Obamacare...the real world
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David Olsen
(bivysack.com) - F

Locale: Channeled Scablands
thrilled on 03/07/2014 13:31:08 MST Print View

What didn't the doctors like?

Michael L
(mpl_35) - MLife

Locale: The Palouse
what i got out of it on 03/07/2014 13:54:14 MST Print View

From my meeting, and this wasn't about the new healthcare act, was that they were not happy. They feared the decreasing reimbursement rates. They anticipated a decline in providers. They were very negative.

Again, this was peripheral to what I was discussing with them. But that was the gist of it.

Rick Adams
(rickadams100) - M
right/left on 03/07/2014 16:07:54 MST Print View

Many of these posts would be more valuable without the references to "you on the right" and "you on the left". I'm sure some will find positive things in the law but many will not, and it doesn't have to do with politics. I started this thread with a post about how our actual company provided medical insurance was changing due to the ACA, real life situations for real families.

If this law was fully implemented as written it would be interesting to see if more or less people ended up insured. It sure looks like our current administration places little value on small business people. In many states people are now able to keep their "substandard" policies for at least 2 more years and big business recieved a one year reprieve and I will wager that gets extended. Small business? you get to implement this now. I'd also wager that small businesses in many states will eventually get a delay as well, however, California, who's state capitol is owned by one unnamed party, will continue with implementation as they did on non-grandfathered individual policies.

I'm all for personal responsibility for your health care and insurance decisions with a gov backstop for catastrophic health problems. I'd like everybody to have an opportunity for med insurance, but not be forced to buy it.

My own experience with the ACA, and that of my people, is decidedly negative. It will have to evolve radically and quickly to be a good thing.

jerry adams
(retiredjerry) - MLife

Locale: Oregon and Washington
Re: right/left on 03/07/2014 18:10:37 MST Print View

"I started this thread with a post about how our actual company provided medical insurance was changing due to the ACA, real life situations for real families."

I'm an individual. This year, under ACA, I paid 5% less. Most years I get a 5% increase so maybe this is 10% less than what I would have paid. I have something like $20 copay.

My brother got a 50% increase. He has high deductible. I have tried to convince him this isn't so bad, because his payment is fairly low regardless, and if he got an expensive illness he could switch to a low deductible policy, which he couldn't have done pre-ACA, so he's getting something for that 50% increase.

For this reason, I don't think there should be any choice about type of policy. Everyone should have a moderate copay because that discourages people from going to the doctor fivilously. Maybe the copay should be dependent on your income.

Rick Adams
(rickadams100) - M
copay on 03/07/2014 18:39:29 MST Print View

I think your policy benefits from a smaller increase as I think from prior discussions it is a medicare advantage policy, which I think has very limited risk for the insurer. You would know better than I of course.

I think except for medicare, copayment plans should be scaled back. If you really want to cut medical expenses have the consumer pay the first $1000 at least out of pocket except for preventive. People make different decisions about care when they have to pay for it. The convenience of the emergency room or urgent care give way to the cost savings of a regular doctor's visit. Also, some of the "we can x-ray that just to be sure (even though I know it's not broken)" goes away too.

After the deductible is met a signifigant flat rate copay would be fine.

jerry adams
(retiredjerry) - MLife

Locale: Oregon and Washington
Re: copay on 03/07/2014 20:41:51 MST Print View

I got a few years before Medicare : )

But I think this all is representative of everyone under ACA - some people a little better off, some worse. and 95% of the people have insurance with employer, Medicare, or Medicaide so ACA has no effect, although like you said, employer paid for insurance rates may change. Hard to determine whether changes are due to ACA or just the steady increases we've been seeing for years.

I read some study that psycologically, a bigger co-pay doesn't proprotionally discourage un-necesary trips to doctor. If you have $100 instead of $20 it doesn't reduce trips to doctor very much.

The decision to x-ray should be medically based. They shouldn't do it if it's not necesary. If it is necesary, someone shouldn't have to decline because they can't afford it. $1000 deductible may be difficult for some people.

I think there should be rules, for example when to x-ray, based on data. If your leg is sore but you can still walk on it, don't do an x-ray, wait a week. Or whatever the data based rule would be. But leave final decision to doctor because you can't always have a perfect set of rules.

Or to put it another way, look at what places like the Mayo Clinic and Cleveland Clinic are doing and replicate that nationally.

jerry adams
(retiredjerry) - MLife

Locale: Oregon and Washington
Re: Re: Let's be real on 03/07/2014 20:47:04 MST Print View

"Jerry, public education is pretty good, compared to the Congo or interior China..."

Story on news tonight.

Kansas Supreme Court ruled that reductions to public education funding are unconstitutional.

According to CBS, $1.1 billion cut in taxes, primarily to wealthy people. They interviewed someone that said they were wealthy and got tax cut but said it wasn't good because of cuts in education spending.

According to PBS, the tax cuts were due to the bad economy.

Either way, funding for public education is being reduced.

If I was a young person choosing a career, I would think twice about becoming a teacher. I bet the quality of teachers is reducing over time. "free market" and so forth...

Justin Baker
(justin_baker) - F

Locale: Santa Rosa, CA
Re: Re: Re: Let's be real on 03/08/2014 01:19:36 MST Print View

There could be a 99% tax on the wealthy and liberals would still complain about a tax cut.

Edited by justin_baker on 03/08/2014 01:20:33 MST.

jerry adams
(retiredjerry) - MLife

Locale: Oregon and Washington
Re: Re: Re: Re: Let's be real on 03/08/2014 07:59:45 MST Print View

How about a slightly progressive tax, for example:

poverty level of income - zero or negative tax
middle income - 40% (including SS, and employer contribution)
high income - 50%

Scott Jones
(Endeavor) - M
Obamacare...the real world on 03/09/2014 23:08:46 MDT Print View

http://www.huffingtonpost.com/alan-colmes/shame-on-republican-state_b_4044941.html

The republican party has hit an all time low. Hopefully they will run tea party crazy Ted Cruz so they will lose 40 out of the 50 states in the next election.

Scott Jones
(Endeavor) - M
Obamacare...the real world on 03/09/2014 23:09:26 MDT Print View

http://www.huffingtonpost.com/alan-colmes/shame-on-republican-state_b_4044941.html

The republican party has hit an all time low. Hopefully they will run tea party crazy Ted Cruz so they will lose 40 out of the 50 states in the next election.

Michael L
(mpl_35) - MLife

Locale: The Palouse
Re: Obamacare...the real world on 03/10/2014 15:01:47 MDT Print View

that isn't biased "reporting" at all...

jerry adams
(retiredjerry) - MLife

Locale: Oregon and Washington
Re: Re: Obamacare...the real world on 03/10/2014 16:27:51 MDT Print View

Gallup Poll - uninsured rate went from:

14.8% Jan 2008

up to 18.6% July 2013

down to 16.1% Jan 2014 after people could sign up for ACA

It'll be interesting to see this over the next year or so - more statistically valid

http://www.gallup.com/poll/166982/uninsured-rate-shows-initial-decline-2014.aspx

Kathy A Handyside
(earlymusicus) - M

Locale: Southeastern Michigan
Re: Re: Another delay in the works on 03/20/2014 19:28:04 MDT Print View

Marc - You are absolutely correct. ObamaCare is nothing but a big giveaway to the health insurance industry.

J Mag
(GoProGator) - F
Politics, amirite? on 03/29/2014 20:26:30 MDT Print View

I don't want to get involved in this for sure, but I think for ANYONE to be happy with their party right now you have to be at least a little biased...

While I did not vote for Obama, I always found it surprising how nobody really cared that he didn't accomplish any of the things he ran on in his first term. e.g.:

1. Getting out of Iraq
2. Closing Guantanamo
3. No new taxes
4. Cutting spending
5. Fixing the economy
6. Universal healthcare

Some of those ideas I did agree with, but it seemed like nobody really brought this up around election time. And I don't think you can blame all those misses on a divided Congress.

I would identify more as a Republican (especially fiscally), so I am very disappointed to see "my" side's strong stance on gay marriage and birth control along with some other issues :(

jerry adams
(retiredjerry) - MLife

Locale: Oregon and Washington
Re: Politics, amirite? on 03/29/2014 20:34:40 MDT Print View

He tried to close Guantanamo but congress thwarted him

The others he accomplished to some degree

I am biased and voted for Obama. Thank God, McCain or Romney didn't get elected.

Katharina ....
(Kat_P) - MLife

Locale: Pacific Coast
Re: Re: Politics, amirite? on 03/29/2014 23:12:27 MDT Print View

Yeah, no fan of McCain or Romney here....but to be happy with Obama right now is just ludicrous.

Charles G.
(Rincon) - M

Locale: Desert Southwest
A nation of takers? Some perspective. on 03/30/2014 06:05:42 MDT Print View

http://www.nytimes.com/2014/03/27/opinion/kristof-a-nation-of-takers.html?action=click&contentCollection=Health&module=MostEmailed&version=Full&region=Marginalia&src=me&pgtype=article

jerry adams
(retiredjerry) - MLife

Locale: Oregon and Washington
Re: A nation of takers? Some perspective. on 03/30/2014 07:30:34 MDT Print View

ha, ha, ha,... you tricked me, I thought it would be about how welfare encourages lazy poor people

the biggest welfare to banks though, is the Federal Reserve creates money out of thin air, loans it to banks cheap, and then they loan it to people and the government at higher rates. That's a big reason the banks recovered so quickly after the "big recession"

jerry adams
(retiredjerry) - MLife

Locale: Oregon and Washington
Re: Re: A nation of takers? Some perspective. on 03/30/2014 07:34:27 MDT Print View

and then the banks giver their execs mega-bonuses because they're such capable, intelligent, hard working people.