<p>dstark, you lost me in that last post. </p>
<p>That is because it was directed at busdriver11. I edited the post and put busdriver’s screen name in the post. </p>
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<p>OK, now only one more concept:</p>
<p>MOST people who do not have employer-sponsored health insurance and must buy on the individual market are “hard up for money”. Really. I don’t have an extra $2000 to throw around for a Silver plan, let alone worry about counting up how many hospitals or doctors are on networks. And my problem is that I might make too much money to get subsidies – most people who are buying individual policies do not. </p>
<p>Generally, people who are employed at higher salary ranges also have employer provided insurance. It’s just one of those perks that is expected once salaries hit $40K or so. </p>
<p>So the whole point of ACA is to enable people who are “hard up for money” to get insurance. </p>
<p>So cost is and always has been a factor for us. Over the years I’ve seen my premiums go up and up and up, and policy benefits get shaved back repeatedly – the first reversal of the trend came with ACA, when all of the sudden I could actually get a free annual physical with my high-deductible policy, and the insurance company had to send me a refund check every year to make up for charging me too much in premiums. (Not a big check, but at least it was something). </p>
<p>They didn’t name the law the “Premier Health Care for Everybody” act – it’s called the “Affordable Care Act” because the goal is that everyone will be able to buy insurance that they can afford. And the only way the policies can be affordable is if they also direct patients to providers that provide lower cost care. </p>
<p>Yes, there are some people like GP who have more money and would prefer to have Cadillac-style policies, even if the premiums were higher – but the vast majority of beneficiaries of ACA are not in that boat. Most of us aren’t worried about whether we will have an opportunity to pick Dr. McWonderful – we’re worried about whether we will be able to afford to see Dr. Anybody.</p>
<p>DStark wrote: “What is wrong with this? (Community Health) They have a huge network.”</p>
<p>As I pointed out in my [post</a> on Feb 8](<a href=“Affordable Care Act Scene 2 - Insurance Premiums - #9803 by calmom - Parent Cafe - College Confidential Forums”>Affordable Care Act Scene 2 - Insurance Premiums - #9803 by calmom - Parent Cafe - College Confidential Forums), the Community plan seems the highest price option, at least in the Silver tier. </p>
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<p>The point I was making is that Washington has a very strong exchange, with a good range of options to choose from. At the low end there is Group Health, with primary care provided mostly through its own network of clinics, but two well-regarded hospitals (Children’s and Virginia Mason) available for more serious health needs; and at the other end of the range there is Community, which includes every hospital, but at a 20% higher cost with the example that I posited. </p>
<p>I assume that cost differentials may be more significant for larger families or older insureds – the comparison tool is down right now, so I can’t run a model of costs for, say, a married couple in their 60’s, or 40-something parents with 3 kids. </p>
<p>So there are options for different budgets. </p>
<p>There seems to be an argument being made that all policies should have equally broad networks – which essentially would drive up premium costs all around. That seems to me to be a very anti-consumer policy – it would require many people to pay jacked up premiums for theoretical access to facilities they would never use. </p>
<p>Maybe we’re finally cutting through the issue with Calmom’s 4:13 post, above. The talk moved fast in the past few hours, but: not everyone can afford the same options. For GP to want the ultimate best, just in case, is very personal. And the GPs out there can and should look for the right options for them. ACA is not designed for them. </p>
<p>Calmom , you contradicted yourself in your posts. On the one hand, you said there are people like me who would pay for a Cadillac plan or Dr. McWonderful, but because there aren’t many of us, no reason to accommodate us. On the other hand, you complement the Washington exchange for making these types of options available to its residents. I agree if they can do it in Washington, they should be able to do it in California.</p>
<p>LF, yes let’s cut through the issue. I can’t look for the right options on the individual market in Ca. The options aren’t available. I have only two insurance companies to choose from and each of them have very restricted networks. To add insult to injury, Covered Ca. wouldn’t allow for any delay in cancelling the non-grandfathered plans even though Obama asked them to do it.</p>
<p>Two other points:</p>
<p>There are many self-employed and semi-retired people who are affluent and would like to have more choices than offered on the individual markets in many states. To say that most people in the individual market are poor is not accurate.</p>
<p>Community Health Plan is only offered in 26 of the 39 counties in the state of Washington. So there are plenty of people in Washington who do not have the opportunity to avail themselves of this wider network</p>
<p>"For instance, one study shows that while a commercial plan would have about 40 cardiologists per 100,000 people, a typical ObamaCare plan would have an average of only 15.</p>
<p>Dr. Scott Gottlieb of the American Enterprise Institute, or AEI, found a similar situation in a county in Florida where there are “seven pediatricians for a county that serviced almost a quarter of a million children. We found plans in San Diego County that only gave you access to 10 dermatologists.”</p>
<p>The root of the problem is that extra benefits offered on healthcare.gov were so expensive the only thing insurers could do to hold down costs was clamp down on providers.</p>
<p>“I found counties, for example, again in California, where the nearest urologist was 90 miles away,” says AEI’s Gottlieb. “So if you think of the range of conditions, which you might need to see a urologist, sometimes you’re not going to be able to drive 90 miles to see one.”</p>
<p><a href=“ObamaCare patients may encounter fewer doctors, longer wait times | Fox News”>http://www.foxnews.com/politics/2014/02/11/obamacare-patients-may-encounter-fewer-doctors-longer-wait-times/</a></p>
<p>GP- are you dealing with CA insurers and do you blame them? Last time I asked, you said you have a plan. My question was about where you point your finger. You said you had an insurance plan.</p>
<p>Fact is, we can’t go back to a year ago. And I don’t think ACA is about going back. You want what you want. It isn’t available or not at the cost you want. Or there are trade offs. Or maybe you do find something suitable enough. I want back parts of my life a year ago, too. It isn’t available. I am a firm believer in protest. We all get some chance to offload on CC- but don’t let it divert you. </p>
<p>If the plans are not to your liking, don’t tell me so and so agrees with you, don’t bring me hit-lines. Take it to the insurer, OIC, state reps. Because they are your first point of blame. They made or allowed these plans that don’t meet “your” needs, in your cotext, per your thinking. There may be a law that spurred them, but clearly, your state problems are not what I find in my state, so you need to start with your state. </p>
<p>More to say, cutting myself off.
Since I now see your latest posts, one add: again, you are finding factoids, not vetting them!<br>
One guy and you want us to extrapolate. C’mon. If forced to, I’ll show you the questions you should ask before linking. But I’m frustrated at this skeet shooting. No, make that whack-a-mole.</p>
<p>“With less than seven weeks of open enrollment to go, ObamaCare enrollment — and payments — have slowed to a near-crawl in some states.”</p>
<p><a href=“http://news.investors.com/politics-obamacare/021014-689516-obamacare-enrollment-signups-stagnate-lag-2014-targets.htm”>Error - Investors.com;
<p>The college comparison is interesting. </p>
<p>You can only go the top schools if your dad works for a large corporation or is unemployed. No kids of successful small businessmen are allowed because most small business owners are struggling and can’t afford it. Wow.</p>
<p>Dstark, thanks for the info on NY enrollment. </p>
<p>GP, whack-a-mole.
Acting: not the example I would use.</p>
<p>actingmt, your post pretty well sums it up</p>
<p>LF, having trouble reading articles that don’t adhere to the orthodoxy. It’s called cognitive dissonance.</p>
<p>BTW, I bailed from the individual market. Have group insurance now. Unfortunately, most people in the individual market don’t have that option.</p>
<p>haha, You’re having CD? “In psychology, cognitive dissonance is the excessive mental stress and discomfort experienced by an individual who holds two or more contradictory beliefs, ideas, and/or values at the same time.” Wiki. I don’t think you hold two views. I suspect you mean me, “orthodoxy” being a step up from “cheerleaders,” (A term I think another used, not you.) </p>
<p>I am asking you to vet. It really feels like you are Limbaughing us, extrapolating and trying to build on fears. Speculating based on a few examples. There are issues with ACA. I can tell from some posts that others besides the anti side are aware. But whack-a-mole doesn’t cut it.</p>
<p>And we know you bailed. For now. And I do think a concern about particular hospitals is - or can be- valid. But it’s too soon to know trends, too alarmist to predict.</p>
<p>“Speculating based on a few examples”</p>
<p>There have been hundreds if not thousands of examples. You can accuse me of building on fears (putting a name to it betrays your political preferences) but at least I didn’t make things up like, “you can keep your plan and doctor or the typical family will save $2,500 a year”.</p>
<p>Well, if they keep randomly delaying the big things (which is highly constitutionally questionable in the first place) it seems we have to wait a very long time while the vast majority remains unaffected and people with exchange plans who used to have insurance now cannot see their doctors. It’s bizarre.</p>
<p>GP, you don’t see that your antagonists are not towing a party line. They are interpreting differently. One has said, over and over, it’s too soon. Several have dug extensively, not hit back with knee jerk party speak. </p>
<p>We are saving 10k/year over the indiv plan, about 6k over the former group Cadillac. It matters. Same network (my docs and hosp choices.) </p>
<p>I don’t know about “hundreds if not thousands of examples.” Maybe you’re counting the numbers delayed via online. That doesn’t predict doom. That’s stupidity on the part of planners, no question. (Said from a project mgt and crisis mgt background.) Can’t count that without looking into the resolutions, as well- which, as said, we won’t know til after 3/31. And even that is not the end point. </p>
<p>“We are saving 10k/year over the indiv plan…Same network (my docs and hosp choices.)”</p>
<p>Well, maybe it should concern you that millions of your fellow Americans are not afforded a similar outcome.</p>
<p>What’s this really about, GP, behind your insistence? If you retain what has been covered, you know my position about others, my concerns for them. It’s offensive to be called cheerleaders just so you can fling down your gauntlet. Over and over.</p>
<p>Picking at others, mocking statements, too-easily rebutted links. I’m sorry, it’s trollish.<br>
I’m taking a break. Argue on. Ha, I think you are just set against any good news outcomes. </p>