<p>Share their stories and vote, I guess. The message board is the sharing stories part. They are pretty powerless and they probably know it at this point. </p>
<p>What do you think anyone can do about this, emily? We all just have to figure out what to cut out of our budgets so we can pay the increased costs of the higher premiums and higher deductibles. </p>
<p>Or we can all just issue a collective: “bwahhhhhwahhhh.”</p>
<p>It seems to go with this thread to mangle. Calmom did a nice job pointing out that your “save 2500” came through as “the typical family will save up to $2,500 every year.” </p>
<p>It’s not vetting when a set of folks push their personal opinions or personal tales. Opining, “…hey …this really really fluster clucked me!” is not standing back and looking at the whole. And, standing back and looking at the whole is not “cheerleading.” If we can’t recognize the difference, there is no productive discussion, imo. </p>
<p>From the beginning of this thread, many of us (called the cheerleaders or heartless or other quick dismissals) acknowledged that there are issues (and that some are paying more, yes.) That seemed to get ignored. I think, because some wanted to set up an “us and them” position, further your own sense of injustice, get a rise out of others, fan some flames. In the process, the chance for some juicy “big” questions was skipped. Instead we got links to personal tales of woe we couldn’t substantiate, anecdotes about a person here and there who has a problem. Those may be very real circumstances, but they don’t prove the whole thing needs to be tossed. It doesn’t even offer enough detail to see IF that person did get screwed and HOW it came to be. </p>
<p>Without enough info, the potential for deceit runs on both sides. (Face it.) We’re supposed to be outraged because a hard-working hairdresser, worth a long drive, with a back-up for appointments, had a 50% increase in her present policy. Just on the face of it, we’re supposed to be outraged? A second-hand tale with no further info? The questions a poster or two asked, for background and about the lady’s options…got ignored. </p>
<p>We went through a few pages of insurance brokers telling that rates would climb for 2015 by 50% or more, mounting outrage among some- and those opinions have yet to be proved. It was supposed to “prove” something that brokers, in advance of any 2015 rates being filed, said this? Garbage in, garbage out.</p>
<p>You can’t “correct the misinformation coming out of Washington” if you only look for another media tale of woe, some rightist repeat of their mantra, some onesie-twosie anecdotes, article after article quoting each other, etc. </p>
<p>I didn’t see this thread as a venue for telling your personal tales of woe. Nope, I thought it was to discuss from a wholer perspective, inform each other. Nor do I see how some of you can begin to “correct” anything, when you rest on your personal experiences and make broad, universal assumptions and sweeping statements from that. </p>
<p>And I know someone will pull some one phrase from this post and chop into it, I understand the urge is that great. In several cases, I did ask you to wait and see- especially before Oct 1 2013 and more recently, with the rate hike predictions. Overall though, I have advocated not going with the first soundbites, not assuming, instead doing some genuine digging and some analysis. Then, form informed opinions. Apologies to anyone this offends, but the superficial thinking here is a real issue.</p>
<p>And it was Pelosi who made the “pass it” comment. </p>
<p>“Share their stories and vote, I guess. The message board is the sharing stories part. They are pretty powerless and they probably know it at this point.”</p>
<p>"What do you think anyone can do about this, emily? We all just have to figure out what to cut out of our budgets so we can pay the increased costs of the higher premiums and higher deductibles.</p>
<p>Or we can all just issue a collective: “bwahhhhhwahhhh.” </p>
<p>So, it sounds like you (again collectively) are not going to do anything about it. </p>
<p>There are several things I would do if I felt strongly about this (or any other issue) besides just voting. And while I might not be successful in effecting the change I desire - I don’t see the point of just throwing up my hands and saying woe is me. </p>
<p>^ one person’s voice is one person. Get enough together and you magnify the influence. Isn’t that at the root of the country’s founding? If Californians really hate how ACA is operating in CA, by all means, band together, go for it. But I hope you distinguish between ACA itself and how Covered CA and your insurers rolled it out. To be effective, having the right target matters. As does the right argument. </p>
<p>Emily, any idea how rate filings are going in NY? </p>
<p>“Emily, any idea how rate filings are going in NY?”</p>
<p>Nope. I assume they’ll be a press release at some point and an article in the paper - but ACA isn’t remotely a story here anymore. </p>
<p>Emily:
</p>
<p>So far what we have done is raised prices for our customers…that’s working well. We are now running spread sheet scenarios to see what the graph/numbers indicate as the best of a number of business moves. </p>
<p>I am keeping well informed on the unintended consequences which are coming to light. </p>
<p>What I am not doing is fighting a battle with my State’s DOC. I’d rather invest my limited time and energy doing something that has a potential for a positive bottom line effect.</p>
<p>LF:
</p>
<p>Why validate any past outrage when it comes to increased premiums? We do’t know know the basis for any anecdotal information for pre-ACA rate increases. With this logic no one, anywhere, ever should have complained about health insurance rate increases. </p>
<p>And, yes…I know it was Pelosi who in a moment of unguarded honesty uttered the infamous “we got to pass it to know what’s in it statement”. So, my question to you is…if someone of Pelosi’s level was unable (or unwilling?) to vet the bill…how could you or I ever have done so. Hard to vet that which filled with umpteen 'TBD" sections at the time of passage.</p>
<p>Take the challenge. Try to propose a substantive change that you support and that you think the other side (detractors if you’re a supporter, supporters if you’re a detractor) would also agree with.</p>
<p>D- if someone is going to give an example, why not the supporting details, the whole truth? Rather than asking us to take the OMG as the final word? So we can see it and then judge, store that info and see how it pans out, among many. </p>
<p>As for Pelosi, who says “unguarded honesty?” That presumes there is some “honest” back story that’s being hidden from the gentle folk. Do you know that? (See the slant in your phrase?) Maybe her comment was just stupidity. An inability to choose her words. If she’s not serving her people, she can be voted out. Assuming people aren’t too busy to vote. (Did you ever see her defense of her comment? Doesn’t satisfy me, but she points to the process. The process our Congress was going through.) </p>
<p>It doesn’t take much effort to add your voice to a protest. At a minimum, you can write a letter, sign a petition (so dang easy online,) or place a call to their office, where all those junior interns take your call and ask some questions (ha, vet you.) And then get back to your personal business. The alternative is waiting for someone else. </p>
<p>By the way, Obama didn’t write ACA. Both sides had a hand in what came out.</p>
<p>Okay…I’ll take the challenge</p>
<ol>
<li><p>Reinstate the group policy option for all mom/pop/family businesses. If the replacement individual policy market is such a better option for these family businesses…trust me…you’ll have to expand the network capacity, build a bigger parking lot or a wider road to handle the hoards that would trample for the better option. If it’s not a better option…don’t force it on a group of people who really have no union, lobby or political clout just because you can.</p></li>
<li><p>Offer staged policies…give people a choice of whether or not they want chiropractic care, maternity care, infertility care as part of their policies. </p></li>
<li><p>Since the ACA mandate was forced on all the States, force the States to reinstate cancelled policies. Do not hide behind the ‘I told them they could keep them but the heartless insurance companies are refusing’. And, give some of those seemingly unlimited federal $$ to those companies to cover their costs for reinstating policies. After all…they just spend a fortune retuning their systems to handle your demands.</p></li>
<li><p>Open the Health insurance market across State lines. If, as is one of the prime selling points, all policies must now meet a minimum standard of coverage…then what is the problem. Why not let me choose a policy from State A - which offers coverage for black lung, instead of from State B which offers coverage for mold. </p></li>
<li><p>To accommodate issues which arise from being in State A but having a disagreement with policy from State B - make it so the consumer sues/challenges in the state of residence. Hey way back 20 years ago we took a cruise company (registered in the usual 3rd world tax haven) to small claims in CA. Why…because the point of purchase was in CA. Oh…and we won that case. So, stop the excuse of protecting consumers from recourse if they purchase across state lines. If Amazon, Apple, Ebay can do it…hey…rise to the challenge, call them and ask for their help.</p></li>
</ol>
<p>6.Mandate a full disclosure of all costs for all CPT codes for each and every provider/facility/insurance company. That way I can decide if I want to go to facility A or B when it comes to the ingrown toe nail or the cardiac surgery. This way I can choose to pay $100 for the toe nail instead of $350.</p>
<ol>
<li> Address the Medical reimbursement issues. Pages back I posted the payment my insurance company paid for a certain CPT code, and the corresponding Medical rate. I don’t recall the exact numbers but the Medical rate was about 25% of my post negotiated rate. How in the blazes is covering all these people with Medical going to work if providers can not afford to treat them. (and no, making the acceptance of Medical mandatory is NOT the answer). </li>
</ol>
<p>How’s that for a start…</p>
<p>"So far what we have done is raised prices for our customers…that’s working well. We are now running spread sheet scenarios to see what the graph/numbers indicate as the best of a number of business moves.</p>
<p>I am keeping well informed on the unintended consequences which are coming to light.</p>
<p>What I am not doing is fighting a battle with my State’s DOC. I’d rather invest my limited time and energy doing something that has a potential for a positive bottom line effect."</p>
<p>So you are not doing anything to effect change in regards to ACA, then, correct? And it’s good that you have found a solution that works for you, personally. I think, in the end, this is what most are going to do - find a way to live with it. ACA will then cease to be an issue of great importance to anyone. </p>
<p>EmilyBee: I vote.</p>
<p>And how could I forget…</p>
<ol>
<li>Since mandates are so popular…mandate that no company gets to offer any policy without a complete and prior vetting by the DOC or the feds of the provider network. You guys wanted to get into the Health insurance management area…then actually do some management.</li>
</ol>
<p>"How’s that for a start… "</p>
<p>Very good. So how are you going to get these things addressed by someone who has the power to implement these changes in the law? </p>
<p>“EmilyBee: I vote.”</p>
<p>And that is going to do what to get the things you have listed in your post addressed? </p>
<p>Dietz, good start, send the letter.<br>
The codes, though, are complex in practice. Of all the questions I asked, for a recent hospital procedure, many came back, “it depends.” It depends on how long the procedure takes, which depends on what they see. Anesthesiology charges depend on that same time issue. Would the biopsy, depending on the initial look, be read by one or two specialists? would they need to add Test X? An ambulatory center (cheaper time rates) would preclude the level of service the doc wanted. (Long story, this was reasonable.) </p>
<p>And then when the bill came it was all lower than I projected. The hospital went ahead and charged its rates, the insurer knocked it down to negotiated/approved, for the final category of coding the hospital and docs described. Anesthesia was a pittance, compared to the max amount they had warned me of. </p>
<p>But yes, a toe nail is different. My D1 had a procedure where the doc office knew in seconds, what our charges would be. D2 recently had something, scary but simple, where we actually got paperwork with the cost, beforehand.</p>
<p>You don’t even have to start a grassroots campaign. Just send your thoughts. And if many do the same, you will have potential influence in numbers. You don’t need a lobby or PAC. Sign some petition (if this is so unpopular, these should be abundant.) And it can start with one letter- to your congressperson or the insurance regulators. Print it X times and send it. No one is saying quit your job. </p>
<p>as for medicaid reimbursement, I still say we need to get on what the docs actually need to charge.</p>
<p>Comments on dietz’s proposal:</p>
<ol>
<li><p>Reinstate group policies for family businesses: I don’t understand the issue here. That is, I don’t know the ACA regulation that you’re opposing. So I neither agree nor disagree.</p></li>
<li><p>Let healthy people decide not to cover diseases and conditions that they are lucky enough not to have and not to be likely to get: No way I would agree to letting healthy people not pay for sick people. Nope. Not a chance.</p></li>
<li><p>Let insurers reinstate non-compliant policies: Nope. I didn’t like the administration letting any non-compliant policies stand. I certainly don’t want to see any more non-compliant policies.</p></li>
<li><p>Selling insurance across state lines: Oh come on. We talked about this already. You already know that supporters don’t agree to sell across state lines. We already said that we think it would lead to a race to the bottom.</p></li>
<li><p>Letting a consumer sue in state B about their state A insurance policy: If the laws governing my policy are in state A, then how can I sue in state B? State B can never be in charge of interpreting or implementing state A’s laws. This doesn’t make any sense to me.</p></li>
<li><p>Full disclosure of costs: I agree with this one. I fear that it would help less than you and I hope.</p></li>
<li><p>Medicaid reimbursement: This one clearly needs to be addressed. One issue that is hard to deal with is national rates, versus large differences in medical costs by area. What does one do about that?</p></li>
</ol>
<p>Overall, dietz, you didn’t do a particularly good job about making proposals that I would agree with. You lean heavily on finding ways for healthy people not to pay for sick people, an approach I disagree with. And I call bad faith on number 4.</p>
<p>I don’t think it’s necessary to call out Dietz’s ideas. I think she has every right to go for them and let the chips fall where they may - knowing there will also be vocal opposition to all the things she proposes (and I don’t mean on a message board.) </p>
<p>I am quite sick of hearing people complain about ACA but doing nothing to change it. So, even if I think their ideas are misguided, I have respect for the ones who have the cojones to at least try to change what they don’t like, instead of just crying into their beer. </p>
<p>What I don’t have any patience or sympathy for are those who complain but won’t do anything other than that. </p>
<p>I had thought that dietz was trying my challenge of coming up with proposals ACA supporters would agree with.</p>
<p>I think when it’s phrased, “have healthy people pay for sick people,” it paints a picture of absolutes- this guy has no issues and that gal needs cancer care. To me it’s about pooling all of us, knowing our med needs can shift with little warning. Based on stats overall, maybe the younger person gets lower rates than the older. But nothing says the young person on lower premiums won’t need expensive care. Nor that the middle-aged person with in good health today won’t run into an issue tomorrow. </p>
<p>It’s not enough to vote out someone you think is responsible- or vote in someone you think “gets” your position. These folks are responsible for managing more than healthcare. That needs to be a holistic and weighed decision, imo. Consider all you value or find important.</p>
<p>CF: No snark intended but the ideas put forth weren’t tailored towards you. The ACA camps are heavily and deeply divided. To come up with proposals which the pro camp would embrace are as unlikely as the current anti ACA camp embracing the current system. In a nutshell …those that are harmed by this bill need to be made whole.</p>
<p>I think the best we can hope for is to part out this big big bill and change parts. Which brings me full circle to another comment I’d made previously. This should never have been implemented in one fell swoop. But…that only starts another round of disagreement. </p>
<p>
</p>
<p>The race to the bottom is limited by the mandated coverages…isn’t that one of the big benefits of the ACA? Are you saying the newly formed ACA compliant plans are the ‘bottom’.?</p>
<p>Oh…I realize I miss read the item about which I was commenting…oops</p>
<p>However, CF: I agree with hour proposals but I’m unfamiliar with Medicaid ‘clawback’. </p>