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Thread: The health care debate thread.

  1. #181
    Sam the Sheepdog LA Ute's Avatar
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    Megan McArdle is an economist right-leaning but level-headed. She writes a lot about Obamcare. Her latest:

    There’s a reason that unions fight so hard to keep their gold-plated insurance, even making significant salary concessions to do so, and that’s because their members really want low-deductible insurance.


    U.S. cost-sharing is actually low, by international standards; just 23 percent of our private health spending comes from out-of-pocket expenditures by the consumers of health care. We like being insulated from costs, and we’re rich enough to demand it. Assuming that the Cadillac tax goes into effect (though I’m still sort of skeptical), a whole lot of those in the 80 percent category are going to lose a plan they liked because the government made it too expensive for companies to keep delivering it. Yes, of course, companies already cancel plans quite frequently. But these cancellations are going to happen all at once, because the law demanded it.


    Moreover, the people who end up in those plans won’t just be choosing them as the cost of other plans goes up; they’ll be forced into them because the other plans aren’t offered at all. They are going to be screaming mad, and Democrats should not delude themselves that they will be soothed by all the marvelous things that may then be happening in the individual market. That’s why I still think there is a good chance that this gets rolled back before it goes into effect — but that is going to create its own, not insubstantial, budget problem: The Cadillac tax is supposed to raise about $80 billion by 2023.


    And this just looks at price, not things such as provider networks, which is going to bring on a long and lasting wave of public outrage starting sometime around March of next year.
    http://www.bloomberg.com/news/2013-1...d-a-lemon.html

    "It is only with the heart that one can see rightly; what is essential is invisible to the eye."
    --Antoine de Saint-Exupery

    "Things fall apart; the centre cannot hold."
    --Yeats

    “True, we [lawyers] build no bridges. We raise no towers. We construct no engines. We paint no pictures - unless as amateurs for our own principal amusement. There is little of all that we do which the eye of man can see. But we smooth out difficulties; we relieve stress; we correct mistakes; we take up other men's burdens and by our efforts we make possible the peaceful life of men in a peaceful state.”

    --John W. Davis, founder of Davis Polk & Wardwell

  2. #182
    Sam the Sheepdog LA Ute's Avatar
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    Megan McArdle is smart:

    Obamacare’s biggest problem, as I have written, was that the architects of the law demanded an enormously ambitious software project on an impossibly hubristic deadline. Whatever slim chance this had of working was ultimately doomed — not by Republicans, but by the administration’s own paranoid and self-destructive decisions to manage a software project as if it were a top-secret campaign strategy rather than a mission-critical component of the most ambitious federal entitlement expansion in almost 50 years.

    Remember that when Cutler wrote that devastating memo, Democrats still had control of both houses of Congress. The administration failed to rectify the shortcomings he identified because it did not understand that making a program happen is very different from writing out a description of it.

    The administration did not refuse to issue key regulations and guidelines, or to announce the final number of states that would be building their own exchanges, because Republicans used secret mind-control rays or stole the notebooks they had used to write the draft memo. They delayed because they did not want Republicans to be able to tell the public about them before Barack Obama was safely re-elected to a second term.

    In other words, most of the damage was done not by lack of funding, but because the administration was either incompetent or trying to insulate itself from the perfectly ordinary, natural, legitimate and, dare I say, patriotic function of an opposition party, which is to point out to the public when the party in charge is doing something that the public wouldn’t like. Reframing “criticism of the administration” as “sabotage” deserves an Oscar for outstanding lifetime achievement in the field of political spin.
    http://www.bloomberg.com/news/2013-1...-campaign.html

    "It is only with the heart that one can see rightly; what is essential is invisible to the eye."
    --Antoine de Saint-Exupery

    "Things fall apart; the centre cannot hold."
    --Yeats

    “True, we [lawyers] build no bridges. We raise no towers. We construct no engines. We paint no pictures - unless as amateurs for our own principal amusement. There is little of all that we do which the eye of man can see. But we smooth out difficulties; we relieve stress; we correct mistakes; we take up other men's burdens and by our efforts we make possible the peaceful life of men in a peaceful state.”

    --John W. Davis, founder of Davis Polk & Wardwell

  3. #183
    Sam the Sheepdog LA Ute's Avatar
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    "It is only with the heart that one can see rightly; what is essential is invisible to the eye."
    --Antoine de Saint-Exupery

    "Things fall apart; the centre cannot hold."
    --Yeats

    “True, we [lawyers] build no bridges. We raise no towers. We construct no engines. We paint no pictures - unless as amateurs for our own principal amusement. There is little of all that we do which the eye of man can see. But we smooth out difficulties; we relieve stress; we correct mistakes; we take up other men's burdens and by our efforts we make possible the peaceful life of men in a peaceful state.”

    --John W. Davis, founder of Davis Polk & Wardwell

  4. #184
    Sam the Sheepdog LA Ute's Avatar
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    Richard Fernandez:
    Obama is waist deep in quicksand. The first rule of quicksand is not to struggle; to swim your way out. But Obama won’t. Can’t. The deeper he gets the harder he thrashes. No shame. No self control. And therefore this may end in the manner of the Beast From Hollow Mountain.”
    Plus this:

    Meanwhile the conservatives, who cannot at present account for more than half the voters, are in a strategic waiting game. At best they can consolidate the half into the nether millstone against which events may grind. The single greatest task for conservatives is to fix their own leadership problems. In so doing they must avoid the single greatest mistake Obama has made, which is to rely on fantasy. The facts, however unpalatable. The truth, no matter how bitter.
    And this from Peggy Noonan:

    People are wondering if we are seeing the end of liberalism. We are not. Liberalism, a great and storied American political tradition, will survive this. But progressivism—liberalism without blood—has been badly, deeply damaged. We are seeing the end of its first major emanation, ObamaCare.
    Last edited by LA Ute; 11-16-2013 at 01:26 PM.

    "It is only with the heart that one can see rightly; what is essential is invisible to the eye."
    --Antoine de Saint-Exupery

    "Things fall apart; the centre cannot hold."
    --Yeats

    “True, we [lawyers] build no bridges. We raise no towers. We construct no engines. We paint no pictures - unless as amateurs for our own principal amusement. There is little of all that we do which the eye of man can see. But we smooth out difficulties; we relieve stress; we correct mistakes; we take up other men's burdens and by our efforts we make possible the peaceful life of men in a peaceful state.”

    --John W. Davis, founder of Davis Polk & Wardwell

  5. #185
    Sam the Sheepdog LA Ute's Avatar
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    Walter Russell Mead:

    All this has plunged the White House into the deepest hole of the Obama presidency to date, but the biggest shock isn’t about the cruddy rollout, the kludgy law or the disingenuous sales job by which it was passed. The biggest shock and the most damning revelation came in the President’s hasty and awkward press conference when President Obama responded to a reporter’s question about his knowledge of the website’s problems:

    OK. On the website, I was not informed directly that the website would not be working as — the way it was supposed to. Ha[d] I been informed, I wouldn’t be going out saying, boy, this is going to be great. You know, I’m accused of a lot of things, but I don’t think I’m stupid enough to go around saying, this is going to be like shopping on Amazon or Travelocity, a week before the website opens, if I thought that it wasn’t going to work.
    This was eyepopping. Obamacare is the single most important initiative of his presidency. The website rollout was, as the President himself has repeatedly stated, the most important element of the law’s debut. Domestically speaking there was no higher priority for the President and his staff than getting this right. And the President is telling the world that a week before the disaster he had no idea how that website was doing.


    Reflect on that for a moment. The President of the United States is sitting in the Oval Office day after day. The West Wing is stuffed with high power aides. His political appointees sit atop federal bureaucracies, monitoring the work of the career staff around them. The President has told his core team, over and over, that the health care law and the website rollout are his number one domestic priorities.


    And with all this, neither he nor, apparently, anyone in his close circle of aides and advisors knew that the website was a disaster. Vapid, blind, idly flapping their lips; they pushed paper, attended meetings and edited memos as the roof came crashing down. It is one thing to fail; it is much, much worse not to see failure coming. There is no way to construe this as anything but a world class flop.

    "It is only with the heart that one can see rightly; what is essential is invisible to the eye."
    --Antoine de Saint-Exupery

    "Things fall apart; the centre cannot hold."
    --Yeats

    “True, we [lawyers] build no bridges. We raise no towers. We construct no engines. We paint no pictures - unless as amateurs for our own principal amusement. There is little of all that we do which the eye of man can see. But we smooth out difficulties; we relieve stress; we correct mistakes; we take up other men's burdens and by our efforts we make possible the peaceful life of men in a peaceful state.”

    --John W. Davis, founder of Davis Polk & Wardwell

  6. #186
    Sam the Sheepdog LA Ute's Avatar
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    This is a devastating political ad.


    "It is only with the heart that one can see rightly; what is essential is invisible to the eye."
    --Antoine de Saint-Exupery

    "Things fall apart; the centre cannot hold."
    --Yeats

    “True, we [lawyers] build no bridges. We raise no towers. We construct no engines. We paint no pictures - unless as amateurs for our own principal amusement. There is little of all that we do which the eye of man can see. But we smooth out difficulties; we relieve stress; we correct mistakes; we take up other men's burdens and by our efforts we make possible the peaceful life of men in a peaceful state.”

    --John W. Davis, founder of Davis Polk & Wardwell

  7. #187
    It's come to this:



    "Ninety feet between home plate and first base may be the closest man has ever come to perfection." - Red Smith

  8. #188
    Quote Originally Posted by LA Ute View Post
    This is a devastating political ad.

    Yes, it is. It's going to be difficult for the Senators who voted against the Enzi amendment now to explain their votes to the public. All of these Senators deserve to lose in the upcoming election given that they knew fully well what this was going to do to the country (see, for example, the DPHHS estimates in the CFR release for June 18, 2010) and that they chose to ignore it.

  9. #189
    This is why we do this people. This is why Obamacare is important.

    http://dooce.com/2014/01/14/someone-got-new-eyewear/

    When a presumably wealthy mommy-blogger who has a Christmas list like this, or who can afford to leave the kids behind when things just get too stressful for a quick jaunt to the east coast, or while she flies across the world on poverty tourism... but now... now she only has to pay a $25 copay versus full price to replace her daughter's broken glasses.

    It is these people who I love seeing are no longer a victim to an out of control healthcare system with robber-barrons waiting to make you fly coach at every corner.

    Apologies for the rant. Truth is if a family that couldn't afford replacement glasses can now get them or things like that, then mission accomplished with Obamacare, but I'll be honest when I say it bothers me to read of this person whining about the cost of healthcare when she lives a life of which 90% of the US population can only dream.

  10. #190
    Quote Originally Posted by sancho View Post
    So I know I upset people when I joke about it, but I'm being sincere when I ask... How do you guys find this stuff? Seriously.
    Lol -zing. I know her and her ex-husband actually. She is actually quite a funny writer and my wife follows her blog.

    Now how other people know about Kristina Basket's every move is between them and the bush they are hiding behind (although I discovered vinneedee works with the gymnasts, so he is excused but not the others).

  11. #191
    Five-O Diehard Ute's Avatar
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    Quote Originally Posted by Rocker Ute View Post
    Lol -zing. I know her and her ex-husband actually. She is actually quite a funny writer and my wife follows her blog.

    Now how other people know about Kristina Basket's every move is between them and the bush they are hiding behind (although I discovered vinneedee works with the gymnasts, so he is excused but not the others).
    Yes, he does and has for years. And some of us are friends of his, and others on the coaching staff (and former assistants who are now head coaches elsewhere)

    The alumni provide them with updates about what they're doing that they can share. They often post it on the Utah Gymnastics Facebook page as well.

  12. #192
    Quote Originally Posted by Diehard Ute View Post
    Yes, he does and has for years. And some of us are friends of his, and others on the coaching staff (and former assistants who are now head coaches elsewhere)

    The alumni provide them with updates about what they're doing that they can share. They often post it on the Utah Gymnastics Facebook page as well.
    But you have to admit there are some people out there who may have a obsession with her ranging from slightly creepy to unhealthy.
    Last edited by Rocker Ute; 01-15-2014 at 08:36 AM.

  13. #193
    Five-O Diehard Ute's Avatar
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    Quote Originally Posted by Rocker Ute View Post
    But you have to admit there are some people out there who may have a obsession with her ranging from slightly creep to unhealthy.
    Having known many gymnasts and their parents, there are a few for almost every gymnast unfortunately.

  14. #194
    So I mentioned earlier that I was one of those, "If you like your health plan we are gonna bump you off your health plan" people in Utah. We got dropped, picked up new insurance through Blue Cross. Our pediatrician was on the plan when we switched, confirmed with both the provider and the insurer. Our plan is supposed to have free flu shots with in-network providers so my wife takes our kids to get the shots with their pediatrician.

    Apparently recently they had moved to a new office about 2 blocks south of where they were. Kids get their shots and all is good... until today (two months later by the way) we get a bill for $130 (or about $43 per flu shot) with a note that the pediatrician is not in our provider network anymore because they moved two blocks south. We could have got the shots through the school or just about anywhere else for $7-10 each.

    Lovely.

    It is this sort of nonsense that gets ignored while fixing other problems that don't exist. I used to work for an insurer. Had I known they moved offices I would have warned my wife to check again because they might need to reapply for to be part of the same networks with various insurers. After working for an insurer I never understood how provider networks actually reduced costs. The insurer I worked for just had the networks to keep out competition for their parent company. It would seem to me that any insurer could say, "These are our reimbursement rates and if you meet our standardized, quantifiable and tracked quality standards (and I know they are standardized, quantified and tracked because I set the system up while there) and accept our rates, you are part of that network."

    Uhg.

  15. #195

    Toronto doctor smacks down U.S. Senate question on Canadian waitlist deaths

    http://news.nationalpost.com/2014/03...itlist-deaths/

    “On average, how many Canadian patients on a waiting list die each year? Do you know?” Republican Senator Richard Burr asked at the end of a prickly exchange with Dr. Danielle Martin, vice president of Medical Affairs at Toronto’s Women’s College Hospital.

    “I don’t, sir, but I know that there are 45,000 in America who die waiting because they don’t have insurance at all,” she said.

  16. #196
    Administrator U-Ute's Avatar
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    One of the biggest gripes I have with the ACA is the fact that it does nothing to control the real problem of rising health costs. The largest influence, based on the Time article early last year, and my own personal experience, seems to be hospital costs.

    Maryland is trying a new program which puts caps on hospital costs. It will be interesting to see where this goes:

    http://america.aljazeera.com/article...ealthcare.html

  17. #197
    Sam the Sheepdog LA Ute's Avatar
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    This ad is getting a lot of attention. My guess is that it is pretty effective.


    "It is only with the heart that one can see rightly; what is essential is invisible to the eye."
    --Antoine de Saint-Exupery

    "Things fall apart; the centre cannot hold."
    --Yeats

    “True, we [lawyers] build no bridges. We raise no towers. We construct no engines. We paint no pictures - unless as amateurs for our own principal amusement. There is little of all that we do which the eye of man can see. But we smooth out difficulties; we relieve stress; we correct mistakes; we take up other men's burdens and by our efforts we make possible the peaceful life of men in a peaceful state.”

    --John W. Davis, founder of Davis Polk & Wardwell

  18. #198
    Administrator U-Ute's Avatar
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    Quote Originally Posted by LA Ute View Post
    This ad is getting a lot of attention. My guess is that it is pretty effective.
    Effective? Probably. Truthful? Hard to say. I haven't seen any hard evidence to the claims in this political-ad which claims to be non-political. It offers no proof, just a lot of rhetoric. The last anti-Obamacare poster child the anti-Obamacare groups trotted out turned out to be a huge flop.

  19. #199

  20. #200
    Sam the Sheepdog LA Ute's Avatar
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    Quote Originally Posted by U-Ute View Post
    Effective? Probably. Truthful? Hard to say. I haven't seen any hard evidence to the claims in this political-ad which claims to be non-political. It offers no proof, just a lot of rhetoric. The last anti-Obamacare poster child the anti-Obamacare groups trotted out turned out to be a huge flop.
    It's only a 30-second ad so it's got to hit the key points. Everything in it is truthful, based on what I know. There is a response to every claim made, but Democrats do not want to get into the subject. That the source of the ad's effectiveness, IMO. It calls attention to uncomfortable subjects for those who voted for the ACA.

    "It is only with the heart that one can see rightly; what is essential is invisible to the eye."
    --Antoine de Saint-Exupery

    "Things fall apart; the centre cannot hold."
    --Yeats

    “True, we [lawyers] build no bridges. We raise no towers. We construct no engines. We paint no pictures - unless as amateurs for our own principal amusement. There is little of all that we do which the eye of man can see. But we smooth out difficulties; we relieve stress; we correct mistakes; we take up other men's burdens and by our efforts we make possible the peaceful life of men in a peaceful state.”

    --John W. Davis, founder of Davis Polk & Wardwell

  21. #201
    He who dares, wins. Damage U's Avatar
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    Quote Originally Posted by tooblue View Post
    From what I have seen as a health care worker their is a lot of truth to what this guy says. There is a ton of blame to go around for all involved from insurance companies and hospitals down to you and I. Yes, no one negotiates on price other than the government. The biggest thing that we as consumers can do is shop around. That knee pain that you've had for six months can wait another week while you shop for a cheaper MD. You don't need to run to the ER on Easter Sunday to have it looked at (true story today). For example, my father in-law needed a CT scan for kidney stones. His insurance company sent him to "their" hospital for the exam. The scan cost him $2,200. If he would have driven a little farther down the road to another hospital it would have cost him $1,500. Yet, if he would've come to the radiology clinic that I work at the cost would be $500 for he exact same exam. In fact, our radiologist read all the exam for the second hospital. Just because your doctor gives you a prescription for something doesn't mean you have to go their "guy".

  22. #202
    Quote Originally Posted by Damage U View Post
    From what I have seen as a health care worker their is a lot of truth to what this guy says. There is a ton of blame to go around for all involved from insurance companies and hospitals down to you and I. Yes, no one negotiates on price other than the government. The biggest thing that we as consumers can do is shop around. That knee pain that you've had for six months can wait another week while you shop for a cheaper MD. You don't need to run to the ER on Easter Sunday to have it looked at (true story today). For example, my father in-law needed a CT scan for kidney stones. His insurance company sent him to "their" hospital for the exam. The scan cost him $2,200. If he would have driven a little farther down the road to another hospital it would have cost him $1,500. Yet, if he would've come to the radiology clinic that I work at the cost would be $500 for he exact same exam. In fact, our radiologist read all the exam for the second hospital. Just because your doctor gives you a prescription for something doesn't mean you have to go their "guy".
    This is the hard part about being a consumer. There are certainly conditions where it pays to shop around, but there are also big advantages to staying within a system. Medicine is increasingly fragmented, and it's very difficult to keep all the contributing specialists on the same page. If the condition is complex, the value of the medical care is more a function of coordination, communication, and standardization of practices than it is of the component tests/ procedures.


    if a consumer does plan to use an alternate provider, the referring clinician should be notified so the appropriate communication takes place. You don't want to be the guy in renal failure due to CT contrast because in your referring doc's system radiology is responsible for checking your kidneys, but the outside radiology service views it as the referring doc's responsibility. You also don't want a medical history that reads like Johnny Cash's "one piece at a time", because that's going to buy the patient a repeat of all the studies.

  23. #203
    Administrator U-Ute's Avatar
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    Quote Originally Posted by Damage U View Post
    From what I have seen as a health care worker their is a lot of truth to what this guy says. There is a ton of blame to go around for all involved from insurance companies and hospitals down to you and I. Yes, no one negotiates on price other than the government. The biggest thing that we as consumers can do is shop around. That knee pain that you've had for six months can wait another week while you shop for a cheaper MD. You don't need to run to the ER on Easter Sunday to have it looked at (true story today). For example, my father in-law needed a CT scan for kidney stones. His insurance company sent him to "their" hospital for the exam. The scan cost him $2,200. If he would have driven a little farther down the road to another hospital it would have cost him $1,500. Yet, if he would've come to the radiology clinic that I work at the cost would be $500 for he exact same exam. In fact, our radiologist read all the exam for the second hospital. Just because your doctor gives you a prescription for something doesn't mean you have to go their "guy".
    I have tried this. Nobody will give me a quote. They hum and haw about unknown forces in the universe which preclude them from giving me an accurate quote.

  24. #204
    Sam the Sheepdog LA Ute's Avatar
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    "It is only with the heart that one can see rightly; what is essential is invisible to the eye."
    --Antoine de Saint-Exupery

    "Things fall apart; the centre cannot hold."
    --Yeats

    “True, we [lawyers] build no bridges. We raise no towers. We construct no engines. We paint no pictures - unless as amateurs for our own principal amusement. There is little of all that we do which the eye of man can see. But we smooth out difficulties; we relieve stress; we correct mistakes; we take up other men's burdens and by our efforts we make possible the peaceful life of men in a peaceful state.”

    --John W. Davis, founder of Davis Polk & Wardwell

  25. #205
    Sam the Sheepdog LA Ute's Avatar
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    Poor guy getting roasted:



    He pretty much earned it.

    "It is only with the heart that one can see rightly; what is essential is invisible to the eye."
    --Antoine de Saint-Exupery

    "Things fall apart; the centre cannot hold."
    --Yeats

    “True, we [lawyers] build no bridges. We raise no towers. We construct no engines. We paint no pictures - unless as amateurs for our own principal amusement. There is little of all that we do which the eye of man can see. But we smooth out difficulties; we relieve stress; we correct mistakes; we take up other men's burdens and by our efforts we make possible the peaceful life of men in a peaceful state.”

    --John W. Davis, founder of Davis Polk & Wardwell

  26. #206
    Administrator U-Ute's Avatar
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    Another problem in the ability to show around is that each provider is on a different schedule with regards to when they renegotiate contracted rates.

    I have been getting cortisone shots in my back for a pinched nerve due to a bulging disc. I went in to get a shot March and took note of the costs. When I went back to get another one in September, the cost had gone up by 15%. When I asked why, it was because the facility renegotiated their contract with my insurance company in June.

  27. #207
    http://www.msn.com/en-us/money/other...pus/ar-AAaYIHn

    From another article:

    they persist in our mass delusion: that there is some magic pot of money in the health-care system, which can be painlessly tapped to provide universal coverage without dislocating any of the generous arrangements that insured people currently enjoy. Just as there are no leprechauns, there is no free money at the end of the rainbow; there are patients demanding services, and health-care workers making comfortable livings, who have built their financial lives around the expectation that those incomes will continue. Until we shed this delusion, you can expect a lot of ranting and raving about the hard truths of the real world.
    "Be a philosopher. A man can compromise to gain a point. It has become apparent that a man can, within limits, follow his inclinations within the arms of the Church if he does so discreetly." - The Walking Drum

    "And here’s what life comes down to—not how many years you live, but how many of those years are filled with bullshit that doesn’t amount to anything to satisfy the requirements of some dickhead you’ll never get the pleasure of punching in the face." – Adam Carolla

  28. #208
    Quote Originally Posted by Mormon Red Death View Post
    I paid an additional 1400 in medicare tax and was required to fill out some new tax form related to this additional money (Form 57something). In essence, my takes sneakily went up without me knowing about it. I have an undergraduate accounting degree, an MBA and a JD and I don't understand what this new tax is.

  29. #209
    Quote Originally Posted by Two Utes View Post
    I paid an additional 1400 in medicare tax and was required to fill out some new tax form related to this additional money (Form 57something). In essence, my takes sneakily went up without me knowing about it. I have an undergraduate accounting degree, an MBA and a JD and I don't understand what this new tax is.
    the place where I work

    2013 Premium Taxes and Reg Fees $76 Million
    2014 Premium Taxes and Reg Fees $251 Million (All due to the ACA)

    We posted our first loss in 20+ years due to the Tax bill. Not coincidentally my bonus went with those taxes.
    Last edited by Mormon Red Death; 04-14-2015 at 11:57 AM.
    "Be a philosopher. A man can compromise to gain a point. It has become apparent that a man can, within limits, follow his inclinations within the arms of the Church if he does so discreetly." - The Walking Drum

    "And here’s what life comes down to—not how many years you live, but how many of those years are filled with bullshit that doesn’t amount to anything to satisfy the requirements of some dickhead you’ll never get the pleasure of punching in the face." – Adam Carolla

  30. #210
    Quote Originally Posted by Mormon Red Death View Post
    the place where I work

    2013 Premium Taxes and Reg Fees $76 Million
    2014 Premium Taxes and Reg Fees $251 Million (All due to the ACA)

    We posted our first loss in 20+ years due to the Tax bill. Not coincidentally my bonus went with those taxes.
    Somebody is supposed to swoop in now and tell you this didn't actually happen.

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