Doctor visit limits...what else...

[billc]

Well, it begins, the decline of the American medical system...

http://www.breitbart.com/Big-Govern...it-Doctor-Visits-For-Benchmark-ObamaCare-Plan

As part of its “benchmark” health care plan to satisfy ObamaCare’s requirement of the establishment ofEssential Health Benefits (EHB’s) in each state, the state of New York has requested that annual doctor visit limits be substituted for lifetime and annual dollar limits in health care plans.

States had until October 1, 2012 to choose an existing health care plan to serve as the minimum “benchmark” plan that would contain the EHB’s as required by ObamaCare. President Obama’s signature health care law gives HHS Secretary Kathleen Sebelius sole authority to determine the EHB’s for the insurance plans in the state health insuranceexchanges.

In its letter to the Centers for Medicaid and Medicare Services (CMMS), the state of New York wrote:

Removal of Annual/Lifetime Dollar Limits - New York State awaits further federal guidance on the process for substituting dollar limits on benefits with actuarially equivalent quantitative limits (e.g., annual visit limits).
​

If ObamaCare is not repealed, millions of currently uninsured people will be sent into the state exchanges to purchase health insurance, or pay the “tax” as the Supreme Court defined it. The sheer numbers of new patients alone will make for longer waiting times to get in to see doctors. In addition, as many businesses find it is too costly to offer health insurance benefits to their employees, these individuals, and their families, will also be sent into the exchanges. Finally, as New York, and perhaps other states, are granted permission by HHS to make annual doctor visit limits part of their EHB package, the number of visits will be carefully monitored, leading to an even greater rationing of health care.

ObamaCare is gradually setting up a two-class system of health care access in this country. Only the very wealthy will be able to obtain the types of treatments and access to health care that many Americans have enjoyed in the past.

 

[arnisador]

The decline is just beginning now? Really?

 

[Bob Hubbard]

The systems pretty much broken now. Costs are continuing to spiral out of control, gouging is insane, doctors are dropping accepting any insurance at all and going cash-only. While the so called 'fix' helped a few million people, it hurt about the same number. Businesses are phasing out plans or going bare-minimum coverage and opting to pay the fines rather than the insurance companies. I still hold to my opinion that it's an overreach, and not much besides an unethical forced bail out of insurance campaign contributors. The so called "free" stuff that insurance companies are 'required' to offer doesn't seem to apply to existing clients, just new ones. Seems by already having coverage I'll get less than the guy who signs up on Monday. Great fix. But, whatever. The more the government fiddles with anything, the more the **** it up.

 

[Josh Oakley]

And obamacare and Medicare themselves are looking for and finding as many reasons not to pay as they can, even for legitimate claims.

Sent from my DROID RAZR using Tapatalk 2

 

[billc]

http://www.breitbart.com/Big-Govern...or-Hospitals-That-Readmit-Sick-Patients-Begin

Hospitals who re-admit patients within 30 days after they were discharged will now have to, under an Obamacare provision, pay fines as of October 1, 2012, which could force hospitals to slash programs that help the elderly, the poor, and the chronically ill.

According to a study, "about two-thirds of the hospitals serving Medicare patients, or some 2,200 facilities, will be hit with penalties averaging around $125,000 per facility this coming year."
This provision was inserted into Obamacare as a cost-cutting measure, but it will force hospitals to give the poor, elderly, and chronically ill substandard care.

As the Examiner notes:

Some observers believe that the new provision will place an enormous amount of added pressure on these populations, given that patients cannot be certain that their treatment will be up to par in the event of the need for readmission to the hospital after discharge. And hospitals that are already feeling the squeeze financially due to cutbacks in reimbursements from the government may be forced to limit the level of care given during readmission, resulting in patients being discharged long before they are ready.
​

 

[arnisador]

The more the government fiddles with anything, the more the **** it up.

On the other hand, private insurance was hardly doing a bang-up job on its own...and you certainly do want some regulation here, dude. Imagine what they'd be doing without it.

 

[WC_lun]

The 17,000 peole a year who die in th US because they cannot afford medical care would argue that something needs to be done...if they could. If not what has been done, then what?

 

[Bob Hubbard]

On the other hand, private insurance was hardly doing a bang-up job on its own...and you certainly do want some regulation here, dude. Imagine what they'd be doing without it.

I can imagine it.

2.9 Health Care

We favor restoring and reviving a free market health care system. We recognize the freedom of individuals to determine the level of health insurance they want (if any), the level of health care they want, the care providers they want, the medicines and treatments they will use and all other aspects of their medical care, including end-of-life decisions. People should be free to purchase health insurance across state lines.

Remove handcuffs, allow free market competition, and enforce existing laws against "price setting". Encourage competition, which will drive prices down and improve efficiency.

As it stands now, all the system does is encourage bloat and rising prices.

The system as it is now, thanks to the government's "helping" is well represented by the Sunday, October 7th 2012 Crankshaft.
http://www.seattlepi.com/comics-and-games/fun/Crankshaft/

My doctor visit's a $40 "co-pay". Insurance pays the other $270.

If I didn't have insurance, the cost is $60.

Hmm... Of course, that insurance payment can take 6+ months to show up to the doctor, with a ton of paperwork involved.

My chiropractor basically said he could cut he fees in half if he didn't have to have staff spend so much time dealing with insurance red tape, and waiting half a year to get paid. He also said that the additional requirements he's being hit with are why he's raising rates. But just for cash customers. The insurance company sets his rates for him, and only pays him what they want. So as his costs of complying go up, his income from those companies does not. Hence why doctors are dropping accepting insurance.

Of course, if too many of them do that, I'm sure the government will "Mandate" they do accept insurance or find other work. More "Helping", while we already face an artificial shortage of qualified medical personnel due to the AMA's quota system.

Of course, medical school costs a fortune too, which goes back to that system you and I bounced around a while back. Every doctor I've brought it up to has loved it.

Now everyone says "single payer, single payer", which is nice, in principle. But I think Canada's the only nation I know of that's single payer that's not got high taxes and still buckling under the strain. Single payer is another term for monopoly. And as someone who's dealt with the gas company, electric company and cable company with their 'single payer' authorized monopolies, I can say, the customer service isn't too great.

When the government and their authorized monopolies control supply and funding, you get shortages and inflation. Always.
Comes with subsidies and mandates.


You don't get a ship moving by first miring it in concrete, and making the engine so complex MENSA goes "Huh?". Well, that's government 'fixing' of anything.

 

[billc]

This just appeared tonight...

http://www.powerlineblog.com/archives/2012/10/annals-of-government-medicine-15.php

Recent investigations have revealed hospitals administered by Britain’s National Health Service to be veritable houses of horrors. Here is the latest shock headline: Patients starve and die of thirst on hospital wards. Hospital conditions under socialized medicine appear to be trending toward the medieval:

Forty-three hospital patients starved to death last year and 111 died of thirst while being treated on wards, new figures disclose today.
The death toll was disclosed by the Government amid mounting concern over the dignity of patients on NHS wards.
The Office for National Statistics figures also showed that:
* as well as 43 people who starved to death, 287 people were recorded by doctors as being malnourished when they died in hospitals;
* there were 558 cases where doctors recorded that a patient had died in a state of severe dehydration in hospitals….
The records, from the Office for National Statistics, follow a series of scandals of care of the elderly, with doctors forced to prescribe patients with drinking water or put them on drips to make sure they do not become severely dehydrated.
Katherine Murphy, chief executive of the Patients Association, said the statistics were a grim and shaming reflection of 21st century Britain. …
In many wards nurses were dumping meal trays in front of patients too weak to feed themselves and then taking them away again untouched.
​

Many of those who starve or die of thirst are elderly, but by no means all:

In July, an inquest heard that a young man who died of dehydration at a leading hospital rang 999 for police because he was so thirsty. Officers arrived at Kane Gorny’s bedside, but were told by nurses that he was in a confused state and were sent away.
The footballer and runner, 22, died of dehydration a few hours later, an inquest heard in July.
…[H]e was in hospital for a routine hip replacement. Doctors had warned that, without regular medication to control his fluid levels, he would die. But when he was admitted to St George’s Hospital in Tooting, South London, staff ignored repeated reminders from Mr Gorny and his family to give him the tablets, and he became severely dehydrated after being refused water.
His mother told the inquest that in May 2009 she received a distressed phone call from her son, in which he said he had called the police because he was so desperate for a drink.
Shortly before he died, his mother found him delirious and saw that his medication was untouched. … He died of water deficit and hypernatraemia, a medical term for dehydration, three days after he was admitted to hospital.
​

It has often been said that the paradigm of socialism is the public rest room. The British used to expect something better from their hospitals.

 

[billc]

There are many fixes for the problem of healthcare, the ability to cross state lines, medical savings accounts and other ideas that have been brought up in other places to address the problems. It has never helped a situation for the government to step in and start mandating fixes to problems. This cost cutting feature of fining a hospital if a patient is re-admitted before 30 days is up...how will they track that accurately. Law enforcement officers here on the study...how often do you bring the same people into the E.R. for treatment during a month, homeless people without coverage, guys who get into fights? Will the hospital get dinged for guys like this, and then have to wade through the morass of red tape to explain to the government that no...these guys were brought in for brand new problems and not for a problem stemming from their last visit. We'll they have to pay the fine first, and then file a counter claim to try to recoup that money? How much time, effort and money will go into that.

There were a lot of people who were happy with their current health care plans. Why was it necessary to ruin their plans to help the people who don't have coverage? You may say that isn't going to happen, but explain why a company would keep their health plans if they can just drop them and let their employees try their hand at obama mandated insurance? From what I have read, the fine is less than a lot of companies pay for the insurance plans. I know one company that pays over 10,000 dollars a year for their coverage...dropping their health coverage would save them a lot of money, why wouldn't they?

I guess an even bigger question is, Why is a company required to pay a tax/fine for not offering healthcare to their employees? That is the big question. Why did it all of a sudden go from being a "perk/benefit" to a government enforced mandate? Why shouldn't a company then be required to provide all employees with nutritional food each day...or be taxed/fined if they don't. Why shouldn't a company be forced to pay for the homes of their employees, since employees need somewhere to live, and why not do that with a tax/fine as well?

When did a private company become the mandated caregiver to their employees?

 

[billc]

First, the government steps in to fix a problem that could be fixed without their help. Then, when people try to avoid the government "fix" new laws will be created to close that gap and new policing agencies will be needed...a case in point...

http://hotair.com/archives/2012/10/09/obamacare-transforming-america-into-part-timer-nation/

Under ObamaCare, companies of more than 50 workers who do not provide health-insurance coverage have to pay significant fines, although not nearly as costly as the insurance itself. That alone might have employers bailing out of the health-insurance market, but the Orlando Sentinel reports that at least one company is testing a way to avoid both costs. Employers do not have to provide health-insurance coverage to part-time workers under ObamaCare as long as they work less than 30 hours a week, and one restaurant company has begun experimenting with changing over entire staffs to part-time work to avoid the ObamaCare mandates and fines (via Instapundit):

In an experiment apparently aimed at keeping down the cost of health-care reform, Orlando-based Darden Restaurants has stopped offering full-time schedules to many hourly workers in at least a few Olive Gardens, Red Lobsters and LongHorn Steakhouses.
Darden said the test is taking place in “a select number” of restaurants in four markets, including Central Florida, but would not give details. The company said there has been no decision made about expanding it. …
Analysts say many other companies, including the White Castle hamburger chain, are considering employing fewer full-timers because of key features of the Affordable Care Act scheduled togo into effect in 2014. Under that law,large companies must provide affordable health insurance to employees working an average of at least 30 hours per week.
If they do not, the companies can face fines of up to $3,000 for each employee who then turns to an exchange — an online marketplace — for insurance.
​

This is the problem with massive government interventions into markets. They create perverse incentives, and force participants in markets to look for alternatives to the massive costs of those interventions. This is one example. Businesses usually prefer stable labor pools, and full-time status and reasonable benefits usually help provide that kind of stability. As a hiring manager for years, I can tell you from personal experience that managing a part-time staff creates its own costs and headaches, much of which won’t be felt in the home office of a multiple-location entity like Darden.
However, the costs may not outweigh the savings any longer derived from dumping benefits for workers — and that’s doubly true in a bad job market for workers.

 

[WC_lun]

Bill, really? Do you even know what you are supporting when you talk about buying across state lines? You do realize that was legal at one time and the states put a stop to it. Insurance companies would set up shop in a state that has rather lenient insurance laws then sell cheap to whomever. The problem came when a person would start submitting claims. Then those insurance companies would deny claims or find an excuse to drop the consumer all together, effectively bilking the customer and his home state out of thousands of dollars. All perfectly legal because the insurance companies were following the very low statutes in thier state of origin. The state letting them do this wins because they get tax money from the profits. This also used to happen with banks and credit cards quite a lot. Look at a few credit cards and you might be suprised they are issued from only one or two states.

Medical savings accounts already exsist. You put a portion of your check into them tax free. You get to pull money out of the account only to reimburse yourself for medical expenses. Of course if you don't spend all the money you place in that account, you lose the money. It also does not help someone with a sudden onset illness or someone too poor to pay enough into thier account to cover medical cost. There is also a cap amount on how much you can put in the account, though I do not remember what that is.

 

[arnisador]

We use a health savings account each year.

 

[billc]

Here is a nice description of obamacare...

http://www.americanthinker.com/2012/10/interminable_sentence_nails_obamacare.html

In August 2012, a candidate for Illinois State Senate, District 18, Dr. Barbara Bellar, thought she would start a fundraising event with a lighthearted tone. She claimed that she could describe ObamaCare (the ACA) in one sentence -- one very long sentence.

Because Dr. Bellar so accurately portrayed the current national sentiment about the ACA, a video of her speaking her very long sentence went viral. As of 10/7/12, it had received 2,434,958 hits on YouTube.

This is what she said, verbatim. (Bullets were inserted by this author.)

We are going to be gifted with a healthcare plan [the ACA]:

We are forced to purchase, and fined if we don't;

• Which purportedly covers at least 10 million more people
• Without adding a single new doctor; but
• Provides for 16,000 new IRS agents;
• Written by a committee whose chairman says he doesn't understand it;
• Passed by a Congress that didn't read it; but
• Exempted themselves from it; and
• Signed by a president who smokes;
• With funding administered by a treasury chief who didn't pay his taxes;
• For which we will be taxed for four years before any benefits take effect;
• By a government which has already bankrupted Social Security and Medicare;
• All to be overseen by a surgeon general who is obese; and
• Financed by a country that's broke.

​

 

[WC_lun]

This doesn't really have anything to do with the point being made, does it? People are dying and going broke due to how things were. change was neccesary. Don't like the change, make valid suggestions on how it could be better. The status quo is not acceptable.

 

[Bob Hubbard]

This doesn't really have anything to do with the point being made, does it? People are dying and going broke due to how things were. change was neccesary. Don't like the change, make valid suggestions on how it could be better. The status quo is not acceptable.

Simple fix.

Increase the Medicaid and Medicare deductions from paychecks by 5% (starting number).
Raise the limit on eligibility to $30,000.
Simplify the application process.

Instant national single payer system providing basic coverage to the lower incomes while maintaining the existing private insurance system.

To go further, establish minimum coverage guidelines nationally, and require all private insurers to comply while opening up competition nationally.

There was no need for the mechanism of Obamacare and it's unconstitutional except under a loophole mandate.

 

[billc]

Yeah...what Bob said...

 

[Xue Sheng]

What amazes me about this whole argument is that no one seemed to notice when Romney said we need to repeal Obama care and…

“replace it with something that works”

Which means next up….Romney Care…. Don't think he'll do it.... just look at Massachusetts... Of course politics being what it is (broken) it is likely to be called unconstitutional by the Democrats should Romney beat Obama in the election….

 

[Steve]

Single payer... look around at what's working and what's not and figure it out. There is no perfect health plan, but there's a lot out there that's a hell of a lot better than what we have.

 

[Xue Sheng]

Single payer... look around at what's working and what's not and figure it out. There is no perfect health plan, but there's a lot out there that's a hell of a lot better than what we have.

Agreed

I am just amazed at the partisan politics around this issue from those that appear to be selectively deaf based on the person making the statements political affiliation

But we should not forget that some of those systems, that appear to work, do cut you off for certain procedures and treatments based on age… and some of those are very necessary if you wish to keep breathing

NOTE:
Just did a bit of research, I did not delete the above statement about age cut offs, because I made it, however, I did italicize it. That may not be true based on what I was just reading and I need to do more research to be certain