... The reason has NOTHING to do with how much I spent learning HOW to BE a capitalist. If THAT was the barometer, I spent NOTHING. I'm a high school dropout...

Nahhh... Liberals use a different measure.

So you were a high school dropout, I want doctors who like most have gone deep into debt to learn their craft.

[talaniman]

We have improved with the ACA because now providers and injurers are haggling among themselves and ordinary folks aren't caught in the middle and kicked to the curb to save the bottom line. Hell those expensive hospitals weren't taking me anyway. I mean why is the price the same whether they cure me or NOT!

That's your free market at work, setting prices for effective service. Let 'em haggle.

[talaniman]

Borrowing for higher education is an investment, and you may not get a return on that investment in a year or two. Or 5.

[tomder55]

BS . My mom was treated at MD Anderson as a Medicare patient . The Mayo Clinic did too until it took a loss of $840 million in a year from treating Medicare patients.
You think they should work for nothing; or at a rate of compensation that the government decides .

[excon]

Hello again, tom:

You think they should work for nothing; or at a rate of compensation that the government decides .

Nothing is a little cheap, but I'm for the government making those decisions... Clearly, when the INDUSTRY makes them, it's BANKRUPTING us..

Although price controls are an anathema, BANKRUPTING the country is WORSE.

excon

[tomder55]

ah yes ,the Milhouse solution ! Nixonomics !

[excon]

Hello again, tom:

Well, you've got the Randian solution. Going broke BUILDS character!

excon

[talaniman]

If people can work and be broke all the time, then why can't hospitals? Why can't corporations? I thought they were people too? Kick people off welfare, and kick corporations off too.

Maybe I got my Americas mixed up. I thought there was one but I see there are two.

[speechlesstx]

So you want to go to a hospital that relies heavily on bloodletting, leeches and homemade tonics.

[talaniman]

What an untapped market, selling leeches to hospitals. Hmmmmmmmm!

[paraclete]

Maybe I got my Americas mixed up. I thought there was one but I see there are two.

I think you are right and so did Romney. he was aware of the other 47%