Health Care Thread

God Damn blakkheim we know the website sucks and they're having a shit fit over it. We'll get through this together man. All this cancelled policy shit isn't reason to panic because they're still selling policies! He was full of shit when he said everyone could keep their plan, we know. Do you think consistent plans for everyone will have benefits with billing etc down the road? Half the shit I've filed it's random whether they actually pay it or I have to appeal.

This policy cancelled panic is not a big deal and everyone fucking knows it.

Picasso_sl said:

This policy cancelled panic is not a big deal and everyone fucking knows it.

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I'm sure the people who are sick and depended on their newly canceled plans will feel better now that you have told them their misery means nothing.

Borzak_sl said:

Because what's in the law, plans have to follow the law. He said it wasn't worth the hassle with the reimbursements and the way referalls would work.

He also doesn't take regular insurance as far as I know either. I have always paid cash. If he wants to refer me to another Dr. he just does so and I pay them cash as well. My mother will have to change Dr.'s under her new plan as well now because she lives 30 minutes from "town" and that "town" is across state lines and they sent a letter stating that it's now out of the plan and it's the only plan available to her. So now she has to drive 2 hours to Jackson because it is in state and available with the plan.

I guess you would call my Dr. a boutique Dr. for lack of a better term. He limits his patients and you get personalized care including house visits if necessary.

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Under the AMA he's required to give normal procedure codes on his billing and you can still file an "out of network" claim with almost any provider and still be covered. (i.e. Medicare is usable ANYWHERE as long as you're willing to prepay and get reimbursed unless the practice is operating outside of AMA guidelines, which shouldn't be legal I'd wager)

Basically all he's saying is he's not running a front office that will process those claims for you and assuming the rates they require. You can still use any insurance that allows "out of network" doctors without a hitch besides being on the hook for the bill until reimbursed by insurance.

Synj_sl said:

Not being confrontational here but who gets to decide what is valuable? That's like telling someone they have to have a $1000 NVIDIA 3DFX Voodoo Monster 3 graphics card because they wont have enough teraflops to run EQ when all they want is to play minesweeper.

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When health care is expected to be provided and literally you've paid more than the max value it will ever pay out in 3 years and after that you would've literally been better off putting the same money under your mattress for an "insurance fund" - it's pretty safe to say it's not valuable.

Basically the argument that catastrophic plans had "value" to anyone is like saying check cashing services have "value" to people - it's predatory nonsense targeted at the uninformed.

"substandard" but not predatory plans were supposed to be grandfathered - only because of the insurance companies taking actions that invalidated them (likely intentionally) did they become "illegal".

Only the predatory plans had no chance of continuing.

Or for your analogy - an only 12" black and white that only takes analog signals over an antennae with no coax that can't even be used anymore because those signals no longer even exist - that's about the value those plans had.

Picasso_sl said:

This policy cancelled panic is not a big deal and everyone fucking knows it.

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Not the Dems who are going to lose their seats in 2014. It's a pretty big deal to them.

Nor to the 40+ million who will have their insurance cancelled when the employee mandate goes into effec - and now you know why the Obama administration illegally suspended the employer mandate for a year.

Nor to the families that had decent insurance and are now being forced to pay 5x the amount for ACA insurance.

Vaclav_sl said:

"substandard" .

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Calling plans substandard doesn't make them so - indeed many ACA plans have higher deductibles, much higher premiums and loads of bullshit like requiring maternity care coverage for men and women long past child bearing age.

Basically you guys are trying to force people to buy Escalades when they're pretty fucking happy with their Ford F150.

Pretty much everyone who uses the term "substandard" in reference to cancelled policies to justify forcing people to buy shit they don't want and/or need are dicks.

fanaskin_sl said:

dude this is such a pedantic viewpoint the narrowness and specificity of new regulations made this practically impossible, seriously a $5 change in the plan nullifies it, combine that with the new "essential health benefits" that adds stuff that 1/2 the population literally will never use and it's really dishonest to say that it's the insurance companies doing this. it's a very narrow view to blame insurance companies and it's ademocratic pollster strategy.

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Any of the NEW additions were exempt for grandfathered plans so that's a complete nonstarter and it had to be more than a $5 change unless you had below $10 in copays. Average plan that was cancelled had copay adjustments in the range of $10-15.

(I think it was 18.75% was how much the copay had to adjust to "break it"? Something ridiculous like that)

If I had the programming savvy and time I'd make a fucking web game of "Can you break this plan under ACA standards?" where you'd have the legal limits as a threshold and you had to run coverage both HIGHER AND LOWER on multiple categories in order to make it fail ACA muster. Even "just adjusting the copays" outside of the allowed range (which was technically above the legally allowed amounts if they didn't adjust other things - 5% per year was allowed, with 3 years and 18.75% being the "too much difference" limit... see the problem here?) wasn't able to happen without changing another moving part to get to the threshold, which was often increasing another benefit to ALLOW THEM TO INTENTIONALLY PUSH IT OVER THAT NUMBER.

If they literally raised copays by the max they were allowed, they could not have mathematically hit the "cutoff" point without other factors in play, it's literally impossible without it.

You guys make it try to sound like it was "Oops, we goofed - this happened" when it was obviously quite deliberate. Even one insurer went on the record in the WaPo print article I was reading yesterday stating that they INTENTIONALLY wanted to force people to the exchanges and even if they are allowed to reextend old policies they won't, because they DON'T WANT TO KEEP THEM.

Araysar_sl said:

Obama could go on live TV tomorrow, rape an infant and still win a 3rd term if one was allowed.

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Mainly because they would nominate a repulsive jackass to run against him.

tad10_sl said:

Calling plans substandard doesn't make them so - indeed many ACA plans have higher deductibles, much higher premiums and loads of bullshit like requiring maternity care coverage for men and women long past child bearing age.

Basically you guys are trying to force people to buy Escalades when they're pretty fucking happy with their Ford F150.

Pretty much everyone who uses the term "substandard" in reference to cancelled policies to justify forcing people to buy shit they don't want and/or need are dicks.

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Jesus Christ, tad10 - get a fucking 6th grader to teach you some reading comprehension skills - you literally quoted my post while clearly not reading a fucking word beyond "substandard". Those policies weren't supposed to be fucking cancelled and wouldn't have been if the insurance companies didn't tinker with them to MAKE THEM FAIL.

Predatory plans were supposed to be where the net benefit would by design always be a net loss for the consumer - but "substandard" where they're just missing minutiae like maternity coverage were not supposed to have been cancelled outside of factors in control of the insurance companies.

Hell, if you want to take Obama completely literally - I should be pissed that he cancelled my grandmother-in-law's policy when she died - she never opted out of that coverage, his statement was that "You can keep your coverage if you like it" - she loved Medicare, but now she can't know she has it anymore while she's lying in her grave even though he said you can keep it if you like it. Where is his honesty on this matter? And what about people that refuse to pay their premium? He didn't say we'd have to continue paying bills for it, why did it get cancelled when I stopped paying - I liked it, I just didn't want to pay for it...

Seriously, WTF logic do you idiots use?

IF Obama THEN... seems to be the foundation of making a programming routine to emulate you.

Araysar_sl said:

Its not a republican primary if there arent 8 utterly repulsive scumbags competing to see who can be the most dimwitted and primitive scum bucket

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And two decent guys - one that gets thrashed and another that turns into a repulsive scumbag. (At least temporarily - sometimes they later post-campaign come back to reality.... i.e. McCain)

Vaclav_sl said:

Jesus Christ, tad10 - get a fucking 6th grader to teach you some reading comprehension skills - you literally quoted my post while clearly not reading a fucking word beyond "substandard". Those policies weren't supposed to be fucking cancelled and wouldn't have been if the insurance companies didn't tinker with them to MAKE THEM FAIL.

Predatory plans were supposed to be where the net benefit would by design always be a net loss for the consumer - but "substandard" where they're just missing minutiae like maternity coverage were not supposed to have been cancelled outside of factors in control of the insurance companies.

Hell, if you want to take Obama completely literally - I should be pissed that he cancelled my grandmother-in-law's policy when she died - she never opted out of that coverage, his statement was that "You can keep your coverage if you like it" - she loved Medicare, but now she can't know she has it anymore while she's lying in her grave even though he said you can keep it if you like it. Where is his honesty on this matter? And what about people that refuse to pay their premium? He didn't say we'd have to continue paying bills for it, why did it get cancelled when I stopped paying - I liked it, I just didn't want to pay for it...

Seriously, WTF logic do you idiots use?

IF Obama THEN... seems to be the foundation of making a programming routine to emulate you.

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HHS rewrote the regulations to force the insurance companies to drop the coverage of those plans. The insurance companies had no choice but to follow those regs. Blaming the companies for something that was always intended by the design of ObamaCare is really a sad statement on your inability to accept facts. Business, especially big business, have to abide by the regulations put in place or they are not in business for very long.

The whole basis of ObamaCare is spreading out the risk among as big a pool as possible, and if the millions of people on the low cost catastrophic plans had been allowed to keep them then the cost to everyone else would go up much higher than it is already. You know that and yet you continue to spout the lies and talking point spin of this discredited administration. Ick.