It’s an excellent time to be changing your state of Residency, don’t you agree?
North Carolina initially was setting up its own exchange, but with the election of Pat McCrory and control of both houses in Republican hands, the NC Exchange is being dismantled. I had a chat with Blue Cross / Shield and they sound ready to go offering “must issue” coverage, even if the Federal web site isn’t working.
The only significance of the “defunding” debate is the premium subsidy that wouldn’t apply to me anyhow.
I still believe this is designed to fail. The end game is universal coverage using a payroll tax and managed by Medicare. The only tangible effect of NC Republicans opting out is that now the future is controlled in Washington instead of Raleigh.
We should expand it to include mandatory auto coverage- that is automobile coverage for everyone. Everyone deserves a car… and the policy must include oil changes, filters, and weekly gasoline coverage so people can get to work and reduce unemployment. 😉
Transportation insecurity is a major problem in America. Here in Chicago, some people don’t even know if they’ll be able to find a parking spot tonight.
Solve it like my local town has with reserved spaces – to insure that a significant number of spaces remain unused because there is a shortage. 😉
I think that system started in Chicago.
On my trip downtown, on street parking is so expensive you can park anywhere you want – except the half of the space that is empty but reserved for police.
“the policy must include oil changes, filters, and weekly gasoline coverage ,”
LOL classic, and a free bag of cheetos !
I change the oil in my car myself, so I am opting out of Obo-care.
Justice Roberts must have been threatened or he could be just a Horse’s-ass !
Parrott
Absolutely. Cheetos or tortilla chips – salsa is covered but not guacamole.
END GAME
So many in the mainsteam media, including Fox News have called Sen Cruz a fool and said he has no endgame. He lays it out clearly here with his friend Sen Paul playing the Ed McMahon role for him. Regardless of your politics and position on the Afforadable Care Act, it is an interesting clip. Enjoy:
http://www.youtube.com/watch?v=U2yu-Mo1ogo
This video is priceless- reading bedtime Green Eggs and Ham to his daughters over C-Span
http://www.businessinsider.com/video-ted-cruz-reads-green-eggs-and-ham-defund-obamacare-2013-9
Yeah it was CC, I watched too !
Everyone call their senator and say ditch OBO-care.
http://www.c-span.org/Events/Sen-Cruz-Debates-CR-Defunding-Health-Care-Law/10737441638-1/
live feed from c-span Rand is speaking now
parrott
I would guess that the insurance companies get a decent cut because they aren’t raising any alarm; further the IRS as collection agency insures decent payment rate. I got my first garnishment order for student loans this week. There is no way out of it for me or the employee. There is also no recognition or compensation to me for my costs.
Where is my red line in the sand? I used to think it was the second amendment. My red line will mean more than the Kenyon’s in the White House.
Yeah They must Hpaws. The insurance companies are not running any ads whining at all. It must be a big cut. Fed employees are exempt along with the congress and Prez. That is so gay. They should have to suffer through this cheit like the rest of us.
so ashamed of Virginia’s two ‘reid-puppet’ senators.
parrott
By definition, the insurance companies make money- no one works for free. If the regulators insist on a price where they make no money – they walk away as they should.
They loved the requirement that all policies have added benefits – covering children until age 26, paying for birth control pills, etc because each expenditure is more profit for them – they basically estimate the total costs and then add in their cost and profits and sell it to the public that is not required by law to buy it.
The new law makes it illegal for folks like Donald Trump to go to a doctor and pay cash- he must pay the middle man and provide that middleman’s computer with his entire medical history – which they are required by law to share with the government. Ask yourself the real purpose of the new law.
Bingo – insurance is structured as a “cost plus” business model. How much did we spend last year, add in a % that the state insurance department approves.
This means there is very little incentive to say “no” to any treatment plan. 80 year old diabetic needs a third liver transplant? No problem. There is a huge risk – both legally and media coverage to say “No, you can’t have that”.
Want to add aroma therapy and Roy Masters’ meditation tapes? No problem.
The only pushback would be from employers paying the premiums – but with an increasingly long list of mandated coverages, competition isn’t offering many options.
Most Americans are not covered by medical insurance, they are instead covered by their employers. Any company over about 50 employees does not actually buy medical insurance but instead pays the “insurance” companies an administration fee to administer the program.
What that means is that if you are diagnosed with cancer, AIDS or some other expensive illness, the costs drop to your employers bottom line and they have a significant incentive to terminate your employment.
Just ask John LaBarca how that works…
http://youtu.be/zbXP5Zq2L8Y
My explanation above was a bit simplified. I should add that those small employers that do purchase insurance rather than administrative services from the medical insurance companies, do so for their “group” or “groups” of employees. Those groups each pay different rates based on the profiles of the members in the groups and the groups past and project future expenses.
Personal advice from CC : if you come down with a very expensive illness, it is in your best interest not to tell your employer about it until you have to.. and preferably after you have finished your medical procedures. Employers get usage reports from the insurance companies but they are not down to the SSN level. The groups and reports may be down to a small enough group of employes that they can make an educated guess on who is spending all the money on chemotherapy expenses… absences are a good clue.
Bottom line is this – when you get sick, the doctors don’t work for free- there is no such thing as free medical care – someone has to pay them.
This is close to the catch-22 that I’m in – I probably have a couple issues that could benefit from inspection by a trained doctor – but the moment I ask, it’s going to wind up in a database that could make it harder to get insurance in the future.
If you intend to stay out of the database, pay cash. It may no longer be legal to see a doctor without showing ID, so consider Ontario or Mexico – the money you save will more than pay for your transportation costs.
I do remember back in the 1980s asking a doctor – since I’m paying you cash and there is no insurance involved, why are you asking me to sign a release to share my medical information with insurance companies? He mumbled some answer like well that’s just how our computer system works – it requires sharing your data. It was a highly unsatisfactory answer then, but I understand exactly why it was done.
Perhaps we need a law similar to that for credit reports that lets you get a copy of the information kept about your medical history. If “must issue” and rating for prior medical history goes away, then there will be no need for that. Sunlight is a good disinfectant.
“if …rating for prior medical history goes away”
I don’t think it will under obamacare… It is done at the group level… rather than at the individual level but there is more than one group. I could be wrong, I honestly haven’t read all 20,000 pages. 😉
It’s all pretty confusing. What is going into effect on October 1st (maybe) is two pools – one for individuals and one for “small” businesses – the idea is still that individuals seeking “must issue” policies are probably going to be atypical high cost policies. Small Business gets their own pool. “Big Business” isn’t allowed to use the exchanges until 2017, I think – with the employer mandate delayed a year, they don’t face the penalty for not having insurance plans for their employees that pays at least 60% of the costs.
should have said “sell it to the public that is now required by law to buy it. “
Just pay the fine and take your chances in the emergency room. That seems to be the path most healthy, younger folks are going.
Perhaps the only way to stop the complete enslavement of all Americans is to stop participating in the current system and let it crash. If anyone was paying attention to the G-20 meeting a few weeks ago they would have learned the BRICSA nations have now funded an alternative world banking system, which is designed to allow them to do business without using the current world reserve currency. Once that system gains traction and al-Obama destroys the 40 hour work-week in America, the decline of the USD could really begin to take hold.
We could all be doing ourselves a favor and help things along by refusing to participate in their system. I seriously doubt anything like that will happen because we are all so cowardly and will cling onto our comfortable lifestyle no matter how much abuse we suffer. By way of example consider what resistance was there from the majority of people who were rounded-up from the ghettos, stuffed into cattle cars, shipped to the death camps, and then calmly walked naked into the Nazi gas chambers over 70 years ago?
Art has stated what is obvious, the whole health care-tax is destined to fail. States who opted out did so largely because the faux-law aka, ObamaCare is too vague and no one knows for certain how to implement it. Throwing the exchanges back to the Feds means its future is controlled by al-Obama, who can be blamed for its failure.
“defund Obamacare” is much different than Repeal Obamacare – even if you scuttle the subsidy and the individual mandate, the list of changes to the insurance business stay – “must issue” with no rating or denial for pre existing conditions, premium parity for male vs female, limiting premiums for people in their 50s and 60s to 300% of what a healthy 20 year old will pay.
All are deliberate disortions of the marketplace that will have unintended consequences. As a guest on John Batchelor pointed out, if the exchange pools don’t get broad participation, the pools will end up having only the really sick people, raising the costs next year, speeding up the death spiral.
The “tax” if you don’t buy insurance starts at 1% of your income or $95, whichever is greater. So if you have $40k in income, the tax/fine will be $400. You get by without paying the tax if you can’t buy a plan for less than 8% of your income ($3200 yr in my example)
But that’s just easing in the process – by 2016, it is $695 or 2.5% – keep in mind paying the tax doesn’t provide any benefits.
But, if congressional aides can not afford ObamaCare with a 6 figure income why should we expect those making less be able to afford it? What happens if you miss a payment?
Everyone keeps talking about the cost of individual policies. The problem for traditional families like mine where the principal wageearner (the dad) has to cover 3 or 4 other people with only one income, the cost to cover everyone is averaging $3300/yr per person. Suddenly we’re looking at $13K-$16K/yr, and that’s paid with after-tax income. (And the deductibles are $6000 out-of-pocket per person before the insurance begins to cover anything!) Will the 8% of income fine exemption apply to the total cost of the family policy or just the individual cost to cover the principal wage earner? Obviously it will apply only to the cost of individual insurance for the wage-earner, because that’s a better deal for the government. If you have a family to insure, too bad- you should have used a condom or gotten a government job.
So just like with welfare and AFDC, next we’ll see an epidemic of Obamacare-driven divorces as previously stable middle class marriages are forced to break up so that the mom and kids can get subsidized coverage and avoid the fines.
I lost my good health insurance within just 3 months of Obamacare passing in 2010. Self-employed and over 50, no other insurance was available at any price. Six months later I suffered a first-ever kidney stone that cost me over $40,000 cash money out of pocket for a 30-minute outpatient procedure. The hospital wouldn’t cut me any deductions even if I offered cash because I was from the wrong demographic, e.g., “conservative white male self-employed professional”. I’m still paying on that debt today.
I too will refuse to participate in Obamacare. It’s already caused me great financial harm. And I won’t pay the fine. The U.S. Constitution is written in plain English and anyone who reads it will readily conclude that it doesn’t give the Federal government the power to compel U.S. citizens to purchase anything. It doesn’t matter what the SCOTUS ruled, we all know that power was never given to the Federal government. If they want to send a hard working self-sufficient nuclear/mechanical engineer to jail and destroy all my dependents over that, then so be it.
Health care as % of GDP
http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS
Other than a few outliers like Micronesia – most of the civilized world spends about 10% of GDP on health care – the US is around 17%. Is our care really that much better or is the current system that inefficient? Does every hospital really need its own MRI and CAT scanners?
MRI and CAT scanners serve a useful purpose, but I wonder how much of that 17% is due to unnecessary tests? I betcha banning medical lawsuits and sending all disputes to mediation or arbitration could also put a serious dent in that 17% figure.
You don’t really have to look much past this chart, Art. … but if you want to, you will find a similar one for nurses and medications by country…. add in the number of lawyers involved in the industry and you have the complete picture in less than two sentences. 😉
http://www.hcjz.hr/slike/foto_vijest/x118112800822389848.jpg
The best primary care experience I had was with a female physician’s assistant. She had the time to give me a thorough exam. I’m thinking part of the problem is the supply of doctors is deliberately constrained and much primary care can be done by nurses and PAs that don’t need so much education.
Agree with all your points…. but don’t forget pharmacists. I got sick while working in Mexico City and walked from the office two blocks to a local pharmacy.
Between my lack of Spanish and the Pharmacist’s lack of English, he was able to offer me a bottle of antibiotics. It was $5 for a about a 30 day supply and it was a name brand pharmaceutical company… in fact it was manufactured in New Jersey.
Had I been in the USA, my good medical insurance would have had me pay the doctor several times the $5 just for the co-pay to get he script to present to a pharmacist.
When I made my cash purchase in Mexico City, the pharmacist did not ask for my ID and did not record the sale in a data base for the Drug Enforcement Agency… saving himself and myself some time and cost and giving us both more privacy.
Back when I had my last visit to a pharmacy, I asked how much one of the prescriptions would cost if if I paid cash instead of insurance + $10 copay. The answer was something like “less than $10 – we set the minimum price to $9.95 because of the $10 copay
Costco, and Walmart have a long list of generics for that price or less. Walgreens has a great subscription plan for about $50 per family that will provide extreme discounts to regular users of drugs.
There are similar dental plans such as the GE Signature plan that provide steep discounts off “customary” prices.
They do the membership route so that the “customary” prices can remain inflated. It’s a bit like shopping in the malls, if you are not getting a “discount”, you are doing something wrong.
Ted Cruz shines a spotlight on the disaster that is Obamacare and the GOP establishment does nothing but bash him.
Vile…. very vile lol
http://www.politico.com/story/2013/09/peter-king-ted-cruz-phone-calls-97396.html