Obamacare...(new title): GOP DEATH PLAN: Don-Ryan's Express

[Larry]

you of course are free to believe the changes to Medicare in ACA are totally unrelated, the DRs being dropped and their patients might view it differently.....the Drs obviously do.

Guess your first attempt to move your own goalposts from "Obamacare caused this", to "anybody who disagrees with my unsupported, unbelievable claim, which I've now declined five invitations to try to support, is trying to claim that the presence of Obamacare had absolutely no impact whatsoever", didn't work, so you decided to try again?

----------

And I love your attempt to claim that the doctors are suing because the doctors believe they were dropped because a law got passed.

Your opinion:  Isn't suing somebody for doing something, which a law caused them to do, kinda dumb?  Aren't your odds of winning a lawsuit, where even the plaintiff (according to you) believes that the defendant did this because of a law, kinda close to zero? 

[chipwhich]

Curious Larry, has the ACA had any negative impact on the health care industry or Americans in general?

[twa]

Larry, they are suing the ins company because of the ins companies actions that they believe are a result of ACA changes.....the ins companies actions are what the suit is over,blame doesn't matter unless the ins company blames ACA

You can continue the game of ignoring impacts such as dropping plans and providers if you wish.

I don't need to prove cause when affect is apparent...just as the Drs don't need to show ACA caused their firing.

I'm demonstrating harm and impacts....defending and deflecting is the defenders job.


Op-ed warning

 

 'an unexpected natural or human-caused event,'    otherwise known as **** happens.don't blame me  

http://online.wsj.com/news/articles/SB10001424052702304644104579191810822985326


The Washington Post's Ezra Klein--who for the past few months has oscillated wildly between cheerleading for ObamaCare and honest criticism of its implementation--responded to the announcement with some of the latter. "The administration agreed with a group of senators. . . who argued that having your insurance plan canceled counted as 'an unexpected natural or human-caused event,' " Klein noted, adding pointedly: "For these people, in other words, Obamacare itself is the hardship." He added:

This puts the administration on some very difficult-to-defend ground. Normally, the individual mandate applies to anyone who can purchase qualifying insurance for less than 8 percent of their income. Either that threshold is right or it's wrong. But it's hard to argue that it's right for the currently uninsured but wrong for people whose plans were canceled. . . .
Republicans will immediately begin calling for the uninsured to get this same exemption. What will the Obama administration say in response? Why are people who plans [sic] were canceled more deserving of help than people who couldn't afford a plan in the first place?
That's an excellent point, but it falls short of capturing the perversity of the Sebelius decree. To understand why, begin with the observation that the distinction between being and not being able to "afford a plan" is a fuzzy one. Some lack insurance because they are so poor that they could not possibly pay the premiums, but it makes more sense to consider the decision to carry insurance or not as the product of each person's subjective evaluation of costs, benefits and risks. A person who forgoes insurance does so because, in his circumstances, he does not think it worth the money.

That analysis excludes those who, in the pre-ObamaCare regime, would have purchased insurance but couldn't because pre-existing conditions made them uninsurable. But for those who are insurable but choose to go without insurance, the injury of ObamaCare consists entirely in the new tax the law imposes upon them beginning this year.

Those who had policies canceled, however, were injured in a different way by ObamaCare. For them, insurance, at least as it existed before ObamaCare, was worth the cost. They fell victim to Obama's fraudulent claim that "if you like your plan, you can keep it." If they are now unable to find a plan worth buying, their primary injury consists in being deprived of insurance. The new exemption spares them only of the lesser injury--one might call it an insult--of being taxed for being a victim of ObamaCare.

For neither group of the now-uninsured does the Sebelius decree alleviate the injury ObamaCare inflicts. Nor does it do anything for a third category of ObamaCare victims: those whose plans were canceled and who have purchased new policies that are costlier, inferior or both.

[Larry]

Curious Larry, has the ACA had any negative impact on the health care industry or Americans in general?

 

Curious chipwich, has the ACA had any positive impact on the health care industry or Americans in general?

 

Do you seriously want to try to play that game? 

Edited January 5, 2014 by Larry

[chipwhich]

Curious Larry, has the ACA had any positive impact on the health care industry or Americans in general?

 

Do you seriously want to try to play that game? 

 

Just seeing if you had any objectivity, but now you are moving the goal posts.

[Larry]

Larry, they are suing the ins company because of the ins companies actions that they believe are a result of ACA changes.....

Do you actually have any support for this, IMO, completely unbelievable assertion of yours that these doctors actually believe that they were cancelled because of a law, and they're suing the company who was complying with the law, anyway?

 

I don't need to prove cause when affect is apparent

 

 

Ah, got it. 

 

"Whenever anything bad happens, it's Obamacare's fault, because after all, something bad happened, and therefore I don;t have to even attempt to come up with a theory as to how Obamacare caused it.  All I have to do is yell 'something bad happened', and whether Obamacare caused it, in fact, whether it's even believable that Obamacare caused it, doesn't matter." 

 

If all you care about is party politics, you're probably right.  After all, the Republicans, with your enthusiastic support, have been blaming Obamacare for every single insurance rate increase, and then simply pretending like you haven't noticed, when people point out that Obamacare hasn't even taken effect, yet. 

 

And it's been working. 

 

"Some guy in Cleveland had his rates go up by 130%, because of Obamacare". 

"Obamacare hasn't even gone into effect yet." 

"And some company in Atlanta cancelled all their employee's insurance, because of Obamacare".

"Obamacare hasn't gone into effect yet."

"And family in Omaha had their deductible double, because of Obamacare"

 

Has been selling.  For years. 

 

Actually finding something in there, that we can point at, and say "this clause is actually costing the average person this much money"?  Not one attempt to even try to do that. 

 

Why do that, when we can simply find somebody, somewhere, who says something bad happened, and then simply declare that Obamacare did it, without any effort to even support this claim, or to even some up with some hypothetical way that this might have been caused by Obamacare? 

 

In five years of attacking Obamacare, the only parts of it I've even seen the attackers try to complain about, are the individual mandate (because it makes a nifty sound bite, and because it's supposedly crucial to the law, and therefore, if we can get rid of that part, we can use it as a tool to kill the whole thing), and the birth control mandate (because it feeds into the narrative that telling people how to run their sex life is freedom of religion, and that anybody who tries to tell us that we don;t have the right to regulate other people's sex lives is an attack on the poor, oppressed, Christians). 

 

You'd think that, in five years, they could have found something better to complain about, if it was remotely as bad as they're trying to claim it is. 

 

But why bother, when all we have to do is find somebody whose health insurance went up, just like it's been doing every year of his life? 

[Larry]

Just seeing if you had any objectivity, but now you are moving the goal posts.

 

Just noticed that I made a mistake, in my reply, that you're referring to.  Which might have made it tough to understand what I was saying.  I've edited it. 

Edited January 5, 2014 by Larry

[twa]

Do you actually have any support for this, 

 

The stated opinion of the affected group is usually sufficient proof of their opinion existing  ,there are of course other groups of Drs of the same opinion....but since you don't accept their word we can wait to see if the ins company throws ACA under the bus.

 

But if you are more comfortable with the Lie of the Year winner's side .

[Larry]

The stated opinion of the affected group is usually sufficient proof of their opinion existing

Could you point me at said stated position?

[twa]

Could you point me at said stated position?

 

from the ins co

http://nypost.com/2013/11/09/blame-game-begins-over-obamacare-debacle/

 

The nation’s largest health insurer, UnitedHealthcare, claims the Affordable Care Act is responsible for forcing it to boot doctors from its Medicare Advantage program that serves thousands of elderly patients in the New York metro region.

CEO Jack Larsen, under fire for separating seniors from their MDs, took out full-page ads to explain that cuts in Medicare spending forced the ­insurer’s hand.

“We are working to collaborate with a more focused network of physicians to help us provide higher quality and more affordable health care coverage to meet the needs of our members, and help them get more from their health plan benefits,” Larsen said.

“This work has become even more urgent in light of the severe funding reductions for Medicare Advantage plans that have come from Washington.”

 

from Drs

“What the government is looking for is to manage better care by adding a patient centered medical home so that you have a doctor who is totally invested with taking care of every aspect of the patient and coordinating it. This is clearly not a patient centered decision,” said Dr. Michael Saffir, President of CT State Medical Society.

http://www.wtnh.com/news/health/thousands-of-doctors-fired-by-united-healthcare

what a fired Dr may look like

 

Via WSJ,

 

...

 

The company said it is managing its network, in part, to provide more value for members, particularly given Medicare's new five-star rating system

 that ties bonus payments for insurers to certain measures of cost and quality.

 

"That's what's driving our actions," said Austin Pittman, president of UnitedHealth's networks. He also said, "It's no secret that we are under substantial funding pressure from the federal government."

 

are you sure you want Drs opinions on obamacare?

 

 

http://blog.heritage.org/2012/03/14/side-effects-doctors-fear-obamacare/

 

 

[Larry]

from the ins co

Funny. I asked you to support your assertion that the doctors believe they were cut because of Obamacare.

You post a quote that says "the insurance company says so".  And then says "The doctors say this decision is contrary to the government's goals" 

 

That said, though, later on, you make an interesting point.  That this decision, by the insurance company, might have been done out of an attempt to make the company's quality rating statistics, so they can get paid more.  (That the doctors got cut, because they were making the company's stats look bad.  (Or the company thought that they might.))

 

That's certainly a motivation that I can understand and believe.  Sounds like a plausible explanation, at least. 

 

That said, though.  If that was the motive for cutting the doctors, what do you do?  Stop rating companies for quality? 

 

[twa]

You have a interesting interpretation of the Dr's opinion of the govt goals,This is clearly not a patient centered decision is not supportive .

 

meanwhile the judge wants to know why this unprecedented mass firing is happening

http://articles.courant.com/2013-12-03/business/hc-unitedhealthcare-lawsuit-network-20131203_1_medicare-advantage-network-fairfield-county-medical-association-unitedhealthcare

One of UnitedHealthcare's several attorneys in the case, William H. Jordan, said UnitedHealthcare cut its network with permission from the U.S. Centers for Medicare & Medicaid Services. Judge Underhill took issue with that assessment, saying that federal Medicare officials appeared only to be approving the 90 days' notice that UnitedHealthcare gave to doctors — not the substance of the letter.

Jordan replied, "I think it's much more than the ministerial or procedural issue."

Lawyers for the doctor associations want a temporary injunction to keep the doctors in-network until the matter is resolved in court.

>

>

 

 

 Underhill asked attorneys for UnitedHealthcare to provide an affidavit showing a previous unilateral termination of doctors without cause and without consent, to illustrate what has been done in the past. He also asked the medical associations for an affidavit that would illustrate how previous terminations have been handled.

 

http://articles.courant.com/2013-12-06/news/hc-united-health-care-doctors-1206-20131206_1_unitedhealthcare-medicare-advantage-fairfield-county-medical-association-patients/2

Larger Context

The legal battle between UnitedHealthcare and the Connecticut medical associations flared in U.S. District Court on Tuesday, when their lawyers debated whether, by contract, the insurer has the right to eliminate thousands of doctors on Feb. 1.

But the drama is playing out against the larger backdrop of health care reform. A trade group for health insurers, America's Health Insurance Plans, has warned that the Affordable Care Act cuts payments to insurers who take part in Medicare Advantage.

In 2010, the nonpartisan health policy group Kaiser Family Foundation sorted through the effects of cutting Medicare Advantage and wrote in an analysis, "ome companies may decide to raise beneficiaries' premiums and/or cost-sharing requirements, reduce their network of providers, reduce extra benefits, or make improvements to obtain quality-based payments."

Matthew Borsch, a financial analyst for Goldman Sachs who covers UnitedHealth Group — the parent company of UnitedHealthcare — attended a recent investor conference held by the insurer.

UnitedHealth Group highlighted "an enormous" $1.6 billion after-tax earnings impact from health reform and other head winds in 2014, mostly in the Medicare Advantage business," Borsch wrote in a Dec. 4 note to investors.

State Sen. Kevin Kelly, R-Stratford, said in a statement Thursday, before the ruling: "Obviously the decision to cut doctors from the Medicare Advantage program was an attempt to save funds in the wake of the Affordable Care Act losses. However, shifting the problems caused by the new law onto those most in need is unacceptable."

[twa]

on a lighter note

‘Little Sisters’ Unionize, Seek ObamaCare Exemption

http://scrappleface.com/2014/01/04/nuns-unionize-seek-obamacare-contraception-exemption/

Just hours after the Justice Department contested the Supreme Court delay of a federal mandate for contraceptive insurance, a plaintiff’s attorney announced that the Little Sisters of the Poor would form a collective bargaining unit and seek an exemption from ObamaCare.

“The nuns have sought refuge in a higher power,” according to an unnamed lawyer working on the case. “By incorporating as the International Sisterhood of Mercy Workers (Local 316), they hope to join the dozens of other organized labor groups that the Obama administration has shielded from the devastating impact of ObamaCare.”

The ISMW will reportedly devote itself to electing Democratic candidates, and to activism and lobbying in support of the party’s legislative agenda.

“The nuns have taken a vow of fundraising,” the attorney said, “and view their new calling as a sacred trust to be accepted on faith, just like any other union does.”

A White House spokesman said the president was “impressed with the sisters’ devotion, and inclined to reward their repentance.”

[Larry]

Observing that you didn't answer my question. 

 

Assuming that those doctors were "fired" because the insurance company wanted a five star quality rating (so they could qualify for bigger payments from Medicare.) 

 

Assuming that this qualifies as "this law caused these 'firings'." 

 

Should that section of the law be repealed?  Is it a bad law? 

 

Or maybe it just needs some adjustments?  Is there some way of tweaking it, so that we keep the "reward for quality" elements, without the "firing" aspects?  (I've tried to think of one, and I'm haven't come up with one.) 

Edited January 6, 2014 by Larry

[twa]

How you you measure certainly has a impact on the results you get....tweaking seems a poor solution and twerking about as effective:P

 

take policies themselves for example

 we are told the ACA plans are better because they offer different/expanded  coverage.

 

after the rate ,out of pocket increases, and headaches the better is rather questionable.

 

did they use the wrong metrics to start with to arrive with a end product with so many perverse incentives?

[Larry]

Having trouble figuring out if that's a "yes" or a "no". 

[twa]

Having trouble figuring out if that's a "yes" or a "no". 

Tweaking wholesale firing would seem insufficient, tweaking the rules that might encourage it could work.

 

 so, no and yes.

 

Curious that the state medicare board hasn't intervened already 

[martytheman]

Glad to see you guys are taking this to heart:

 

[Larry]

Oh, I'm not aware that the government can "tweak individual firings". I was discussing what to do about the rule that supposedly caused the firings.

Seems to me that, assuming said rule did cause this, (and assuming that this is typical, and not just some extreme outlier), then it's certainly a good idea to look for ways of pursuing the good intention (better quality) with less collateral damage.

Glad to see you guys are taking this to heart:

My glasses haven't looked like that for, well, for a few years. Edited January 6, 2014 by Larry

[twa]

I assume the mass firings are a leveraging tactic to bypass existing contracts and pressure those left.

 

reminds me of the mandated coverage tactic that resulted in plans being cancelled

[chipwhich]

Got IT?  This should really expedite things.

 

http://www.washingtonpost.com/politics/obama-administration-to-end-contract-with-cgi-federal-company-behind-healthcaregov/2014/01/10/001eb05a-719e-11e3-8b3f-b1666705ca3b_story.html?wpisrc=al_excl

[twa]

rates be rising,buckle up cupcake

http://www.forbes.com/sites/scottgottlieb/2014/01/10/new-survey-private-health-insurance-rates-set-to-rise-significantly-in-2014/

Among the states seeing the highest annualized rate hikes (for the full 2013 year) in the individual market are Connecticut, which is averaging a 37% increase; Florida (42%); Illinois (33%); Michigan (39%); and Minnesota (35%).

Among the states with the biggest annualized spike in the small group rates are Delaware, which is averaging a 35% increase; Michigan (30%); and Minnesota (50%).

These rate increases have broad implications.

Federal Reserve Board Member Jeffrey Lacker said today that the FRB is closely watching what impact the higher costs could have on the economy.

Lacker said that he expects a “lot of turmoil” in the healthcare industry, and that the Fed will be monitoring how Obamacare unfolds.

In a speech to the Greater Raleigh Chamber of Commerce this afternoon he said “I think the Affordable Care Act is something that we are watching very closely because it’s something that could well have a substantial economic impact.”

In other words: You can’t hit the average middle class family for $2,000 or $3,000 in additional healthcare costs and not expect some macroeconomic impacts.

[chipwhich]

In other words: You can’t hit the average middle class family for $2,000 or $3,000 in additional healthcare costs and not expect some macroeconomic impacts.

 

Gee just what I have been saying.

 

The rich get richer and the poor get more out of pocket expenses.

 

Income inequality just gets bigger.

 

But hey if you choose to sign up, you will be broke but ya might not have to go bankrupt.

 

I am sure someone will post how there is no evidence that this is a result of Obamacare....tax on the lower and middle class.  :cheers:

[Larry]

Wonder what all those insurance companies are gonna do with all those huge buckets of money they'll be raking in. 

[chipwhich]

Wonder what all those insurance companies are gonna do with all those huge buckets of money they'll be raking in. 

 

Glad you are admitting Obamacare is stuffing the pockets of Corporate CEO's in the medical industryl