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1  General Politics / U.S. General Discussion / Re: Subsidies through Healthcare.gov may be illegal. on: July 22, 2014, 05:28:46 pm
I won't comment on the decision because I don't know enough about the law to comment intelligently.

That being said, the consequences of this being upheld by the supreme court would be devastating. This would in effect lead to many more healthy people not joining plans, leading to a sicker pool of patients signing up for ACA plans, leading to higher and higher premiums. While some conservatives who live in their mom's basements and don't interact with the real world will be ecstatic, this decision would unnecessarily hurt a lot of people.

There are a lot of problems with the ACA, and I have outlined some myself and been accused of posting clickbait, but the subsidies are not it. Whoever came up with this challenge is an ideologue whose only concern is defeating Obama, not upholding the constitution or creating better public policy. The ACA is the law of the land and businesses have adjusted to it. There are many ways of making the law better but destroying it creates more uncertainty and hurts the economy.
2  General Politics / U.S. General Discussion / Re: Obamacare enrollees having trouble finding specialists on: July 20, 2014, 06:01:11 pm
I never said that all plans by one insurer have the same network. BlueCross of TN has several, and I believe all of them are available on the exchange. My point, and I don't think you get this, is that my network is shared with other insured people and not all of them bought their policies on the exchanges. There are people who have their policies sponsored by their employers who have the exact same network I do. There is no such thing as an Obamacare network. But even if there were, it would be incumbent on you to mathmatically demonstrate that the problems are substantially more severe than for the same population, many of whom had no legit insurance at all, before the ACA. Otherwise, your headline may as well say "Chinese people having trouble finding specialists." In some cases, it may be literally true because it's an issue for everybody, but there is a profoundly misleading issue of connectivity implied.

Sigh. Some plans are narrow network and some are not. I don't understand why this is so hard for you to get, although I should not be surprised. Even BCBST, who you say is your insurer, has a P network and a S network.

And before you say both networks are available on the exchange, in order to get the better network one must pay more. My point is that even the cheapest plans on the exchange with the crappy network has a high premium and high deductible.
And this is different than employer sponsered plans because? Restrictive networks are an issue. I agree with you on that. My concern is that you are suggesting it's a problem primarily for the "Obamacare" crowd. Many employers also give a few options with different (subsidized) prices for insurance, even if they are within the same insurer. Before the exchanges were in operation, I had a policy that I bought individually and I also had to choose my network carefully then. What is the specific connection between the ACA and the network issue? 

It's not a good value considering the premium, especially for the young.
3  General Politics / U.S. General Discussion / Re: Obamacare enrollees having trouble finding specialists on: July 19, 2014, 10:57:29 pm
I never said that all plans by one insurer have the same network. BlueCross of TN has several, and I believe all of them are available on the exchange. My point, and I don't think you get this, is that my network is shared with other insured people and not all of them bought their policies on the exchanges. There are people who have their policies sponsored by their employers who have the exact same network I do. There is no such thing as an Obamacare network. But even if there were, it would be incumbent on you to mathmatically demonstrate that the problems are substantially more severe than for the same population, many of whom had no legit insurance at all, before the ACA. Otherwise, your headline may as well say "Chinese people having trouble finding specialists." In some cases, it may be literally true because it's an issue for everybody, but there is a profoundly misleading issue of connectivity implied.

Sigh. Some plans are narrow network and some are not. I don't understand why this is so hard for you to get, although I should not be surprised. Even BCBST, who you say is your insurer, has a P network and a S network.

And before you say both networks are available on the exchange, in order to get the better network one must pay more. My point is that even the cheapest plans on the exchange with the crappy network has a high premium and high deductible.
4  General Politics / U.S. General Discussion / Re: Obamacare enrollees having trouble finding specialists on: July 19, 2014, 10:12:05 am
Even those bronze plans and ones with narrow networks have very high premiums as well as deductibles. It is really not a good deal for a whole bunch of people.
Insurance is not supposed to be a good deal. It's not an invrstment. It's insurance. It's there to cover your Inks just in case something terrible happens.

And if you are having trouble finding a specialist to treat your cancer, it defeats the purpose.

Also, one can determine value in insurance. It actually is a great deal for those who are old, because their premiums are lower now. Not so much for Obama's base.
Obama's base is the working poor. They are getting enormous subsidies. It's an incredible deal for them. And despite the clickbait headline, I don't see any evidence here that people in exchange based plans have more difficulty finding docs than those with employer sponsered plans. These are the same private insurance plans that people get through their employers. Mine is with BlueCross. I doubt the doctor's office even knows that I bought mine on the exchange. There is, in fact, no such product as Obamacare.

Every plan has its own network, and the premium is priced based on that. Of course there are employer plans with narrow networks as well, but it's a hilariously naive thing to say that all plans by an insurer have the same network. It could be true for a PCP or a hospital, but plans within an insurer will vary when it comes to specialists as their service is more valuable and they have an upper hand in negotiations with insurers. When designing narrow network plans, such as the Obamacare plans, insurers will likely not include a lot of well known and sought after specialists in that network.

Also, Obama's base includes young, single people of all economic backgrounds. The subsidies for these plans aren't so great if you haven't popped out a couple of kids yet.
5  General Politics / U.S. General Discussion / Re: Obamacare enrollees having trouble finding specialists on: July 19, 2014, 09:10:36 am
Even those bronze plans and ones with narrow networks have very high premiums as well as deductibles. It is really not a good deal for a whole bunch of people.
Insurance is not supposed to be a good deal. It's not an invrstment. It's insurance. It's there to cover your Inks just in case something terrible happens.

And if you are having trouble finding a specialist to treat your cancer, it defeats the purpose.

Also, one can determine value in insurance. It actually is a great deal for those who are old, because their premiums are lower now. Not so much for Obama's base.
6  General Politics / International General Discussion / Re: Pew polls the world on opinions of the US, China, etc. on: July 18, 2014, 09:43:38 am
What has Pakistan ever done for the US though? Why would they have any expectations from a relationship where they have given nothing? Even helping the mujahideen was ultimately in Pakistan's interests as they gained greater control over Afghanistan.

In addition, why do they think the US should support them in wars they unilaterally start against India for no good reason? Every single war in the history of India/Pakistan has been started by Pakistan. They have deluded themselves into thinking this is proper behavior befitting a country that is committed to a peaceful and prosperous world. And to make things worse, they have nuclear weapons.
7  General Politics / U.S. General Discussion / Re: Obamacare enrollees having trouble finding specialists on: July 18, 2014, 07:55:02 am
Even those bronze plans and ones with narrow networks have very high premiums as well as deductibles. It is really not a good deal for a whole bunch of people.
8  General Politics / International General Discussion / Re: Pew polls the world on opinions of the US, China, etc. on: July 17, 2014, 08:07:09 pm
The ISI supported the Pakistani Taliban as much as the CIA did. It turned out be unfortunate for both countries.

That was a long time ago, and as pointed out, they weren't the Taliban. The ISI built the Taliban so they could have control of Afghanistan. As you may know, the relationship between the non-Pashtun Afghani population and Pakistan is not great. And to this day the ISI continues to support terrorist groups, and will continue to do so.
9  General Politics / International General Discussion / Re: Pew polls the world on opinions of the US, China, etc. on: July 17, 2014, 05:40:51 pm
Tue fact that Pakistanis hate America as much as India and fear us more really shows how bad our foreign policy really is.

Are you arguing that we shouldn't have killed Bin Laden?
No, but just about everything else we've done has been horrible. The drone strikes, the interventions in the Tribal Regions, etc. And I do think that we could have handled the UBL raid better, but his death is enough for me to shove my principles under the rug.

That is a very naive view of the world. The Pakistanis hate us because we are actually doing something about their constant coddling of terrorists. The ISI trains terrorists and the Pakistanis celebrate them as freedom fighters. I was the biggest opponent of the Iraq war and I still strongly oppose invasions and regime changes, but surgical strikes against terrorists is one of the best innovations of US foreign policy in recent years.
10  General Politics / U.S. General Discussion / Obamacare enrollees having trouble finding specialists on: July 17, 2014, 02:07:24 pm
Quote
Primary care doctors have reported problems making referrals for patients who have purchased some of the cheaper plans from the federal insurance marketplace. Complaints about narrow networks with too few doctors have attracted the attention of federal regulators and have even prompted lawsuits.


Quote
Narrow provider networks are not new, but they’ve attracted attention again with the rollout of the ACA. Analysts point out that narrow networks are a powerful tool for insurance companies seeking to control costs – especially since they can no longer control costs by excluding sick people or adjusting premiums by gender or age.

The insurance industry's position is that patients have choices. Plans with access to more hospitals and specialists are available, but usually at a higher price.

"Our goal was to offer an array of plan choices,” says Louis Adams, a spokesman for Blue Cross Blue Shield of Texas. “We created more focused networks as a way to offer a broad range of plans with lower premium prices, both on the exchange and in the retail market in general."


Quote
Sawhney worries that when patients learn that some medical doors are closed, they will decide insurance is simply not worth the money.

“I don’t want patients to get discouraged,” she said. “I don’t want patients when they have a choice again to say, ‘You know what? I’m just not going to sign up because it doesn’t matter if I have insurance or I don’t have insurance, I still have problems getting health care.’”

The president of the Harris County Medical Society, Dr. Elizabeth Torres, said she fears there could also be a backlash among primary care doctors. Not because the narrow-network HMOs have lower reimbursements, she said, but simply because it’s too hard to find the specialists.

“If it’s going to cost us a lot of hassle, administratively and as far as finding the specialists, then it’s going to be less likely and less favorable for us to actually want to be part of the plan,” said Torres, an internist in the Houston suburb of Sugar Land.


Quote
That could change going forward. CMS regulators have told insurers they will be examining the new batch of plans in 2015, to make sure plans offer “reasonable access” – particularly in the areas of hospitals, mental health, oncology and primary care. Regulators also hinted they might develop rules in the future that are more specific: for example, a limit on how far a patient must travel to reach an in-network specialist, or a limit on how long a patient must wait for an appointment.


http://www.kaiserhealthnews.org/Stories/2014/July/17/narrow-networks-specialists-community-health-centers-insurance.aspx
11  General Politics / U.S. General Discussion / Re: US uninsurance rate drops to 13.4%, record low on: July 17, 2014, 07:28:49 am
I have insurance because of it and I am immensely grateful.

I think most people in this forum, unless they got covered by the Medicaid expansion or through their parents, lost out because of the ACA. I will actually have to pay more than double the amount I pay for insurance next year because of the ACA.

As a self-employed freelancer, I too have insurance solely because of the ACA. Best of all, it's at a significantly lower rate than when I had to make COBRA payments several years ago.

I bought insurance from the individual market last December and it was much cheaper than I thought it would be. Of course, it doesn't cover pre-existing conditions or maternity coverage, but it covers everything else after a $2,500 deductible. The plan is grandfathered in till this December but after that I must buy from the exchange. Those plans have premiums that are double what I am paying currently, and a higher deductible. My experience with the individual market was surprisingly pleasant and I would like the option of not having to pay for maternity coverage, which is not an option on the exchange plans.
12  General Politics / U.S. General Discussion / Re: US uninsurance rate drops to 13.4%, record low on: July 16, 2014, 09:41:28 pm
I have insurance because of it and I am immensely grateful.

I think most people in this forum, unless they got covered by the Medicaid expansion or through their parents, lost out because of the ACA. I will actually have to pay more than double the amount I pay for insurance next year because of the ACA.
13  General Politics / U.S. General Discussion / Re: US uninsurance rate drops to 13.4%, record low on: July 16, 2014, 09:36:21 pm
US uninsurance rate drops to 13.4%, record low

The threat of a fine of several hundred dollars has an effect on consumer habits.  Who knew?


It's actually $95 this year.

^Pretty sure that is the lowest it could be.  It is a percentage of your income with a cap that increases yearly.

Yeah, you are correct.
14  General Politics / U.S. General Discussion / Re: US uninsurance rate drops to 13.4%, record low on: July 16, 2014, 09:25:32 pm
US uninsurance rate drops to 13.4%, record low

The threat of a fine of several hundred dollars has an effect on consumer habits.  Who knew?


It's actually $95 this year.
15  General Politics / U.S. General Discussion / Re: Paul Krugman: "The Affordable Care Act is working" on: July 16, 2014, 09:20:18 pm
Obamacare is successful if you define success as increased coverage. But it has also led to more workers being confined to 29.5 hours a week so employers don't have to pay for their health insurance. So the working class don't get health insurance through their work as the law intended, make less money because their hours got cut and have to buy insurance that may be overpriced compared to their individual actuarial risk. This law is just too big and too complex to simply say it has been a success or a failure. It has clearly been both with some winners and some losers.
16  General Politics / U.S. General Discussion / Re: Plan to split California into 6 states advances on: July 16, 2014, 09:09:20 pm
The only logical split of California would be along the line north of Kern County. Maybe leave Kern county with Northern California but that is it. Anything else is complete nonsense. I hope this gets destroyed at the ballot box.
17  Other Elections - Analysis and Discussion / Congressional Elections / Re: Would Carly Fiorina (R-California) win a rematch in 2016 against Barbara Boxer? on: July 11, 2014, 11:43:37 am
Yeah, the national GOP brand is too toxic currently for Republicans to win statewide. I could see a moderate Republican who is pro-SSM, Marijuana and Abortion winning but if they get tied at all to the national party they lose. And this candidate would likely need to be fairly moderate on fiscal issues as well, and it's hard to see such a candidate being backed by GOP primary voters (even with the top two system).
18  Other Elections - Analysis and Discussion / 2014 Gubernatorial Election Polls / Re: CA-Field Poll: Gov. Moony (D) up 20 on: July 08, 2014, 09:20:13 am
That's excellent news, but in all honesty, I think Jerry Brown is just too conservative. After his term is up, maybe Nancy Pelosi will retire from the House and have a go at the Governorship.

Yeah, why should there be good, responsible governance in California? That state's government should always be dysfunctional!
19  General Politics / U.S. General Discussion / Re: And the most patriotic State is ... on: July 05, 2014, 08:57:20 am
Not surprised by California at all.

Actually, on the one metric that actually matters, that being funding for veterans, California is ranked 2nd. Who gives a flying  about googling flags or liking something on Facebook? Also, measuring historical sites on a per capita basis is unfair. Of course states like Wyoming which don't have any people are going to be #1 on a per capita basis in everything.
20  General Politics / U.S. General Discussion / Re: Should the Washington Redskins change their name? on: June 24, 2014, 08:32:32 pm
If you are not Native American or Irish, your opinion is not worth much.

I find this way of the thinking simply silly. 

If whether or not something 'is offensive' isn't to be judged by whether the people at which it's directed are offended by it, how is it to be judged? Whether uninvolved members of the general public think they should be offended? Some sort of external rubric handed down from on high?

Sbane is saying, in essence, we can't have an opinion.  I see pages and pages of opinions here Nathan, and many who are offended, and probably none of them are from Native Americans.....but their opinions don't count? 

We have discussions here all the time about what is misogynistic.....but only the females here have a right to an opinion?

I assure you if the opinions of a vast majority of Redskins fans were to change the name, or else, it would be changed. 

What I am trying to say is that you are not in a position to say what is or isn't offensive to Native Americans. I didn't say you can't have an opinion on this issue. Of course you can have an opinion and post about it. I am talking more specifically about you or others here saying that "redskins" should not be an offensive word to Native Americans.
21  General Politics / U.S. General Discussion / Re: As flawed as it is, here is, in my view, the brighest spot of US Healthcare on: June 24, 2014, 05:23:35 pm
Yeah, there are issues of access based on location, in poor urban areas as well as in rural areas. Still, I would argue those hospitals have better access to the newest innovations than hospitals in other OECD countries.

I agree. The biggest problem in our system is the cost/incentive structure.  Basically everything in our healthcare system is a market failure that makes no sense.  That's the overriding question without a doubt. 

But, I just go back to my original point.  A lot of our spending on so called top-notch care is wasteful spending on things like Nexium and needless procedures which don't make anyone healthier.  Just look at our list of top selling pharmaceuticals:  Many of those drugs just treating the symptoms of over-eating.  Our medical system hasn't figured out how to address the root causes of those conditions, but we spend billions and billions treating the symptoms.  It's not a good system for anyone, but the people profiting off our sickness.

One of the reasons for that is the way we pay for healthcare. By having insurance pay for all of our healthcare needs, we do not realize what the real cost of our medications, doctors visits, labs etc are. Hell, we complain when the insurance companies try to pass on even 10% of the cost. If we were paying for non-acute care out of pocket (with a stop loss provision for those with expensive chronic conditions), we may make wiser choices and drive down the cost of healthcare. Obviously one can't choose what hospital one goes to if they get into an accident or have a stroke, but patients definitely have more choices in the outpatient setting.
22  General Politics / U.S. General Discussion / Re: As flawed as it is, here is, in my view, the brighest spot of US Healthcare on: June 24, 2014, 12:33:36 pm
Yeah, there are issues of access based on location, in poor urban areas as well as in rural areas. Still, I would argue those hospitals have better access to the newest innovations than hospitals in other OECD countries.
23  General Politics / U.S. General Discussion / Re: As flawed as it is, here is, in my view, the brighest spot of US Healthcare on: June 24, 2014, 09:59:39 am
If you can't afford to pay for something, how do you consider that having access to it?  If you hit your coverage limit and the procedure or medicine you need costs $100k, you have as much access to it as you have access to a new $100k Mercedes. 


I suppose the "problem" with healthcare is that you are oftentimes sold a Mercedes without you knowing and assuming insurance will cover it. So they do have access to these devices, they might just get screwed over by the insurance company afterwards. Obamacare does tackle this situation by abolishing coverage limits.

No.  If you don't have insurance approval or a means to pay for expensive medicine or care, nobody is going to do it.  Do you think a hospital is going to do a $20k procedure and just hope that someday you pay your $100k bill?  They would if you came into the ER with a gunshot wound, sure.  They wouldn't if you have a chronic illness that's not an imminent emergency.  Or, in the case of medicine, you can't go to CVS and say, "can I pretty please have this medicine for free?" 

I was actually in this exact situation as a young invincible healthy person.  I developed a chronic inflammatory disease and my doctor prescribed an expensive drug.   I hit my prescription coverage limit the second time I filled the prescription and I couldn't afford $200k a year on medicine so I had to go without medicine I desperately needed.  But, it was OK because I theoretically had access to it, right?


Where did I defend coverage limits?

Also, even if an insurance company denies a certain procedure or medicine, it is not based on whether you have a good insurance plan or a crap one. All policies sold by that insurer would deny covering that, no matter how "Cadillac" your plan is. If an insurer denies covering something, it must medically justify that. With obamacare solving the coverage limit problem, it is true that the vast majority of people in America have access to the new innovations in medicine today.
24  General Politics / U.S. General Discussion / Re: As flawed as it is, here is, in my view, the brighest spot of US Healthcare on: June 24, 2014, 06:53:44 am
Obamacare is, and by far, the brightest spot of US healthcare.

Actually, no, he's right. Innovation is where the US is the world leader in health services.

Maybe that's just me, but I don't really prize the quality of healthcare if it's the privilege of an elite.
Ugh, in 2008, only 14% of Americans were uninsured. While this is a number that everyone would agree is too high in and of itself as the most vulnerable Americans were unprotected, healthcare was hardly the privilege of "teh elites" before Obamacare.

A good share of these 86% only had extremely limited and low-quality coverage. Certainly not what it takes to have access to the finest American health innovation. And yes, I know Obamacare has only partially changed that.

No, Antonio you are completely wrong about that. These people did have access to those innovative procedures/medicines. It is the payment mechanism that is the problem. These people might have had high copays try couldn't pay or coverage limits which they crossed and got screwed.

If you can't afford to pay for something, how do you consider that having access to it?  If you hit your coverage limit and the procedure or medicine you need costs $100k, you have as much access to it as you have access to a new $100k Mercedes. 


I suppose the "problem" with healthcare is that you are oftentimes sold a Mercedes without you knowing and assuming insurance will cover it. So they do have access to these devices, they might just get screwed over by the insurance company afterwards. Obamacare does tackle this situation by abolishing coverage limits.
25  Presidential Elections - Analysis and Discussion / Presidential Election Trends / Re: When will Orange County, CA turn (Atlas) red, if it does turn? on: June 23, 2014, 05:34:00 pm
Depends if Republicans continue to do poorly with Asians or not. If their problems continue, then 2016 is a possibility with a 8-10 point national Democratic win. I don't think that's likely, and even if it happens due to a Clinton candidacy, it won't be because of people in Orange County swinging to the democrats.
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