<p>What does that^ mean, lookingforward??</p>
<p>“Lasma, the problem with your idea is that it is simply unenforceable. When the person shows up in the emergency room with a serious disease or injury, he will be treated, no matter what paper work he has signed.”</p>
<p>Actually, it is a little more complex than that (and worse). If someone shows up in the emergency room for fainting spells related to cancer, the ER has to treat the emergent condition, but not the underlying one. So the patient could return to the ER again and again and again, without receiving the treatment really needed. Same thing happens with people who go to the ER for pain of any kind: the ER has to control the pain, but does not have to treat the condition that causes it.</p>
<p>As we learned earlier in the thread, not enough info is currently released. I know we are trying to cobble together from what has been revealed- but we also found some omissions in early info. It bothers me when misinfo swirls and grows a life of its own.</p>
<p>MY financial guy told me to wait til more details come forth.</p>
<p>Back to UCLA and Cedars</p>
<p>Posted, in ref to LA Times article: “Cedars-Sinai Hospital is not going to accept any of the exchange insurance plans. UCLA will accept one.”</p>
<p>I’ll admit, I freaked when I saw the post quote. So I looked at the LA Times article and assume I found the right one:</p>
<p>*People who want UCLA Medical Center and its doctors in their health plan network next year, for instance, may have only one choice in California’s exchange: Anthem Blue Cross. </p>
<p>And Cedars-Sinai Medical Center, one of Southern California’s most prestigious and expensive hospitals, said it’s not included in any exchange plans at the moment.*</p>
<p>But note the same article continues: Details on these insurance networks aren’t known yet as insurers and providers wrap up their contracts and await regulators’ review in the coming weeks. It’s possible some medical groups and hospitals could be added.</p>
<p>I think the answer is right here:
</p>
<p>The article at [Insurers</a> limit doctors, hospitals in state-run exchange plans - Page 2 - Los Angeles Times](<a href=“http://articles.latimes.com/2013/may/24/business/la-fi-health-rates-deals-20130525/2]Insurers”>http://articles.latimes.com/2013/may/24/business/la-fi-health-rates-deals-20130525/2) says that Blue Shield is creating a narrower PPO network for the exchanges, but Health Net is seeking approval from the state to use its existing network, which does include both named hospitals: </p>
<p>
[quote[Health Net Inc., another exchange option in Southern California, said it expects to seek state approval to use its existing network, which includes both UCLA and Cedars-Sinai, for one of its exchange plans.
[/quote]
</p>
<p>So that seems to be basically a fear-mongering article – note the use of the word “may” in this sentence: “People who want UCLA Medical Center and its doctors in their health plan network next year, for instance, may have only one choice in California’s exchange: Anthem Blue Cross.” As in, they “may have only one choice” or they “may” have multiple choices.</p>
<p>I think fear is a huge part of the problem that people are dealing with now. Until they know things for sure, (and it doesn’t seem that easy to find out the final resolution), people are going to be fearful. Healthcare is such a personal issue that involves so much money.</p>
<p>NOT that these two hospitals have opted out, as earlier stated.<br>
Negotiations are incomplete, at this point.
I think, despite what has been previewed, we still have to wait for October.</p>
<p>Hey, awesome, we just got a letter from our company telling us about how our health care benefits will change because of the ACA. I guess I don’t have to wait till October.</p>
<p>Even though their plan is compliant, they will be required to pay tens of millions of dollars in new fees to the government, based upon the number of people they cover. I guess that is a reward for covering huge numbers of people (certainly wouldn’t want to call it a penalty).</p>
<p>In addition, since our plan is considered a “cadillac” plan, they are going to cut way back on it. Higher deductibles for employees, so they don’t have to pay a punitive tax.</p>
<p>I’m so glad that besides the extra taxes that I’m paying to support the ACA, that now I will be getting less coverage than I had before. I feel like now we are really contributing to the group effort to make sure nobody has better coverage than anyone else, because it really wasn’t fair, was it?</p>
<p>Paying more money for less is awesome! </p>
<p>Said no one, ever.</p>
<p>^^Ha. Well gee, Samurai, I’m sure it must help someone in the big picture of things if we all pay more money for less coverage (even though my company is self insured). Theoretically it sounds like it should be a benefit to my company to pay for less than they have been paying voluntarily…except for all the additional fees, lawyers and administrators they’ll have to pay.</p>
<p>Maybe if we’re really lucky, they’ll pass a law that makes us work more for less pay also. Then require the companies to pay it back to the federal govt in fees.</p>
<p>Unfortunately, my efforts to lobby Congress for single payer–which would have made our business significantly more competitive–went nowhere. Our Senators, both Dems, and our Rep, also Dem, were in favor, but ultimately compromises were made to ensure 60 votes in the Senate (which is patently in violation of the Constitution).</p>
<p>Ultimately, we will be all be paying higher prices for goods and services to make up that difference that before might have been profit for an employer, but is now being paid in penalties and corporate attorney fees and compliance costs.</p>
<p>
</p>
<p>It’s unenforceable under current law, true. The law would have to be changed, and I don’t think that would happen. We as a society don’t have the stomach to turn sick people away from emergency care, I don’t think, regardless of their ability to pay.</p>
<p>I wasn’t really serious about my proposal. It’s an expression of frustration that those same “resisters” who will opt out of ACA for philosophical reasons, will then show up at ERs and expect it to be paid for by those of us who ARE taking responsibility for our health care costs. I didn’t mind so much when it was impossible for so many to get insurance. But it’s not impossible now, and anyone who gets healthcare while refusing to pay anything into the pool is nothing but a free-loader.</p>
<p>We spend about 18% of GDP on health care. I wonder if we could move to a single payer system with a model to cap spending at 16% of GDP and pay for it with a transparent tax. No more Medicare tax for the employer and employee, no more hc costs for the employer or employee, no more fear of losing a job and with it healthcare.</p>
<p>Would we be willing to see a 16% tax on everything that makes up our national GDP? How would employers handle compensation if they no longer paid for HC. Would busdriver get a $20,000 pay increase if her company did not fund her HC? With a $20k raise paying 16% tax on purchases might not be so bad. I am assuming the cost of her Cadillac plan would be $20k for a family.</p>
<p>Is our Medicare model worthwhile to follow. It does not appear seniors are ready to give it up even though they complain about it.</p>
<p>The current regime of employment-based health insurance is largely the legacy of decades of favorable tax treatment, along with exemption from wartime government wage controls.</p>
<p>Does anyone know what the enrollment period in the exchanges may look like?</p>
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<p>That is generally how I felt the other day standing in line at the pharmacy behind the 250+ lb. woman who had a mountain of sweet junk foods and diabetic test strips in her basket. It is the price we pay to live in a free country.</p>
<p>Actually, Tom, getting a 20k pay increase in lieu of insurance would be a bad deal, (and no, it wouldn’t happen as we are union, pay increases are negotiated). As that amount would be taxed highly, add on the additional taxes, and it would be a serious negative.</p>
<p>Obviously though, it’s not all about me… I’m just pointing out a direct example of the ACA affecting certain groups of people negatively. My union did not support it, but I don’t know why some of the major union groups did. It was obvious that anyone with very good company provided insurance was going to be hurt. And I know that unions are only concerned with their power and benefits to their membership at the cost of all else. Since this was an obvious negative to their membership, I can only conclude they thought supporting the ACA would increase their power.</p>
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<p>In a free country, only those who make those stupid choices would have to live with the consequences of those choices.</p>
<p>Ok, then we are surely not free.</p>
<p>If you want to pass laws against diabetics eating sweet junkfood, I might not object.</p>
<p>busdriver I also have excellent insurance. I do not believe a national system would be better for me as an individual. I do believe it would be better for the country overall though.</p>
<p>busdriver: Your letter today, sadly, brings to reality that which I figured early on in this debacle would be the case. Those that have been paying, taking responsibility and ‘sucking it up’ will be asked to pay more, take on more responsibility for others and well…$%# it up some more.</p>
<p>Those that haven’t been paying will probably choose either a low cost penalty, ignore the law (if your are under the IRS radar - how will you be held accountable, the system can’t even add a premium increase for smokers because - it cant’ figure out how to do it and the IRS can’t collect the back taxes it is owned NOW and KNOWS about. Oh yeah, no problems) or simple let themselves be subsidized. The cold cruel reality - the only place to get the funding needed for this ‘improved’ system is to dig into the pockets of those already on file, those who proved willing to play by the rules, those who have been ‘doing the right thing’ all along. But hey, it’s really all about someone feeling good about themselves because they did something good for someone else with the earnings of a third party who really have no say in the matter.</p>
<p>Ahhh…how wonderful. Now, like the FA ‘game’ in University payment, we all have to learn the ACA game. Some will be better than other at figuring out the loopholes, some will make $$ teaching other to use the loopholes and some will simply do what they have been doing…which is nothing.</p>