If you like Your healthcare!!

I wish people would just stop with the "rationed care" scare tactic.

That's what we have now. That's what we've had since the advent of insurance coverage.

Absolutely untrue.

I find that one as familiar with the system as you are would fabricate to enforce the leftist view.


No government official stands between you and healthcare today.

If you have a private plan and they decline after hearings, you can decide that you will pay for healthcare youself.

We do not have rationed healthcare. It is not like Canada, where you would have to leave the country to purchase care that they would either not give you, or you do not wish to wait the prolonged time for treatment.

Please retract.
Absolutely not. Our current public plans ration, deny, and restrict reimbursement for services. Same with private insurance. Sure, technically someone has the option of paying out of pocket, but how many of us can afford that? You're well versed in healthcare, it seems. Certainly you are aware of the costs of even the most routine care.

On a personal note, I had surgery 4 years ago to remove an ovarian tumor. I was in the hospital 4 days. The hospital bill alone was over $30K. The surgeon's bill was over $10K. The anesthesiology bill was over $2K. Radiology... I can't recall offhand.

So we're talking over $42,000 for one 4 day hospital stay. I wasn't on a specialized unit. No complications, nothing untoward. A fairly routine stay. No way in hell I could have afforded to pay that bill.

Having the "option" to private pay means nothing if you can't afford it.

I hope you are well, and remain well. This is why I believe in the free enterprise system, which has benefitted all of us in longer and healthier lives. I hope you and yours have both.

Since you admit that one can pay out of pocket, "... Sure, technically someone has the option of paying out of pocket,..." why not leave it up to the individual to decide whether or not that is feasible.

That in a nutshell, is the difference between liberal thinking and conservative thinking.

Collective or individual. Which is the priority.

Perhaps it is our view of community, or as Edmund Burke called them, "the little battalions.'

If the price of one's life is $42,000, and members of ones family and community helped by loans or gifts, the cost is covered. Possibly this view explains why Conservatives give charity in so much greater amounts.
 
Absolutely untrue.

I find that one as familiar with the system as you are would fabricate to enforce the leftist view.


No government official stands between you and healthcare today.

If you have a private plan and they decline after hearings, you can decide that you will pay for healthcare youself.

We do not have rationed healthcare. It is not like Canada, where you would have to leave the country to purchase care that they would either not give you, or you do not wish to wait the prolonged time for treatment.

Please retract.
Absolutely not. Our current public plans ration, deny, and restrict reimbursement for services. Same with private insurance. Sure, technically someone has the option of paying out of pocket, but how many of us can afford that? You're well versed in healthcare, it seems. Certainly you are aware of the costs of even the most routine care.

On a personal note, I had surgery 4 years ago to remove an ovarian tumor. I was in the hospital 4 days. The hospital bill alone was over $30K. The surgeon's bill was over $10K. The anesthesiology bill was over $2K. Radiology... I can't recall offhand.

So we're talking over $42,000 for one 4 day hospital stay. I wasn't on a specialized unit. No complications, nothing untoward. A fairly routine stay. No way in hell I could have afforded to pay that bill.

Having the "option" to private pay means nothing if you can't afford it.

I hope you are well, and remain well. This is why I believe in the free enterprise system, which has benefitted all of us in longer and healthier lives. I hope you and yours have both.

Since you admit that one can pay out of pocket, "... Sure, technically someone has the option of paying out of pocket,..." why not leave it up to the individual to decide whether or not that is feasible.

That in a nutshell, is the difference between liberal thinking and conservative thinking.

Collective or individual. Which is the priority.

Perhaps it is our view of community, or as Edmund Burke called them, "the little battalions.'

If the price of one's life is $42,000, and members of ones family and community helped by loans or gifts, the cost is covered. Possibly this view explains why Conservatives give charity in so much greater amounts.
Thank you.

Does this legislation forbid private pay?

I still hold that just because you can pay out of pocket doesn't mean it's an option if the cost is absurdly out of reach. And yeah, there are fund-raisers and such, pickle jars next to the cash register and neighborhood bake sales... They work well at times for the heart-string-tugging cases, but in general? I've seen far too many slip through the cracks to believe that can be the answer.

In any case, neither one of us is going to change what the other believes or feels should be done. But no worries. Your side is going to win.
 
Absolutely not. Our current public plans ration, deny, and restrict reimbursement for services. Same with private insurance. Sure, technically someone has the option of paying out of pocket, but how many of us can afford that? You're well versed in healthcare, it seems. Certainly you are aware of the costs of even the most routine care.

On a personal note, I had surgery 4 years ago to remove an ovarian tumor. I was in the hospital 4 days. The hospital bill alone was over $30K. The surgeon's bill was over $10K. The anesthesiology bill was over $2K. Radiology... I can't recall offhand.

So we're talking over $42,000 for one 4 day hospital stay. I wasn't on a specialized unit. No complications, nothing untoward. A fairly routine stay. No way in hell I could have afforded to pay that bill.

Having the "option" to private pay means nothing if you can't afford it.

I hope you are well, and remain well. This is why I believe in the free enterprise system, which has benefitted all of us in longer and healthier lives. I hope you and yours have both.

Since you admit that one can pay out of pocket, "... Sure, technically someone has the option of paying out of pocket,..." why not leave it up to the individual to decide whether or not that is feasible.

That in a nutshell, is the difference between liberal thinking and conservative thinking.

Collective or individual. Which is the priority.

Perhaps it is our view of community, or as Edmund Burke called them, "the little battalions.'

If the price of one's life is $42,000, and members of ones family and community helped by loans or gifts, the cost is covered. Possibly this view explains why Conservatives give charity in so much greater amounts.
Thank you.

Does this legislation forbid private pay?

I still hold that just because you can pay out of pocket doesn't mean it's an option if the cost is absurdly out of reach. And yeah, there are fund-raisers and such, pickle jars next to the cash register and neighborhood bake sales... They work well at times for the heart-string-tugging cases, but in general? I've seen far too many slip through the cracks to believe that can be the answer.

In any case, neither one of us is going to change what the other believes or feels should be done. But no worries. Your side is going to win.

I can't document this, but the implication is that to ration the use of, say MRI's, it would become illegal as it is in Canada.

I've seen other strategies, such as the Amish in Lancaster who use cash and the fairly large size of their community to lever hospitals to give the same prices as they do to healthcare plans.

And many of them go to Mexico for operations. Medical tourism is catching on.

If my side wins, we both win.

Be well.
 
TennCare is the State of Tennessee’s health care insurance program, designed to expand health insurance to the uninsured through the state’s Medicaid program by utilizing managed care. Launched in 1994 by then-Governor Ned McWherter, it was hoped the program would solve of the state’s biggest problems: access to affordable health care insurance and a Medicaid budget that was fast consuming the largest portion of the state’s budget. It was one of the nation’s first Medicaid “waivers,” with the overarching requirement that the program be “budget neutral,” or require no greater federal funding than the previous Medicaid program. The state sought to accomplish this by replacing the Medicaid fee-for-service payment method with a managed care model. At the time, managed care was fairly new to Tennessee health care providers.

The state moved more than 800,000 Medicaid recipients into competitively-bid managed care insurance companies, and extended the same benefits to 500,000 more people who were not Medicaid-eligible, but were uninsured or deemed uninsurable due to pre-existing conditions.

In its first year of operation, TennCare enrollment quickly grew close to the federal cap of 1.5 million people, meaning the federal government would not share in the cost of the number above that. In response to the growth in enrollment, in 1995 the state closed eligibility to adults who were uninsured.

In its first five years, TennCare saved the state money – providing health care insurance to many more people at a cost that was less than a traditional Medicaid program.

In 1996, the state carved out behavioral health services, contracting with behavioral health organizations for mental health and substance abuse services.

In its first four years, TennCare accomplished what the state set out to do: stop the escalating costs of Medicaid, a problem that drove many other states to subsequently explore alternatives. But through those years, problems began to develop related to the operation of the seven managed care organizations (MCOs). A first one simply pulled out of the program, and the state shifted enrollees to the other managed care organizations. But then two other MCOs developed financial problems, and physicians began complaining loudly that they were not being paid. The state was forced to take over one contractor, and attempted to keep the MCO afloat through receivership. Another larger MCO was bailed out by the state before it was finally liquidated. In both cases, health care providers were left with millions in unpaid bills. Though the state tried to pay off the debt, it was never able to fully compensate providers.

By 1999, it was clear that a reform was necessary. Doctors and hospitals lobbied the state to require that a certain percentage of the money paid to the MCOs in the form of monthly capitation payments be routed on to providers. More problems developed, as the MCOs were unable to manage care or costs under the constraint of the new mandate.

In 2002, the state’s waiver agreement with the federal government was renewed, but CMS would not agree to many of the funding mechanisms Tennessee won in its original waiver, making the program even less cost-effective. In addition, although the state’s Medicaid eligibility remained intact – with Tennessee offering more eligibility categories than most other states – enrollment in the so-called “waiver” population was curtailed. After the new waiver went into effect, enrollees were (1) either Medicaid-eligible or (2) both uninsurable and below 250% of the federal poverty threshold.
TennCare - Wikipedia, the free encyclopedia

The enacted statute, chapter 58 of the acts of 2006, established a system to require individuals, with a few exceptions, to obtain health insurance.[24] Chapter 58 has several key provisions: the creation of the Health Connector; the establishment of the subsidized Commonwealth Care Health Insurance Program; the employer Fair Share Contribution and Free Rider Surcharge; and a requirement that each individual must show evidence of coverage on their income tax return or face a tax penalty, unless coverage was deemed unaffordable by the Health Connector.[24] The statute also expands MassHealth (Medicaid and SCHIP) coverage for children of low income parents and restores MassHealth benefits like dental care and eyeglasses. A merger of the individual (non-group) insurance market into the small group market will allow individuals to get lower group insurance rates. Payment rates are increased to hospitals and physicians, and a new "Health Care Quality and Cost Council" will issue quality standards and publicize provider performance.[25] Chapter 58 also sets up a Disparities Council, funds automated prescription ordering in hospitals, and implements changes to the public health council, state insurance laws, mandated benefit requirements, and other health-related programs.

On October 26, 2006, the Commonwealth enacted chapter 324 of the acts of 2006, legislation making adjustments and technical corrections to chapter 58. The statute contains 82 sections and includes sections amending effective dates for many of the private insurance provisions of chapter 58. Another technical corrections bill, chapter 450 of the acts of 2006, was enacted on January 3, 2007. The statute includes more adjustments to effective dates. A third technical corrections statute was enacted on November 29, 2007, as chapter 205 of the acts of 2007
Massachusetts health care reform - Wikipedia, the free encyclopedia

Health care reform in Massachusetts has led to a dramatic increase in the number of people with health insurance. But there's an unintended consequence: A sudden demand for primary care doctors has outpaced the supply.

Primary Care From The ER

Kamela Christara appears at the triage window in the emergency room at Cooley Dickinson Hospital in western Massachusetts.

The 47-year-old single mother has advanced Lyme disease, and she can't find a primary care doctor to oversee her care. She's called half a dozen practices in three towns, and none are accepting new patients. So when problems come up, even routine ones, she comes to the emergency room. Each time, she goes through her medical history with the intake nurse.

Christara is worried she'll keep getting sicker if no one doctor is tracking her health. Even her regular prescriptions come from the emergency department.

At least Christara doesn't have to pay out of pocket for this ER visit. She has the state's Medicaid insurance, which was expanded under a landmark health reform law passed in 2006. It requires all residents to have health insurance — either through a state-subsidized plan, an employer or privately bought insurance. As a result, an estimated 440,000 more people have health coverage. And they all need a primary care doctor to get into the system.

Too Many New Patients, Not Enough Doctors
Mass. Health Care Reform Reveals Doctor Shortage : NPR

On the contrary, there is plenty of evidence out there that supports the contention that these kinds of healthcare programs are failures from the beginning. What is really amazing about this is the fact that there is this belief that by spending more money you somehow save money.
 
I diagnosed myself with diabetes back in March. I called my doc, whom I'd been seeing since he opened his practice. At first I was told they'd work me in that week, but later was refused and told that I was considered a "new patient" since I'd not seen him for a couple of years (I'd been traveling in my job and since my return had no need to see him; I did however keep him abreast of any health issues that arose while I was out of town and had all records forwarded to him). I was told the earliest appointment for a "new" patient was the end of July. Over 4 months away.

So I said 'screw that' and looked for a new doc. I don't live in a small town. There are a ton of docs here. I called every one that I knew from working in the area for so long and others besides. Almost all were not taking new patients, and for the few that were, they gave me appointments even farther out than my own doc. I lucked the hell out and found a guy who was new to an established practice (one I'd already called); so new he wasn't even listed with them yet. He was able to see me within a week and I just love him to pieces.

This is a common problem here. I suspect it has a lot to do with us being a regional care center, covering people all over this part of the state, WVA and NC/TN too. Wait times for damn near any procedure is ridiculously long. My dad waited over 6 months for a hip replacement. A friend over 4 months for an MRI to diagnose an issue with fainting. I see and hear this stuff every damned day. And like I said, it's not a lack of docs or resources here, it the lack of them in all these other areas our city provides healthcare services for.
 
I will add this Emma, if your side does prevail in this healthcare for all , you will win one thing and that the goal of being able to make the statement of "we have healthcare coverage for every american" . However, what you will also have is a nation that is deep in debt, that is in such a state that it owe's it's very existance to a foreign nation, it will be be in a postiion where it will produce little, and want for everything and expect all. So if you consider this kind of nation where medical innovation is non-existant, Doctors and medicine is average at best when you can get and good only for those able to afford it. So yes if you consider this winning then by all means, please do so. However spending almost a Trillion dollars in an effort to save money and then hoping that somehow as if by magic because it has never worked anywhere else, that suddenly all healthcare costs will come down and everyone will have access to high quality healthcare is nothing but a fantasy and will result in a tragic legacy for this nation.
 
I will add this Emma, if your side does prevail in this healthcare for all , you will win one thing and that the goal of being able to make the statement of "we have healthcare coverage for every american" . However, what you will also have is a nation that is deep in debt, that is in such a state that it owe's it's very existance to a foreign nation, it will be be in a postiion where it will produce little, and want for everything and expect all. So if you consider this kind of nation where medical innovation is non-existant, Doctors and medicine is average at best when you can get and good only for those able to afford it. So yes if you consider this winning then by all means, please do so. However spending almost a Trillion dollars in an effort to save money and then hoping that somehow as if by magic because it has never worked anywhere else, that suddenly all healthcare costs will come down and everyone will have access to high quality healthcare is nothing but a fantasy and will result in a tragic legacy for this nation.
Well, like I said before (here or other thread, can't remember lol), I don't believe it's going to be a utopia like many on the left seem to think, nor do I believe the dire doom-and-gloom that many on the right seem certain is going to occur. But it will certainly lead to an improvement over what we have now.
 
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It will not be an improvment you'll be soon dead and those who are not aborted will be saddled with your bills.
It is unconscionable .
 
Emma, I'm sure someone someplace will be happy with it's passage and I suppose that if some of those are get insurance free of charge at the expense of their neighbors and their country. While it may seem a good thing to them, they will have sacrificed their nation and their childrens future for their own short term comfort.
 
He is talking about eliminating the need for employers to provide health insurance for their employees by setting up a pool that people can choose from, buying the policy that best fits their needs. One that doesn't tie their insurance coverage to their job.

I think it's a great idea. Personally, I'd rather see single payer but the exchange combined with a public option is the next best thing IMO.
 
Emma, I'm sure someone someplace will be happy with it's passage and I suppose that if some of those are get insurance free of charge at the expense of their neighbors and their country. While it may seem a good thing to them, they will have sacrificed their nation and their childrens future for their own short term comfort.

I am looking at the long-term. I believe it will be cost-effective and lead to decreased spending in the long run.
 
Not only will Obamacare ration your healthcare Section 163 of the bill allows the government real-time access to a person’s bank records, including direct access to bank accounts for electronic fund transfers.

Does this not bother everyone??
 
Emma, I'm sure someone someplace will be happy with it's passage and I suppose that if some of those are get insurance free of charge at the expense of their neighbors and their country. While it may seem a good thing to them, they will have sacrificed their nation and their childrens future for their own short term comfort.

I am looking at the long-term. I believe it will be cost-effective and lead to decreased spending in the long run.

I'm sorry Emma while I respect your opinion history is not on your side on this issue. Every single Govt. entitlement program like this has ended up costing 10 to 50 times more than it was originally thought. Not only that from a delivery standpoint , it's my belief it will lower quality and delivery to such a degree that the people that actually have the govt. insurance will not be much better off than they are now. Let's set aside for a moment that the Govt. clearly does not have any constitutional authority to institute such a program and the fact we have a massive deficit even in terms of long term results this healthcare legislation is at the very least misdirected. If the real issues that cause healthcare to rise are never addressed all you really do is add more people to the healthcare roles and cost even more money. I highly doubt that this will lead to decreased spending, in fact I;m positive this will lead to a massive Govt. system that sucks money. The real way to fix healthcare is to address it head on and then those citizens that really want things like single payer can advocate for it in the states they live and let the voters decide whats best for them.
 
Emma, I'm sure someone someplace will be happy with it's passage and I suppose that if some of those are get insurance free of charge at the expense of their neighbors and their country. While it may seem a good thing to them, they will have sacrificed their nation and their childrens future for their own short term comfort.

I am looking at the long-term. I believe it will be cost-effective and lead to decreased spending in the long run.

I'm sorry Emma while I respect your opinion history is not on your side on this issue. Every single Govt. entitlement program like this has ended up costing 10 to 50 times more than it was originally thought. Not only that from a delivery standpoint , it's my belief it will lower quality and delivery to such a degree that the people that actually have the govt. insurance will not be much better off than they are now. Let's set aside for a moment that the Govt. clearly does not have any constitutional authority to institute such a program and the fact we have a massive deficit even in terms of long term results this healthcare legislation is at the very least misdirected. If the real issues that cause healthcare to rise are never addressed all you really do is add more people to the healthcare roles and cost even more money. I highly doubt that this will lead to decreased spending, in fact I;m positive this will lead to a massive Govt. system that sucks money. The real way to fix healthcare is to address it head on and then those citizens that really want things like single payer can advocate for it in the states they live and let the voters decide whats best for them.
Well, I disagree with you on this, but it doesn't matter really. It's not going to pass.
 
I am looking at the long-term. I believe it will be cost-effective and lead to decreased spending in the long run.

I'm sorry Emma while I respect your opinion history is not on your side on this issue. Every single Govt. entitlement program like this has ended up costing 10 to 50 times more than it was originally thought. Not only that from a delivery standpoint , it's my belief it will lower quality and delivery to such a degree that the people that actually have the govt. insurance will not be much better off than they are now. Let's set aside for a moment that the Govt. clearly does not have any constitutional authority to institute such a program and the fact we have a massive deficit even in terms of long term results this healthcare legislation is at the very least misdirected. If the real issues that cause healthcare to rise are never addressed all you really do is add more people to the healthcare roles and cost even more money. I highly doubt that this will lead to decreased spending, in fact I;m positive this will lead to a massive Govt. system that sucks money. The real way to fix healthcare is to address it head on and then those citizens that really want things like single payer can advocate for it in the states they live and let the voters decide whats best for them.
Well, I disagree with you on this, but it doesn't matter really. It's not going to pass.

Emma, seriously while I understand this issue is really important to a lot of Americans why not go to the state you live in and be a strong advocate for single payer in your state? I have no doubt in mind that states like Cali. and NY would have no trouble passing such a measure as well as many others and one thing more, you are well within your rights to do so because the voters in your states would have voiced their desires there. There are indeed a few states that already offer some form of healthcare already, Mass for example. I have no issues with those that wish healthcare costs to come down heck I want that too, the Federal Govt. though is not the mechanism for that to happen nor is legislation through mandates upon your citizens.
 
15
•HR 3200 IH
1 (b) REQUIREMENTS FOR QUALIFIED HEALTH BENE2
FITS PLANS.—On or after the first day of Y1, a health
3 benefits plan shall not be a qualified health benefits plan
4 under this division unless the plan meets the applicable
5 requirements of the following subtitles for the type of plan
6 and plan year involved:
7 (1) Subtitle B (relating to affordable coverage).
8 (2) Subtitle C (relating to essential benefits).
9 (3) Subtitle D (relating to consumer protec10
tion).
11 (c) TERMINOLOGY.—In this division:
12 (1) ENROLLMENT IN EMPLOYMENT-BASED
13 HEALTH PLANS.—An individual shall be treated as
14 being ‘‘enrolled’’ in an employment-based health
15 plan if the individual is a participant or beneficiary
16 (as such terms are defined in section 3(7) and 3(8),
17 respectively, of the Employee Retirement Income Se18
curity Act of 1974) in such plan.
19 (2) INDIVIDUAL AND GROUP HEALTH INSUR20
ANCE COVERAGE.—The terms ‘‘individual health in21
surance coverage’’ and ‘‘group health insurance cov22
erage’’ mean health insurance coverage offered in
23 the individual market or large or small group mar24
ket, respectively, as defined in section 2791 of the
25 Public Health Service Act.
http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:h3200ih.txt.pdf

If you like your doctor, you will be able to keep your doctor, period. If you like your health care plan, you'll be able to keep your health care plan, period. No one will take it away, no matter what." Barack Obama 6-15

As long as it's qualified under the terms of the bill which Obama tends to neglect everytime he makes that claim.

pajesus navy, why are you being so inefficient in these postings of yours, or should i say. ''selective''?

you merely need to read a few paragraphs further to get at the truer picture?

(b) GRACE PERIOD FOR CURRENT EMPLOYMENT9
BASED HEALTH PLANS.—
10 (1) GRACE PERIOD.—
11 (A) IN GENERAL.—The Commissioner
12 shall establish a grace period whereby, for plan
13 years beginning after the end of the 5-year pe14
riod beginning with Y1, an employment-based
15 health plan in operation as of the day before
16 the first day of Y1 must meet the same require17
ments as apply to a qualified health benefits
18 plan under section 101, including the essential
19 benefit package requirement under section 121.

5 yr grace period....sheesh, ours changes every year with matt's employer! it'll be a relief to have the same plan we have now for 5 years!

the changes required after the 5 years, are a good thing as well...imo!!!
 

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