<p>This interesting (from the LA Times article):</p>
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<p>She thought that she was just deciding not to see patients who bought on the exchange, but in fact she was deciding not to see patients with individual insurance, however purchased.</p>
<p>This is also interesting:
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<p>I’m in favor of that legislation, as described. For one thing, regular providers are supposed to be available. Networks are supposed to have enough doctors to handle health care. So if the networks are inadequate, then the insurers should certainly pay for the person to get the care the network was supposed to be providing.</p>
<p>Ok, so the 97 and 115 complaints were about provider networks and LAT says the total is at least 1498. So, if 60% of 1.4 million are ABC and BSC related, it looks like .0018 have lodged complaints. </p>
<p>Now, they have a quote, “These narrow networks are making a huge difference in terms of affordability…” But does anyone interpret this as, “we had a thousand docs, we’ll just shift it down to 500?” Or is the narrowing the result of docs refusing the reimbursements? Which came first, the chicken or the egg? </p>
<p>“If they pay, they run.” Huh? How? Does the govt tell my docs how to provide actual medical care for me? How to make decisions? If you think so, why the diffs among states? It seems you are thinking some ultimate “Big Brother.” Mary’s treatment will be this, Bob’s will be that, Susie won’t get her meds, John will be left to die. </p>
<p>That sounds like a mantra without facts to back it up. Please provide some evidence that subsidized health plans are more highly regulated than other health plans. All health plans, subsidized and not, are regulated. Nobody has any doubt that federal and state governments can regulate health plans, whether subsidized or not.</p>
<p>I’m not at all convinced that the small volume of complaints means that the provider lists were, in general, accurate, or that the insurers provided accurate, easily available information about which providers were on which plans.</p>
<p>To the contrary, I have seen ample evidence that the provider lists were inaccurate, and the insurers made it difficult to find out which doctors were on which plans. We know that the provider lists (with information provided by insurers) were removed from the web because they were wrong. We also know that Anthem, at least, wasn’t answering its phones.</p>
<p>For that reason, the California investigations seem, to me, to be justified. I would say, what were they waiting for, but we don’t know how long the investigators have been investigating. Just because it’s not in the paper doesn’t mean it’s not happening. </p>
<p>Flossy, my husband’s coverage is not subsidized. So he is paying in full for insurance from a private, for-profit corporation. The medical care itself is provided by a different private, for-profit corporation. Will you please explain how that’s government run health care?</p>
<p>As to there being too much regulation in the restaurant business, fine. So you do call it “government run nutrition”?</p>
<p>That isn’t. But, that isn’t Obamacare, either. </p>
<p>Edit to add - I would call it government-run nutrition if it was priced beyond the ability of most people to afford it and subsidized and then you where told what you could eat for lunch and which provider restaurant you could select to patronize from a few available options. </p>
<p>We agree there was an issue with provider lists in CA. Pretty heinous. It blocked ordinary functionality. There should have been (or be) a financial concession- paying for doctor charges as in-net when they indicated the docs were. Without penalizing the pool.</p>
<p>Isn’t subsidized, in some respects, like a Pell grant? The govt kicks in, does have some regulations, but does not teach. Does not run the colleges. Someone can always try to say, “Yeah, but.” But it’s still vague and opinion and the rest of us do not have to understand your reasoning.</p>
<p>As long as subsidies like Pell grants remain small in comparison, it is not too problematic. When it is reaching a nontrivial portion od GDP, it becomes gov run business. we all know how inefficient they are.</p>
<p>Flossy, I’ll tell you how Obamacare has benefited my DH even though he doesn’t get a subsidy.</p>
<p>First, he cannot be declined or forced to pay more because of his medical history. Second, if he ever does lose a lot of income he’ll still be able to get insurance. Third, if he doesn’t like the plan he chose this year, he’ll be able to choose a different one next year. Fourth, if the insurer overcharges, he’ll get a rebate. Fifth, we could keep our daughter on his plan if we wanted to. Sixth, if he gets an expensive illness, he cannot be rescinded. Seventh, there are no caps on his coverage. Eighth, he does not have to pay an arm and a leg for expensive screenings like colonoscopy. Ninth, we will never be bankrupted by medical bills. </p>
<p>Igloo, I’d say read this whole thread. Insurers raising rates is not new. Otoh, folks posting the rate hike requests for their states, laying in some context about past hikes, comparing reserves now and over the past few years, risk adjustments and corridors, etc…could be informative. </p>
<p>Lasma, No-one ever said their weren’t people who would benefit from aspects of this law. Of course, there are winners. Lot’s of them if you count Medicaid expansion, obviously. That has nothing to do with the government run question I was answering. There are people who would benefit from government run restaurants, too. We just disagree, that’s all.</p>
<p>Lot’s of them if you count Medicaid expansion, obviously. Kind of ironic to see this since we heard repeatedly from a few on this thread that docs won’t take those patients. Relatively recent posts, too. </p>
<p>Igloo, so if more students become eligible for Pell grants all higher Ed will become government run? Somehow I don’t think private uni’s are going to consider themselves govt run. But, hey, if you want to go in that direction I guess all farms are government run, and any business, institution which receives grants from the gov’t are govt run. Even supermarkets who accept food stamps and landlords who accept housing vouchers under Section 8 must be considered government run. And the banks, AIG who got bazillions in the bailout - government run. </p>
<p>No Flossy, you said that my husband’s coverage "isn’t Obamacare. " Your words. And i was helping you to see that, in fact, it is Obamacare. And it still isn’t government run healthcare. </p>
<p>Okay, I don’t know your husband’s situation, obviously.</p>
<p>The more the government controls the funding for something the more they control the whole thing. That seems very simple to me. Unless you think they are just really nice and want to give people stuff that they take from other people who they decide don’t really need it anyway. I don’t think that. But, I’m fine with agreeing to disagree and am currently tiring of this discussion. Break time. </p>
<p>Facts, Flossy, please. Not slogans. If you want to convince us that subsidized insurance is more government controlled than non-subsidized insurance, you must give us evidence of the greater government controls on subsidized insurance vis-a-vis unsubsidized insurance. </p>
<p>Also, do you say that agriculture in the US is government run?</p>
<p>Flossy, I just explained my husband’s situation a few posts ago</p>
<p>Btw, my husband isn’t a “winner” because of those 9 things I listed, or I should say he’s no more a “winner” than everyone else. NO ONE had those protections before Obamacare. Now we all do.</p>
<p>Farm subsidies have a lot of issues, too, Largely they benefit big agriculture. Small farms are going under every day. It’s really just politics.</p>