<p>Flossy, are you referring to the spousal fraternity as this miserable group? :)</p>
<p>2022? No-one knows what will happen by then and certainly no-one was figuring in this dismal start. ACA proponents have got to be freaked. Have you seen SNL or John Stewart? It’s quite brutal.</p>
<p>Spousal fraternity - Yes</p>
<p>Fignewton, this CBO table shows the uninsured stabilizing at 30 million by 2016.</p>
<p><a href=“http://www.cbo.gov/sites/default/files/cbofiles/attachments/43900_ACAInsuranceCoverageEffects.pdf[/url]”>http://www.cbo.gov/sites/default/files/cbofiles/attachments/43900_ACAInsuranceCoverageEffects.pdf</a></p>
<p>Narrow networks…</p>
<p>[Narrow</a> Networks Found To Yield Substantial Savings | Managed Care Magazine Online](<a href=“http://www.managedcaremag.com/archives/1202/1202.narrow_networks.html]Narrow”>Sitemap - Managedcaremag.com)</p>
<p>From dstark’s link:</p>
<p>
</p>
<p>So, yeah, this trend was happening before the ACA.</p>
<p>We can disagree about whether it makes sense for employers to try to save money on health care costs. Me, I don’t think employers are obligated to provide employees the Mercedes Benzes and Porsches of the health care world.</p>
<p>CF… I am joking. </p>
<p>The Kaiser Foundation has done a great job. </p>
<p>GP, try just to read the topic sentences from CF’s link. They are usually highlighted. It is a great link. </p>
<p>I dont know why CBO is using higher uninsured numbers. Might be partly because there are going to be more millions more uninsured because states opted out if the medicaid expansion.</p>
<p>I dint know why CBO and the Kaiser Foundation stsrt out with different uninsured numbers with the CBO numbers much higher.</p>
<p>[The</a> Uninsured After Implementation Of The Affordable Care Act: A Demographic And Geographic Analysis ? Health Affairs Blog](<a href=“http://healthaffairs.org/blog/2013/06/06/the-uninsured-after-implementation-of-the-affordable-care-act-a-demographic-and-geographic-analysis/]The”>http://healthaffairs.org/blog/2013/06/06/the-uninsured-after-implementation-of-the-affordable-care-act-a-demographic-and-geographic-analysis/)</p>
<p>dstark, I wish I saw this article in Feb of 2012 about narrow networks, particularly the part about Blue Shield. I would have never given up my grandfather status if I had known.</p>
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</p>
<p>Making estimates of the future is always going to involve uncertainty. Over the course of ten years or more, will a slow, fumbling start really make much difference?</p>
<p>“I don’t think employers are obligated to provide employees the Mercedes Benzes and Porsches of the health care world.”</p>
<p>How about Toyotas and Hondas?</p>
<p>Goldenpooch, that table shows the number of uninsured declining from 55 million to 30 million, or about 25 million insured due to the ACA. The numbers I quoted were from 2012 (soon after the Supreme Court modification), but they are not that different from this table, also from the CBO. Since these are projections, other entities like Kaiser can come up with different numbers. The uncertainty in the 25 million figure could easily be ± 10 million. Does it really make any difference?</p>
<p>Well… GP… We cant go back so it is kind of wasting energy to look back and think what if. </p>
<p>We have to look forward now. Hopefully, you will like Anthem’s network. </p>
<p>One thing one or more of the insurance companies mentioned was quality hospitals were still in their narrow networks. Cleveland Clinic in one. Johns Hopkins in one. </p>
<p>I do want UCSF in mine and everything I have seen and been told says UCSF will be in mine. Having said this, I am not going to UCSF unless I have something like cancer.
You never mention Stanford. I guess Stanford is too far for you. For something really serious Stanford could be great. I will settle for UCSF. :)</p>
<p>Is Stanford in the Anthem network?</p>
<p>Kaiser’s numbers are for 2012 and CBO for 2013, but that doesn’t explain 57 million vs 47 million. And AFAIK, both are counting undocumented immigrants so that’s not it.</p>
<p>Also, look at the Prior Law table in the CBO link. The CBO says that the US will gain 16 million population by 2022, a plausible estimate. But then they don’t project any growth at all in Uninsured. Rather, they have a substantial net growth in employer-covered people, and a small growth in small group plans and Medicaid enrollment. Seems like an odd projection to me.</p>
<p>Dont know GP.</p>
<p>I will check eventually. Interesteddad provided a link… Have to find it. </p>
<p>I have two friends that had cancer surgery at Stanford and everything looks good. They rave about Stanford.</p>
<p>I thought Goldenpooch was in southern California, so he’d be unlikely to be treated at Stanford no matter what insurance he had?</p>
<p>How far do the PPO markets extend?</p>
<p>Yeah, now I am confused. I thought the PPO networks were statewide. Have they changed this, too?</p>
<p>I don’t know… I just thought if you lived in southern California you’d probably not come all the way up here to go to the hospital, that’s all.</p>
<p>
</p>
<p>Smoking and drinking are behaviors. High BMI, high blood pressure, and high A1C are medical conditions. They may be partially caused by behaviors, just like a host of other medical conditions–heart disease, high cholesterol, HIV, STDs, pregnancy, chronic obstructive pulmonary disease, cerebrovascular disease, mesothelioma and certain other cancers, kidney stones and certain other kidney diseases, gout, mercury poisoning (too much sushi?), lead poisoning (really just about any kind of poisoning), hernias, broken bones, concussions, shin splints, sprained ankles, plantar fasciitis, ACL tears, rotator cuff tears, back injuries, gunshot wounds, injuries incurred in automobile or motorcycle or ORV accidents. The list is almost endless.</p>
<p>It’s understandable that for-profit health insurers would seek to exclude coverage of people in high risk/high cost categories. That’s why people with pre-existing conditions were generally unable to purchase health insurance on the individual market. But the justification for employer-sponsored health insurance, if there is one, is that especially for large employers, they sponsor a sufficiently large risk pool that these various conditions and their associated medical risk/cost profiles will cancel each other out and come to approximate the risk profile of the public generally.</p>
<p>If employers start charging differential employee premiums based on conditions like high BMI, high blood pressure, and high A1C, it begins to undercut that justification for employer-sponsored health care. And there’s really no logical stopping point. Why not also charge a higher premium for anyone who has a condition that may be caused in part by behavioral factors? For that matter, why stop with behavioral factors? Type 1 diabetes is genetic; predisposition to Type 2 diabetes is also genetic. Both can be controlled to some extent by behaviors, but rarely perfectly. So we know diabetics are, on average, going to cost more than non-diabetics. So why not just say anyone genetically predisposed toward either Type 1 or Type 2 pays more? Or anyone with a family history of heart disease, or cancer? Or sickle-cell anemia? If you go very far down that road, the whole idea of risk-pooling, i.e., of insurance, breaks down.</p>
<p>I suspect some of us are more inclined to punish people who are obese (or have related conditions like high blood pressure or diabetes) because it’s easy to disapprove on moral grounds of people who eat poorly, eat too much, and/or don’t get sufficient exercise; it seems to be something they bring on themselves. Yet obesity, high blood pressure, and diabetes do have a genetic component; people’s metabolisms differ and their bodies process calories differently, so while staying slim may be a simple matter of willpower for some, others eating an identical diet and living an identical lifestyle can be putting on weight. And even on the behavioral side, it’s much more complicated than individual lifestyle choice. Childhood obesity is epidemic; children are generally not in a position to make informed consumer and lifestyle choices. They learn from their families, and obesity tends to run in families due in part to genetics and in part to cooking and eating habits and patterns of physical activity or inactivity acquired from early childhood; not to mention that, as kids, they often have little choice but to eat what’s served them. Other institutional factors also come into play. Until Michelle Obama made a crusade of it, school lunches and other free school meals were notoriously unhealthy in many places. Studies have shown that something as simple as the size of the bowl or plate used for school lunches can have a dramatic impact on caloric intake, because kids will take (or be offered) what looks like a reasonable amount relative to the size of the bowl or plate. Modern families eat fewer home-cooked meals than in the past; obesity is also associated with a high rate of non-home-cooked meals which generally have a higher carb and higher fat content and on average come in larger servings as measured by caloric content. We also have a fast food industry and a junk food industry that spend billions trying to lure kids into eating the unhealthiest crap, and most of them are suckers for it. Studies show childhood obesity is strongly correlated with the number of hours kids spend watching television, but because similar hours spent looking at other kinds of screens are not similarly correlated with obesity, it suggests it’s the advertising trying to lure kids to eat unhealthy stuff that’s the culprit here, not the physical inactivity associated with watching a screen. Other studies have shown that physical proximity to fast food outlets and convenience stores is strongly correlated with obesity. Left to their own devices, kids don’t stand a chance against this kind of institutional onslaught, and once they’re obese as kids there’s a very strong probability they’ll be obese as adults. To some extent, then, punishing the obese is just blaming the victim.</p>