Beauty

[Gooday]

On 3/27/2015 stray770 said: The problem with ACA is that the middle class is again taking the burden of cost. For those in the upper percentile, it doesn't matter... For those with a modest income, well, they make out best. I disagree that the US does not have the best health care in the world. People come here for care, including our neighbors in Canada. The problem is the access to care and pretty soon, people of middle income, will not be able to afford the premiums and yet, have too much income to be eligible for ACA or Medicaid nor do they want it. The government can not handle anything efficiently and I don't want them nosing about in my health care. Another big issue is your right to privacy, once the government is involved you can kiss that good bye....every government database is linked and we do know how efficient their websites and systems work....some people were helped especially if they had pre existing conditions and everyone should have insurance...but, it has to be done right and not at a cost to middle income families or the most vulnerable in our society, those on Medicare. Government involvement + loss of the middle class is socialism.

Well stated.

[Gooday]

On 3/27/2015 CouponQueen said:

Not going to quote a ton of posts.

I agree with the poster on flat tax for ALL..do away with all IRS forms - deductions etc..ONE flat tax for EVERYBODY..that way everybody is paying their share and share some of the responsiblity of filling the gov't coffers for programs etc.

The middle class get hit no matter what..Not wealthy to have huge corp write offs..not poor enough to sign up for every free resource out there..and want more! Flat tax everybody shares the cost..!

Nothing is going to work here in the USA as our medical is for profit..and with for profit comes the expectation obviously to MAKE money..

I do believe we have great health care..procedures..technonlogy...knowledge it is obtaining it and affording it that is the issue..the reimbursement rates for Medicaid and Medicare as so low MDs cannot afford to have too many ..which is why they had a limit.

Practices cost huge amounts of money alone..with the biggest being insurance..then you need quality support staff..who know their job..you may think it is "only the receptionist but she is the first person you see - you need to have a professional knowledgeable person ..and then it just goes to the RN..the billing dept...etc.. The Billing Dept or person who codes is very important and one simple number off on the code can mean huge costly errors.

Thank you, thank you! The billing and coding gal I worked with for years is going to out of a job next month. My former boss has chosen to become a paid employee of the hospital. The hospital has it's own billing dept. She worked for him for 15 years. She is 66 years old and fortunately, it will not effect her financially. However, this is NOT HER DECISION. The M.A. will also be out of a job because of this and the Office Manager/R.N. will get half her pay and the doctor will have to pay out of his own pocket her other half. She is also 66 and contemplating retirement.

The coding/procedure numbers have changed with added numbers and offices are having a difficult time keeping up.

It is a hot mess for sure. Open up your pocketbooks people, your options are dwindling.

[suzyQ3]

We can post anecdotal experiences on either side till the cows come home. It doesn't change the facts.

From Ronald Brownstein, an esteemed analyst who is a regular contributor to the LAT:

This hostility to the ACA has become impervious to contrary evidence. Like all major federal legislation, the law has exhibited flaws and produced unintended consequences. But, by any reasonable accounting, it is contributing to an array of positive healthcare trends.

Since O*ama signed the law, the number of Americans lacking health insurance has declined by 16.4 million. That’s fewer than advocates hoped, but it has still reduced the share of uninsured Americans by more than one-third. In a 2014 survey by the nonpartisan Commonwealth Fund, three-fourths of the newly insured said they were satisfied with their coverage. And 14 million fewer adults in 2014 than 2012 said they deferred needed care because they couldn’t afford it, the survey found.

From 2011to 2013, federal figures show, per capita health expenditures grew at the slowest rate ever recorded. Although cost growth ticked up in 2014, largely because of rising drug expenses, the long-term trends remain promising. “It’s hard to be wildly optimistic,” says Len Nichols, director of George Mason University’s Center for Health Policy Research and Ethics, “but I do think we’ve bent the [cost] curve, and there is momentum in our direction.” Premiums for employer-provided insurance rose nearly 40% less from 2011to 2014 than they had in the previous three years. In the ACA exchanges, premiums increased minimally in year two, largely because 25% more insurers participated. The exchange markets “show significant stability,” says Caroline Pearson, senior vice president of consulting firm Avalere Health.

Total cost estimates for implementing the ACA have plummeted. At the same time, quality is improving: Studies have found steady declines in both hospital-acquired illnesses and hospital readmissions since the law’s passage. In states that expanded Medicaid, doctors are diagnosing more diabetes cases early, too — ensuring cost-savings and better health later.

The law isn’t solely responsible for these trends. But with provisions that range from penalizing hospitals for substandard care to rewarding coordination between doctors, it has accelerated a critical shift toward linking physician compensation to the standard — not just the volume — of care. The law’s initial experiences offer promise that expanding access, restraining costs and improving quality can be complementary, even reinforcing, goals.

In a rational political system, Americans would be debating how to improve the law and smooth its inevitable bumps (like overly restrictive coverage networks). Instead, we remain trapped in a theoretical debate increasingly disconnected from the law’s actual impact. The ACA’s survival beyond President O*ama may depend on whether ideology or Americans’ experience with the law counts more in deciding its fate.

[VioletEyes]

On 3/27/2015 suzyQ3 said:

We can post anecdotal experiences on either side till the cows come home. It doesn't change the facts.

From Ronald Brownstein, an esteemed analyst who is a regular contributor to the LAT:

This hostility to the ACA has become impervious to contrary evidence. Like all major federal legislation, the law has exhibited flaws and produced unintended consequences. But, by any reasonable accounting, it is contributing to an array of positive healthcare trends.

Since O*ama signed the law, the number of Americans lacking health insurance has declined by 16.4 million. That’s fewer than advocates hoped, but it has still reduced the share of uninsured Americans by more than one-third. In a 2014 survey by the nonpartisan Commonwealth Fund, three-fourths of the newly insured said they were satisfied with their coverage. And 14 million fewer adults in 2014 than 2012 said they deferred needed care because they couldn’t afford it, the survey found.

From 2011to 2013, federal figures show, per capita health expenditures grew at the slowest rate ever recorded. Although cost growth ticked up in 2014, largely because of rising drug expenses, the long-term trends remain promising. “It’s hard to be wildly optimistic,” says Len Nichols, director of George Mason University’s Center for Health Policy Research and Ethics, “but I do think we’ve bent the [cost] curve, and there is momentum in our direction.” Premiums for employer-provided insurance rose nearly 40% less from 2011to 2014 than they had in the previous three years. In the ACA exchanges, premiums increased minimally in year two, largely because 25% more insurers participated. The exchange markets “show significant stability,” says Caroline Pearson, senior vice president of consulting firm Avalere Health.

Total cost estimates for implementing the ACA have plummeted. At the same time, quality is improving: Studies have found steady declines in both hospital-acquired illnesses and hospital readmissions since the law’s passage. In states that expanded Medicaid, doctors are diagnosing more diabetes cases early, too — ensuring cost-savings and better health later.

The law isn’t solely responsible for these trends. But with provisions that range from penalizing hospitals for substandard care to rewarding coordination between doctors, it has accelerated a critical shift toward linking physician compensation to the standard — not just the volume — of care. The law’s initial experiences offer promise that expanding access, restraining costs and improving quality can be complementary, even reinforcing, goals.

In a rational political system, Americans would be debating how to improve the law and smooth its inevitable bumps (like overly restrictive coverage networks). Instead, we remain trapped in a theoretical debate increasingly disconnected from the law’s actual impact. The ACA’s survival beyond President O*ama may depend on whether ideology or Americans’ experience with the law counts more in deciding its fate.

Thank you for a factual post. Some of these posts made me just sit here and SMH. Knowledge is power and apparently some just want to make this into a contest to see who can post the most outrageous and bogus information.

[LTT1]

A doctor "dumped" me about four years ago... he had been my doctor for 20 or more years. When the next doctor asked me "why?" I said I was mystified... didn't know. The doctor looked down and muttered "he must have attended the seminar."

Which seminar? Apparently one in the area which instructed physicians to "dump" their least actual $$ produced vs time spent on this patient. I supposed I was high maintenance... ?? This happened before the ACA, but since that time, I have heard of the doctors who require a $1500.00 payment (outside of insurance) to maintain a patient. One doctor promised to be available by cell phone 24/7 as part of the "package deal." ACA is just their excuse. Private insurance is not any more lucrative for them, IMO.

[LeaLeander]

On 3/26/2015 Icegoddess said:

On 3/26/2015 Cinder63 said:

On 3/26/2015 Icegoddess said:

On 3/26/2015 jackthebear said:

On 3/26/2015 Icegoddess said:

Not defending the insurance companies because I think they are a lot of the problem, but the ACA tells the insurance companies all sorts of things they MUST cover that maybe they weren't covering before depending on what plan you have. I have no need for pediatric or obstetric coverage (including pediatric dental and optical) but it must be included in my plan. Yet, I have to get separate plans for dental and optical for myself (and they aren't any good anymore). Also, remember the insurance companies are having to cover all those people with pre-existing conditions so those of us that are healthy are subsidizing the coverage for those that have a lot of expenses.

My daughter has run into this issue with her son's ADHD doctor changing over to cash only.

I don't have a huge issue with the dental coverage being mandatory, as there are kids who don't get to the dentist at all, and good teeth are very important.

And as for dental and optical insurance we have never had any.

I don't have children at home, so I don't see why I need pediatric dental or optical. I also don't need obstetric care but have to have that too.

Because that's how insurance pools work.

If pools were sliced and diced so that, for example, only people your age, s*x and with your particular medical conditions/hereditary risks were in the pool, you would be in for an extremely rude awakening when it came to premiums.

In a pool, young pay for old, old pay for fertile, healthy pay for sick, etc.

I'm not interested in an insurance pool. That's the point. For pediatric care, that is what a Family Plan is for. Plus, the promise was that costs would go down, but instead mine went up, way up even though I had obstetric coverage before. $6000 deductible? I don't use $6000 in medical care a year, so it is actually a deterrent to going to the doctor. I don't want to pay for other people and I don't expect other people to pay for me.

I simply don't know what to say to this kind of ignorance about how the world works. Insurance IS risk pools. You cannot purchase insurance "just for yourself."

Costs did go down for many people. Those whose costs went up are probably in an age range where they are a bigger liability to insurers and now are being charged more fairly for the burden they place on the system.

[Mj12]

On 3/27/2015 suzyQ3 said:

We can post anecdotal experiences on either side till the cows come home. It doesn't change the facts.

From Ronald Brownstein, an esteemed analyst who is a regular contributor to the LAT:

This hostility to the ACA has become impervious to contrary evidence. Like all major federal legislation, the law has exhibited flaws and produced unintended consequences. But, by any reasonable accounting, it is contributing to an array of positive healthcare trends.

Since O*ama signed the law, the number of Americans lacking health insurance has declined by 16.4 million. That’s fewer than advocates hoped, but it has still reduced the share of uninsured Americans by more than one-third. In a 2014 survey by the nonpartisan Commonwealth Fund, three-fourths of the newly insured said they were satisfied with their coverage. And 14 million fewer adults in 2014 than 2012 said they deferred needed care because they couldn’t afford it, the survey found.

From 2011to 2013, federal figures show, per capita health expenditures grew at the slowest rate ever recorded. Although cost growth ticked up in 2014, largely because of rising drug expenses, the long-term trends remain promising. “It’s hard to be wildly optimistic,” says Len Nichols, director of George Mason University’s Center for Health Policy Research and Ethics, “but I do think we’ve bent the [cost] curve, and there is momentum in our direction.” Premiums for employer-provided insurance rose nearly 40% less from 2011to 2014 than they had in the previous three years. In the ACA exchanges, premiums increased minimally in year two, largely because 25% more insurers participated. The exchange markets “show significant stability,” says Caroline Pearson, senior vice president of consulting firm Avalere Health.

Total cost estimates for implementing the ACA have plummeted. At the same time, quality is improving: Studies have found steady declines in both hospital-acquired illnesses and hospital readmissions since the law’s passage. In states that expanded Medicaid, doctors are diagnosing more diabetes cases early, too — ensuring cost-savings and better health later.

The law isn’t solely responsible for these trends. But with provisions that range from penalizing hospitals for substandard care to rewarding coordination between doctors, it has accelerated a critical shift toward linking physician compensation to the standard — not just the volume — of care. The law’s initial experiences offer promise that expanding access, restraining costs and improving quality can be complementary, even reinforcing, goals.

In a rational political system, Americans would be debating how to improve the law and smooth its inevitable bumps (like overly restrictive coverage networks). Instead, we remain trapped in a theoretical debate increasingly disconnected from the law’s actual impact. The ACA’s survival beyond President O*ama may depend on whether ideology or Americans’ experience with the law counts more in deciding its fate.

Thank you for posting the facts. I hope everyone will read your post.

[Mj12]

On 3/27/2015 Cinder63 said:

On 3/26/2015 Icegoddess said:

On 3/26/2015 Cinder63 said:

On 3/26/2015 Icegoddess said:

On 3/26/2015 jackthebear said:

On 3/26/2015 Icegoddess said:

Not defending the insurance companies because I think they are a lot of the problem, but the ACA tells the insurance companies all sorts of things they MUST cover that maybe they weren't covering before depending on what plan you have. I have no need for pediatric or obstetric coverage (including pediatric dental and optical) but it must be included in my plan. Yet, I have to get separate plans for dental and optical for myself (and they aren't any good anymore). Also, remember the insurance companies are having to cover all those people with pre-existing conditions so those of us that are healthy are subsidizing the coverage for those that have a lot of expenses.

My daughter has run into this issue with her son's ADHD doctor changing over to cash only.

I don't have a huge issue with the dental coverage being mandatory, as there are kids who don't get to the dentist at all, and good teeth are very important.

And as for dental and optical insurance we have never had any.

I don't have children at home, so I don't see why I need pediatric dental or optical. I also don't need obstetric care but have to have that too.

Because that's how insurance pools work.

If pools were sliced and diced so that, for example, only people your age, s*x and with your particular medical conditions/hereditary risks were in the pool, you would be in for an extremely rude awakening when it came to premiums.

In a pool, young pay for old, old pay for fertile, healthy pay for sick, etc.

I'm not interested in an insurance pool. That's the point. For pediatric care, that is what a Family Plan is for. Plus, the promise was that costs would go down, but instead mine went up, way up even though I had obstetric coverage before. $6000 deductible? I don't use $6000 in medical care a year, so it is actually a deterrent to going to the doctor. I don't want to pay for other people and I don't expect other people to pay for me.

I simply don't know what to say to this kind of ignorance about how the world works. Insurance IS risk pools. You cannot purchase insurance "just for yourself."

Costs did go down for many people. Those whose costs went up are probably in an age range where they are a bigger liability to insurers and now are being charged more fairly for the burden they place on the system.

Absolutely.

[kitty60]

I would just like to know the true cost of health care. I pay my own premium on high deductible and don't use insurance often. I have to have a test done next week and when scheduling she was trying to figure out so the insurance would pay. In the end I said it really didn't matter as I will have to pay as I (fortunately) never meet my deductible. She then told me the insurance cost but if they could arrange to set my up as a CASH customer it would be less! Still working on this. I guess it's not as easy as it sounds.

[LTT1]

My mother once said..."This health insurance stuff is bad news." I was young, she was a thinker, so I asked why? She said "because we lose the ability as patients to dictate our wishes for medical care through where we take our dollars." I think I can see now where she was "coming from."

The question is this: what can we as consumers of health care now do to correct some of the practices we don't like? Maybe there is no answer for this question.