patrick.net

She's really enjoying her Prime Rib Turd.
Hey it's shaped like a steak, looks like a steak, but damn if every bite she takes she has to spit it back out.

BUT HEY!!! She's a fan...

No, she will be provided a much simpler explanation for her pain - it's the evil insurance companies seeking to subvert the wonderfulness of the ACA. Mix in a healthy dose of Republican obstructionism and there you have it.

The pattern is, insurers are buying corporate practice groups and hospital corporations in order to avoid the MLR rules, then raising prices in order to maximize profits within the context of the MLR rules. Independent practitioners are squeezed in a vice between higher costs and lower pay, until they surrender: either by retiring, or going to work for a corporate practice group, hospital corporation, or PhRMA. That may explain why physicians oppose the legislation by an even wider margin than the general public. The "growing national trend toward consolidation" had already begun, even before the current administration, but the legislation enlarged it and made it mandatory.

curious2 says

"I'm a complete fan of the Affordable Care Act, but now I can't sleep at night," Nelson said. "I can't imagine this is how President Obama wanted it to happen."

Bad news, Tulip, Obama had no idea what he was promoting, he just spewed out the lies and misinformation presented on his teleprompter.

If you elect a "roll with it and spin" politician, that's what you get.

What made anybody think Obama ever even read more than a paragraph of the thing? Too much trouble, and irrelevant to the political goal.

curious2 says

And there you have it: the facts disprove both parties' myths, but people stick to their sides anyway. She couldn't keep her old insurance, she can't keep her doctor, she can't even sleep at night, but she's still "a complete fan."

So damn true.

curious2 says

The pattern is, insurers are buying corporate practice groups and hospital corporations in order to avoid the MLR rules, then raising prices in order to maximize profits within the context of the MLR rules.

The Affordable Care Act is indisputable proof that capitalism epically fails at solving some economic problems including running a health care system.

All health insurance needs to be nationalized. It's debatable whether or not health care providers need nationalizing, but certainly the insurance and payment systems need to be. Additionally, we need a single payer system.

OTOH, if you go to a drug company's website after seeing an ad on TV, they can probably hook you up with a licensed pusher "doctor" whom they're incentivizing to prescribe a daily pill that you're probably better off without. Also, mandatory prepayment for "free preventive care" will inevitably lead to more biopsies and treatment, again mostly unhelpful and potentially injurious, with many opportunities for revenue maximizing medical misadventures.

It's all Obama's fault!!!

Dan8267 says

It's debatable whether or not health care providers need nationalizing....

I agree with many of your comments, and the evidence shows Britain's NHS delivers better results at lower costs than the American system, but private medical insurance did not really become a problem until government stepped in to "help" with subsidies and mandates. We end up with lemon socialism, privatizing gains while socializing losses, and it is neither capitalist nor a free market. Without price controls, subsidies tend to be captured by sellers instead of helping buyers; even Medicaid seems to enrich sellers without helping purported beneficiaries. Likewise, sellers use unfunded mandates and licensing to eliminate competition, then raise prices. The result is especially pernicious when it applies to your own health; even your own body is no longer your own, when someone else can convert it into their mandatory revenue center.

Update: "California exchange pulls error-ridden physician list--again

The exchange has touted the directory as an important consumer tool because some insurers have sharply limited the number of doctors and hospitals...."

"Insurer Admits Nearly 1,000 Doctors Wrongly Placed On Covered California Provider List... State regulations allow insurers to change their provider lists without notice."

"for many consumers, some enrollees located physicians thought to be in their plan, and subsequently discovered they were not."

Yeah, you mean like when your Doctor writes you a recommendation script and tells/warns you to get over there today and have this test ran pronto, so that he can continue his diagnosis. Which you follow the instructions to the letter.

But the Insurance company tells you that they wont pay for the facility fee, because it's owned by the Hospital, and the insurance plan clearly states that they don't cover hospital bills, you must go through your PC. You'll also get a bill for the blood-work, and Doctor, because they were out of network. But also, even though you could have SWORN that you saw and read, $35 deductible(Or how much ever it is) Now why am I getting a $350? Oh that's because you got to read the coverage section where they break down, the Co-insurance portion. Where they only cover 70% of a procedure, you're on the hook for the other 30% regardless of out of pocket caps.

Many consumers and people who are under the illusion that they have socialized healthcare will soon be in for very hard fucking reality eye opener. Even with insurance these bills will clean you out, and make you bankrupt. Like Obamacare was supposed to prevent, instead it has exacerbated the possibility of it.

Because there is no cheaper alternative, Obamacare made very damn sure of it. Nancy said it wouldn't work and she'll lose profits, if those sorry sons of bitches can just run to a cheaper Doctor and get the same thing done cheaper than the ACA copay, and coinsurance.
What do we do? What do we DO?

CaptainShuddup says

Many consumers and people who are under the illusion that they have socialized healthcare will soon be in for very hard fucking reality eye opener.

No one in America other than you and a smattering of the dumber rushbots are so wilfully ignorant that they believe obamacare is sociialized medicine.

Call it Crazy says

With many doctors opting out of plans and enrolless having less choice of doctors, I think many will end up at the emergency rooms,

I work in healthcare. Every physician I know (with the exception of one very odd concierge MD who is struggling to maintain his practice) accepts insurance.

In New Hampshire, "Concord's one hospital won't accept any policies offered by the marketplaces. To see a doctor, specialist or primary care provider affiliated with the hospital, patients on these Obamacare plans will have to pay out of their own pocket. The closest in-network hospital is in Manchester.

"Can you imagine having to go 25 miles away to Manchester to get access to a health care provider that is covered by your insurance?" Harte asked. "Right now, Concord is one big black hole of health care for people buying these plans."
...
And it's not just Concord. Nationally, consumers are learning a number of well-known hospitals won't accept insurance offered through the marketplaces."

25 miles in a New Hampshire winter can be a dangerously long drive, especially for a person who is ill and/or on meds.

"Fed up with declining payments and rising red tape, a small but growing number of doctors is opting out of the insurance system completely."

elliemae says

Every physician I know....

Elliemae has been deteriorating lately, and has forgotten that the plural of anecdote is not data. Her migraines are making her suicidal, which puts her at further risk of a toxic SSRI Rx. She has even turned anti-vax, calling vaccines "completely useless." It's sad, but she gets upset if anyone suggests the trouble might be caused by her meds, so we can only watch and wait for her to figure it out herself.