ACA, Unintended Consequences, and You - [tsrblke]

Hello Horde! I’m tsrblke (that’s Lke not ike).

I’ll be your host for today’s edition of “ACA, unintended consequences and you.” Today’s edition is called “NYT buries the lede.” The NYT recently ran a story that is quite tragic about a family that took their little girl in for work on her heart. Sadly, although they had insurance, they apparently got socked with tons of “out of network charges.”

Now people will likely want to hash blame all over the place here. It’ll be said the parents should have asked more questions (although do you ask who the assisting surgeon is going to be for your operation?) Or the hospital should have ensured everyone was a participating provider (that assumes a level of coordination I have yet to see at any hospital.)

So let’s pass on the blame for a moment and ask “How is Obamacare going to mes this up?”

Conveniently, the NYT sorta tells us:

"It is conceivable that the problem gets worse for some people if the Affordable Care Act encourages narrower networks, which some people think it might do" - claims Timothy Jost, a professor at the Washington and Lee University School of Law and expert on health care laws.

Ah, some people think there will be smaller networks. Ignore that link in the quote that goes to an article saying that there are, in fact, smaller networks. That’s just crazy talk! (by the by, at least one insurer in my area won’t have the largest provider in it’s network.)

Something the NYT doesn’t discuss, but really needs to be brought up, is another odd consequence of Obamacare. As a result of the whole “Accountable Care Organizations” part of the law, hospital systems have been buying up medical practices like hotcakes. I remember being at one conference where a system VP said something akin to “we’re not sure what to do with these practices, but we keep buying them.” (I’d note that my PCP got bought out, and the integration has not gone well.)

Now, the article seems to imply that the new out of pocket maximums may help dampen the blow, but let’s grab the first plan we can find on ehealthinsurance.com. Wow, those limits for out-of-network are just crazy. Well, there goes that.

So what does this mean? Well, I’m a PhD(c) so I have no real world advice for you. But here’s the lay of the land: Insurers, who are going to have to cut costs to avoid this “adverse selection death spiral” are going to use the biggest bargaining chip they have: cutting network size to pit providers against each other. Combined with the buyout of practices by hospitals, we could be in for a wild ride. I know very little about the nuts and bolts of provider/insurer negotiations, but if you live in a town with lots of competing providers (who may even move between hospitals) you’re going to need to pay special attention to everything going on. And what if your surgeon likes to work with an anesthesiologist who’s not in your network? Then you have some really hard choices to make.

And be prepared for doing bill analyses every time you have any major work done.

Posted by: Open Blogger at 01:23 PM



Comments

1 wheeeeeeeee!!!!!

Posted by: phoenixgirl @phxazgrl at October 22, 2013 01:28 PM (8JJ6O)

2 The letter I just got from my health insurance company--cancelling my policy due to Obamacare--states:

"To keep premium costs down, we have a new network of doctors and hospitals. Our goal is to work with doctors who will offer the best care possible--at the lowest cost. This means that THE NUMBER OF DOCTORS AND HOSPITALS IN OUR NETWORK IS CHANGING. THE NUMBER OF DRUGS WE NOW COVER IS ALSO SMALLER. But don't worry, we still offer quality coverage for you and your family." (caps lock added for emphasis)

So the number of doctors, hospitals, and drugs covered are all smaller. That's definitely a narrower network.

Well done, Democrats!

Posted by: AAA at October 22, 2013 01:29 PM (hQJ+o)

3 Now people will likely want to hash blame all over the place here.

Nope, because this isn't a simple matter.

Posted by: Blacque Jacques Shellacque at October 22, 2013 01:29 PM (vd7A8)

4 The number of in-network providers to choose from has been increased from 50 to 5. Just like the chocolate rations.

Posted by: Jenny Hates Her Phone at October 22, 2013 01:31 PM (GmTxn)

5 Obama logic - I budgeted a website for $80M, it cost $600M to sell insurance to cover 20M uninsured and it doesn't work. (Insert somebody's fault here). If you took $80M and divided it by 20M that would deliver $4M per uninsured for actual medical care. Amazing detachment Obama et. al. have. Literally amazing

Posted by: Chaos, it the other dark meat at October 22, 2013 01:32 PM (oDCMR)

6 If that shutdown did nothing else..... it did cause the media to go even more batshit insane blaming the evil repubs for trying to ruin the ACA for everyone. Now those people who heard that are looking more closely at the ACA and finding out what is in it. They are also finding out that the repubs were right and the media was lying about how wonderful it would be.

Posted by: madamemayhem at October 22, 2013 01:32 PM (S2RnE)

7 About that out of pocket max..... What exactly does that mean? I called my states exchange "help" line and was told it means... well nothing. Co pays, still have to pay those regardless. Stuff not covered, pay up. So I said, I am seeing an out of pocket max of 6250 for one policy but in theory, I could pay 20K and was told yep.

Anyone know what exactly the out of pocket max really means?

Posted by: AndrewsDad at October 22, 2013 01:33 PM (C2//T)

8 We have nothing to worry about. Obama has put his top men in charge.

Top. Men.

Posted by: Cicero (@cicero) at October 22, 2013 01:34 PM (8ZskC)

9 "But FREE HEALTHCARE FOR EVERYONE! So that's great!"

- Louie and Lonnie LIV

Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea at October 22, 2013 01:34 PM (4df7R)

10 Because nothing says unintended like 1-800-F1UCKYO

Posted by: t-bird at October 22, 2013 01:34 PM (FcR7P)

11 3

Yeah, I don't know who'd be sanctimonious enough to tell parents who were dealing with a newborn in the ER that they should've comparison-shopped right then. Who thinks they'll need to figure out which pediatric cardiologist is good and in-network? Regular pediatrician, sure, but this is crazy, complex stuff.

Posted by: Jenny Hates Her Phone at October 22, 2013 01:34 PM (GmTxn)

12
Anesthesiologist? We don't need no stinkin' anesthesiologist.

Posted by: BackwardsBoy, who did not vote for this shit at October 22, 2013 01:34 PM (0HooB)

13 >>I’m tsrblke (that’s Lke not ike).

You'll always be "TaserBike" to me.

Thanks for stepping up to the plate while Ace is vacationing.

Posted by: Mindy, back from the land of huge pickup trucks at October 22, 2013 01:35 PM (ZrNcx)

14 Wait. Why did I support this shit?

Posted by: Mr. Low Information Voter at October 22, 2013 01:35 PM (8ZskC)

15 You'll always be "TaserBike" to me.

You, too? lol! I do the same thing!

Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea at October 22, 2013 01:36 PM (4df7R)

16 12

Posted by: L at October 22, 2013 01:36 PM (GmTxn)

17 Something the NYT doesn’t discuss, but really needs to be brought up, is another odd consequence of Obamacare

What "needs to be discussed" is that ChoomCare is being run by a bunch of America-hating wealth redistributionists, who are bent on funneling money to Community Organizers, terrorists and other tight buddyroos of President Historic First©.

Anyone outside of D.C. who tried a scheme like this wouldn't even get the courtesy of a trial. They'd go directly to prison.

The next president -- if there is one -- needs to grant Charles Ponzi a full posthumous pardon. The poor schmuck was a piker.

Posted by: MrScribbler at October 22, 2013 01:36 PM (kaGpp)

18
Glaring and scary.

Hospitals are buying up medical practices?

What does this mean exactly? Do they get the doctors, too?

What's the cost?

Posted by: artisanal 'ette at October 22, 2013 01:36 PM (IXrOn)

19 We're headed towards a 2 tier health care system. One for the rich and one for the rest of us. Was the old system perfect- hell no, but now they ruined it beyond all get out. And your damn right, people better be real sure who is in and who is out of their network and includes the Hospitals. And it's only going to get worse. I count myself amongst the lucky few still having Tricare.

Posted by: Nevergiveup at October 22, 2013 01:37 PM (t3UFN)

20 4 The number of in-network providers to choose from has been increased from 50 to 5. Just like the chocolate rations.
Posted by: Jenny Hates Her Phone at October 22, 2013 01:31 PM (GmTxn)

uʍop ǝpᴉsdn sᴉ plɹoʍ ǝɥʇ

Posted by: phoenixgirl @phxazgrl at October 22, 2013 01:37 PM (8JJ6O)

21 Who will be the first person to die because of this cluster%^@?

Posted by: Lester at October 22, 2013 01:37 PM (qTsuK)

22 Wait. Why did I support this shit?
Posted by: Mr. Low Information Voter


...said no LIV ever.

Posted by: t-bird at October 22, 2013 01:37 PM (FcR7P)

23 Anesthesiologist? We don't need no stinkin' anesthesiologist.


A real man only needs a shot of whisky and a bullet to clamp between his teeth.

Posted by: 404care.gov at October 22, 2013 01:37 PM (8ZskC)

24 Wow....ace apparently just left the keys to the blog on the front table.


j/k tsrblke! Good post!


Ins. broker recently told my husband that Sisters of St. Mary (SSM) (where I worked another lifetime ago) are reducing their docs from 15k to 4k.

Posted by: Tami - GO CARDS - WOOHOO!!! at October 22, 2013 01:37 PM (bCEmE)

25 Anesthesiologist? We don't need no stinkin' anesthesiologist.
Posted by: BackwardsBoy, who did not vote for this shit at October 22, 2013 01:34 PM (0HooB)



"Yeah! All I need is the doctor and whoever the nurse is who delivers the knockout juice and we're good to go."

-Publik skool edgucaded LIV

Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea at October 22, 2013 01:37 PM (4df7R)

26 >>You, too? lol! I do the same thing!
Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea at October 22, 2013 01:36 PM (4df7R)

Must be the effects of bounding on a trampoline.

Posted by: Mindy, back from the land of huge pickup trucks at October 22, 2013 01:37 PM (ZrNcx)

27 Anyone know what exactly the out of pocket max really means?
Posted by: AndrewsDad at October 22, 2013 01:33 PM (C2//T)

It means what you will have to pay before you max deductible maxs out and then your add on your co=pays up to when that maxs out if it does.

Posted by: Nevergiveup at October 22, 2013 01:38 PM (t3UFN)

28 If you took $80M and divided it by 20M that would deliver $4M per uninsured for actual medical care. Amazing detachment Obama et. al. have. Literally amazing
Posted by: Chaos, it the other dark meat at October 22, 2013 01:32 PM (oDCMR)

Actually 20m into 80, is 4, 4 dollars. I know, math right?

Posted by: Oldsailors Poet Palin/Bolton 2016 at October 22, 2013 01:38 PM (XIxXP)

29 If you want it then baby you've got it, hey bust a move.

Posted by: The Jackhole at October 22, 2013 01:39 PM (nTgAI)

30 This Post Approved for Reduced Edginess and Content

Posted by: AOSHQ Post Patrol at October 22, 2013 01:39 PM (MhA4j)

31 Anyone know what exactly the out of pocket max really means?
Posted by: AndrewsDad at October 22, 2013 01:33 PM (C2//T)

this is a stick up

Posted by: phoenixgirl @phxazgrl at October 22, 2013 01:39 PM (8JJ6O)

32 Must be the effects of bounding on a trampoline.
Posted by: Mindy, back from the land of huge pickup trucks at October 22, 2013 01:37 PM (ZrNcx)


It all becomes clear....

Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea at October 22, 2013 01:39 PM (4df7R)

33 Anyone know what exactly the out of pocket max really means?
Posted by: AndrewsDad at October 22, 2013 01:33 PM (C2//T)

this is a stick up
Posted by: phoenixgirl @phxazgrl at October 22, 2013 01:39 PM (8JJ6O)

Yup that pretty much sums it up

Posted by: Nevergiveup at October 22, 2013 01:39 PM (t3UFN)

34 Who will be the first person to die because of this cluster%^@?


Posted by: Lester
=====

Oh. we'll let you know. You can count on that, EVIL REPUBLICANS!!...!!!

Posted by: The MSM Borg Collective at October 22, 2013 01:40 PM (HjPtV)

35 Anyone know what exactly the out of pocket max really means?
Posted by: AndrewsDad at October 22, 2013 01:33 PM (C2//T)


It means you will pay it back twice before you get it.

Posted by: Oldsailors Poet Palin/Bolton 2016 at October 22, 2013 01:40 PM (XIxXP)

36 We're headed towards a 2 tier health care system. One for the rich and one for the rest of us. Was the old system perfect- hell no, but now they ruined it beyond all get out. And your damn right, people better be real sure who is in and who is out of their network and includes the Hospitals. And it's only going to get worse. I count myself amongst the lucky few still having Tricare.
Posted by: Nevergiveup


not sure if everyone everywhere else has this but n nyc, all the cool doctors require you to pay in cash, no insurance accepted. is a response to all the problems associated with hmos and stuff in the 80s and 90s.

something similar and less convenient coming down the pike thanks to obama.

Posted by: yankeefifth at October 22, 2013 01:40 PM (Z9EHQ)

37 "To keep premium costs down, we have a new network of doctors and hospitals. Our goal is to work with doctors who will offer the best care possible--at the lowest cost.


Teleconference & robotic surgery from Mumbai FTW!

Posted by: rickb223 at October 22, 2013 01:41 PM (h1D+w)

38 Nah....He's Technical Sergeant Blake.

Posted by: CharlieBrown'sDildo at October 22, 2013 01:41 PM (oJ5Fd)

39 Who will be the first person to die because of this cluster%^@?

how's the fainter and her foetus doing?

Posted by: phoenixgirl @phxazgrl at October 22, 2013 01:41 PM (8JJ6O)

40 And it's only going to get worse. I count myself amongst the lucky few still having Tricare.
Posted by: Nevergiveup


I remembered when people complained about Tricare.

Posted by: Oldsailors Poet Palin/Bolton 2016 at October 22, 2013 01:41 PM (XIxXP)

41
not sure if everyone everywhere else has this but n nyc, all the cool doctors require you to pay in cash, no insurance accepted. is a response to all the problems associated with hmos and stuff in the 80s and 90s.

something similar and less convenient coming down the pike thanks to obama.
Posted by: yankeefifth at October 22, 2013 01:40 PM (Z9EHQ)


Yup it's headed that way.

Posted by: Nevergiveup at October 22, 2013 01:41 PM (t3UFN)

42
Status report. FUBAR. Good job Dems!
Oh, and need to add. To Marco Rubio. If you are reading this. You're a traitorous piece of shit. Thanks.

Posted by: Minnfidel at October 22, 2013 01:41 PM (ixf9H)

43 Nice Bike, BUT THE CONSEQUENCE IS INTENDED.

They want the NHS baby...

Posted by: sven10077 at October 22, 2013 01:41 PM (9jfyN)

44 hey N

Posted by: yankeefifth at October 22, 2013 01:42 PM (Z9EHQ)

45 A real man only needs a shot of whisky and a bullet to clamp between his teeth.

Make that a stick, since they want to ban bullets.

Posted by: Blanco Basura at October 22, 2013 01:42 PM (4WhSY)

46 Anyone know what exactly the out of pocket max really means?


Means bend over.

Posted by: rickb223 at October 22, 2013 01:42 PM (h1D+w)

47
I remembered when people complained about Tricare.
Posted by: Oldsailors Poet Palin/Bolton 2016 at October 22, 2013 01:41 PM (XIxXP)

Family coverage for $195 a month with a $200 deductible. Go match that anywhere!

Posted by: Nevergiveup at October 22, 2013 01:42 PM (t3UFN)

48 Gee, isn't that "narrower networks" thing a problem with Medicare/aid?
Of course, things can get better when everyone is on government health care.
Of course.

Posted by: Nickshaw at October 22, 2013 01:43 PM (9Xn+t)

49 43 Nice Bike, BUT THE CONSEQUENCE IS INTENDED.

They want the NHS baby...
Posted by: sven10077 at October 22, 2013 01:41 PM (9jfyN)


i believe it's intended too

Posted by: phoenixgirl @phxazgrl at October 22, 2013 01:43 PM (8JJ6O)

50 A real man only needs a shot of whisky and a bullet to clamp between his teeth.

Make that a stick, since they want to ban bullets.
Posted by: Blanco


well, under obamacare you need at least two shots of whisky, one for the guy on the table and one for the guy standing over him so he does not get squeamish.

Posted by: yankeefifth at October 22, 2013 01:43 PM (Z9EHQ)

51 how's the fainter and her foetus doing?
Posted by: phoenixgirl @phxazgrl at October 22, 2013 01:41 PM (8JJ6O)


She used enough mousse and gel to create a functional crash helmet from her hair, so I'm sure she's fine. And a fetus is just a clump of cells, so who cares, right? Don't go treating it like a person. Then the Reichwingers win!

Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea at October 22, 2013 01:43 PM (4df7R)

52 Don't buy into this and don't get sick.

Posted by: Boss Moss the Redskin Savage at October 22, 2013 01:43 PM (ujMoa)

53 That great plan with the low premium obama was pushing yesterday in his sales pitch has a $12,000 deductible. Choke on that one

Posted by: Nevergiveup at October 22, 2013 01:44 PM (t3UFN)

54 Family coverage for $195 a month with a $200 deductible. Go match that anywhere!

keep that up, and it's quite a draw for enlistment!

Posted by: Jay in Ames at October 22, 2013 01:44 PM (i2Lsf)

55
Vets See Surge in Business as People Seeking Care Claim to be Dogs and Cats

Posted by: Future Headlines Today at October 22, 2013 01:44 PM (bkTIc)

56
I need to talk to my PCP about accepting chickens as form of payment.

Posted by: Foghorn Leghorn at October 22, 2013 01:44 PM (EGPJQ)

57 I always thought trsblke was a terminate and stay resident program for cyclists.

Posted by: SpongeBobSaget at October 22, 2013 01:44 PM (epxV4)

58 tsrblke????

Boy, they'll let anybody post around here.

Other than me, that is.

Posted by: BCochran1981 - Credible Hulk at October 22, 2013 01:44 PM (da5Wo)

59 Make that a stick, since they want to ban bullets.
Posted by: Blanco


well, with ammo shortages do you really want to waste a round?

Posted by: yankeefifth at October 22, 2013 01:44 PM (Z9EHQ)

60 In Colorado Obamacare is now called 'Broinsurance' per their really, really, responsible ad message:


http://tinyurl.com/lj57ums

Posted by: Tami - GO CARDS - WOOHOO!!! at October 22, 2013 01:45 PM (bCEmE)

61 JT Marlin upgrades Nationwide Shaman Registry Corp. to STRONG BUY

Posted by: JT Marlin at October 22, 2013 01:45 PM (8ZskC)

62 Unintended. I do not think that word means what you think it means.

Posted by: Inigo Montoya at October 22, 2013 01:45 PM (ukp+x)

63 Anyone know what exactly the out of pocket max really means?

Try H&R Block if you have a tax question.

Posted by: Chief of Just Us, John Roberts at October 22, 2013 01:45 PM (FcR7P)

64 Keep increasing the costs, limit the choices, and the only place to turn will be single payer.

It's the goal, always has been. Sebelius said that on The Daily Show, paraphrased.

Posted by: Jay in Ames at October 22, 2013 01:45 PM (i2Lsf)

65 49 PhxGrl,

the moderate wing keeps acting like we aredealing with sane, honorable people...

Posted by: sven10077 at October 22, 2013 01:45 PM (9jfyN)

66 Gee, isn't that "narrower networks" thing a problem with Medicare/aid?Of course, things can get better when everyone is on government health care.Of course.
Posted by: Nickshaw at October 22, 2013 01:43 PM (9Xn+t)


Next on the docket: requiring that all medical practices accept government-subsidized health insurance.

Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea at October 22, 2013 01:45 PM (4df7R)

67 I'm pretty sure the people who comment at the NYT live on a different planet than I do, with the possible exception of the guy who said (paraphrase): "You're bitching about spending $10K to save your daughter's life--and you're going to spend more than that on cable television before she graduates from high school."

Posted by: HeatherRadish™ at October 22, 2013 01:46 PM (/kI1Q)

68 Family coverage for $195 a month with a $200 deductible. Go match that anywhere!
Posted by: Nevergiveup at October 22, 2013 01:42 PM (t3UFN)

My last job I paid nothing. I mean 0, zilch nada. No co-pays, no drug costs, no office visits, nothing. Now that was seven years ago, I was in the union and our company sold many expensive pretty motorcycles. But still, that was not long ago. My how times have changed

Posted by: Oldsailors Poet Palin/Bolton 2016 at October 22, 2013 01:46 PM (XIxXP)

69 Other than me, that is.

Posted by: BCochran1981 - Credible Hulk at October 22, 2013 01:44 PM (da5Wo)

INNA

[Irish Need Not Apply]

Posted by: CharlieBrown'sDildo at October 22, 2013 01:46 PM (oJ5Fd)

70
36 "We're headed towards a 2 tier health care system."

More realistically, it will be a 3 tier system like Argentina.

You'll have universal, single payer used mainly by the poor and lower middle class.

Unions and tradeor business associations will have special clinics for their members, offering a better quality of service.

At the top, you will have a private group like the Swiss Medical Clinics in Argentina, which are really first class operations. Purely cash for service, but actually fairly reasonably priced.

Posted by: jwest at October 22, 2013 01:46 PM (u2a4R)

71 Yep, the FUBAR is on purpose.
It'll get so complicated, so confusing, everybody (they hope) will just say fuck it -- all the docs and nurses and aids work for the feds now.

Posted by: Flatbush Joe at October 22, 2013 01:46 PM (ZPrif)

72 47 NeverGiveUp,

I beat it with uh Humana at the Dayton Hub of Emery Worldwide

Posted by: sven10077 at October 22, 2013 01:46 PM (9jfyN)

73
Posted by: Mr. Low Information Voter at October 22, 2013 01:35 PM (8ZskC)


----
Because the dems called it "health care" not health insurance. They said everyone has a right to quality, affordable health care. The LIVs thought that "health care" meant medical care or medical treatment and were all like, "Hell yeh, everyone should be able to go the dr. or the hospital." So they voted to make "health care" meaning medical treatment more affordable. (They had noticed that their dr. bills were getting higher also.)
But that was NOT what the dems meant. They meant health insurance. And to be blunt what they REALLY meant was "We are going to destroy the private health insurance market and get single payer socialized medicine in the U.S. even if it kills you people."

What I want to know is when will someone on the Right stand up and say this bluntly without backing down or sugar coating it? Why in the bloody hell do the people on the right call it "health care" also? Do any of these people have a clue?

Posted by: madamemayhem at October 22, 2013 01:46 PM (S2RnE)

74
Out-Of-Pocket-Max

Isn't he the younger brother of Ben Dover?

Posted by: Foghorn Leghorn at October 22, 2013 01:47 PM (EGPJQ)

75 And what if your surgeon likes to work with an anesthesiologist who’s
not in your network? Then you have some really hard choices to make.


Then he can pay the anesthesiologist out of his own fucking pocket.

Posted by: Hollowpoint at October 22, 2013 01:47 PM (SY2Kh)

76 Next on the docket: requiring that all medical practices accept government-subsidized health insurance.
Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea at October 22, 2013 01:45 PM (4df7R)



I just mentioned that the other day. I asked how long until private docs go to cash only and then how long after that before the govt makes that illegal.

Posted by: BCochran1981 - Credible Hulk at October 22, 2013 01:47 PM (da5Wo)

77 Family coverage for $195 a month with a $200 deductible. Go match that anywhere!

keep that up, and it's quite a draw for enlistment!
Posted by: Jay in Ames at October 22, 2013 01:44 PM (i2Lsf)

that's "Reserve Select" for Reservists. Actually in some ways better than for Active Duty since we can go to anyone we want. But I did get a notice that they are raising it to $203 a month. Just had to smile at that

Posted by: Nevergiveup at October 22, 2013 01:47 PM (t3UFN)

78 You'll always be "TaserBike" to me.


OMG, me too. That's what happens when your nic gets too cute by half.

Posted by: Oldsailors Poet Palin/Bolton 2016 at October 22, 2013 01:48 PM (XIxXP)

79 Where it really get interesting is when you try to find specialists...

We've had this problem with TRICARE for years... case in point...

Tore an elbow Tendon... there are only Two Orthopedic Docs within 60 miles I could go to.... and although there is a HUGE Sports Medicine Group in Fresno, they will not take TRICARE...

Posted by: Screaming Liberal Skank at October 22, 2013 01:48 PM (lZBBB)

80 6 If that shutdown did nothing else..... it did cause the media to go even more batshit insane blaming the evil repubs for trying to ruin the ACA for everyone. Now those people who heard that are looking more closely at the ACA and finding out what is in it. They are also finding out that the repubs were right and the media was lying about how wonderful it would be.

Posted by: madamemayhem at October 22, 2013 01:32 PM (S2RnE)


This is EXACTLY why I thought it was a good idea to attempt to stop it at all costs.


If we stopped it we won. If we didn't stop it, we still win.


Posted by: Diogenes' Lamp at October 22, 2013 01:48 PM (bb5+k)

81

Why would anyone trust their health to the same people who provided my 'security'?

Posted by: Ambassador Stevens at October 22, 2013 01:48 PM (Pr6hk)

82

I asked my doctor about whether we were going to be moving to a cash payment system, and she started joking about the hospital wanting to buy her out. "Fuck no!" she said to the hospital, they just want to put you into their little cog-filled machine. She's athletic, hot, and smart. To smart to sit there sucking up fumes in a bureaucracy. I foresee a massive cash economy for medical care.

Posted by: imp at October 22, 2013 01:48 PM (niFY8)

83 Posted by: HeatherRadish™ at October 22, 2013 01:46 PM (/kI1Q)

The disconnect between what medical care costs and what people pay is the fundamental problem.

It's simple really....Until market forces are allowed to bear on health-care we are screwed.


Posted by: CharlieBrown'sDildo at October 22, 2013 01:48 PM (oJ5Fd)

84 INNA

[Irish Need Not Apply]
Posted by: CharlieBrown'sDildo at October 22, 2013 01:46 PM (oJ5Fd)



That's discrimination.

Which means........I'M A VICTIM!!!!!

Where's my free shit Obama?!?!?

Posted by: BCochran1981 - Credible Hulk at October 22, 2013 01:48 PM (da5Wo)

85 I need to talk to my PCP about accepting chickens as form of payment.
Posted by: Foghorn Leghorn at October 22, 2013 01:44 PM (EGPJQ)


My favorite Rodney Dangerfield bit was him talking about how he wanted to live on an old timey farm. The best line(delivered in classic Dangerfield style) was, "I wanna pay my doctor with a hog!"

I'm cracking up right now just thinking about it. NEVER fails to make me laugh.

Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea at October 22, 2013 01:48 PM (4df7R)

86 my insurance card through united health care states:

This card does not guarantee coverage. To verify benefits, view claims, or find a provider, visit the websites or call.

Posted by: phoenixgirl @phxazgrl at October 22, 2013 01:48 PM (8JJ6O)

87 Obamacare? Never heard of it

Posted by: Charlie Gibson at October 22, 2013 01:48 PM (Pr6hk)

88
Zerocare is just the fucking berries!
/moo moo ca-choo

Posted by: maddogg at October 22, 2013 01:49 PM (xWW96)

89 Posted by: artisanal 'ette at October 22, 2013 01:36 PM (IXrOn)

We had two giant hospital corporations join together. Then, this year we noticed that the hospital corporation was buying all the doctor's practices. Some of the doctors stayed on as salaried employees and some retired in disgust. One doctor was finally forced to send a letter of explanation as to why he's gone and a new doctor is there in his place. The receptionist was still there, she made sure all the patients knew the doctor was not overjoyed to sell his practice to the hospital corporation nor was he thrilled with the doctor who replaced him, although the letter spoke glowingly about said doctor. He went to another county and became a hospital administration for a different hospital corporation. He seems to have given up delivering babies.

It makes me wonder what is going on. Is it no longer feasible for a doctor to have a private practice?

Posted by: just a citizen at October 22, 2013 01:49 PM (Nx76m)

90 Keep increasing the costs, limit the choices, and the only place to turn will be single payer.

It's the goal, always has been. Sebelius said that on The Daily Show, paraphrased.


The .feralgov can't run an info website & yet people think they can run single payer?

Posted by: rickb223 at October 22, 2013 01:49 PM (h1D+w)

91 But 7.2% unemployment.

And the middle class.

And shit.

Posted by: dananjcon at October 22, 2013 01:49 PM (wmU4G)

92 I need to talk to my PCP about accepting chickens as form of payment.

My dad used to take apples. Given the price of apples these days, a bushel seems like a better payment than billing Medicaid.

Unfortunately liability insurance carriers tend to demand dollars.

Posted by: HeatherRadish™ at October 22, 2013 01:49 PM (/kI1Q)

93 Not only are they increasing the number of Doctors in your network from 50 to 5, but 2 of them are trying to learn English!

Posted by: Countrysquire at October 22, 2013 01:50 PM (LSJmV)

94 interesting fact, tsa gropes are now considered part of your annual physical!

Posted by: yankeefifth at October 22, 2013 01:50 PM (Z9EHQ)

95 INNA

[Irish Need Not Apply]


GTT.
(Gone To Texas)

Posted by: rickb223 at October 22, 2013 01:50 PM (h1D+w)

96 I asked my doctor about whether we were going to be moving to a cash payment system, and she started joking about the hospital wanting to buy her out. "Fuck no!" she said to the hospital, they just want to put you into their little cog-filled machine. She's athletic, hot, and smart. To smart to sit there sucking up fumes in a bureaucracy. I foresee a massive cash economy for medical care.
Posted by: imp at October 22, 2013 01:48 PM (niFY


Another example of the left destroying private practice. The goal is truly to destroy the private medical practice, and this is just another example of how they are doing it.

Posted by: artisanal 'ette at October 22, 2013 01:50 PM (IXrOn)

97 Tore an elbow Tendon... there are only Two Orthopedic Docs within 60 miles I could go to.... and although there is a HUGE Sports Medicine Group in Fresno, they will not take TRICARE...
Posted by: Screaming Liberal Skank at October 22, 2013 01:48 PM (lZBBB)

Not sure which Tricare you had then. But just because those DRs don't "Take" Tricare does not mean you can not use it there. You pay the DRs and Tricare will reimburse you at what ever rate they reimburse at. We have 1 DR we have to do that with. But it still works out great

Posted by: Nevergiveup at October 22, 2013 01:51 PM (t3UFN)

98 Why would anyone trust their health to the same people who provided my 'security'?
Posted by: Ambassador Stevens at October 22, 2013 01:48 PM (Pr6hk)


"Who are you?"

- LIVs

Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea at October 22, 2013 01:51 PM (4df7R)

99

Silly Democrats didn't realize I offered them a lifeline in August...

To provincial to recognize a good deal when it slaps them in the face.


Posted by: Ted Cruz at October 22, 2013 01:51 PM (Pr6hk)

100 Then you have some really hard choices to make.
=========
Take to aspirin and die quietly, comrade.

As you shuffle off, be warmed by the thoughts that those who never took a moment's care to provide for themselves will be now taken care of at your expense.

Go to sleep comfortably, for you have the gratitude of the State upon you passing.

Posted by: RoyalOil at October 22, 2013 01:52 PM (VjL9S)

101 Have you seen this?This is not a joke.


http://tinyurl.com/msf5ljm

Posted by: steevy at October 22, 2013 01:52 PM (zqvg6)

102 I'll take the hog but I've only got a raccoon for change.

Posted by: Old Doc Brown at October 22, 2013 01:52 PM (8ZskC)

103 Nothing like a "profit loophole" to bring out the quacks and shysters.

Posted by: Fritz at October 22, 2013 01:52 PM (UzPAd)

104 I'm sure the government can pass a law turning lawyers and feminist study majors into Physicians and Nurses .


Signed Dr Carlos Read My Boxers Danger

Posted by: DrDrill at October 22, 2013 01:52 PM (Z6fGK)

105 My favorite Rodney Dangerfield bit was him talking about how he wanted to live on an old timey farm. The best line(delivered in classic Dangerfield style) was, "I wanna pay my doctor with a hog!"

I'm cracking up right now just thinking about it. NEVER fails to make me laugh.Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea at October 22, 2013 01:48 PM (4df7R) -----------Imagine paying a muzzie doctor with a hog... he'd probably prefer sheep. They don't slide around as much.

Posted by: Foghorn Leghorn at October 22, 2013 01:53 PM (EGPJQ)

106 If they're planning on destroying the private health insurance industry like they say, why aren't the Pubbies saying how many good American tax-paying jobs are being lost?

Posted by: BackwardsBoy, who did not vote for this shit at October 22, 2013 01:53 PM (0HooB)

107 I just mentioned that the other day. I asked how long until private docs go to cash only and then how long after that before the govt makes that illegal.
Posted by: BCochran1981 - Credible Hulk at October 22, 2013 01:47 PM (da5Wo)


I'm honestly surprised it didn't happen years ago. Now that we've got so many Baby Boomers shifting onto Medicare and more and more people moving onto Medicaid, with fewer and fewer providers accepting either, you'll start to hear rumbling about it very soon.

Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea at October 22, 2013 01:53 PM (4df7R)

108
"Anyone know what exactly the out of pocket max really means?"

They will empty your pockets.

Posted by: Brown Line at October 22, 2013 01:54 PM (VrNoa)

109 *tabulates*


Let's see. You get a point for taking to the fourth paragraph to make a spelling error. You lose ten points for messing up mess.


That leaves you with 27 points!

I spent many many many years dealing with the minutiae of medical billing, insurance coverage and the ins and outs of network v. non-network providers. I can tell you from personal and professional experience that attempting to insure that each and every person who provides care to you is in network is impossible.


My personal favorite story is about how the largest group of anesthesiologists in the area were all listed as in network providers for the three largest insurance carriers in the area. However. However, in an incredibly common practice to muck about with malpractice limits and Medicare/Medicaid reimbursement rates and the like, the physicians were all technically working for XYZ Billing Service, LLC. Guess what entity was not an in network provider? Yeah. It took many years of multiple litigation and finally a class action suit to get the insurance company to pay the in network rates. Protip: do not freaking put in an email that you are fully aware that the LLC is not a provider but that the since the doctors want to be in network they'll still be listed that way in the documents and on the website.

Posted by: alexthechick - SMOD. Mmmm. Blondies with whipped cream. at October 22, 2013 01:54 PM (VtjlW)

110 106 If they're planning on destroying the private health insurance industry like they say, why aren't the Pubbies saying how many good American tax-paying jobs are being lost?

Posted by: BackwardsBoy, who did not vote for this shit at October 22, 2013 01:53 PM (0HooB)



Stupid. Party.

Any other questions?

Posted by: BCochran1981 - Credible Hulk at October 22, 2013 01:54 PM (da5Wo)

111 as badly as every element of obamacare is, from the way the law is written to the technology implementation, it is entirely possible the effect will be to refocus everyone's attention on the problems and inefficiencies of medical services in the US and even get some smart people wit a lot of money to offer something new and better.

if obamacare is screwing up everything so much as to increase premiums and deductibles it is an opportunity for someone to provide better services and make more money. an insurance company with a pool paying higher premiums could offer a category killer product, and not in the obama sense.

Posted by: yankeefifth at October 22, 2013 01:54 PM (Z9EHQ)

112 Then you have some really hard choices to make.
=========
Take to aspirin and die quietly, comrade.



Nah. Load up magazines & take a bunch of useless idiots with me...

Posted by: rickb223 at October 22, 2013 01:54 PM (h1D+w)

113 Unintended Consequences.

tweeting my junk seemed like a good idea at the time.

voting for Obamacare seemed like a good idea at the time

marrying Hillary's Muzzy Muff-Diver seemed like a good idea at the time

Posted by: Danger, Carlos Danger - Agent Double O Naught at October 22, 2013 01:54 PM (Pr6hk)

114 why aren't the Pubbies saying how many good American tax-paying jobs are being lost?
Posted by: BackwardsBoy, who did not vote for this shit

+++++++++++++++++++++++++++++++++

Don't be silly. Only government shutdowns cost people jobs.

Posted by: Countrysquire at October 22, 2013 01:54 PM (LSJmV)

115 My friend who lives in DC was telling me he was offered concierge medical care by his doctor. This was a new concept to me as the giant monolithic hospital corporation seems to be eating every doctor's office in its sight.

Posted by: just a citizen at October 22, 2013 01:54 PM (Nx76m)

116 Hello Horde! I’m tsrblke (that’s Lke not ike).

I lke Ike. M bke lks Ike.

Posted by: Mary Poppins' Practically Perfect Piercing at October 22, 2013 01:55 PM (zF6Iw)

117 73
Why in the bloody hell do the people on the right call it "health care" also? Do any of these people have a clue?

Posted by: madamemayhem at October 22, 2013 01:46 PM (S2RnE)


I gave up complaining about that years ago. Nobody listened.

One again, the Left sets the terms of the debate.

Posted by: rickl at October 22, 2013 01:55 PM (zoehZ)

118
the moderate wing keeps acting like we aredealing with sane, honorable people...

Posted by: sven10077 at October 22, 2013 01:45 PM (9jfyN)


And that has been pissing me off since Reagan. I can give Reagan a pardon because up till then, no one knew just how back stabby and lying were the Democrats, but after Reagan got screwed over by ole Tip O'Neal, Here comes George HW thinking that he could make a deal with them!


They rolled him like a dumbshit, and he still hasn't figured it out yet.

Posted by: Diogenes' Lamp at October 22, 2013 01:55 PM (bb5+k)

119

The goal is truly to destroy the private medical practice

The goal is to destroy the upper middle class of entrepreneurs and self-employed. The statists join with the corporatists in this goal (and use the union goons for muscle!). It is really a form a fascism. They make it impossible for a private individual to employ anyone, with all the damn byzantine regulations, and then taxation and third party payers force everyone into their bureaucratic mode.

Who'da thunk in middle age I'd become an anti-fascist kook?

Posted by: imp at October 22, 2013 01:55 PM (niFY8)

120 Gosh, the sooper smarty pants Harry Reid sure has been quiet lately.

Posted by: John the Libertarian at October 22, 2013 01:56 PM (/rhjC)

121 But I want every health care provider to be a slave of the state!

Well, them first, anyway...

Posted by: Parker at October 22, 2013 01:56 PM (YkW3i)

122 O-Care is making me healthier in one way. I'm going to the gym a lot more and working out harder.

Because G-d forbid I should need health care now.

Posted by: BlueStateRebel at October 22, 2013 01:56 PM (7ObY1)

123 Have you seen this?This is not a joke. http://tinyurl.com/msf5ljm
Posted by: steevy at October 22, 2013 01:52 PM (zqvg6)


Jesus H. Christ.

"Now that you can get Obamacare, go ahead and drink yourself to distraction! Not only do you have the money, but when you end up in the ER after running your car into a phone pole at 125MPH, you're covered!"

Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea at October 22, 2013 01:57 PM (4df7R)

124 All of this over about 5 % of the population.

Genius.

Posted by: LASue at October 22, 2013 01:57 PM (gjIQF)

125

I have a procedure to fix this, but Barry and Valerie will not enjoy the irony of it all.



Posted by: Dr Gosnell at October 22, 2013 01:57 PM (Pr6hk)

126 110 ... You seem to have this slippery Cut and Paste thingy down pat. Care to whip up a quick tutorial for the more Barrel Oriented among us ?

Posted by: ScoggDog ... LiB Party at October 22, 2013 01:57 PM (uRcOW)

127

why aren't the Pubbies saying how many good American tax-paying jobs are being lost?

Bought and paid for by corporate America, as are the Dems.

Posted by: imp at October 22, 2013 01:57 PM (niFY8)

128 It makes me wonder what is going on. Is it no longer feasible for a doctor to have a private practice?

-------

Malpractice insurance. It sucks. My dad hasn't been in private practice for ages for that, and other reasons. One of my kids' doctors doesn't take any insurance, either---stapled to every receipt is the code you use to try and get reimbursed by your insurer on your own, if you want, but doctors who can get away with it simply don't waste their time and aggravation and money (office staff doesn't code for free) on dealing with insurance.

Posted by: Jenny Hates Her Phone at October 22, 2013 01:58 PM (GmTxn)

129 The best line(delivered in classic Dangerfield style) was, "I wanna pay my doctor with a hog!"

Doc Hollywood was one of my favorite MJFox movies, before he went all Bathory in 2004.

Posted by: HeatherRadish™ at October 22, 2013 01:58 PM (/kI1Q)

130 I lke Ike. M bke lks Ike.


The Fonz and Mr. and Mrs C. were good Republicans.

If Happy Days was on nowadays, no way in hell that would happen.

Posted by: BlueStateRebel at October 22, 2013 01:58 PM (7ObY1)

131
90 "Keep increasing the costs, limit the choices, and the only place to turn will be single payer."

If we used my plan and got the deregulated free market non-catastrophic segment, we would have nurse practitioners in mall store fronts with "Broken Limbs "R" Us" signs.

It will be like Earl Scheib - We'll fix any break of any limb for $49.95.

If you've got aboil on your ass, there will be a specialty shop for that too. And anything else that ails you.

The market placewill take care of everything once weget a chance to use it.

Posted by: jwest at October 22, 2013 01:58 PM (u2a4R)

132
>>You'll always be "TaserBike" to me.<<





I read it as "Taser Blackie", but then I'm just a right-wing racist.

Posted by: Roy at October 22, 2013 01:58 PM (VndSC)

133 O-Care is making me healthier in one way. I'm going to the gym a lot more and working out harder.

Because G-d forbid I should need health care now.


You do that. Because someone needs to stay healthy & work to pay for my seriously poor life choices!!

Posted by: rickb223 at October 22, 2013 01:58 PM (h1D+w)

134 O-Care is making me healthier in one way. I'm going to the gym a lot more and working out harder.

Because G-d forbid I should need health care now.
Posted by: BlueStateRebel


of course, as with all unintended consequences, obamacare will have the effect of enabling less motivated sedentary people to be more sedentary and even less motivated. odds of obama voters making lifestyle changes to improve health are zero.

Posted by: yankeefifth at October 22, 2013 01:58 PM (Z9EHQ)

135
LIVs think of the world differently. To them:
"Out of network" means only getting one bar on their O-Phone.
"Co-pay" means not having enough on the EBT card.
"Provider" is the guy who gets smokes without the state tax.

Posted by: Foghorn Leghorn at October 22, 2013 01:59 PM (EGPJQ)

136 More "unintended consequences"...Hospitals are required to use single-dose vials of injectable meds, ostensibly to prevent medication errors and cross-contamination, but also because CMS has told them they will deny Medicare funds from the Hospital if they don't. So if your Primary Care doc is owned by the hospital, he too must use single-dose vials. Unfortunately, the HUGE number of drug shortages has made finding single-use vials VERRRRY difficult for some meds, if not impossible. Thus, if you're going to your PCP for a B-12 shot, GOOD LUCK!

Posted by: Pelosi Schmelosi at October 22, 2013 01:59 PM (Mijq/)

137 more and more people moving onto Medicaid, with
fewer and fewer providers accepting either, you'll start to hear
rumbling about it very soon.

Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea
====
I will agree with Hollowpoint on one thing - Republicans will have to come up with an ObamaCare alternative sooner rather than later. No cut and past job will pass muster with the people of this country.

Posted by: mrp at October 22, 2013 01:59 PM (HjPtV)

138
All of this over about 5 % of the population.

Genius.


And written by a guy in jail at the time. How could that not work out?

Posted by: BackwardsBoy, who did not vote for this shit at October 22, 2013 01:59 PM (0HooB)

139 131 JWest,

there'll be cheaper medical after Ogabe Weimar's the buck....

Posted by: sven10077 at October 22, 2013 01:59 PM (9jfyN)

140 You mean to say that when every sane person in the country said the cACA Obama HellCare would cost more, have higher deductibles, and provide fewer treatment options were the REAL experts and not the lying liars in the democrat party?

Well at least the medicaid rolls are swelling so we got that going for the productive citizens.

Posted by: Worlds Most Interesting Man at October 22, 2013 02:00 PM (WGm5T)

141 You seem to have this slippery Cut and Paste thingy down pat. Care to whip up a quick tutorial for the more Barrel Oriented among us ?
Posted by: ScoggDog ... LiB Party at October 22, 2013 01:57 PM (uRcOW)



1) Highlight text you want.
B) Copy
IV) Start italics [ i ]
q) Paste
11010010) Close italics [ /i ]

Posted by: BCochran1981 - Credible Hulk at October 22, 2013 02:00 PM (da5Wo)

142 Have you seen this?This is not a joke.





http://tinyurl.com/msf5ljm



Posted by: steevy at October 22, 2013 01:52 PM (zqvg6)
**The website: "do you got insurance dot com"
grammatically correct for the O-bot generation.

Posted by: dananjcon at October 22, 2013 02:00 PM (wmU4G)

143 It will be like Earl Scheib - We'll fix any break of any limb for $49.95.

Call 1-800-DOCTORB! The "B" is for "Bargains!"

Posted by: Dr. Nick Riviera, Hollywood Upstairs Medical School at October 22, 2013 02:00 PM (zF6Iw)

144 I can sympathize with the family in the NYT story; about 8 years ago, my youngest son was born with a rarecondition known as Congenital Hyperinsulism.The only hospital capable of treating this was the Children's Hospital of Philadelphia. My employer's health care provider at the time- Cigna- really went above and beyond for my family.Once they received all the information from the doctors here in NC, they waived the "out of network" proviso, and basically took care of everything.

Posted by: DaveinNC at October 22, 2013 02:00 PM (boNGU)

145 The Fonz and Mr. and Mrs C. were good Republicans.

If Happy Days was on nowadays, no way in hell that would happen.


Ritchie would be smoking pole in Arnold's bathroom & Joni would be pregnant before starting HS.

Posted by: rickb223 at October 22, 2013 02:01 PM (h1D+w)

146 You pay the DRs and Tricare will reimburse you at what ever rate they reimburse at. We have 1 DR we have to do that with. But it still works out great


Posted by: Nevergiveup at October 22, 2013 01:51 PM (t3UFN)


The Tricare rate was WAY lower than the Doctors there would take for a walkin patient... I checked... and any test I wanted done would have to be scheduled by my Primary Care Doc to get insurance approved (at least that's what they told me over the phone...).

Point is... that when you lower the reimbursement rate, which ALL of these programs do, you give your patients less choice as to Doctor....

Posted by: Romeo13 at October 22, 2013 02:02 PM (lZBBB)

147 an obamacare alternative is not so necessary as simple targeted ideas that will either undermine obamacare or enable alternative.

reforming medical malpractice laws would make private practices more viable. opening up sales across state lines. why replace one lousy idea with another, simply deregulate in certain areas to allow people to abandon obamacare easily.

Posted by: yankeefifth at October 22, 2013 02:02 PM (Z9EHQ)

148

Let's review the facts of the case

44 million people uninsured (estimated)

11 million illegals
11 million making over $75,000 / year who self-insure
11 million already qualified for medicare / medicaid
11 million actual people looking for insurance

So we have killed the insurance of tens (if not hundreds) of millions for this quickly festering abortion????

Posted by: Math B Hard at October 22, 2013 02:02 PM (Pr6hk)

149 The disconnect between what medical care costs and what people pay is the fundamental problem.

It's simple really....Until market forces are allowed to bear on health-care we are screwed.


Posted by: CharlieBrown'sDildo at October 22, 2013 01:48 PM (oJ5Fd)


As I said before, Medical "Insurance" has removed much of the market forces that would normally keep prices under control. Add to that that the supply of medical providers is limited by a state imposed monopoly, and we are quite a distance away from a fair market system.


"Insurance" is a large part of the problem. People paying their own bills would restore some of the Free Market functionality to the health care system.


Posted by: Diogenes' Lamp at October 22, 2013 02:02 PM (bb5+k)

150 What I want to know is when will someone on the Right stand up and say this bluntly without backing down or sugar coating it? Why in the bloody hell do the people on the right call it "health care" also? Do any of these people have a clue?
Posted by: madamemayhem at October 22, 2013 01:46 PM (S2RnE)




Sarah Palin has been saying this. There was an article linked here the other day where she said all this mess was a grand farce just to get people clammoring for single payer. But what's the dumb snowbilly from Alaska know anyway...

Posted by: Havedash at October 22, 2013 02:02 PM (BRhGr)

151 I just mentioned that the other day. I asked how long until private docs
go to cash only and then how long after that before the govt makes that
illegal.


Direct pay and concierge service practices have been growing at a healthy clip for years - it's red hot right now. The real beneficiaries of this clusterfuck will probably end up being credit card or other finance companies. It won't be long before medical practices will be running used-car type ads that tout their ability to finance anyone with a pulse.

Posted by: Gristle Encased Head at October 22, 2013 02:04 PM (+lsX1)

152 Personally I'm looking forward to life under BarterCare. I'm a female who has never had a child. Can I trade that for liposuction? Also, I've never had an abortion, and lets see... women are generally reproductive from ages 12 to let's say 52, and being the government, they would probably allow at least 3 abortions per year, for a total of 120 lifetime abortions. So, I'm pretty sure that the fact that I have not had any abortions at all gives me a lot of BarterCare credits, which I may use for laser eye surgery, and may bank the rest for my potential upcoming heart transplant.

Whee! Isn't the government great!

Oh, BTW, men are screwed under this system. Unless of course you say that you're a woman trapped in a mans body, and they I think they allow you 60 lifetime abortion credits since you don't actually have girl parts. But I think you may only be able to use those to purchase hormone treatments.

Posted by: shibumi at October 22, 2013 02:04 PM (25HWz)

153 As long as we're sorta on the subject tsrblke, what does your nic mean and/or stand for?

Posted by: BackwardsBoy, who did not vote for this shit at October 22, 2013 02:05 PM (0HooB)

154
Call 1-800-DOCTORB! The "B" is for "Bargains!"

***

I'm trying to imagine the new strain of 1-800-Lawyers that will arise from all this mess.

Posted by: Niedermeyer's Dead Horse at October 22, 2013 02:05 PM (DmNpO)

155
143 It will be like Earl Scheib - We'll fix any break of any limb for $49.95.

"Call 1-800-DOCTORB! The "B" is for "Bargains!"


Actually, it will be better quality and service than people get now. They will have a market-driven reason to treat you well, plus they will be specialists in that one small segment. That leads to increases in productivity through having the latest equipment and procedures.

Posted by: jwest at October 22, 2013 02:05 PM (u2a4R)

156 Crud. I've got a stomachache and a headache right now. I don't even want to think about going to the doctor, what with this 404care mess screwing the national pooch. Someone point me toward a passing rapist so I can vomit on him/her. No reason my suffering should be limited to just me, right? That's the Obammy way!

Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea at October 22, 2013 02:05 PM (4df7R)

157 As long as we're sorta on the subject tsrblke, what does your nic mean and/or stand for?

***

bless him. Hes not around. The was in draft so he didn't know when it would be published.

Posted by: Niedermeyer's Dead Horse at October 22, 2013 02:05 PM (DmNpO)

158 The Fonz and Mr. and Mrs C. were good Republicans. If Happy Days was on nowadays, no way in hell that would happen.

I don't remember whether Richie was campaigning for Stevenson in that episode. I just liked the "Ike" crack. In fact, a while back I went to Cafe Press and got an "I like Ike" sticker for my motorcycle helmet.

Posted by: Dr. Nick Riviera, Hollywood Upstairs Medical School at October 22, 2013 02:06 PM (zF6Iw)

159 The real beneficiaries of this clusterfuck will probably end up being credit card or other finance companies. It won't be long before medical practices will be running used-car type ads that tout their ability to finance anyone with a pulse.
Posted by: Gristle Encased Head at October 22, 2013 02:04 PM

-----------

Oh, hi there.

Posted by: CareCredit at October 22, 2013 02:06 PM (GmTxn)

160
I'm trying to imagine the new strain of 1-800-Lawyers that will arise from all this mess.
Posted by: Niedermeyer's Dead Horse at October 22, 2013 02:05 PM (DmNpO)

I think you will be signing legal boiler plate agreeing not to sue.

Posted by: Oldsailors Poet Palin/Bolton 2016 at October 22, 2013 02:06 PM (XIxXP)

161 Bye, Dr. Nick!

Posted by: Mary Poppins' Practically Perfect Piercing at October 22, 2013 02:06 PM (zF6Iw)

162 They rolled him like a dumbshit, and he still hasn't figured it out yet.


Appalling, that. Right, fellow conservatives?

Posted by: Marco Rubio, Schumer's Bitch at October 22, 2013 02:06 PM (8ZskC)

163
All these problems in the Clinton Administration, but we can't talk about them because disgraced former senator Ted Cruz shut down the government back in 2013.

At any rate, the best strategy for winning back the White House is a safe, moderate, electable candidate.

Won't you send $10 to help us fight?

Posted by: RNC, 2022 at October 22, 2013 02:06 PM (Ks4nX)

164 Sarah Palin has been saying this. There was an article linked here the other day where she said all this mess was a grand farce just to get people clammoring for single payer. But what's the dumb snowbilly from Alaska know anyway...

Posted by: Havedash at October 22, 2013 02:02 PM (BRhGr)



Yeah but....OHMYGODITSSARAHPALINTHATCRAZYBIMBO!!!

Very few actually take the time to listen to the content of what she's saying and then check it against the facts. Turns out, she's right quite a bit of the time.

Posted by: BCochran1981 - Credible Hulk at October 22, 2013 02:06 PM (da5Wo)

165

You wacko-birds are ignoring the fact that this is a small price to pay for the leadership of a such a set of creases

Posted by: David Brooks at October 22, 2013 02:07 PM (Pr6hk)

166 Already have to do this as I have been in a POS/PPO for years. Have had 6 operations during the last 7 years and have already had one fight over coverage--I was having knee surgery and already had the sleepy shot. The anaesthesiologist doc (in network as I had checked) told me that he was double booked so that his partner would have to finish the job. His partner was not in-network. I fought this and won. I had another operation where the guy dropped my plan the week of the operation and did not inform me--so I got balance billing. Fought that and won too. I have learned to read medical and insurance billing codes as a result and demand in network providers for all services rendered.


Posted by: wg at October 22, 2013 02:07 PM (ElPY7)

167 Any other questions?
Posted by: BCochran1981 - Credible Hulk at October 22, 2013 01:54 PM (da5Wo)



Are you feeling better?

*hides stick behind back*

Asking because I care about you as a person.

Posted by: alexthechick - SMOD. Mmmm. Blondies with whipped cream. at October 22, 2013 02:07 PM (VtjlW)

168
bless him. Hes not around. The was in draft so he didn't know when it would be published.

OK, I'll have to remember to axe him next time.

Posted by: BackwardsBoy, who did not vote for this shit at October 22, 2013 02:07 PM (0HooB)

169 Sorry to hear that you feel bad MWR. Turn that frown into a smile and you'll feel much better!

Posted by: Chad Henderson - Cockjockey at October 22, 2013 02:07 PM (LSJmV)

170 I think you will be signing legal boiler plate agreeing not to sue.

***

Never underestimate the lengths to which an attorney will go to file a suit.

Posted by: Niedermeyer's Dead Horse at October 22, 2013 02:08 PM (DmNpO)

171
Nah. Load up magazines & take a bunch of useless idiots with me...

Posted by: rickb223 at October 22, 2013 01:54 PM (h1D+w)


Nah, not useless idiots. Malignant bureaucratic overlords.

Posted by: Diogenes' Lamp at October 22, 2013 02:08 PM (bb5+k)

172 *hides stick behind back*

This is gonna be GREAT!

/flounder

Posted by: Jay in Ames at October 22, 2013 02:08 PM (i2Lsf)

173 The Tricare rate was WAY lower than the Doctors there would take for a walkin patient... I checked... and any test I wanted done would have to be scheduled by my Primary Care Doc to get insurance approved (at least that's what they told me over the phone...).

Point is... that when you lower the reimbursement rate, which ALL of these programs do, you give your patients less choice as to Doctor....
Posted by: Romeo13 at October 22, 2013 02:02 PM (lZBBB)

That is why I asked what kind of Tricare you had. Tricare Select Reserve has no primary physician and is a much better plan, weird as that seems.

Posted by: Nevergiveup at October 22, 2013 02:08 PM (t3UFN)

174 OK, I'll have to remember to axe him next time.

***

The fun part about posting is the interaction with the commenters in the post, and he missed that.

Posted by: Niedermeyer's Dead Horse at October 22, 2013 02:09 PM (DmNpO)

175 festering abortion????


Posted by: Math B Hard at October 22, 2013 02:02 PM (Pr6hk)
And, all they had to do was ask you to contribute on your IRS form like they ask for the dollar for political campaigns. Now that you see this, you'd give them a hundred bucks just to avoid this mess. And then they could send the uninsured a post card where they could check what insurer they want and it's done.
This is truly a mess like when the privacy laws came out and they would tell you you could not speak to the doctor about your own mother as you are not the designated family spokesperson. That's fine but she chose a family spokesperson who told the family to go to he two sticks as this was her area of expertise and she knew more than all of us. But then again, someone recently found out she's scheduled to inherit everything just her so this kind of stuff can be abused and not in a good way.

Posted by: just a citizen at October 22, 2013 02:09 PM (Nx76m)

176 Sorry to hear that you feel bad MWR. Turn that frown into a smile and you'll feel much better!
Posted by: Chad Henderson - Cockjockey at October 22, 2013 02:07 PM (LSJmV)


Get crotch rot and die, CHAD.

Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea at October 22, 2013 02:09 PM (4df7R)

177
Are you feeling better?

*hides stick behind back*

Asking because I care about you as a person.


*THWACK!*

Me - "Ow! Was that a bug?"

AtC - "No"

Posted by: BackwardsBoy, who did not vote for this shit at October 22, 2013 02:10 PM (0HooB)

178 http://tinyurl.com/msf5ljm
Posted by: steevy at October 22, 2013 01:52 PM...............Good grief. TeH Stooopid, it burns.

Posted by: Minnfidel at October 22, 2013 02:10 PM (ixf9H)

179 I think you will be signing legal boiler plate agreeing not to sue.

Hah! An all-inclusive pre-injury release is unenforceable because it violates public policy.

Try again. (HINT: The best you'll get is an arbitration clause that may work.)

Posted by: Cicero (@cicero) at October 22, 2013 02:10 PM (8ZskC)

180
Who'da thunk in middle age I'd become an anti-fascist kook?

Posted by: imp at October 22, 2013 01:55 PM (niFY



Who'da thunk we would once again be fighting Nazis?


Posted by: Diogenes' Lamp at October 22, 2013 02:10 PM (bb5+k)

181 Get crotch rot and die, CHAD.
Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea
+++++++++++++++++++++++++++++

Sounds like someone needs a big hug...

Posted by: Chad Henderson - Cockjockey at October 22, 2013 02:11 PM (LSJmV)

182 Are you feeling better?

*hides stick behind back*

Asking because I care about you as a person.
Posted by: alexthechick - SMOD. Mmmm. Blondies with whipped cream. at October 22, 2013 02:07 PM (VtjlW)



No. Worse actually. But that's ok because I got yelled at this morning for not calling to let my dad know "where the fuck I was". Where the fuck I was, was asleep. My wife had to shake me awake. Nevermind that it was less than 10 minutes from the time I was woken up to the time I was in the car on the way in and on the phone to dad. Nevermind all the times where they were changing out his meds and he was always late or not here and I left him the fuck alone. Oh no, nevermind that.


Why yes, yes I am bitter and pissy when I'm sick. In fact, here's a 2x4 ma'am. Just don't miss.

Posted by: BCochran1981 - Credible Hulk at October 22, 2013 02:11 PM (da5Wo)

183 170
I think you will be signing legal boiler plate agreeing not to sue.



***



Never underestimate the lengths to which an attorney will go to file a suit.

Posted by: Niedermeyer's Dead Horse at October 22, 2013 02:08 PM (DmNpO)
Patients have been signing informed consent form here forever, there are also more malpractice suits than ever before.

Posted by: just a citizen at October 22, 2013 02:11 PM (Nx76m)

184 We'll never get back to a sane system,the term"paying out of pocket" fills people with horror.The left has succeeded once again.

Posted by: steevy at October 22, 2013 02:12 PM (zqvg6)

185 Actually, it will be better quality and service than people get now. They will have a market-driven reason to treat you well, plus they will be specialists in that one small segment. That leads to increases in productivity through having the latest equipment and procedures.

--------

I have to agree on this. I've read that cosmetic surgery has gotten much cheaper and better over the years, largely because it's not covered by most insurance. Orthodontia seems, in my limited experience, to be getting cheaper and better without being covered by as many plans as other medical/dental expenses (though still more than cosmetic surgery obviously). Anecdote---my dad paid around $5K in 1995 for my braces. This year, we paid around $3K for roughly similar braces for my daughter (her wonky teeth pre-braces look exactly like my wonky pre-teen pictures; the horrible genes are always the strong ones).

Posted by: Jenny Hates Her Phone at October 22, 2013 02:12 PM (GmTxn)

186 Lol, a friend sent me this.



The left wing said they would abolish poverty


The right wing said it would abolish bureaucracy


Odin said he would abolish ice giants


Where are the ice giants?


Vote odin

Posted by: Berserker-Dragonheads Div at October 22, 2013 02:12 PM (FMbng)

187

Pre-order your copies now!

Healthcare Tourism for Dummies

Black Market Healthcare for Dummies

Bone Setting for Dummies

Home Surgery for Dummies

Self-Surgery for Dummies

Death Panel Defense Strategies for Dummies



Posted by: For Dummies Publishing at October 22, 2013 02:12 PM (Pr6hk)

188 Sounds like someone needs a big hug...
Posted by: Chad Henderson - Cockjockey at October 22, 2013 02:11 PM (LSJmV)


*uses lacrosse stick to launch Torso Sized Scorpion at Chad* Sic 'im!

Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea at October 22, 2013 02:12 PM (4df7R)

189 Hah! An all-inclusive pre-injury release is unenforceable because it violates public policy.

Try again. (HINT: The best you'll get is an arbitration clause that may work.)
Posted by: Cicero (@cicero) at October 22, 2013 02:10 PM (8ZskC)

I don't know if medical law is a seperate animal. But when I was a Tandem Master skydiver, our students signed a release and it was solid. One of my friends had a major malfucting and hit the ground at 125 with a student. Her family tried to sue. Couldn't, no lawyer would take it.

Posted by: Oldsailors Poet Palin/Bolton 2016 at October 22, 2013 02:13 PM (XIxXP)

190 The law of unintended consequences is a stone cold bitch

Posted by: Purp at October 22, 2013 02:13 PM (l5zzX)

191 Sounds like someone needs a big hug...

Posted by: Chad Henderson - Cockjockey at October 22, 2013 02:11 PM (LSJmV)


Piss off, two-arm.

Posted by: Face Sized Spider at October 22, 2013 02:14 PM (zF6Iw)

192 YAAAAY! Face Sized Spider to the rescue!

Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea at October 22, 2013 02:14 PM (4df7R)

193 Ever stop to wonder what good healthcare would cost in a world without lawyers?

Posted by: Countrysquire at October 22, 2013 02:14 PM (LSJmV)

194 My dad was an anesthesiologist. One thing I can tell you for sure is that anesthesia by an M.D. is going to become scarce and expensive. And you are playing Russian Roulette if you don't have a M.D. doing your anesthesia.

Health care cost experts love to point at anesthesia by M.D.s as an "excessive" cost in the system. Insurers love to incent surgeons and patients to use nurse anesthetists instead. It's routine now for nurses to do the anesthesia for "routine" surgeries, but believe me, there is no such thing as a routine surgery. I personally know of three people who were killed by improper dosages of anesthetics given by nurses, and another that was paralyzed by a bad spinal. My dad never made a mistake in 35 years of practice.

When I had outpatient knee surgery a few years ago I had to fight my insurance company to get them to pay for a M.D. for my anesthesia. I would have paid for it myself if necessary, but it's just bullshit for them to claim a M.D. is not medically necessary.

This will be happening with other procedures and office visits before long as well. You won't get a M.D. for anything other than surgery. It's one of the easiest ways to cut costs, and also the most dangerous.

Posted by: rockmom at October 22, 2013 02:14 PM (aBlZ1)

195

Don't worry, healthcare will get real cheap when we ban all medical waste

Posted by: EPA Administrator at October 22, 2013 02:15 PM (Pr6hk)

196 On the NYS exchange, even the Platinum plans don't cover out of network care. It's an HMO, no matter how much you pay.

Posted by: Oschisms at October 22, 2013 02:15 PM (hS/ze)

197 BC, noooooo, here, have some booze before I smack you with the board. SMACK


*THWACK!*

Me - "Ow! Was that a bug?"

AtC - "No"
Posted by: BackwardsBoy, who did not vote for this shit at October 22, 2013 02:10 PM (0HooB)



That is completely unfair. I would totes also smack you if there was a bug on you.

Posted by: alexthechick - SMOD. Mmmm. Blondies with whipped cream. at October 22, 2013 02:15 PM (VtjlW)

198 This will be happening with other procedures and office visits before long as well. You won't get a M.D. for anything other than surgery. It's one of the easiest ways to cut costs, and also the most dangerous.
Posted by: rockmom at October 22, 2013 02:14 PM (aBlZ1)


All thanks to your hero John Roberts.

Posted by: buzzion at October 22, 2013 02:15 PM (LI48c)

199 Think what ladders would cost with no lawyers.

Posted by: Boss Moss the Redskin Savage at October 22, 2013 02:15 PM (ujMoa)

200 Oh, hi there.

Posted by: CareCredit at October 22, 2013 02:06 PM (GmTxn)


Yep, Care Credit/GE, Visa, MC, AMEX, whatever. Huge deductibles give people an incentive to shop around and/or negotiate services. Shitty reimbursement rates and endless red tape give MDs an incentive to work with credit card processors over insurance companies.

Posted by: Gristle Encased Head at October 22, 2013 02:16 PM (+lsX1)

201 Tricare Select Reserve has no primary physician and is a much better plan, weird as that seems.


Posted by: Nevergiveup at October 22, 2013 02:08 PM (t3UFN)


I'll have to look into that.... but if its a good deal... its probably no longer available.... LOL... \lets his pessimism out for a walk....

Thanks though...

Posted by: Romeo13 at October 22, 2013 02:16 PM (lZBBB)

202 Ever stop to wonder what good healthcare would cost in a world without lawyers?


Wait, I'll ask.

*in tiny baby's voice*

My life!

Posted by: John Edwards at October 22, 2013 02:17 PM (8ZskC)

203 1) Highlight text you want.
B) Copy
*IV) Start italics [ i ]
**q) Paste
11010010) Close italics [ /i ]

Posted by: BCochran1981


*Preferably composed on Notepad or other simple text editor.

**After proofread, including closing tags, then paste to comment box.

Posted by: weft cut-loop at October 22, 2013 02:17 PM (cb5D2)

204 Well kids, must pick up my youngen from school. Later.

Posted by: Oldsailors Poet Palin/Bolton 2016 at October 22, 2013 02:17 PM (XIxXP)

205 56

I need to talk to my PCP about accepting chickens as form of payment.

Posted by: Foghorn Leghorn at October 22, 2013 01:44 PM

You're going to horse-trade your offspring for healthcare? Good idea.

Posted by: Lester at October 22, 2013 02:17 PM (qTsuK)

206 The law of unintended consequences is a stone cold bitch



Mr. Maths is her master.

Posted by: rickb223 at October 22, 2013 02:17 PM (h1D+w)

207 Posted by: For Dummies Publishing at October 22, 2013 02:12 PM (Pr6hk)

***

I'd like to pre-order my copy of Self-Medicating for Dummies.

Posted by: Niedermeyer's Dead Horse at October 22, 2013 02:17 PM (DmNpO)

208 "I just mentioned that the other day. I asked how long until private docs go to cash only and then how long after that before the govt makes that illegal."

It's a pipe dream. The problem is that the doctor is the least of the expenses. The doctor is independent. Everybody else, the nurses, techs, lab people, etc., are all working for the hospital, who bills you separately. Or bills your insurance separately, and you just don't see it.

People who have experience paying cash though, like me, have seen it. And the problem with this is that the hospital is losing money hand over fist with all the govt and private insurance customers, and thanks to Obamacare, those two become one and the same essentially. Medicare/caid for example pays a FRACTION of what the hospital invoices them for. Seriously. Hospital sends a bill for $1000 and the govt says, "nah, I'll pay $223.72". And yes, the margins they pay are this bad. Private insurance companies do similar things, but not this bad.

The end result? Hospital loses huge amounts of money. So to keep from going out of business they have to get money where they can. Prices go up across the board. People who pay cash are the biggest losers. My wife had some pre-term contractions and was admitted to the hospital. Our insurance didn't cover maternity, so we were cash on anything baby-related. The doctor charged us $100 for his time. We got a $13,000 bill from the hospital. About $250 for the hospital bed/room, and all the rest of it was the cost of administering a saline IV. They gave her water and it cost $12,750. I'm not exaggerating. She seriously could have just drunk some water from a cup. And no, she wasn't passed out or anything either. Awake, conscious, not in any pain whatsoever. Water.

I was livid. Still am. After much yelling they agreed to give us a cash discount of around $9,000. Gee, thanks.

Posted by: Andrew at October 22, 2013 02:17 PM (VjlMj)

209 I'd like to pre-order my copy of Self-Medicating for Dummies.
Posted by: Niedermeyer's Dead Horse at October 22, 2013 02:17 PM (DmNpO)

Shit, we could write that book.

Posted by: Oldsailors Poet Palin/Bolton 2016 at October 22, 2013 02:18 PM (XIxXP)

210 My dad was an anesthesiologist. One thing I can tell
you for sure is that anesthesia by an M.D. is going to become scarce
and expensive. And you are playing Russian Roulette if you don't have a
M.D. doing your anesthesia.





Posted by: rockmom at October 22, 2013 02:14 PM (aBlZ1)

I have a friend who is an M.D. who is an anesthesiologist. He tells me point blank, HE is the dude that keeps you alive on the table, not the surgeon.

Posted by: Berserker-Dragonheads Div at October 22, 2013 02:18 PM (FMbng)

211 I don't know if medical law is a seperate animal. But when I was a Tandem Master skydiver, our students signed a release and it was solid. One of my friends had a major malfucting and hit the ground at 125 with a student. Her family tried to sue. Couldn't, no lawyer would take it.

Posted by: Oldsailors Poet Palin/Bolton 2016 at October 22, 2013 02:13 PM (XIxXP)



What you can't sign away is negligence. If a person behaves in a negligent manner, it doesn't matter what release you signed.

That's what I remember at least.

Posted by: BCochran1981 - Credible Hulk at October 22, 2013 02:18 PM (da5Wo)

212 This will be happening with other procedures and office visits before long as well. You won't get a M.D. for anything other than surgery. It's one of the easiest ways to cut costs, and also the most dangerous. Posted by: rockmom at October 22, 2013 02:14 PM (aBlZ1)

To repeat, if it weren't for the fact that we're all (well, those of us not of the Inner Party) fucked with Barkycare, I would be very, very, coldly happy at his voters dying off because of their Little Black Jesus.

Posted by: Mary Poppins' Practically Perfect Piercing at October 22, 2013 02:18 PM (zF6Iw)

213
I'd like to pre-order my copy of Self-Medicating for Dummies.

Ten Surgeries You Can Do At Home.

Posted by: BackwardsBoy, who did not vote for this shit at October 22, 2013 02:18 PM (0HooB)

214 I'll have to look into that.... but if its a good deal... its probably no longer available.... LOL... \lets his pessimism out for a walk....

Thanks though...
Posted by: Romeo13 at October 22, 2013 02:16 PM (lZBBB)

You have to be a drilling reservist with a paid billet even if it is IAP

Posted by: Nevergiveup at October 22, 2013 02:19 PM (t3UFN)

215 I'm currently on a conference call and none of the others know I'm on. I feel like Jerry Lewis.

Posted by: Countrysquire at October 22, 2013 02:19 PM (LSJmV)

216 This will be happening with other procedures and office visits before long as well. You won't get a M.D. for anything other than surgery. It's one of the easiest ways to cut costs, and also the most dangerous.
Posted by: rockmom at October 22, 2013 02:14 PM (aBlZ1)


There seems to be this misconception in the general population that you don't need to be terribly qualified to be an anesthesiologist. Some of my work involves interacting with health profession preparation programs, and I can't tell you how many people look at the average pay scales of various medical professions and say, "Wow, anesthesiologists make that much? Why?"

I blame pop culture, where all the bad guy has to do is douse a rag with chloroform and cover the ingenue's mouth and nose with it to knock her out before dragging her back to his lair. All you have to do is look at the Russian theater hostage fiasco to see how well that kind of thinking works.

Posted by: MWR, Proud Tea(rrorist) Party Assault Hobbit Chelsea at October 22, 2013 02:19 PM (4df7R)

217 Nobody expects the unintended consequence!!!


Of course unless you actually attended that economics class you took in college, or reads news sources other than the NYT or WaPo

Posted by: Torquemada at October 22, 2013 02:19 PM (Pr6hk)

218 Does anyone remember that crazy cracker Southern sheriff in the James Bond movie The Man with the Golden Gun? In the the film, he and his wife happen to be touring the Far East at the same time Bond is chasing the bad guys, and he and his wife stop at a street bazaar and his wife points out a sculpture of an elephant and suggests they buy it. The sheriff shoots her a quizzical "are you crazy look?", spits some tobacco juice, and says, "Aww, we're Democrats!" That would never pass muster today....

Posted by: JoeyBagels at October 22, 2013 02:19 PM (IlnmK)

219 I don't remember whether Richie was campaigning for Stevenson in that episode. I just liked the "Ike" crack. In fact, a while back I went to Cafe Press and got an "I like Ike" sticker for my motorcycle helmet.


Richie was campaigning for Adlai Stevenson, but only because he had the hots for this girl who was campaigning for Stevenson. He defied his parents who were solid Ike voters.

Fonzie's entire campaign speech for Ike was, as I recall, "I like Ike. My bike likes Ike. Ayyyyyy!"

Posted by: BlueStateRebel at October 22, 2013 02:19 PM (7ObY1)

220
Seems like something called a "free market"* could solve this problem.

Of course, the Brits at one time had cash or independent doctors illegal to protect NHS. I suspect the same will happen with Odeathcare.


*no FSA, this is not a market where you get free stuff.

Posted by: Guy Mohawk at October 22, 2013 02:19 PM (ufpPl)

221 1. Destroy functioning system
2. ???
3. Profit!

Posted by: John the Libertarian at October 22, 2013 02:19 PM (/rhjC)

222 Rest assured. No matter what policy coverage you buy from whomever, no difference in the end. Eventually, when you do receive medical attention, you will pay at that time before you leave the medical facility. Because the medical practitioners will find that the federally approved insurance bureaucrats never pay out. Insurance "providers" will take in policy payments, but never pay reimbursements or fulfill their contractual agreements. How far from what's already happened is that?

And for all those who think that ACA is going to fold on its own, ONLY IN A SANE WORLD, idiots. They'll just keep raising payments due, without ever actually meeting their own contractual agreements.

The only way to get out from under ACA, aside from starving it deprived of funding, is to rescind it.

I'd love to sue Chief Justice Roberts for perpetrating fraud against every American.

Force feed ACA to Roberts, Pelosi, Reid and Obama with their "It's the Law of the Land" insider uniparty Republicans Boehner, McConnell, McCain, Graham, et al.

As with Social Security federally enforced withheld income throughout your entire life, no matter how much health insurance you buy, you'll end up getting nothing from this Ponzi insurance scheme except lost money, lost health care availability, and possible IRS confiscation of your property with you in prison. Because no matter how hard you attempt to comply, there will be a clause you failed to meet at some point. Authoritarians are already squeezing blood out of every American citizen-turnip.

Posted by: panzernashorn at October 22, 2013 02:20 PM (MhA4j)

223 I don't know if medical law is a seperate animal. But when I was a Tandem Master skydiver, our students signed a release and it was solid. One of my friends had a major malfucting and hit the ground at 125 with a student. Her family tried to sue. Couldn't, no lawyer would take it.
Posted by: Oldsailors Poet Palin/Bolton 2016 at October 22, 2013 02:13 PM (XIxXP)



Yup, that's an entirely different animal. That's assumption of risk for a highly dangerous activity in which the public policy is to say hey if you are stupid enough to throw yourself out of a perfectly fine airplane, you are stuck with the terms of the release used by the provider. Also, I would venture to guess that the reason no one would take the case is not the release but the nature of the activity. That's pretty much a textbook assumption of risk scenario.

Posted by: alexthechick - SMOD. Mmmm. Blondies with whipped cream. at October 22, 2013 02:20 PM (VtjlW)

224 My dad was an anesthesiologist. One thing I can tell you for sure is that anesthesia by an M.D. is going to become scarce and expensive. And you are playing Russian Roulette if you don't have a M.D. doing your anesthesia.


***

I have been under general anesthesia on numerous occasions and, frankly, it is far and away the scariest part of any procedure. When someone is taking away my consciousness, I want to know damned well that they can bring me back to consciousness as well.

Good enough is not good enough when it comes to anesthesia.

Posted by: Niedermeyer's Dead Horse at October 22, 2013 02:20 PM (DmNpO)

225 I'd like to pre-order my copy of Self-Medicating for Dummies.


Ten Surgeries You Can Do At Home.


The Kidney: Your Body's Own ATM!

Posted by: Mary Poppins' Practically Perfect Piercing at October 22, 2013 02:21 PM (zF6Iw)

226 Docs used to operate on a cash basis for many things. It was actually affordable and Insurance was for the big stuff. Then the Gov. decided that it needed to start mandating more coverage and it made it worse. Then the prices blew up. Why is it that nobody takes the providers to task for the amounts they charge? My little one broke her arm last year. There was nothing major about it, no surgery's etc. just your run of the mill cast. It was damn near 10K!

Posted by: Minnfidel at October 22, 2013 02:21 PM (ixf9H)

227 Nood.

Posted by: rickb223 at October 22, 2013 02:21 PM (h1D+w)

228 IRS thread up

Posted by: Niedermeyer's Dead Horse at October 22, 2013 02:22 PM (DmNpO)

229 Fonzie's entire campaign speech for Ike was, as I recall, "I like Ike. My bike likes Ike. Ayyyyyy!"

"I'm voting for Obama because <<celebrity>> is!"

Posted by: HeatherRadish™ at October 22, 2013 02:22 PM (/kI1Q)

230 "Does This Look Infected? A Beginner's Guide"

Posted by: Countrysquire at October 22, 2013 02:22 PM (LSJmV)

231
What you can't sign away is negligence. If a person behaves in a negligent manner, it doesn't matter what release you signed.

That's what I remember at least.
Posted by: BCochran1981 - Credible Hulk at October 22, 2013 02:18 PM (da5Wo)


See, I understood you could knowingly sign away negligence. I was told I could unclip my student and push him out of the plane and it would be his fault. That's what they sign going into it. I never signed one cause I was the instructor. Maybe they were FOS, anywho, gotta go, later.

Posted by: Oldsailors Poet Palin/Bolton 2016 at October 22, 2013 02:22 PM (XIxXP)

232 218
Sheriff Pepper? "Boy, you has got to be the ugliest thing I've ever seen."

Posted by: John the Libertarian at October 22, 2013 02:22 PM (/rhjC)

233
I was livid. Still am. After much yelling they agreed to give us a cash discount of around $9,000. Gee, thanks.

Posted by: Andrew at October 22, 2013 02:17 PM (VjlMj)



Have had long experience dealing with hospitals who attempt to overcharge.


Yes, they will do that at every opportunity.

Posted by: Diogenes' Lamp at October 22, 2013 02:23 PM (bb5+k)

234 I'd like to pre-order my copy of Self-Medicating for Dummies.
Posted by: Niedermeyer's Dead Horse at October 22, 2013 02:17 PM (DmNpO)

Shit, we could write that book.


Valu-Rite. That'll be $250.00 for consultation.

Posted by: rickb223 at October 22, 2013 02:23 PM (h1D+w)

235 Posted by: DaveinNC at October 22, 2013 02:00 PM (boNGU)

My son had his 3rd heart surgery (Fontan, but complicated because of dextrocardia) at CHOP and it was an unbelievably good experience, and everything was covered. Had to go there because the surgeon whi did the 1st two surgeries had retired.

I've feared that Obamacare will take care of these types of medical situations/needs by deciding that some kids aren't worth the expense (cue Ezekiel Emmanuel's rationing plans). No paperwork mess if you just don't bother doing it.

Posted by: Lizzy at October 22, 2013 02:26 PM (JRmiD)

236 have been under general anesthesia on numerous occasions and, frankly, it is far and away the scariest part of any procedure. When someone is taking away my consciousness, I want to know damned well that they can bring me back to consciousness as well.
Good enough is not good enough when it comes to anesthesia.

Posted by: Niedermeyer's Dead Horse at October 22, 2013 02:20 PM (DmNpO)

Exactly. People don't realize that all anesthetics are poisons that can kill you if the dosage is wrong, if something goes haywire with your blood gases during surgery, if your potassium level is too low before surgery, etc. A spinal anesthetic can paralyze you or cause you a lifetime of pain if the needle is off by a millimeter or the dosage is wrong.

Michael Jackson was killed by the anesthetic Propofol. On his last tour he traveled with an anesthesiologist. Dr. Murray had givenPropofol to him dozens of times with no problem, but he was a heart surgeon and not a trained anesthesiologist.

Posted by: rockmom at October 22, 2013 02:26 PM (aBlZ1)

237 We'll never get back to a sane system,the term"paying out of pocket" fills people with horror.The left has succeeded once again.

People are afraid of the prospect of paying out of pocket for good reason. Imagine someone making $50k / yr suddenly discovering that they require $200,000 of medical treatment.

Who wouldn't be worried in that scenario?

Posted by: Hollowpoint at October 22, 2013 02:26 PM (SY2Kh)

238 Buzzfeed did a funny post today about websites more popular than the healthcare site. Some of them are pleasant surprises. But makes you wonder if the libs/dems aren't on political sites but on all those porn sites.
http://tinyurl.com/k86zefj

Posted by: just a citizen at October 22, 2013 02:27 PM (Nx76m)

239 Release form law is complex and varies by state. In a few they are almost always ineffective.

Generalizations:

Adults only.

Must disclose known dangers sufficiently. Otherwise assumption of risk is impossible.

Do not commit or attempt to disclaim gross negligence.

Waivers must not violate public policy.

There are a bunch of drafting pitfalls as well. One, make sure "MAY RESULT IN INJURY OR DEATH" is featured prominently.

Posted by: Beagle at October 22, 2013 02:32 PM (sOtz/)

240 Docs used to operate on a cash basis for many things. It was actually affordable and Insurance was for the big stuff. Then the Gov. decided that it needed to start mandating more coverage and it made it worse. Then the prices blew up. Why is it that nobody takes the providers to task for the amounts they charge? My little one broke her arm last year. There was nothing major about it, no surgery's etc. just your run of the mill cast. It was damn near 10K!

Posted by: Minnfidel at October 22, 2013 02:21 PM (ixf9H)

When I was very young almost nobody had insurance. I grew up ina small town in Kentucky where people were generally poor or middle class. My dad gave people a year and sometimes more to pay his bill. He got paid in vegetables, hams, etc. One lady made him a quilt because she had no money. He regularly wrote off bills for many people. My mom did his billing at home and he didn't even have a business office.

In 1974 the IRS changed all of this. They told my dad he could no longer write off an unpaid bill unless he made at least three attempts to collect it. He could no longer barter for payment. So he had to hire a clerk, rent an office,and start hounding people. He hated it and they hated him. That same year he got hit with a frivolous malpractice suit and his practice's insurance premium went from $20k a year to $100k. (His annual income atthat point was about $60k and he had 3 kids in college.)

In two years he raised his rates by 400%.

Posted by: rockmom at October 22, 2013 02:33 PM (aBlZ1)

241 People are afraid of the prospect of paying out of pocket for good reason. Imagine someone making $50k / yr suddenly discovering that they require $200,000 of medical treatment.

Who wouldn't be worried in that scenario?

----------

That scenario is exactly what insurance is for. But people have been conditioned to avoid paying out of pocket for anything, and *that* is the big problem. Office visits, birth control, etc. are routine care and should be paid for out of pocket.

Posted by: Jenny Hates Her Phone at October 22, 2013 02:34 PM (GmTxn)

242 You won't get a M.D. for anything other than surgery. rockmom

When joint replacement surgery began, the M.D. surgeons sliced open the patient and then stepped aside for the "technical consultant" to put cut bone and insert the metallic joint. Many remote controlled surgical procedures are the norm now, with the M.D. gradually being phased out by more IT. At some point when robots/computers provide the blood analysis on the spot for diagnosis, we can anticipate medical training personnel having altered dramatically from what it is today.

New/immediate future, I wouldn't be surprised to find border medical facilities increasing in number. US M.D. private practices on the south side of the border are already established.

Posted by: panzernashorn at October 22, 2013 02:34 PM (MhA4j)

243 That scenario is exactly what insurance is for. But people have been conditioned to avoid paying out of pocket for anything, and *that* is the big problem. Office visits, birth control, etc. are routine care and should be paid for out of pocket.

Posted by: Jenny Hates Her Phone at October 22, 2013 02:34 PM (GmTxn)

What we are getting under Obamacare isn't insurance anymore at all. It is closer to a prepaid health care plan that you may or may not ever use. That's why the new policies are so bloody expensive.

If you can't price it for risk and the consumer cannot choose their level of coverage, it isn't insurance.

Posted by: rockmom at October 22, 2013 02:41 PM (aBlZ1)

244 Seattle Children's Hospital is suing the Washington state exchange because it is in-network for only two of the plans on the exchange. They are the best provider in the state for pediatric specialty care, like the kind needed by the little girl in the story. On the other hand, most of the exchange's "successful" signups are actually enrolling in medicaid, not a private plan (approx 31k of the 35k who have signed up using the exchange), and I think children's hospital is in-network for that.

Posted by: not the mama at October 22, 2013 02:42 PM (5dxeo)

245

My unanswered question …

Was HHS paying healthcare.gov developers during the shutdown ?

Posted by: Bill Gates at October 22, 2013 02:44 PM (e8kgV)

246 I always figured "tsrblke" meant taser bloke. Perhaps an English self-defence fan, or something.
OK, you are right. I still got nothing.

Posted by: Igotnothing at October 22, 2013 02:47 PM (LvQK2)

247 That scenario is exactly what insurance is for. But
people have been conditioned to avoid paying out of pocket for
anything, and *that* is the big problem. Office visits, birth control,
etc. are routine care and should be paid for out of pocket.

Posted by: Jenny Hates Her Phone at October 22, 2013 02:34 PM (GmTxn)

Another part of the problem is that costs have been so skewed by the current system (people not paying, medicare/medicaid not paying enough) that the prices of even routine procedures are completely skewed. One of my friends recently had to pay out of pocket for a urine culture, which cost $350 (that was just the lab work.. the doctor's visit was another bill). Insurance companies negotiate those prices down to something reasonable (at least under $100) but individuals don't have that ability. Regular folk can't afford to pay those kind of prices for routine care.

Posted by: not the mama at October 22, 2013 02:47 PM (5dxeo)

248 Think what ladders would cost with no lawyers.





Or a small aircraft.

Posted by: Larsen E. Whipsnade at October 22, 2013 02:52 PM (rXcBX)

249 The hospital in my town got in a dispute with Cigna and is now out of network. For an in-network hospital, I have to drive to Nashville and have.
Networks can be a bitch.

Posted by: SGT Dan at October 22, 2013 03:12 PM (jCQ+I)

250 Man, I wish I had been around to engage more here

Posted by: tsrblke PhD(c) (No Really!) at October 22, 2013 03:16 PM (GaqMa)

251 You and me both brother. I missed a good thread.

Thanks Trailer Bike!

jk

Posted by: Truck Monkey, Remembering Inconvenient Stuff at October 22, 2013 03:44 PM (32Ze2)

252
Gotta get mine in: I'm a tricky diagnosis, I never get anything normal, and most medications work backwards on me. Been that way my whole life. I've had conditions that took five doctors a year to diagnose, one of which only 3 other people in the US had. As one said, "For someone who's sick, you're pretty healthy." And I am. But once I get sick it's a nightmare for everyone, but I'm very lucky: thus far, they've all been easy to resolve (once they figure out what's wrong).
I learned a long time ago when you've got something tough, go immediately to the best whether he's in your network or not. Tell him up front you're paying cash. They almost always cut their fee by 30 or 50 percent. If you're lucky, the hospital they use for tests IS in network and those will be covered.
You'd have wound up there anyway and you can skip the four "in network" specialists and the time copays you'd have to give them to not know what's wrong with you, let alone test costs.
But that taught me: health care isn't free. Insurance doesn't insure everything. Since I wouldn't walk into my own office without being paid for being there, why should someone who went to university 3 times as long as I did be expected to?

Posted by: Biblio at October 22, 2013 04:33 PM (7o8VY)

253 Doctors and hospitals usually negotiate a fee if you have less than optimal insurance. Of course that's hard to so in an emergency.

Under TFG-Care they would have even more motivation to do so, right? Seems like nothing will happen unless it's an emergency for the next year. Who the hell knows what their coverage is?

Posted by: PJ at October 22, 2013 05:13 PM (ZWaLo)

254 Here's one reason hospitals are buying up medical practices:

My mother was hospitalized tthis past summer for her final illness. Her physician of 40 years could not attend her in the hospital. Instead, she was cared for by "hospitalists". If the term is as new to you as it was to me, a hospitalist is a doctor who is employed by the hospital. The hospital allows only its own doctors to care for patients. This was a pretty new thing for this hospital, only a couple of years as far as I know. It's a small town, so there isn't much choice of hospitals. They are the only game in town.

So what, you ask? Well, my gut tells me that when the doctor is employed by the hospital and not by the patient, the primary loyalty is to the hospital. Treatment policy ser by the business office trumps needs of the patient. I saw this borne out in my mother's case. My father and siblings thought I was nuts when I first explained my thoughts; however, within a few days, they admitted there was no other explanation for some of the medical calls that were made.

Medical care was given, but not to the level I have seen over the years from that same hospital. Her doctor was completely frozen out of her care. In a couple of particulars, the hospital did not even notify her own doctor of developments even though they assured us they would.

I don't think that hospitalists work deliberately against the patient. I just believe that their loyalties are split between the welfare of the patient they are attending and the business strategies communicated to them by their managers. A balance is struck between patient need and profitability.

Altogether, I don't like this development.

Posted by: DaveinW-S at October 22, 2013 08:53 PM (af5Zq)






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