<p>" I know no method to secure the repeal of bad or obnoxious laws so effective as their stringent execution." </p>
<p>Ulysses S. Grant</p>
<p>Yes, let’s make sure that every one of those sick people and poor people get insurance. That’ll show everyone what a terrible thing this law is! </p>
<p>LaMas: That’s what I said…full and stringent implementation…let’s go for it. And, let’s go for it before … say … June of 2016! The faster it is completely implemented that faster one can reliably start using the loopholes. Looks like we are in agreement finally, now it’s just a matter of timing. 
(See… I can snark with the best of 'em)</p>
<p>Where do Californians Get Health Insurance (as per the General Election Pamphlet)</p>
<p>40% - Large Group Employer (minimally or not affected by ACA as of today’s implementation)
37% - Government programs (minimally or beneficially affected by ACA implementation as of today)
7% - Small Group Employer (negatively affected by ACA as of today and will get worse)
9% - Individual Market (take your pick - better off/worse off/break even)
7% - Uninsured (COULD be better off if they signed up)</p>
<p>So, as of today the full, um…not so positive… effects have not hit about 50% of the insured. So, I say…let’s implement, no exemptions, no deferrals, no lawsuits going after the insurance companies for doing what they were tasked with doing, no trying to rework networks etc. Then let’s check back and measure public sentiment.</p>
<p>Anyone in Southern California have an opinion on this new Vivity venture, that is being launched by Anthem (Wellpoint)? It’s a hybrid of an accountable care organization (ACO) and an HMO. Anthem has already roped in seven hospitals including GP’s favorite Cedars Sinai. </p>
<p>Anthem is selling this new insurance product to large employer group market. They claim they’ll be able to deliver care more cheaply, and the savings will be divided between Anthem and the Vivity providers (doctors and hospitals).</p>
<p>If any of you work in Southern California for a big employer, you might be enrolled in this plan next year.</p>
<p><a href=“http://www.modernhealthcare.com/article/20140917/NEWS/309179964”>http://www.modernhealthcare.com/article/20140917/NEWS/309179964</a></p>
<p>LF, in a cataract surgery, what is the bluebook cost of a multifocus lens compared to a normal lens?</p>
<p>Ds, not in HBB, but I see this, which says the multifocal could be up to 2500. I’m guessing you ran across the same link. <a href=“IOLs for Presbyopia: Frequently Asked Questions”>http://www.allaboutvision.com/faq/presbyopia-iols.htm</a></p>
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Hmm… we agree about the narrow networks but not that it’s the insurance companies fault. </p>
<p>As bluebayou’s posted time and time again, they’re simply carrying out the intent of ACA. Fine’s seem inappropriate.</p>
<p>If it’s the intent of ACA, why isn’t it affecting all states the way it is in CA?</p>
<p>LF, that was a great link. Thanks. My wife is only being charged $1,000 extra. I hope the $1,000 is correct. :)</p>
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I’m with dietz, here, regarding all those couch potatoes that hypothetically come in 8 ounces over the obese cut-off. Zero the premium subsidies out - it’ll encourage all 3,097 of them to organize and lobby for less stringent guidelines or some sort of fat-to-body weight-to-height rule.</p>
<p>I suppose you could set it at x% over obese. But not all obese people are a drag on health resources and not all skinny folks are immune to dread diseases. (Same with the couch potato assumption.) So, it sounds limited, at best, and arbitrary, at worst. It also seems futile in that, if they really get sick and lose weight, they re-qualify at a higher level of illness and costs to treat. This is why it’s good to really draw out the ramifications. It just sounds good, at first glance, to call them self-inflicted and try to push them out.</p>
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Gotta give you an attaboy for imagining unintended consequences, dstark but you lose it for complaining about the burdens of regulation. </p>
<p>Noble regulation, the very best kind, the kind that would direct direly needed money away from those who aren’t being good citizens (obese enough they’re wooing diabetes & jacking up premiums for the rest of us) and away from those who truly didn’t win life’s lottery. Couldn’t even afford to buy a ticket.</p>
<p>An actuary can tell you within a few dollars what obesity costs, LF. That outliers don’t add to the total just means the rest are even more expensive.</p>
<p>Much more effort has been spent by the government on much smaller problems and it has a long, successful history of punishing (via dollars) behavior it wants to discourage. That it would do it by denying free money makes the sensitivity even less understandable.</p>
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<p>Even before ACA, there was a shortage of docs, particularly primary care docs, in many/most inner cities, and rural areas. Just passing a law doesn’t magically make new docs appear in the 'hood or anywhere else. And quite frankly, its economically irrational to expect young adults with $300k of debt to be lining up to join a contracted service (Medicaid/Cal) that pays pennies for their services. Now, if the state wanted to pay more/service, or offer tax breaks or loan forgiveness, they might get some takers. But the former would raise premium costs, and the latter two would raise taxes. Lose-lose from a political perspective.</p>
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<p>California law requires insurers to maintain adequate networks in their service areas (defined as being able to see a doctor within 15 miles of their home). Some insurers have chosen to ignore that requirement. I don’t see how that profit-oriented choice is anyone’s fault but theirs.</p>
<p>Several CA insurers have been sued over this issue, both by their members and by a consumer watchdog group</p>
<p><a href=“Cigna, Blue Shield of California sued over narrow networks”>Error 404 Page;
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<p>You can sue anyone over just about anything, but if the doctors refuse to work at those rates and under those conditions, so what if people sue? There still will be no one to provide the services, even if the court says expand your network. </p>
<p>It would be like telling stores to sell more corn, when the farmers have decided to stop growing corn. The courts can tell the stores all they want, but if there is no corn being delivered, there is no point. </p>
<p>EDIT: Here is a data point. Highly doubt it has improved; most likely getting worse.</p>
<p>Pull Quote:</p>
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<p><a href=“California doctors revolt against Obamacare; 70 percent say they will boycott - NaturalNews.com”>http://www.naturalnews.com/043279_obamacare_california_doctors_boycott.html</a></p>
<p>The rates are exactly the point. I’ve no doubt that some doctors are unwilling to work for the rates the insurance companies are offering in the narrow networks, but the insurance companies are offering low rates to save money. They can raise the rates to get more doctors to participate. Low rates are not the only reason doctors don’t participate in networks, but they are the one that I’ve seen most cited.</p>
<p>That link in #15477 … not exactly the most credible source. For example, there’s an article pushing the discredited vaccines-cause-autism hoax. Even better, there’s an article stating that the Ebola outbreak is a vast conspiracy of the US government.</p>
<p>Post 15476 is false. </p>