Obamacare could deny coverage to sick

The rationing, if it occurs, will be obviously far less than the rationing caused now by the insurance industry. Come on, Charles, context.
 
This is supposed to cover them until then, and it is not going to make it.

Believe it or not, I can read, and I read the article I linked to. The problem is these people are not going to make it until 2014 because the money set aside to deal with them until then is not going to be enough. Your idol screwed up, and you want to cover up for him.

I have no doubt you can read, I just assume you haven't read much that's relevant here. For example, the provision of the law that creates this program:

(g) Funding; Termination of Authority-
(1) IN GENERAL- There is appropriated to the Secretary, out of any moneys in the Treasury not otherwise appropriated, $5,000,000,000 to pay claims against (and the administrative costs of) the high risk pool under this section that are in excess of the amount of premiums collected from eligible individuals enrolled in the high risk pool. Such funds shall be available without fiscal year limitation.
(2) INSUFFICIENT FUNDS- If the Secretary estimates for any fiscal year that the aggregate amounts available for the payment of the expenses of the high risk pool will be less than the actual amount of such expenses, the Secretary shall make such adjustments as are necessary to eliminate such deficit.
[...]
(4) LIMITATIONS- The Secretary has the authority to stop taking applications for participation in the program under this section to comply with the funding limitation provided for in paragraph (1).
In other words, this is in the law.

Now I don't Pretend to speak legalize, and I know these laws are written to keep the masses ignorant. But does this not say Stop taking [patients because of limited funding? So it's true some people will not be treated.

That's what it means.
 
That rationing.

Again, what rationing? You cited "concerns," not an actual instance of what you're talking about.

Just to make a point, medical inflation outstrips regular inflation because the government regulations and tort laws force doctors to survive in a market that has no relief valve when it gets to expensive.

Look at the regional variations in Medicare reimbursements per enrollee, a decent proxy for local health care costs. Now, keeping in mind where the high-cost areas are, look at the following map.

It's a state-by-state look at the medical liability environment, provided by the 2009 National Report Card on the State of Emergency Medicine:
LiabilityStateMap.jpg


You can then supplement that with a look at Kaiser's state health facts to check state-by-state regulations. Do those two factors have full (or even much) explanatory power? Not so much. Oversimplifying a complicated issue isn't going to get you very far.

Medical care for people with pre-existing conditions.

This is a bit of an odd complaint. Insurance markets already exclude these people--what you're saying is that their care is rationed right now. Additional resources are provided here to allow some of them to obtain coverage but the problem won't completely go away until the law goes into full effect in 2014. It makes no sense to accuse the law of "rationing" care to these people when this particular provision (the high-risk pools) is reducing the amount of rationing that's currently happening.
 
Rationing is inevitable. Adding millions more people to an already-strained system will mean decisions will be made about who to treat and who to deny treatment to.

Inevitable.
 
Rationing of what? Subsidies?

Medical care for people with pre-existing conditions.

Then explain how it will not be more rationing than what we have now at more cost and. You can't.

Are you really that dense? This whole thing was about ending rationing and denial of coverage by private insurers, which is why it is called Universal Heath Care. But keep defending your statist hero Obama with claims that it is all better now.
 
Look at the regional variations in Medicare reimbursements per enrollee, a decent proxy for local health care costs. Now, keeping in mind where the high-cost areas are, look at the following map.

It's a state-by-state look at the medical liability environment, provided by the 2009 National Report Card on the State of Emergency Medicine:
LiabilityStateMap.jpg


You can then supplement that with a look at Kaiser's state health facts to check state-by-state regulations. Do those two factors have full (or even much) explanatory power? Not so much. Oversimplifying a complicated issue isn't going to get you very far.

Who simplified it? I was just pointing out that medical inflation is not caused by the free market, it is caused by the system of government interference and tort laws. Throw in the employer based health insurance that is also a direct result of government regulation and you have a disaster waiting to happen. Trying to go through all the factors and point out how you are simplifying things yourself in an attempt to make the issues look like something they are not would take a lot more time than I am willing to devote to this issue.

This law does nothing to address the real faults of the system, and even carves out exceptions to perpetrate some of the worst of them. If you want to read a good essay about the basic problem we have in this country I would recommend this one:

How American Health Care Killed My Father - Magazine - The Atlantic

Adding 2000 pages of law and untold pages of regulation to a broken system is not the answer. If Obama wants to get any real respect he will admit that this law is bad, call on Congress to repeal it and start over, and make real changes. Since you aren't going to admit that the law is not the solution I am sure you will continue to deny that the problem actually exists, and continue posting for your puppet masters.

This is a bit of an odd complaint. Insurance markets already exclude these people--what you're saying is that their care is rationed right now. Additional resources are provided here to allow some of them to obtain coverage but the problem won't completely go away until the law goes into full effect in 2014. It makes no sense to accuse the law of "rationing" care to these people when this particular provision (the high-risk pools) is reducing the amount of rationing that's currently happening.

Why is an odd complaint to point out that a law that is supposed to fix something is not working? One thing I can gargantuan, when 2014 rolls around this law will still not work, and people with pre-existing conditions will still be unable to get coverage. If the powers that be thought this had any chance of actually working they would not have delayed the implementation of this part until 2014 because this is the single thing that almost everyone in country thinks is a good idea.
 
Rationing is inevitable. Adding millions more people to an already-strained system will mean decisions will be made about who to treat and who to deny treatment to.

Inevitable.

Exactly. More patients cannot be covered unless we get more doctors and hospitals first, which will take decades.
 
Rationing is inevitable. Adding millions more people to an already-strained system will mean decisions will be made about who to treat and who to deny treatment to.

Inevitable.

Exactly. More patients cannot be covered unless we get more doctors and hospitals first, which will take decades.

Yup.

Health overhaul may mean longer ER waits, crowding
CHICAGO – Emergency rooms, the only choice for patients who can't find care elsewhere, may grow even more crowded with longer wait times under the nation's new health law.
That might come as a surprise to those who thought getting 32 million more people covered by health insurance would ease ER crowding. It would seem these patients would be able to get routine health care by visiting a doctor's office, as most of the insured do.
But it's not that simple. Consider:
_There's already a shortage of front-line family physicians in some places and experts think that will get worse.
_People without insurance aren't the ones filling up the nation's emergency rooms. Far from it. The uninsured are no more likely to use ERs than people with private insurance, perhaps because they're wary of huge bills.
_The biggest users of emergency rooms by far are Medicaid recipients. And the new health insurance law will increase their ranks by about 16 million. Medicaid is the state and federal program for low-income families and the disabled. And many family doctors limit the number of Medicaid patients they take because of low government reimbursements.
_ERs are already crowded and hospitals are just now finding solutions.
Rand Corp. researcher Dr. Arthur L. Kellermann predicts this from the new law: "More people will have coverage and will be less afraid to go to the emergency department if they're sick or hurt and have nowhere else to go.... We just don't have other places in the system for these folks to go."
Kellermann and other experts point to Massachusetts, the model for federal health overhaul where a 2006 law requires insurance for almost everyone. Reports from the state find ER visits continuing to rise since the law passed — contrary to hopes of its backers who reasoned that expanding coverage would give many people access to doctors offices
 
Who simplified it? I was just pointing out that medical inflation is not caused by the free market, it is caused by the system of government interference and tort laws.

It's caused by numerous things, among them the structure of the market (e.g. the insurer-provider negotiation process) and many warped incentives.

Throw in the employer based health insurance that is also a direct result of government regulation and you have a disaster waiting to happen.

Now I'm confused. When someone suggested not too long ago that reform would lead to the demise of much of the employer-based system, you seemed very upset. But it turns out you think that would be a desirable outcome? (If so, I agree, by the way)

This law does nothing to address the real faults of the system, and even carves out exceptions to perpetrate some of the worst of them. If you want to read a good essay about the basic problem we have in this country I would recommend this one:

How American Health Care Killed My Father - Magazine - The Atlantic

I have read that. Do you support mandatory catastrophic coverage?

Why is an odd complaint to point out that a law that is supposed to fix something is not working?

Because the high-risk pools are explicitly not supposed to solve the problem, they're supposed to make a dent in it using a limited budget. I posted the relevant bit of the law so you could see that for yourself. It explicitly says we only have $5 billion to spend on this, we may not be able to cover everyone who wants it. You're ascribing goals to the program that aren't actually part of it and using those goals to bludgeon it. As I've said numerous times now it's intended only to be a stopgap solution to take a chunk out of the problem. The real solution, however, is the exchanges.

One thing I can gargantuan, when 2014 rolls around this law will still not work, and people with pre-existing conditions will still be unable to get coverage.

Why's that?

If the powers that be thought this had any chance of actually working they would not have delayed the implementation of this part until 2014 because this is the single thing that almost everyone in country thinks is a good idea.

As it stands, states have quite a bit of groundwork to lay down over the next two years to get the exchanges going. Most don't know exactly how to do it yet, which is why expert groups are going to be needed to provide guidance and technical assistance between now and late 2013. If the law had called for them to be operational by November of this year, I imagine you'd have a field day when every state missed the deadline.
 
Now I'm confused. When someone suggested not too long ago that reform would lead to the demise of much of the employer-based system, you seemed very upset. But it turns out you think that would be a desirable outcome? (If so, I agree, by the way)

You are certainly confused, I never said that that I liked the system we have, I was sneering at the lie that everyone would be able to keep the plan they currently have.

I have read that. Do you support mandatory catastrophic coverage?

I don't support mandatory anything, but if the government was going to insist that people need to purchase insurance this would be the least objectionable way to get there.

Because the high-risk pools are explicitly not supposed to solve the problem, they're supposed to make a dent in it using a limited budget. I posted the relevant bit of the law so you could see that for yourself. It explicitly says we only have $5 billion to spend on this, we may not be able to cover everyone who wants it. You're ascribing goals to the program that aren't actually part of it and using those goals to bludgeon it. As I've said numerous times now it's intended only to be a stopgap solution to take a chunk out of the problem. The real solution, however, is the exchanges.

Nothing can solve the problem unless insurers can charge people to supply the care that is needed to for those pre-existing conditions. I do not think the exchanges will work, because it will turn out that most people who need the coverage will still be unable to afford it, which will drive up the costs for the rest of us, which is not how this is supposed to work. I will freely admit that I could be wrong about this if you will admit that the only way you can prove you are right is if you can point to results that contradict me. Just remember one thing, it did not work that way in Massachusetts.


Why's that?[

It never has in the past, why will it suddenly work now? Because Obama is smarter than anyone else who has tried it?

As it stands, states have quite a bit of groundwork to lay down over the next two years to get the exchanges going. Most don't know exactly how to do it yet, which is why expert groups are going to be needed to provide guidance and technical assistance between now and late 2013. If the law had called for them to be operational by November of this year, I imagine you'd have a field day when every state missed the deadline.

Yet some states are jumping in, and Congress did not bother with any advice either. If they had gotten advice they would not have modeled the law on a law that failed.
 
You are certainly confused, I never said that that I liked the system we have, I was sneering at the lie that everyone would be able to keep the plan they currently have.

Ah, of course. Partisan sniping over over actually focusing on the outcomes you'd like to see.

Nothing can solve the problem unless insurers can charge people to supply the care that is needed to for those pre-existing conditions.

Three mechanisms are at work here:

1) Risk adjustment at the state level so that plans serving a higher actuarial risk pool are not at a financial disadvantage. For the first three years the exchanges are in existence, HHS will also be establishing risk corridors for the small and group markets in which adjustments are made for a plan based on the ratio of allowable costs to the non-administrative component of premium subsidies.

2) Premium tax credits designed to bolster insurance pools. Obviously they're given to individuals--so they can choose which insurance pool they want to direct the money to--but the ultimate goal isn't just making it possible for more people to afford coverage, it's making sure the pools themselves have additional resources to cover the influx of new customers, including those with pre-existing conditions.

3) The mandate to deter adverse selection, preventing healthy individuals from opting out until they need insurance and leaving the pools disproportionately unhealthy. Obviously this relates to point 2), since lots of those people (including those who are relatively healthy) are vehicles for pumping this extra government money into the insurance pools.

I do not think the exchanges will work, because it will turn out that most people who need the coverage will still be unable to afford it, which will drive up the costs for the rest of us, which is not how this is supposed to work. I will freely admit that I could be wrong about this if you will admit that the only way you can prove you are right is if you can point to results that contradict me. Just remember one thing, it did not work that way in Massachusetts.

I'm not sure what you mean by "work" here, as the main goal of the exchanges it to create a transparent, easily navigable individual market which allows coverage to approach universality. That has happened in Massachusetts. Their law, however, made no attempt at cost control, which is why the rate of cost increases hasn't changed. That's why they're exploring options on that front now. But since you seem to be implying that people with pre-existing conditions can't and don't get coverage in Massachusetts (since that was the single criteria you laid out here), I can assure you that's false.

For that matter you can also look at the Swiss system, which relies on risk adjustment, subsidies to keep personal spending below a certain percentage of one's income, an individual mandate, community rating, and guaranteed issue. They, too, have been able to cover those with pre-existing conditions.

It never has in the past, why will it suddenly work now? Because Obama is smarter than anyone else who has tried it?

Again, since "won't work" is presumably shorthand for the remark that sparked this thread of the conversation--"people with pre-existing conditions will still be unable to get coverage"--I can tell you that in this has worked. Guaranteed issue laws--particularly when they're coupled with risk adjustment and financial support--allow people with pre-existing conditions to obtain insurance.

Yet some states are jumping in, and Congress did not bother with any advice either.

That's not quite true. There was a meeting between HHS officials, the NGA, and other interested state health policy folks in D.C. just last week. There's a process going on that's going to shape how this unfolds over the next two and a half years. Right now we're at the beginning of the process. Federal guidance, technical assistance from knowledgeable organizations, and state-sharing with each other will be the heart of designing and building the exchanges. But it won't happen over the course of a few months and I can tell you that states are more than happy to have the breathing room to figure out how to do this right.
 
Now I don't Pretend to speak legalize, and I know these laws are written to keep the masses ignorant. But does this not say Stop taking [patients because of limited funding? So it's true some people will not be treated.

Damn your lying eyes! :lol: How dare you see the truth? We would never ever ever ever ever ever EVER do that unless it was politically convenient for us and you little people were getting a little too uppity for our noble tastes!

L'equalite et liberte est mort! Vive la Classe Bureaucratique!
 
My Family Doctor, who is also a friend, tells me we already have medical rationing.
Unless you're paying cash for treatment, yes. You are going to, at some point, be rationed by someone. That's an economic reality. As you well know the issue is not that there will be rationing but on what grounds and methods will there be rationing. Nobody but the insane trust the government to handle this kind of program, for their track record in this nation is by far horrific. I can think of only ONE government program that did what it set out to do and left the industry it was involved in better off when it left. ONE: The USRA. Why did it end on a good note? Simple... it disbanded after the 2nd world war and was no longer needed to assist in helping railroads gain their motive power needs.

I could have put up the EPA, believe it or not, because it has done some good things for life... but well, they didn't stop. Now they're brownshirt econazi bastards who think they have a right to regulate your very breathing because they are deliberately misconstruing CO2 as a pollutant.

The only good government programs are those that fix the problem then GO AWAY.
 
Rationing is inevitable. Adding millions more people to an already-strained system will mean decisions will be made about who to treat and who to deny treatment to.

Inevitable.

Exactly. More patients cannot be covered unless we get more doctors and hospitals first, which will take decades.

Yup.

Health overhaul may mean longer ER waits, crowding
CHICAGO – Emergency rooms, the only choice for patients who can't find care elsewhere, may grow even more crowded with longer wait times under the nation's new health law.
That might come as a surprise to those who thought getting 32 million more people covered by health insurance would ease ER crowding. It would seem these patients would be able to get routine health care by visiting a doctor's office, as most of the insured do.
But it's not that simple. Consider:
_There's already a shortage of front-line family physicians in some places and experts think that will get worse.
_People without insurance aren't the ones filling up the nation's emergency rooms. Far from it. The uninsured are no more likely to use ERs than people with private insurance, perhaps because they're wary of huge bills.
_The biggest users of emergency rooms by far are Medicaid recipients. And the new health insurance law will increase their ranks by about 16 million. Medicaid is the state and federal program for low-income families and the disabled. And many family doctors limit the number of Medicaid patients they take because of low government reimbursements.
_ERs are already crowded and hospitals are just now finding solutions.
Rand Corp. researcher Dr. Arthur L. Kellermann predicts this from the new law: "More people will have coverage and will be less afraid to go to the emergency department if they're sick or hurt and have nowhere else to go.... We just don't have other places in the system for these folks to go."
Kellermann and other experts point to Massachusetts, the model for federal health overhaul where a 2006 law requires insurance for almost everyone. Reports from the state find ER visits continuing to rise since the law passed — contrary to hopes of its backers who reasoned that expanding coverage would give many people access to doctors offices

45% Of Doctors Would Consider Quitting If Congress Passes Health Care Overhaul <Investors Business Daily, September 15, 2009
 
Exactly. More patients cannot be covered unless we get more doctors and hospitals first, which will take decades.

Yup.

Health overhaul may mean longer ER waits, crowding
CHICAGO – Emergency rooms, the only choice for patients who can't find care elsewhere, may grow even more crowded with longer wait times under the nation's new health law.
That might come as a surprise to those who thought getting 32 million more people covered by health insurance would ease ER crowding. It would seem these patients would be able to get routine health care by visiting a doctor's office, as most of the insured do.
But it's not that simple. Consider:
_There's already a shortage of front-line family physicians in some places and experts think that will get worse.
_People without insurance aren't the ones filling up the nation's emergency rooms. Far from it. The uninsured are no more likely to use ERs than people with private insurance, perhaps because they're wary of huge bills.
_The biggest users of emergency rooms by far are Medicaid recipients. And the new health insurance law will increase their ranks by about 16 million. Medicaid is the state and federal program for low-income families and the disabled. And many family doctors limit the number of Medicaid patients they take because of low government reimbursements.
_ERs are already crowded and hospitals are just now finding solutions.
Rand Corp. researcher Dr. Arthur L. Kellermann predicts this from the new law: "More people will have coverage and will be less afraid to go to the emergency department if they're sick or hurt and have nowhere else to go.... We just don't have other places in the system for these folks to go."
Kellermann and other experts point to Massachusetts, the model for federal health overhaul where a 2006 law requires insurance for almost everyone. Reports from the state find ER visits continuing to rise since the law passed — contrary to hopes of its backers who reasoned that expanding coverage would give many people access to doctors offices

45% Of Doctors Would Consider Quitting If Congress Passes Health Care Overhaul <Investors Business Daily, September 15, 2009
So, more people will be insured, being treated by even fewer resources than are available now.

Obamacare is going to kill an awful lot of people.
 
So, more people will be insured, being treated by even fewer resources than are available now.

Obamacare is going to kill an awful lot of people.

That's my take on it...yes. Government has no business in this at all. All I can say is that I hope that after November we get more Governors onboard with the 19 presently suing the Federal Government over this UnConstitutional Law. It doesn't take effect until 2014...but the ramifications are already taking hold now.

In a piecemeal fashion? They're going to force this...and it's a contrived, ill-concieved Law that will destroy another part of the private sector. By Design.
 
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So, more people will be insured, being treated by even fewer resources than are available now.

Obamacare is going to kill an awful lot of people.

That's my take on it...yes. Government has no business in this at all. All I can say is that I hope that after November we get more Governors onboard with the 19 presently suing the Federal Government over this UnConstitutional Law. It doesn't take effect until 2014...but the ramifications are already taking hold now.

In a piecemeal fashion? They're going to force this...and it's a contrived, ill-concieved Law that will destroy another part of the private sector. By Design.
And they get pissed when you call them Marxists. :cuckoo:
 
So, more people will be insured, being treated by even fewer resources than are available now.

Obamacare is going to kill an awful lot of people.

That's my take on it...yes. Government has no business in this at all. All I can say is that I hope that after November we get more Governors onboard with the 19 presently suing the Federal Government over this UnConstitutional Law. It doesn't take effect until 2014...but the ramifications are already taking hold now.

In a piecemeal fashion? They're going to force this...and it's a contrived, ill-concieved Law that will destroy another part of the private sector. By Design.
And they get pissed when you call them Marxists. :cuckoo:

That's because the truth hurts them It's like Sunlight to Dracula. And they are Marxists...Statists.
 

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