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  •  I also forgot to include the rising costs (3+ / 0-)
    Recommended by:
    Kombema, TheMomCat, Roger Fox

    of health care. Even with Medicare Advantage and Part D, out of pocket costs can be really high for many seniors, forcing many onto Medicaid, which rapidly depletes their savings and meager income. The system as presently structured is designed to put and keep you at poverty levels for the last years of your life. You won't necessarily die, but your life will be miserable. I can't believe that Obama continues to offer CCPI. It's cruel and stupid and insane and a sign of how disconnected he is from the lives of real people AND political reality.

    I think that deep down he has some sort of bizarre fake martyr complex, being willing to risk political popularity and his party's prospects for doing what he views as the "right thing", even though it's anything but. It's the sort of weird fantasy that only someone who's lived too long in the bubbles of academia and politics can subscribe to. He wants to be the hero of Tom Friedmanland.

    "Reagan's dead, and he was a lousy president" -- Keith Olbermann 4/22/09

    by kovie on Sat Oct 26, 2013 at 08:54:48 AM PDT

    [ Parent ]

    •  Speaking of disconnect: (5+ / 0-)

      They're shocked, shocked I tells ya that more people are signing up for Medicaid than buying private insurance.

      A CBS News analysis shows that in many of the 15 state-based health insurance exchanges more people are enrolling in Medicaid rather than buying private health insurance. And if that trend continues, there's concern there won't be enough healthy people buying health insurance for the system to work.

      [...]

      An administration spokeswoman says coverage provided by the new law offers "a range of options so consumers can pick a plan that best meets their needs ... and their budget."

      But Gail Wilensky, a former Medicaid director, said the numbers are causing concern in the insurance industry, which needs healthy adults to buy private insurance in large numbers for the system to work.

      Medicaid enrollment spike a threat to Obamacare structure?

      No one could have predicted that there are a lot of working poor people.

      And no one could have predicted that if you forced people to buy from private insurance companies that it might not work out well.

      •  The illusion of choice (3+ / 0-)
        Recommended by:
        Kombema, gooderservice, Nada Lemming

        Your point is well made and well taken.  To focus on one aspect which underlines your critique of the delusion that motivation for private profit can substitute for collective action for the good of all, I take issue with this quote:

        ...coverage provided by the new law offers "a range of options so consumers can pick a plan that best meets their needs ... and their budget.
        If it is openly, even enthusiastically, acknowledged that insurance companies are motivated by one goal--maximizing profit--then it is foolish to think that they are offering plans which attempt to best serve consumers.  Are we to assume they're being good citizens?  That goes against the basic premise of free market enthusiasts.  Are we to think of corporations as equivalent to the national government in their motivation to optimally serve the needs of consumers?  Ridiculous.

        I have looked through the plans on offer in my state, a good liberal state with functional, largely responsive government.  The array of choices is dizzying.  There can be little doubt that the plans have been carefully designed by insurers in such a way as to maximize their profits.  Even if consumers had comparable access to statistics and predictive capability, and thus each consumer chose the optimal plan for them, the plan that minimized their expenses, even then the insurers would turn a fine profit I'm sure.  But for us consumers, choosing among plans in the end amounts to a crap shoot, almost pure guesswork.  There is little doubt that all this "choice" being offered will result in millions of people "choosing" a plan which insurance companies could have told them would end up costing them more than another plan.  But, of course, as creatures of profit, the insurance companies are more than happy to add to their bottom line through the process of consumers making choices which do NOT best serve their needs.

        Just to underline this, I now have a good plan.  From what my initial investigation tells me, it looks as though I am going to be forced to pay significantly more for both my insurance and for deductibles and co-pays.  In fact, it looks to me as though, as healthy person, my optimal choice is going to be to pay slightly more than I have been paying for insurance and then pay for all of my health care in the form of deductibles.  I have seen no one else mention this, so I am still trying to determine if this is typical.

        Secrecy is a hot bed of vanity. - Joseph Brodsky They who have put out the people’s eyes reproach them for their blindness. – John Milton 1642

        by geomoo on Sat Oct 26, 2013 at 12:27:28 PM PDT

        [ Parent ]

        •  Why are you having to change the plan you have (0+ / 0-)

          now?

          You can't scare me, I'm sticking to the Union - Woody Guthrie

          by sewaneepat on Sat Oct 26, 2013 at 01:42:27 PM PDT

          [ Parent ]

          •  I assume the word "mandate" applies (1+ / 0-)
            Recommended by:
            TheMomCat

            I am in the early stages, but everyone so far who ought to know has told me I will need to go and choose one of the plans on offer.  I still haven't discussed this with my current insurer, so I can't say definitively.

            Secrecy is a hot bed of vanity. - Joseph Brodsky They who have put out the people’s eyes reproach them for their blindness. – John Milton 1642

            by geomoo on Sat Oct 26, 2013 at 02:02:35 PM PDT

            [ Parent ]

            •  Mandate means you have to have insurance, (1+ / 0-)
              Recommended by:
              geomoo

              Not that you have to have an exchange plan. For instance, my husband has a grandfathered individual BCBS plan and he does not have to change. He  will change, however, because his old plan does not have free preventive care and has a much higher out of pocket maximum than any on the exchange. Deductible of his current plan is $2500 and that will probably be the deductible of the exchange plan he chooses. He has a copay right now, but will not on the exchange plan and the co-insurance is the same for both his current plan and the plan he will change to.

              Tennessee Rural Health (which is where he gets his current plan) writes often to tell him how lucky he is that he can keep his current plan and "not be subject to the tax." we can hardly wait to cancel it.

              Anyway, you should check with your insurance because you should not have to change unless it is just one of those cheapie plans that don't really cover anything - and it sounds like it is not one of those.

              You can't scare me, I'm sticking to the Union - Woody Guthrie

              by sewaneepat on Sat Oct 26, 2013 at 02:31:53 PM PDT

              [ Parent ]

              •  This is encouraging (1+ / 0-)
                Recommended by:
                sewaneepat

                No one has used the term "grandfathering" to me.  I hope you are right.  Thanks for the comment.

                Secrecy is a hot bed of vanity. - Joseph Brodsky They who have put out the people’s eyes reproach them for their blindness. – John Milton 1642

                by geomoo on Sat Oct 26, 2013 at 03:27:10 PM PDT

                [ Parent ]

              •  On second reading, (2+ / 0-)
                Recommended by:
                TheMomCat, sewaneepat

                It sounds as though his plan is specifically grandfathered in.  My plan is NOT on the list of available plans from my current carrier, BCBS.  I think I will have to change.  Of course, my state is Vermont, therefore not as hysterical as Tennessee, so no one is sending me bullshit letters.  They do provide a very thorough, very convenient website for looking at all the plans.  I'll have to find out on Monday with a call to my insurer.

                I just started antibiotics for Lyme Disease. I paid $0 copay when I picked up my prescription.  None of the plans being offered through the exchange comes close to this, even those costing almost twice as much.  Whether or not I can keep my current plan, this seems significant to me.

                Secrecy is a hot bed of vanity. - Joseph Brodsky They who have put out the people’s eyes reproach them for their blindness. – John Milton 1642

                by geomoo on Sat Oct 26, 2013 at 03:32:08 PM PDT

                [ Parent ]

              •  I saw a segment on CBS News where (1+ / 0-)
                Recommended by:
                sewaneepat

                insurance companies are dropping current plans that people have, those plans will not be available in 2014, and the closest plan to replace it will cost them more.  I think it was in California, but not sure.

                I tried to find the link, but haven't been successful yet.

                That's not the first news I've read where it will cost more because insurance companies are dropping/no longer offering to continue/offer current plans.  

        •  You said that much better than I could have. (2+ / 0-)
          Recommended by:
          geomoo, Nada Lemming
          ...coverage provided by the new law offers "a range of options so consumers can pick a plan that best meets their needs ... and their budget.
          Options?  Budget?  So those that can afford healthcare can actually get healthcare, and those that can't afford healthcare can get a tiny bit of healthcare if they're lucky.

          Every human being needs healthcare.  The only option I see is if you're beyond childbearing age, that you can opt out of pregnancy coverage, labor and delivery.

          But other than that, we should all, every one of us, have exactly the same healthcare "policy."  If you're wealthy and develop symptoms that need a special specialist in another part of the country, even if your "health insurance" won't cover it, then you can pay out of pocket to fly to another state and pay out of pocket for the treatment (from the money that you're not paying in taxes).    But if you're poor, you can never do that.  

          Crap shoot?  Oh, yeah, that's exactly what it is.  Millions of people have to guess what their healthcare needs will be for the following year.

          If no one will lead on single payer, then let's not have to guess what next year will bring.  Let us pick a tentative policy for the year, and at the end of the year, after knowing exactly what your medical costs were, go back and amend your policy choice that most closely resembles what the previous year's medical needs were. But oh, what's that you say?  Insurance companies won't make a profit that way?  Ummmm.

      •  It's insane and wasteful to have such (3+ / 0-)

        balkanization of insurance, between states and the federal government, between private and public, and between Medicaid and Medicare. And that's an oversimplification. There's a lot of confusing and inefficient crossover between these programs that guarantees that many people won't find out for programs they need and qualify for, and that money is wasted in overlap.

        E.g. if you're poor and under 64 you get Medicaid.

        If you're well-off and under 64 you get private insurance.

        If you're neither poor nor well-off and under 64 you either get one of these exchange plans if you're in a covered state, or you're shit out of luck.

        If you're over 65 and have means you get Medicare or Medicare Advantage.

        If you're over 65 and poor you get Medicaid.

        If you're over 65 and neither poor nor have means then you're shit out of luck.

        More variables are added based on whether you're single, or married, have kids, are disabled or a minor, are a veteran, and so on.

        This is INSANE!

        "Reagan's dead, and he was a lousy president" -- Keith Olbermann 4/22/09

        by kovie on Sat Oct 26, 2013 at 02:42:56 PM PDT

        [ Parent ]

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