Patterico's Pontifications

12/8/2013

If You Like Your Doctor, You Can Keep Him

Filed under: General — Patterico @ 9:59 pm

You just have to pay more.

111 Comments

  1. $240 more a month to keep my plan. This year.

    Comment by AZ Bob (ade845) — 12/8/2013 @ 10:14 pm

  2. What is it Glenn Reynolds says to the oh-so-bright Left about this?

    Oh, yes. “Hey, rube!”

    Comment by Simon Jester (d21e8e) — 12/8/2013 @ 11:03 pm

  3. “Unexpectedly…”

    this is my surprise face.

    Comment by redc1c4 (abd49e) — 12/9/2013 @ 12:25 am

  4. If you like your doctor, you can keep him . . . on a 10k a year retainer.

    Comment by jakee308 (e940d5) — 12/9/2013 @ 2:31 am

  5. Ezekiel is a modern day Toohey

    Comment by jb (568e14) — 12/9/2013 @ 3:57 am

  6. this just gets better and better;

    http://www.latimes.com/business/la-fi-exchange-names-disclosed-20131207,0,1224576.story#axzz2mm4xX6cO

    Comment by narciso (3fec35) — 12/9/2013 @ 4:05 am

  7. Thank you for providing…

    Comment by Mark (3fb37a) — 12/9/2013 @ 5:45 am

  8. Incompetent and deceitful… quite a combination there, Mr. Obama!

    Comment by Colonel Haiku (066b42) — 12/9/2013 @ 6:21 am

  9. The Obama administration has motored right on past screwing the pooch. They’re nuking the koala.

    http://hosted.ap.org/dynamic/stories/U/US_HEALTH_OVERHAUL_PAPER_APPLICATIONS?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2013-12-07-11-59-45

    FORT LAUDERDALE, Fla. (AP) — Federal health officials, after encouraging alternate sign-up methods amid the fumbled rollout of their online insurance website, began quietly urging counselors around the country this week to stop using paper applications to enroll people in health insurance because of concerns those applications would not be processed in time.

    Interviews with enrollment counselors, insurance brokers and a government official who works with navigators in Illinois reveal the latest change in direction by the Obama administration, which had been encouraging paper applications and other means because of all the problems with the federal website. Consumers must sign up for insurance under the federal health overhaul by Dec. 23 in order for coverage to start in January.

    Comment by Steve57 (20c19c) — 12/9/2013 @ 6:36 am

  10. Newsflash: Obama discovers buying insurance is hard.

    I can hardly wait for this guy’s next epiphany.

    Tonight at nine: Tiger Beat heads down to the situation room to discover what that button does.

    Comment by Steve57 (20c19c) — 12/9/2013 @ 6:42 am

  11. Thanks, voters, for electing what might have been a decent sitcom.

    Next week, an entirely new episode. Barack Obama thinks he’s heating up a Hot Pocket in the microwave in the coffee mess, accidentally launches a torpedo in port. Moments later he discovers nuclear reactors are “complicated.” Apologizes about Rhode Island. Reminds us we still have 56 states left. Suspects Satan is in the attic. Invites the entire country up for a look.

    I don’t know about the rest of you, but I can hardly wait to see how this all turns out. I suspect in a massive fireball, but then I’m an optimist.

    Comment by Steve57 (20c19c) — 12/9/2013 @ 7:07 am

  12. That’s not what she said. ;) And I still had to pay more. ;)

    Comment by nk (dbc370) — 12/9/2013 @ 7:08 am

  13. That seems to be the new “line”

    They probably think they’re safe from this being accused of being a lie.

    Maybe it would cost a lot more, but still it’s possible, right? If you have enough money. Even if no insurance policy will cover all the doctors you want, because they practice in different cities.

    Not really so, because some people are being put on Medicaid. Of course, somebodfy could pay for it anyway, but some doctors maybe only want insurance.

    Also, people going on Medicare (rarely, now) may lose their doctor(s)

    Comment by Sammy Finkelman (ca4c0f) — 12/9/2013 @ 7:16 am

  14. Everyone should go easy on Obama. He just learned about this along with all of us when the news reported it.

    Comment by DejectedHead (a094a6) — 12/9/2013 @ 7:17 am

  15. 6. This is another sign they are really, really, afraid of adverse selection. If they are so afraid this won’t stop it. They’re grasping at straws.

    The whole thing will have to be redone, only, if you want President Obama to sign it, you can’t change any names, or get rid of the website, or say you are repealing it.

    Comment by Sammy Finkelman (ca4c0f) — 12/9/2013 @ 7:19 am

  16. http://hotair.com/archives/2013/12/06/total-number-of-one-on-one-meetings-between-obama-and-sebelius-since-obamacare-was-passed-one/

    Total number of one-on-one meetings between Obama and Sebelius since ObamaCare was passed: One

    Golf games, on the other hand: a gazillion.

    Top. Freakin. Priority.

    Next season: Barack Obama rurns on the TV and discovers he’s the President. Orders Eric Holder to launch an investigation to find out how that happened. Promises the country he’ll bring whoever is responsible to justice.

    Comment by Steve57 (20c19c) — 12/9/2013 @ 7:22 am

  17. 9. More:

    http://www.nytimes.com/2013/12/07/us/politics/flaws-in-enrollment-records-for-insurance-exchange.html?hpw&rref=us blockquote> To be sure that coverage will start on Jan. 1, Ms. Bataille said, consumers must pay the first month’s premium. If they have any doubts, she said, they should call the insurance company to confirm enrollment. The insurer is supposed to send information packets and insurance cards to those who enroll. If consumers have problems or questions, they can ask the government for assistance by calling 1-800-318-2596 toll free, Ms. Bataille said.

    You know what that telephone number spells out?
    F1+&#*^)

    Comment by Sammy Finkelman (ca4c0f) — 12/9/2013 @ 7:25 am

  18. If they have any doubts, she said, they should call the insurance company to confirm enrollment.

    It only took a billion dollars and a tech surge to produce this bit of wisdom.

    Comment by Steve57 (20c19c) — 12/9/2013 @ 7:31 am

  19. Also this.

    The government’s overall goal is to maximize coverage and enrollment. Ms. Bataille suggested that cleaning up the enrollment files would be a herculean task for insurers and the government.

    “We have to very methodically and precisely go through individual transactions at a very granular level directly with insurers to reconcile the information,” she said.

    Comment by Sammy Finkelman (ca4c0f) — 12/9/2013 @ 7:41 am

  20. Largest bait & switch operation evah!

    Comment by Icy (3558fd) — 12/9/2013 @ 7:46 am

  21. Thankfully we now have a massive new government program to inform me that, if I really want to be sure I have insurance, I should check with the insurance company. Using that newfangled device, the phone.

    This is hot on the heels of the highly successful government initiative letting people know if they’re thirsty, they should drink water. And who could forget the platform in the Obama campaign about keeping your tires properly inflated?

    We’re only two trillion dollars away from discovering the answer to the age old question, if you have empty your bladder in the middle of the night should you get out of bed first?

    Comment by Steve57 (20c19c) — 12/9/2013 @ 7:50 am

  22. I believe human nature, in its worst aspects, is fairly universal, which I why I witness the following self-inflicted idiocy and then become much less surprised that, nearer to home, Obama won two major elections. Now the question is if what motivates people in the US can easily start to mirror what motivates people in Venezuela, or places like France or Mexico.

    Reuters, December 9, 2013: Venezuelan President Nicolas Maduro pledged to deepen his “economic offensive” to force businesses to cut prices after his ruling Socialist Party won the most votes in weekend municipal elections.

    With three-quarters of the 337 mayoral races counted by Monday morning, the Socialists and their allies had 49 percent of votes, compared to 43 percent for the opposition coalition and its partners. That result derailed efforts by Maduro’s critics to turn the vote into a show of disapproval for his government and the legacy of late socialist leader Hugo Chavez.

    The president’s candidates benefited from a populist crackdown in November to force merchants to slash prices of goods such as TVs, car parts and home hardware. Maduro’s personal approval rating jumped sharply after he instituted the economic measures, which won over consumers weary of the country’s 54 percent annual inflation. Maduro blames the rising prices on an “economic war” he says is financed by political adversaries.

    [T]he majority in the local polls [does not] help him address the structural imbalances of a state-driven economy struggling with slowing growth, the highest inflation in the Americas and embarrassing shortages of goods such as toilet paper.

    ^ The voting habits of many Venezuelans really aren’t all that different from the voting habits of a fairly large number of urban or blue-state Americans.

    Comment by Mark (58ea35) — 12/9/2013 @ 8:00 am

  23. You have to consider the source, Steve. My friend and officemate used to tell this story about his son. The kid was maybe two or three, and had just learned to go poopoo by himself. They’re out at a restaurant and they see a man come out of the restroom. The kid asks my friend, “Dad, do you think he remembered to wash his hands?”

    Comment by nk (dbc370) — 12/9/2013 @ 8:01 am

  24. nk, I wish that three year old was running the country. Instead of the one we have.

    Comment by Steve57 (20c19c) — 12/9/2013 @ 8:07 am

  25. Weaselzippers came passed this cartoon along.

    http://weaselzippers.us/wp-content/uploads/2013/12/pre-exist-condits.jpg

    It boggles the mind that people can believe this.

    Oh, by the way:

    http://www.zerohedge.com/news/2013-12-07/70-calfornias-doctors-expected-boycott-obamacare

    70% Of Calfornia’s Doctors Expected To Boycott Obamacare

    And yet, there are people who worship Obama who can convince themselves that this scheme is the only thing that stands between them and certain death.

    Comment by Steve57 (20c19c) — 12/9/2013 @ 8:15 am

  26. http://nypost.com/2013/12/07/the-medicaid-time-bomb/

    ObamaCare created a Medicaid time bomb

    A time bomb? No people. It’s not just one time bomb. Anybody still under the illusion these are unintended consequences?

    Comment by Steve57 (20c19c) — 12/9/2013 @ 8:27 am

  27. In California some formerly available doctors are unavailable on all exchange plans. See that WSJ cancer survivor article again. To keep her doctor, she has to move.

    Comment by Kevin M (536c5d) — 12/9/2013 @ 8:49 am

  28. Steve–

    Obamacare did allow some people with preexisting conditions to get insurance they otherwise could not get. But that’s like saying that the trains running on time justified Mussolini. Didn’t need Obamacare to solve the preexisting-conditions problem.

    Comment by Kevin M (536c5d) — 12/9/2013 @ 8:53 am

  29. Has Choom ever carried his own water? How old was he before he paid for his own car? Would he, even now, know how to put air in his tires?

    Obama is playing in the Rose Garden.
    Michelle: Barry, come inside.
    Obama: Why? Am I cold?
    Michelle: No, you’re hungry.

    Hey, Choom! We’re Americans. We build cars, water purifications plants, and medical schools and hospitals.

    Comment by nk (dbc370) — 12/9/2013 @ 8:57 am

  30. People believe what they want to believe and what they are led to believe by peers and media influencers. The people who elected Obama–especially the second time–simply could not conceive that their prince was lying to them and had been all along.

    The crashing poll numbers for the president, both with respect to his administration’s competence and his personal values, show that the light has dawned on a large number of Americans. Unfortunately the light they see is the fireball. If the election were today the results would be different and not favorable to Barack Obama.

    Comment by elissa (e410e0) — 12/9/2013 @ 9:05 am

  31. If you like your aspirin you can keep your aspirin.

    Comment by Colonel Haiku (066b42) — 12/9/2013 @ 9:05 am

  32. 27. Comment by Kevin M (536c5d) — 12/9/2013 @ 8:49 am

    See that WSJ cancer survivor article again. To keep her doctor, she has to move.

    No, that doesn’t help. She’s got different doctors in different hosp[itals working on her case. To keep her doctor(s) she has to buy policies outsiide of the California exchange.

    Comment by Sammy Finkelman (ca4c0f) — 12/9/2013 @ 9:15 am

  33. Kevin, would you wager that more people with preexisting conditions have gained access to health care or lost it?

    I would wager that more people have lost it. In order to maintain the illusion that Obamacare is affordable insurance companies have narrowed their provider networks. If you had good insurance before with the doctors you needed to keep you alive Obama didn’t do you a favor by replacing your plan with insurance in name only. And if you didn’t have health insurance before, Obama hasn’t done you a favor by selling you a policy the doctors you need won’t take.

    Comment by Steve57 (20c19c) — 12/9/2013 @ 9:20 am

  34. http://www.ft.com/intl/cms/s/0/994951f8-5e71-11e3-8621-00144feabdc0.html

    New Affordable Care US health plans will exclude top hospitals

    By Stephanie Kirchgaessner in Washington

    Americans who are buying insurance plans over online exchanges, under what is known as Obamacare, will have limited access to some of the nation’s leading hospitals, including two world-renowned cancer centres.

    Amid a drive by insurers to limit costs, the majority of insurance plans being sold on the new healthcare exchanges in New York, Texas, and California, for example, will not offer patients’ access to Memorial Sloan Kettering in Manhattan or MD Anderson Cancer Center in Houston, two top cancer centres, or Cedars-Sinai in Los Angeles, one of the top research and teaching hospitals in the country.

    But you now have the privilege of paying40-50% more for this. And the insurance companies selling you this insurance that people with pre-existing conditions can’t use will not be able to turn you down.

    Nope. They have to sell you that policy that does you no good whatsoever. If you can afford the premiums and the multi thousand dollar deductible.

    Comment by Steve57 (20c19c) — 12/9/2013 @ 9:29 am

  35. What can be expected of people who are theorists that have no practical experience? They wanted to add tens of millions of low income people to the Medicaid rolls and to seize control of approx. 1/6 of the American economy. As has been pointed out elsewhere, Murphy’s Law and the Law of Unintended Consequences were sure to come into play. This president is an incompetent narcissist and an unabashed serial liar. We will have to steel ourselves for another 3 years of his nonsense. His Coalition of the Clueless will (or should) bear a burden of shame for decades to come.

    Comment by Colonel Haiku (066b42) — 12/9/2013 @ 9:32 am

  36. 21. Comment by Steve57 (20c19c) — 12/9/2013 @ 7:50 am

    if you have empty your bladder in the middle of the night should you get out of bed first?

    Not necessarily, especially if you have some trouble walking, and need to do it a few times a night.

    My father, the four or so years if his life, used something like this,

    http://www.amazon.com/Medline-Urinals-Urinal-Translucent-DYND80235H/dp/B000K6X5O2/ref=sr_1_6?ie=UTF8&qid=1386610004&sr=8-6&keywords=urine+bottle

    which he first got when he was in the hospital. He also used to use Kleenix tissues to wipe himself.

    It is suprising that this is not more commonly available. He used to worry about getting a replacement, as needed.

    This is very very cheap.

    Comment by Sammy Finkelman (ca4c0f) — 12/9/2013 @ 9:33 am

  37. * the last four or so years of his life. I say four because he spent the last six and half months in a hospital.

    Comment by Sammy Finkelman (ca4c0f) — 12/9/2013 @ 9:34 am

  38. Another ObamaCare Lie: Mother’s Dispute With Insurer

    …In a 2012 campaign spot, “The Road We’ve Traveled,” he actually suggested his mom lost her cancer battle because her insurer refused to pay for treatment.

    “That’s a tough thing to deal with — watching your mother die of something that could have been prevented,” chimes in Michelle Obama, as photos of Dunham flash on the screen. “I don’t think he wants to see anyone go through that.”

    Only, his mom never suffered such an injustice.

    According to “A Singular Woman: The Untold Story of Barack Obama’s Mother,” Dunham had an employer-provided health insurance policy that paid her hospital bills directly. Her insurer never denied payment for her cancer treatment.

    Dunham received a base salary of $82,500 and generous medical insurance coverage from Development Alternatives Inc. of Bethesda, Md.

    Read More At Investor’s Business Daily: http://news.investors.com/ibd-editorials-obama-care/110613-678185-obama-mother-preexisting-condition-denial-another-whopper.htm#ixzz2n04PQPOB
    Follow us: @IBDinvestors on Twitter | InvestorsBusinessDaily on Facebook

    Fun Fact: over 60% of insurance companies with over 100,000 subscribers are organized as non-profits. You’d never know that if you listen to the jackwagon who wants you to shut up and take the pain pill because the triple bypass you need is too damned expensive for the gum’mint to approve.

    Comment by Steve57 (20c19c) — 12/9/2013 @ 9:38 am

  39. 35. Comment by Colonel Haiku (066b42) — 12/9/2013 @ 9:32 am

    His Coalition of the Clueless will (or should) bear a burden of shame for decades to come.

    If there is somebody around in public office who’s not clueless. On the other hand, maybe there’s nobody around quite as clueless as the people in charge.

    One idea I read today – maybe only half good – is to let people use the Federal Employee Health Benefits Program (of course this is pretty close to “the public option”)

    http://nypost.com/2013/12/08/how-to-make-good-on-obamas-keep-your-insurance-promise/

    The sticker price of many FEHBP plans is markedly cheaper than ObamaCare. In Florida, for example, the list price for the cheapest FEHBP plans is $409 a month for an individual, with many 2014 plans offering premiums under $500. This is for fairly comprehensive coverage that has typically lower deductibles and/or co-pays than similarly priced ObamaCare plans.

    By comparison, the average Florida premiums for a lower-tier “Silver” plan in ObamaCare ranges from $315 to $464 for an individual, although costs get much higher for older people.

    One problem – every family now enrolled has at least one person working and the age distribution is somewhat low. You’ve got to look into this further – why is it cheaper?

    But at least the website works.

    http://www.opm.gov/healthcare-insurance/healthcare/plan-information/compare-plans/

    Comment by Sammy Finkelman (ca4c0f) — 12/9/2013 @ 9:42 am

  40. 35. …Murphy’s Law and the Law of Unintended Consequences were sure to come into play…

    Comment by Colonel Haiku (066b42) — 12/9/2013 @ 9:32 am

    With respect, colonello. These consequences are not unintended. The law had to be written as a blatant lie to pass. Not even democrats would have voted for it if people understood what an expensive catastrophe this thing is.

    Now, as planned all along, the Democrats can accuse Republicans of being heartless bastards if they don’t go back and make all the expensive fixes to everything that Pelosi and Reid had to break to get this to the Preezy’s desk.

    These are not unintended consequences. This is job security for liberals.

    Why do you think the libs were so cavalier about passing a two thousand plus page law? To find out what’s in it?

    The only consequence that could possibly be unintended would be if a law worked, and actually solved a problem that enabled the gub’mint to shut down a program because their work was done.

    Comment by Steve57 (20c19c) — 12/9/2013 @ 9:48 am

  41. http://ezinearticles.com/?Texas-High-Risk-Pool—Texas-Health-Insurance-Pools&id=5067597

    …The Texas Legislature created the Texas Health Insurance Pool in order to offer health insurance to Texas residents that meet a certain criteria. This program is geared towards people that are not able to attain other health insurance from commercial insurers due to existing medical conditions. The high risk pool in Texas also guarantees portability of coverage to those who lose coverage under an employer plan, state plan, or church plan. It is a safety net for people with pre-existing health conditions that have been denied coverage from other companies even though they could afford the premiums. As of August 2010, there are 26,762 people enrolled in the Texas High Risk Pool.

    Not only does the Texas High Risk Pool offer health insurance to those with pre-existing medical conditions, but also to people that recently lost their employer-sponsored coverage. If a person cannot obtain traditional health insurance coverage, than the Texas High Risk Pool is most likely the next most comprehensive insurance option. The Health Pool provides major medical coverage that is very similar to what is offered at the commercial level with a wide range of specialists and services.

    Article Source: http://EzineArticles.com/5067597

    No, I have a better idea. Let’s just trash tens of millions of people’s policies and force them instead to buy policies that reimburse doctors so little they’d rather retire than keep working.

    Yeah. That’s the ticket.

    Comment by Steve57 (20c19c) — 12/9/2013 @ 9:57 am

  42. Wait just a minute… “not even Democrats would’ve voted for it…” … not everything that has happened/ or will be happening was intended. Republicans won’t be held accountable or responsible for fixing it, not by sentient people.

    Complicit Democrats surely didnt intend to create the conditions that will facilitate their demise in 2014.

    Comment by Colonel Haiku (066b42) — 12/9/2013 @ 10:01 am

  43. I don’t mean to imply everything that has happened was intended. The Democrats just overestimated their ability to manage the speed and intensity of the destruction they had in mind. And to hide the truth.

    It’s kind of like submarines. They really did intend to sink the boat.

    Comment by Steve57 (20c19c) — 12/9/2013 @ 10:09 am

  44. Obama lied and people are going to die because of his lies. He’s become everything liberals claimed about Bush.

    Comment by DRJ (a83b8b) — 12/9/2013 @ 10:10 am

  45. …not everything that has happened/ or will be happening was intended.

    I think that’s a safe thing to say every time you pass a law that’s longer than the Bible that nobody could possibly read.

    Comment by Steve57 (20c19c) — 12/9/2013 @ 10:14 am

  46. Sammy, his coalition is comprised of young people, Hispanics, blacks, single womyn (see Julia and teh Fluke), Hollywood, public employee unions, tattooed lovebois/girls, liberal Jews, etc.. Teh Clueless come in all shapes, sizes and hues.

    Comment by Colonel Haiku (066b42) — 12/9/2013 @ 10:18 am

  47. I can only think of two movies where the main characters held hands and threw themselves off a cliff.

    I can only hope this story works out like Butch Cassidy and the Sundance Kid and not Thelma and Louise.

    Comment by Steve57 (20c19c) — 12/9/2013 @ 10:18 am

  48. Yes, Steve, hence the Law of Unintended Consequences…

    Comment by Colonel Haiku (066b42) — 12/9/2013 @ 10:20 am

  49. “Fun Fact: over 60% of insurance companies with over 100,000 subscribers are organized as non-profits.”

    Steve57 – A quibble. I have no idea where your statistic comes from, but rather than being organized as not-for-profits, I would guess the insurers you refer to are organized a mutuals, reciprocals, fraternals, etc., etc., run for the benefit of their members. They pay taxes, dividends to policyholders in many cases, and focus on keeping costs down because their shareholders are their policyholders. Many do make money because they have a need to grow surplus as they grow in size.

    Comment by daleyrocks (bf33e9) — 12/9/2013 @ 10:20 am

  50. Some State Farm individual companies are mutuals and some are stock companies.

    Comment by daleyrocks (bf33e9) — 12/9/2013 @ 10:22 am

  51. Prudential was formerly a mutual.

    Comment by daleyrocks (bf33e9) — 12/9/2013 @ 10:23 am

  52. Everything you say is true, daley. You won’t get an argument from me.

    http://www.healthinsuranceproviders.com/do-non-profit-health-insurance-companies-exist/

    Comment by Steve57 (20c19c) — 12/9/2013 @ 10:25 am

  53. 38. Barack Obama’s mother didn’t have trouble with health insurance. (Stanley) Ann Dunham had trouble with disability (lost income) insurance, but it did hinge over the question of whether or not, when she applied for the insurance, she had had a pre-existing condition.

    Her employer’s disability had a clause denying any claim due to a pre-existing medical condition, if during the three months before starting work, the claimant had seen a doctor or been treated for the condition which caused the disability.

    The health insurance only required she pass a thorough examination, which in her case involved six separate office visits in Jakarta.

    Ann Dunham wanted the disability to pay her deductible and uncoverd expenses, which amounted to several hundred dollars a month.

    She had seen a New York gynocologist two and half months before starting work in Jakarta, and had followed up on ll the tests except the D&C. Dr. Barbara Shortle’s office notes indicated she had formed a working opinion of uterine cancer, aand that would be the reason for that test, although she probably did not give her a definite diagnosis or tell her patient that, (Ann was afraid she could get cancer) and the doctors in Jakarta did not discover it.

    CIGNA decided her disability was due to a pre-existing condition. (however they were happy before to collect the money, so there was a problem here, in that what kind of insurance was this then?)

    Barack Obama’s mother also could not get Social Security disability because she hadn’t earned enough credits in the previous ten years, and she couldn’t get SSI, because her IRA, which had assets over $2,000, prevented that.

    Ann requested a review of the denial and informed CIGNA that she was turnng over the case to “my son and attorney, Barack Obama.” Years later, during the presidential campaign and even after his election, Obama would allude to his mother’s experience, albeit in abbreviated form, when making the case for health care reform. Though he often suggested she was denied health coverage because of a preexisting condition, it appears from her correspondence that she was only denied disability coverage.

    – A Singular Woman: The Untold Story of Barack Obama’s Mother by Janny Scott (Riverhead Books * 2011) page 338.

    * a division of Penguin

    Barack Obama would later claim that not being at his mother’s bedside when she died was the biggest mistake he made. He had last seen her in New York in September, and later he was in Chicago and she was in Hawaii and he didn’t know how fast it would go. He had last spoken to her before she lost consciousness, several days before she died November 7, 1995.

    Comment by Sammy Finkelman (ca4c0f) — 12/9/2013 @ 10:26 am

  54. 48. Yes, Steve, hence the Law of Unintended Consequences…

    Comment by Colonel Haiku (066b42) — 12/9/2013 @ 10:20 am

    The point I was trying to make was that a lot of these “glitches” were in fact baked into the cake by design. For instance, in order to hide the expense the drafters of this law had to underestimate how may people would require subsidies.

    The general outline of the fraud was deliberate.

    Comment by Steve57 (20c19c) — 12/9/2013 @ 10:33 am

  55. The brother of Chicago’s Ballerina-in-Chief says they’re about to launch a “big PR campaign” that will change everything!

    Delusion flows like Denial River…

    Comment by Colonel Haiku (066b42) — 12/9/2013 @ 10:35 am

  56. Everybody can relax. Barack Obama did commemorate Pearl Harbor Day. By taking a picture of himself.

    https://www.facebook.com/photo.php?fbid=10151996526961749&set=a.53081056748.66806.6815841748&type=1&theater

    Comment by Steve57 (20c19c) — 12/9/2013 @ 10:38 am

  57. Rebranding, colonello. That’s what this entitlement program needs.

    Not like it could use a website. Just better marketing. I think if the Obama administration lectures me a few thousand more times about how I really should be grateful the “more generous” insurance they’re forcing me to buy finally pays for free pap smears I really will truly be grateful.

    Comment by Steve57 (20c19c) — 12/9/2013 @ 10:42 am

  58. It is quite possible that Baracjk Obama’s mother, (Stanley) Ann Dunham suspected she had cancer, but didn’t want it confirmed, at least not until she had health insurance.

    Comment by Sammy Finkelman (ca4c0f) — 12/9/2013 @ 10:43 am

  59. Comment by Steve57 (20c19c) — 12/9/2013 @ 10:33 am

    a lot of these “glitches” were in fact baked into the cake by design. For instance, in order to hide the expense the drafters of this law had to underestimate how may people would require subsidies.

    It was a case of wanting to have your cake and east it – to force the math to work. There is a tax/penalty, but it is way below the cost of the insurance. There is a subsidy, but it stops at incomes well below where it is really affordable.

    Not to menion how that all works out in practice -they assume income is stable and predictable, and residence too.

    The whole thing is, as I said, a compromise with reality.

    Comment by Sammy Finkelman (ca4c0f) — 12/9/2013 @ 10:47 am

  60. You know, with my old insurance if I wanted to get a hysterectomy I had to pay the full freight. But now, thanks to the miracle of Obamacare, I only have to pay 60% of the charge.

    I didn’t even know I had a uterus. It’s a huge relief to know it’s going to cost 40% less to have it removed.

    Comment by Steve57 (20c19c) — 12/9/2013 @ 10:48 am

  61. Love that Serbian/Swedish spelling Sammji ! It’s more probable that it’s just one more lie in teh Litany of Lies

    Comment by Colonel Haiku (066b42) — 12/9/2013 @ 10:54 am

  62. 55. Comment by Colonel Haiku (066b42) — 12/9/2013 @ 10:35 am

    about to launch a “big PR campaign” that will change everything!

    Delusion flows like Denial River…

    This does not cost $19.99 a month.

    Comment by Sammy Finkelman (ca4c0f) — 12/9/2013 @ 11:06 am

  63. 61. Love that Serbian/Swedish spelling Sammji ! It’s more probable that it’s just one more lie in teh Litany of Lies

    Comment by Colonel Haiku (066b42) — 12/9/2013 @ 10:54 am

    It’s only fitting that Sammy speaks Sami.

    Comment by Steve57 (20c19c) — 12/9/2013 @ 11:14 am

  64. “The whole thing is, as I said, a compromise with reality.”

    Sami – The whole thing, as everyone knew, was devoid of reality, in the manner in which it was sold to the American public.

    Comment by daleyrocks (bf33e9) — 12/9/2013 @ 11:23 am

  65. Thanks to Obamacare, I no longer have to worry about getting pregnant.

    Comment by Steve57 (20c19c) — 12/9/2013 @ 11:25 am

  66. This, from the people who think that asking women to pay $9/month for birth control pills is a “war on women”?

    The hypocrisy knows no bounds.

    Comment by bridget (a44b32) — 12/9/2013 @ 11:28 am

  67. You’ll be pleased to know, bridget, that at a cost of $9/mo. given the $6000 deductible after a mere 667 months your birth control is free.

    And, really, what 55 year old woman couldn’t use free birth control?

    Comment by Steve57 (20c19c) — 12/9/2013 @ 11:36 am

  68. What woman in her right mind screws a guy who lets her go broke paying for contraception? How is a government mandate a solution to the problem of neurotic, insecure women?

    Comment by bridget (a44b32) — 12/9/2013 @ 11:41 am

  69. I am willing to pay for liberals to use birth control, just so long as they promise to use it at all times !

    Just say ‘no’ to liberals breeding.

    Comment by Elephant Stone (6a6f37) — 12/9/2013 @ 11:42 am

  70. If you like your totally overrated Ohio State Buckeyes football team, you can keep them.

    Comment by Elephant Stone (6a6f37) — 12/9/2013 @ 11:43 am

  71. bridget – I don’t think feminism is a government mandate yet.

    Comment by daleyrocks (bf33e9) — 12/9/2013 @ 11:43 am

  72. I don’t like my President, and I don’t want to keep him.

    Comment by Elephant Stone (6a6f37) — 12/9/2013 @ 11:44 am

  73. 68. What woman in her right mind screws a guy who lets her go broke paying for contraception? How is a government mandate a solution to the problem of neurotic, insecure women?

    Comment by bridget (a44b32) — 12/9/2013 @ 11:41 am

    I don’t mean to be indelicate, but any woman who agrees to have sex with a guy and can’t arrange for free birth control is too stupid to live.

    Comment by Steve57 (20c19c) — 12/9/2013 @ 11:51 am

  74. I was tossing back a few in the Talkeetna Roadhouse a few years back. A three hundred pound retired Fort Lauderdale police Lieutenant pulled up the bar stool next to me. She had no problem finding guys who were willing to spring for drinks not to mention birth control. Well, given her age it was more like protection from disease.

    Not me, though. I hadn’t been out on the tundra that long. She was literally in hog heaven.

    I honestly never realized this was a problem.

    Comment by Steve57 (20c19c) — 12/9/2013 @ 12:12 pm

  75. How is a government mandate a solution to the problem of neurotic, insecure women?

    This is smart politics because it’s a fairly small gesture that reaps big rewards by reinforcing those negative qualities — and thus helping to make sure these women will continue to identify with and rely on government and Democrats.

    Comment by DRJ (a83b8b) — 12/9/2013 @ 12:24 pm

  76. “Not me, though. I hadn’t been out on the tundra that long.”

    Steve57 – Sometimes a couple dozen more beers before last call has been known to do strange things to a person’s perspective, or so I have been told. Heh.

    Comment by daleyrocks (bf33e9) — 12/9/2013 @ 12:28 pm

  77. I respectfully submit government has done its best to create neurotic, insecure women so it could expand into the business of solving their problems.

    Having solved everything else.

    http://thelifeofjulia.com/

    Comment by Steve57 (20c19c) — 12/9/2013 @ 12:28 pm

  78. Maybe if I had been mainlining heroin, daley.

    But to each their own. If you can’t be with the one you love, love the one you’re with. I am aware of the concept of the WESTPAC 10 but I’ve never partaken.

    http://www.duffelblog.com/2013/02/soldier-extends-for-ninth-consecutive-tour-because-she-likes-to-feel-pretty/

    Comment by Steve57 (20c19c) — 12/9/2013 @ 12:34 pm

  79. Kevin, would you wager that more people with preexisting conditions have gained access to health care or lost it?

    Oh, in a narrow sense they’ve probably gained it.

    The people who’ve lost it, or lost access to their doctors are those of the individually insured who got coverage before they were sick, but not so long ago they were grandfathered. This is not a huge number and many of these were probably on higher-cost plans anyway (HIPAA or high-risk pools). The new Obamacare plans are not likely to cost more than the high-risk plans and anyone who was subsidized is still subsidized.

    So, really the only loss here is in access, and that varies markedly from place to place (bad in CA and NY but nil in DC).

    Others, however, were excluded from the market entirely. Some by sloth or cheapness (never got insurance then got sick) and these are core Obama voters. They aren’t high on my list. But still others had workplace insurance but lost it, perhaps in this colossal economic effup of the last 6 years. Re-entering the individual market after a lapse while sick was a big problem for many people.

    That said though, my main point stands: Several far simpler reforms could have fixed this within the old system. Mussolini was not necessary to get the trains running on time.

    Comment by Kevin M (536c5d) — 12/9/2013 @ 12:36 pm

  80. “I’m looking forward to my ninth year here. It’s been so much fun, I see no point in leaving. Another year of salsa nights, Coffee Bean chats, and a whole new rotation of men to meet. I mean friends. I like to meet new friends.”

    …“I’ve been court-martialed for fraternization seventeen times,” Holder said. “It’s why I’m still a private. But a girl has to have her fun, right? I say, get play over pay any day.”

    Holder smiles, adding, “It took me three years to come up with that rhyme.”

    Holder’s family has tried to convince her to return after she stopped taking leave during her third tour. Her brother, fellow Afghanistan veteran Josh Holder, is the only family member to support his sister.

    “I don’t blame her,” Josh said. “It’s like she lives in some magical alternate universe. If my tour consisted of never seeing combat, making tons of money and everyone wanting to bang me, I’d never come home either.”

    Read more: http://www.duffelblog.com/2013/02/soldier-extends-for-ninth-consecutive-tour-because-she-likes-to-feel-pretty/#ixzz2n0ohRuRt

    Comment by Steve57 (20c19c) — 12/9/2013 @ 12:38 pm

  81. She’s got different doctors in different hosp[itals working on her case. To keep her doctor(s) she has to buy policies outsiide of the California exchange.

    Not so, Sammy. CA exchange plans are offered on a district basis, typically based on county of residence. There are plans offered in some parts of the state that are not available to residents elsewhere in the state. For example, in Los Angeles you cannot buy a Blue Cross PPO, only an EPO, but you can get the PPO plan other places. HMO plans aren’t available in some rural districts. Etc.

    IIRC, the WSJ lady said that plans were available to residents of other counties that met her needs, but not where she lived.

    Comment by Kevin M (536c5d) — 12/9/2013 @ 12:42 pm

  82. Kevin, I agree with your main point. It’s true in the narrow sense. I’m still trying to get a feel for how narrow that is. I also agree with DRJ. Obama lied. People will die. Bush gets blamed for exactly that. But I think given how many tens of millions will lose their health insurance, and their doctors, and the rates people get cancer or heart disease, I’m convinced more people will likely die from the lousy health care their new, overpriced insurance will provide them than ever got killed in the sandbox.

    Comment by Steve57 (20c19c) — 12/9/2013 @ 12:44 pm

  83. Remember when they had to quickly pass the bill not only to find out what’s in it, but to stop poor people without insurance from dying in the streets ?

    I wonder how many people have died in the streets while they’ve been waiting for this website to get fixed.

    Comment by Elephant Stone (6a6f37) — 12/9/2013 @ 12:53 pm

  84. Steve (#41)

    Lots of states had high-risk pools, but they tended to be very high cost and most working people could not afford them. So while it seemed a solution for the unemployed guy who exhausted his COBRA during his skin cancer treatment, it really wasn’t.

    The problem was that, even though insurers accepted employees with preexisting conditions all the time, there were perverse disincentives preventing that in the private market. Obamacare does not solve those disincentives so much as mandate them (and sticking the healthy self-employed with the entire bill rather than spreading it out).

    It also tends to discriminate against responsible people in favor of deadbeats, but that’s just because deadbeats vote for people like Obama.

    Comment by Kevin M (536c5d) — 12/9/2013 @ 1:03 pm

  85. I don’t mean to be indelicate, but any woman who agrees to have sex with a guy who can’t afford $9/month for birth control needs to be more picky.

    FIFY.

    Comment by Kevin M (536c5d) — 12/9/2013 @ 1:05 pm

  86. BTW, it is going to get very interesting come, about March, when we start hearing about people who’ve lied about their income, signed up for the “Enhance Silver” (read: free Platinum) plans, and then gotten their bypass surgery or whatever they needed at no cost, and then dropped their insurance again (so they could use the $19/month on more crack).

    Turns out that while incorrect tax credit advances have to be repaid, incorrect copay subsidies do not.

    Comment by Kevin M (536c5d) — 12/9/2013 @ 1:13 pm

  87. Just gets better and better;

    http://legalinsurrection.com/2013/12/obamacare-like-a-multi-million-car-winter-highway-pile-up/

    Comment by narciso (3fec35) — 12/9/2013 @ 1:14 pm

  88. So letme get this straight. The lied about keep your plan if you like it. They lied about keep your doctor if you like your doctor. They lied about the $2,500 average saving. They lied about prescription coverage. They lied about the web site. They lied about paper applications. The penalty is now a tax. They are going to tax my employer provided health insurance because they consider it a “Cadillac” plan, which it isn’t. They make up the law as they go. Reid exempts most of his staff yet he’s the one who forced it through. Why aren’t more people angry about this and calling for the repeal of Obamacare?

    Then I learn this week that in California the exchanges will pay the same to doctors as California’s version of Medicaid, which is 30 percent of Medicare and 70 percent of California doctors will not accept payments from the exchange.

    I learned last year that many doctors and hospitals will no longer accept Medicare patients because the can’t afford to provide care at the low Medicare rates. They would go broke ate the Medicare rates and the California Medicaid rates are 30 percent less than Medicare payout rates.

    Why hasn’t this been repealed?

    Comment by Tanny O'Haley (c0a74e) — 12/9/2013 @ 1:39 pm

  89. The California Medicaid payout rates are not 30 percent less, they are 30 percent of the Medicare payout rates.

    Comment by Tanny O'Haley (c0a74e) — 12/9/2013 @ 1:42 pm

  90. Why hasn’t it been repealed?

    Because that would be Racist, or something.

    Comment by askeptic (b8ab92) — 12/9/2013 @ 2:22 pm

  91. Washington. The Obamacare success story that, when you look at it, isn’t so much.

    http://seattletimes.com/html/localnews/2022371201_exchangenetworksxml.html

    Many health-exchange plans exclude top hospitals from coverage

    If you like your orthopedist you can keep your orthopedist. Unless you like your dermatologist. Then you can’t.

    …Not only could they wind up paying most or all of the bill, they would lose the law’s cap on out-of-pocket expenses.

    Premera, for example, limits annual out-of-pocket costs for in-network care at $6,350. But out-of-pocket expenses for care outside the network are “unlimited.”

    Comment by Steve57 (20c19c) — 12/9/2013 @ 4:44 pm

  92. That’s like the ‘never pay’ insurance, they sold the vicar, in the Python sketch.

    Comment by narciso (3fec35) — 12/9/2013 @ 4:55 pm

  93. Comment by Tanny O’Haley (c0a74e) — 12/9/2013 @ 1:39 pm

    They are going to tax my employer provided health insurance because they consider it a “Cadillac” plan, which it isn’t.

    No, that’s a lie, too. They are not going to tax it. Not any time soon, anyway. That is the the provision of the law that is last scheduled to go into effect – I think in 2019, they postponed it from 2018. The reason they said they would tax it, was to make the math look better.

    Why aren’t more people angry about this and calling for the repeal of Obamacare?

    Well, for one thing repeal is not the answer.

    Why hasn’t this been repealed?

    Of course one reason is that you need a 2/3 majority in both houses to do so right now, and it is not such an overwhelmingly oobvious disaster yet. That won’t happen till the spring of 2015 or so.

    But also the Republicans in the House have passed almost nothing but straight repeal – now they did some postponement. That is because there is really nothiong on the table and because they would differ from each otgher if they tried. Somebody has to wqork on serious alternatives.

    remember, the entire health care payment system is messed up and has been messed up for around 45 years, getting steadily worse.

    Comment by Sammy Finkelman (ca4c0f) — 12/9/2013 @ 4:57 pm

  94. http://www.beckershospitalreview.com/racs-/-icd-9-/-icd-10/bronze-exchange-plans-pose-bad-debt-risk-for-hospitals.html

    Comment by Sammy Finkelman (ca4c0f) — 12/9/2013 @ 5:02 pm

  95. No, that’s a lie, too. They are not going to tax it. Not any time soon, anyway. That is the the provision of the law that is last scheduled to go into effect – I think in 2019, they postponed it from 2018. The reason they said they would tax it, was to make the math look better.

    Sammy, you went from ‘that’s a lie’ to ‘the reason they are doing it is to make the math look better’.

    It sounds like it’s not a lie, then.

    Comment by Dustin (bfbac8) — 12/9/2013 @ 5:04 pm

  96. A B Stoddard, of the Hill, (figures) says the promise was that they would get cheaper coverage,
    as Inigo Montoya would say;

    Comment by narciso (3fec35) — 12/9/2013 @ 5:10 pm

  97. People will readily buy insurance either where there is a relatively trivial premium, or there is a relatively trivial deductible, but not where both are high in relation to income, but Obamacare makes both high.

    Comment by Sammy Finkelman (ca4c0f) — 12/9/2013 @ 5:12 pm

  98. SF: She’s got different doctors in different hospitals working on her case. To keep her doctors) she has to buy policies outsiide of the California exchange.

    Comment by Kevin M (536c5d) — 12/9/2013 @ 12:42 pm

    Not so, Sammy. CA exchange plans are offered on a district basis, typically based on county of residence. There are plans offered in some parts of the state that are not available to residents elsewhere in the state. For example, in Los Angeles you cannot buy a Blue Cross PPO, only an EPO, but you can get the PPO plan other places. HMO plans aren’t available in some rural districts. Etc.

    Yes, but there is no plan anywhere I think that would let her see her primary oncologist at Stanford University’s Cancer Institute, and her other primary care doctors at the University of California, San Diego (not to mention the M.D. Anderson Cancer Center in Houston, Texas, which she also uses)

    http://online.wsj.com/news/articles/SB10001424052702304527504579171710423780446 (behind a pay wall)

    Also posted here: http://www.freerepublic.com/focus/news/3087163/posts

    UCSD has agreed to accept only one Covered California plan—a very restrictive Anthem EPO Plan….except for emergencies. Stanford accepts an Anthem PPO plan but it is not available for purchase in San Diego (only Anthem HMO and EPO plans are available in San Diego).

    IIRC, the WSJ lady said that plans were available to residents of other counties that met her needs, but not where she lived.

    Somewhere else she could get a PPO plan that included Stanford. But she didn’t seem to consider this a big obstacle.

    She says she can get coverage outside the exchange:

    My choice is to get coverage through the government health exchange and lose access to my cancer doctors, or pay much more for insurance outside the exchange (the quotes average 40% to 50% more) for the privilege of starting over with an unfamiliar insurance company and impaired benefits.

    Comment by Sammy Finkelman (ca4c0f) — 12/9/2013 @ 5:26 pm

  99. Stories like this warm my heart.

    http://www.nytimes.com/2013/12/07/us/politics/health-law-eases-some-worries-but-creates-others-in-north-carolina.html?partner=rss&emc=rss&_r=1&

    CHARLOTTE, N.C. — Mike Horrigan is a lifelong Democrat with heart problems who supports President Obama’s health care law because he expects it will help many people obtain better insurance, including himself.

    But under the new law, the Affordable Care Act, Mr. Horrigan’s coverage by a state high-risk insurance program was eliminated, then replaced by a more expensive plan. His wife’s individual plan was canceled for being substandard, then suddenly renewed — also at a higher price.

    So while Mr. Horrigan, 59, believes the law will improve health care in the long run, its short-term effect has been chaotic and trying for him and his wife, Kay. “It’s more stressful than it needed to be,” he said.

    He thought he was voting himself bennies that others would pay for. Instead he got screwed. And he still believes that somehow, magically, this law will somehow result in better and no doubt cheaper health care for him in the future.

    Amazing.

    Comment by Steve57 (20c19c) — 12/9/2013 @ 5:26 pm

  100. One comment at the Free Republic site says that the policies that he has reviewed all drop out of network coverage – but thats how people used to see specialists when they were seriously ill!

    If you live in Los Angeles county, you can see the specialists at Cedars Sinai hospital. But if you live in San Bernadino you can’t. Clearly Anthem has a contract with Cedars Sinai, and yet they don’t provide any insurance coverage at all to a resident of nearby San Berdnadino or Riverside CA at that hospital.

    So he said what’s going on here is they are forcing patients to go to a small number of hospitals, thereby increasing the volume at those hospitals, in return for which the insurers asked for a wider spread on their discount price vs. the list price. (a greater discount.)

    Comment by Sammy Finkelman (ca4c0f) — 12/9/2013 @ 5:32 pm

  101. I wonder if this will make Time’s Scandal of the Year. It competes with the IRS scandal and the NSA scandal.

    Comment by Kevin M (536c5d) — 12/9/2013 @ 6:12 pm

  102. This is smart politics because it’s a fairly small gesture that reaps big rewards by reinforcing those negative qualities — and thus helping to make sure these women will continue to identify with and rely on government and Democrats.

    Right – and it keeps the focus on religious people, not the women’s own problems.

    Comment by bridget (67c2cb) — 12/9/2013 @ 6:17 pm

  103. Sammy–

    You are correct. UC accepts the EPO not the PPO, which is weird, but that’s what their website says. They also accept a Healthnet PPO, but HealthNet only offers a bronze plan. I guess if you are going to max your OOP anyway, that might not matter.

    Comment by Kevin M (536c5d) — 12/9/2013 @ 6:21 pm

  104. Perhaps we need a new word to describe medical care balkanization: Obamatized.

    Comment by Kevin M (536c5d) — 12/9/2013 @ 6:22 pm

  105. He thought he was voting himself bennies that others would pay for. Instead he got screwed. And he still believes that somehow, magically, this law will somehow result in better and no doubt cheaper health care for him in the future.

    Bad deals [Youtube] never get better.

    Comment by Kevin M (536c5d) — 12/9/2013 @ 6:36 pm

  106. All Obamacare will do is create a huge, new market to get around Obamacare.

    It’s one thing to create a government-run pension scheme for old people, such as Social Security.

    It is another thing entirely to try to create a government-run market of health insurance for mostly healthy people.

    I still do not understand why the left did not try to simply create a new single-payer bureaucracy for those with pre-existing conditions and some below the poverty line.

    Oh wait, I forgot. This whole clusterfark was never intended to insure anyone. Carry on.

    Comment by Ag80 (eb6ffa) — 12/9/2013 @ 6:47 pm

  107. The Obammie Commies have it figured out. We don’t fight back, so they go 2 or 3 more steps toward Fascism. This will not end nicely.

    Comment by Gus (70b624) — 12/9/2013 @ 9:23 pm

  108. Comment by Ag80 (eb6ffa) — 12/9/2013 @ 6:47 pm

    I still do not understand why the left did not try to simply create a new single-payer bureaucracy for those with pre-existing conditions and some below the poverty line.

    Slightly expand Medicare to include people with pre-existing conditions and fold Medicaid into Medicare?

    Liberals often want a one-time solution for all people for all time. Or at least something that pretends to be that. This wouldn’t be it.

    What was being proposed was “the public option” meaning being able to get or buy into Medicare or something else run by the federal government.

    Oh wait, I forgot. This whole clusterfark was never intended to insure anyone. Carry on.

    The important thing was that there be no sizable (serious) losers, at least in theory.

    Comment by Sammy Finkelman (ca4c0f) — 12/10/2013 @ 3:09 am

  109. Many members of Congress and their staff – who have a December 15, actually December 16, and not a December 23 deadline on the DC Health exchange, are having trouble signing up:

    http://politicalticker.blogs.cnn.com/2013/12/06/now-whos-having-trouble-with-health-care-signup-ask-congress/comment-page-3/

    The chief administrative officer of the House, Dan Strodel, send an e-mail saying they could have an additional week using his office.

    Comment by Sammy Finkelman (3bb3ae) — 12/10/2013 @ 10:13 am

  110. Now the New Yorker wrote about this breakthrough in the treatment of hapatitus C.,

    I’m kind of surprised the FDA allowed this so soon:

    http://www.newyorker.com/online/blogs/elements/2013/12/a-new-treatment-for-hepatitis-c.html?utm_source=tny&utm_medium=email&utm_campaign=dailyemail&mbid=nl_Daily%20(76)

    Comment by Sammy Finkelman (3bb3ae) — 12/10/2013 @ 10:57 am

  111. Forbes Magazine: No, You Can’t Keep Your Drugs Either Under Obamacare

    many drugs may not be covered at all, and the costs patients incur by buying them with cash won’t count against out of pocket caps….Drugs on your health plan’s formulary will typically have fixed co-pays….these co-pays can already be substantial, pushing people quickly to their annual out-of-pocket limits — $6,350 for individuals and $12,700 for families (after which insurers pay the full tab)

    People whose annual income is at or below 250% of the Federal Poverty Level will qualify for cost-sharing reductions. (That comes out to families of four earning less than about $60,000, or individuals earning less than $30,000). But people qualify for these cost-sharing subsidies only if they enroll in a higher cost, “silver” Obamacare plan.

    Take, for example, the drug Copaxone for multiple sclerosis.

    Someone on a bronze plan would be responsible for paying about 40% of the drug’s costs out of pocket, on average. That comes out to about $1,980 a month.

    If you buy the highest cost platinum plan, the out of pocket costs drop to $792 a month. But you’re probably better off with the cheaper bronze plan anyway.

    Since you’re going to hit your out of pocket cap regardless of your plan, you might as well save money on the premium….the provider networks (and formularies) used by low cost “bronze” and high cost “platinum” plans are often the same,\.. , staff at the Centers for Medicare and Medicaid Services is arguing that patients will have the option to appeal formulary decisions — to try and compel a health plan to cover a given drug.

    But this appeals process can take months. And there is no sure chance of winning.

    If a drug costs tens of thousands of dollars a year, how many patients will be able to foot that bill out of pocket until they win an appeal. Or take the chance that they could lose the appeal, and be stuck with the full cost of the drug?

    The biggest problem in all of this is that consumers will have a very hard time figuring out where they stand….The government was supposed to mandate that plans made this information easily accessible. But in many cases, that never happened.

    Comment by Sammy Finkelman (3bb3ae) — 12/10/2013 @ 2:39 pm

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