home

Wednesday Open Thread

I think I'll be very happy with the view of my new home -- the patio is 445 sq ft and has views of south, west and east. Now I just have to do the hard part: Moving.

I should be moving the 17 to 19 (no way can this be done in a day.)

Since I havn't see the news, here's an open thread, all topics welcome.

< Government Shuts Down | War on Drugs: Cheaper and Purer Than Ever >
  • The Online Magazine with Liberal coverage of crime-related political and injustice news

  • Contribute To TalkLeft


  • Display: Sort:
    Ed Snowden (5.00 / 1) (#1)
    by Edger on Wed Oct 02, 2013 at 07:01:32 AM EST
    has given a written statement to the European Parliament's Civil Liberties Committee entitled "The Work of a Generation".
    [his] words were entered as testimony at the European Parliament's Civil Liberties Committee in Brussels on Monday.

    Jesselyn Radack of the US Government Accountability Project (GAP) and a former whistleblower and ethics adviser to the US Department of Justice, read Snowden's statement into the record.
    [...snip...]
    "The surveillance of whole populations, rather than individuals, threatens to be the greatest human rights challenge of our time. The success of economies in developed nations relies increasingly on their creative output, and if that success is to continue, we must remember that creativity is the product of curiosity, which in turn is the product of privacy.

    "A culture of secrecy has denied our societies the opportunity to determine the appropriate balance between the human right of privacy and the governmental interest in investigation. These are not decisions that should be made for a people, but only by the people after full, informed, and fearless debate. Yet public debate is not possible without public knowledge, and in my country, the cost for one in my position of returning public knowledge to public hands has been persecution and exile. If we are to enjoy such debates in the future, we cannot rely upon individual sacrifice. We must create better channels for people of conscience to inform not only trusted agents of government, but independent representatives of the public outside of government."

    more...

    uhhhmmm... "trusted agents of government"?

    Now back to your regularly scheduled kabuki.

    Edward Snowden (5.00 / 1) (#67)
    by KeysDan on Wed Oct 02, 2013 at 02:21:19 PM EST
    should be allowed to return to the US with only the provision that he provide community service for a year--specifically to assist in implementation of the Affordable Care Act.  HealthCare.gov  experienced early glitches, delays, and shutdowns.   The technical difficulties are apparently due to higher than expected interest in health care coverage and exchanges.   Of course, consideration might also be given to staggering search days, e.g., by age cohorts or alphabet for the initial enrollment period.  

    Parent
    I continue to find it stupid beyond reason, this (5.00 / 3) (#72)
    by Anne on Wed Oct 02, 2013 at 02:38:43 PM EST
    amazement at "higher than expected interest" in access to health insurance - did they forget, in the nearly-four years people have been waiting for this day to come, that there are MILLIONS of people who have no coverage?

    I completely understand why Charlie Pierce talks about "things that make me want to guzzle anti-freeze," because this is the kind of utterly moronic response - higher than expected interest - that makes me want to ask for a double.  With a chaser of windshield-washer fluid.

    Jesus.

    Parent

    The real reason for the (none / 0) (#114)
    by MO Blue on Wed Oct 02, 2013 at 09:47:25 PM EST
    "higher than expected interest" in access to health insurance:

    The Adorable Care Act promotion has become a viral hit. ;o)

    Parent

    I like how you think... (5.00 / 3) (#75)
    by kdog on Wed Oct 02, 2013 at 02:44:03 PM EST
    even better, since the NSA knows no furloughs, put their geek-squad arses to work doing something productive for a change, fixing the bugs in healthcare.gov

    Parent
    I am (5.00 / 5) (#4)
    by Ga6thDem on Wed Oct 02, 2013 at 08:44:28 AM EST
    not a fan of Obamacare but darn the lies the GOP is putting out about it are continually annoying. I have referred several people today on Facebook to the website to just check it out and find out the facts for themselves. It's not like there is nothing to criticize but making up crazy stuff just makes the GOP look even more insane than they already are.

    The Jimmy Kimmel video is classic (5.00 / 2) (#5)
    by CoralGables on Wed Oct 02, 2013 at 08:56:52 AM EST
    They are propaganda experts and the media is (5.00 / 1) (#7)
    by Angel on Wed Oct 02, 2013 at 09:38:36 AM EST
    complicit in furthering their agenda.  Sickening.  

    Parent
    Obamacare v. Affordable Care Act? (5.00 / 2) (#6)
    by Anne on Wed Oct 02, 2013 at 09:38:31 AM EST
    Take a look...

    I guess I shouldn't be surprised that there are people who don't know that these are the same thing, and are reacting to the "Obama" part of "Obamacare," but it just demonstrates how poorly the administration and Democrats sold the legislation once it was signed into law.

    Why Obama just gave in to the label - vanity? - and didn't stick to referring to it as the ACA is a mystery to me.

    `Course a lot of things about this are a mystery to me, and I guess there's little point in asking why this or that was or wasn't done, because things are what they are and now we have to deal with them.

    I get why it would make finding the right plan easier if one can see all of them in one place, but I don't know why the plans on the exchange are not the same plans available if one goes directly through any given insurance company.  Why are subsidies only available through an exchange?  To me, this smacks of segregating/herding the poor, the sick and the too-young-for-Medicare-too-well-off-for-Medicaid into groups that ultimately may receive a lower quality of care and service for not that much less money.  Are certain hospitals and doctors going to become known for only dealing with "those" people?

    So, here's a question: what do you think happens next if this whole exchange/subsidy thing doesn't work?  If people report not being able to get the care they need, even with "affordable" insurance?  Are changes made?  

    I guess it's too soon to know, but I'm not sure that if I were someone who didn't have insurance, and wasn't happy about the availability of the doctors and other providers I wanted to see, I wouldn't just take my chances, and wait to see how this whole thing plays out.  If they do levy fines, I expect people to fight them on the basis of not being able to get what they need, from their choice of providers.

    I see bureaucratic clusterfkery coming, and soon.  And not only is that going to be an issue for a lot of people who've waited a long time to be able to "afford" quality health care, but it's going to be a big political issue that's not going to work well for Democrats.


    None of (5.00 / 4) (#8)
    by Ga6thDem on Wed Oct 02, 2013 at 10:02:43 AM EST
    this surprises me because Obama after all said he hands off policy stuff to other people. When you hand off policy like that and have no involvement in it, and frankly really don't care about policy all that much in the first place you really are not going to be able to explain it to people. He really is not interested in how policy affects people's lives or even sees how it can. More or less all this gets back to my belief that Obama likes BEING president not necessarily the JOB of president.

    Parent
    14 GOP Reps (5.00 / 2) (#9)
    by CoralGables on Wed Oct 02, 2013 at 10:05:52 AM EST
    now say they will vote yes on a clean CR if it comes up for a vote in the House. If one of these is in your district, thank them. Only need three more to reach a majority in the House. Then the real pressure starts to hit Boehner.

        Rep. Robert J. Wittman, R-VA
        Rep. E. Scott Rigell, R-VA
        Rep. Frank R. Wolf, R-VA
        Rep. Jon Runyan, R-NJ
        Rep. Lou Barletta, R-PA
        Rep. Devin Nunes, R-CA
        Rep. Peter T. King, R-NY
        Rep. Patrick Meehan, R-PA
        Rep. Michael G. Grimm, R-NY
        Rep. Michael G. Fitzpatrick, R-PA
        Rep. Charles W. Dent, R-PA
        Rep. Erik Paulsen, R-MN
        Rep. Frank A. LoBiondo, R-NJ

    Ted Cruz on the other hand doesn't care. His clown show has now made him the GOP frontrunner for the Republican nomination for President in 2016.


    Parent

    Pressure? (5.00 / 2) (#21)
    by Dadler on Wed Oct 02, 2013 at 11:11:09 AM EST
    This is America, not Europe or even Canada. We are corruption city in the "advanced" world. There hasn't been any real pressure on a politician in this country since I don't know when. Between corruption, violating the constitution left and right, you name it, high ranking pols are basically immune. And so what if they get voted out of office? They then go get a much more well paying lobbyist job.

    We have a very short view here, IMO. The same corrupt system is at work here, in spades, as the ACA is nothing ultimately but a huge boon to private companies. Every other law in history has been subverted and gotten around by big money corps. Healthcare providers will be no different, will ultimately figure out how to profit off sh*tty care. Can't be any other way UNTIL the American people are actually given freedom here. And freedom means a non-profit public option.

    Period.

    Without that, logic and history tell us we are mostly pissing into the wind. That said, I'm glad Tracy is getting a better shake, I think some people will. For most folks, however, there is no reason to believe the system won't start to be gamed from the go by those with power...the healthcare corporations that care, obviously, about profit first, care second.

    Parent

    Canadians generally don't confuse (none / 0) (#140)
    by jondee on Thu Oct 03, 2013 at 07:58:28 AM EST
    "market forces" with the mysterious workings of Divine Providence the way significant people in the U.S do..

    Why that's the case, whether it's the influence JD Rockefeller's American Beauty Rose theology in which people are pepetually unconsiously trying to prove they're one of the "elect", is beyond me..

    Parent

    I don't want a clean CR (5.00 / 4) (#116)
    by Peter G on Wed Oct 02, 2013 at 10:13:23 PM EST
    I want a CR with reversal of the "sequester."

    Parent
    Shhhh . . . ! (5.00 / 1) (#120)
    by nycstray on Wed Oct 02, 2013 at 10:58:06 PM EST
    That would interfere with the perceived win some are hoping to cheer for . . .

    Parent
    The Senate and Schumer (none / 0) (#121)
    by MKS on Wed Oct 02, 2013 at 10:59:44 PM EST
    at one time supposedly gave that idea some thought.

    Parent
    I wish someone would sequester Schumer. (5.00 / 1) (#123)
    by shoephone on Wed Oct 02, 2013 at 11:05:14 PM EST
    Permanently.

    Parent
    And, the names listed are the ones who (none / 0) (#20)
    by christinep on Wed Oct 02, 2013 at 11:09:27 AM EST
    have gone public.  According to some of those listed above -- e.g., Nunes, Dent, King -- there may be as many as a plurality of Repubs ready to vote on a clean bill.  (Note: As to the "partial funding" ruse lately, my understanding is that yesterday's 2/3 vote procedure was employed because it would block any related request for a clean bill vote.  Similarly, my understanding is that the "majority vote" procedure expected to be used today may well open up that possibility of a test vote on a clean bill.  Have you heard or seen that take?)

    The Denver Post editorial today was about as anti-Tea Party Repub as they have ever written ... essentially, the editorial calls the Repubs fools for pursuing what is probably a severely damaging approach for them.  Big $$$ tends to shift away from perceived fools, too ... a growing reality about concerned big business interests who normally support Repubs is their move away from Repubs in this instance, per the NYTimes today.

    May the pressure continue to grow.  And, as for the impatiently ambitious Cruz, he may soon have to acquaint himself with the goats of history.

    Parent

    Do you have a source for: (none / 0) (#25)
    by NYShooter on Wed Oct 02, 2013 at 11:19:34 AM EST
    "...GOP frontrunner for the Republican nomination...?"

    or, is this your analysis? (BTW, I agree)

     

    Parent

    Yesterday's PPP poll (5.00 / 0) (#33)
    by CoralGables on Wed Oct 02, 2013 at 12:01:58 PM EST
    had Cruz in the lead.

    Today's Q poll just released has Rand Paul

    The biggest beneficiary of what's going on may be Hillary. Today's Q poll has her beating Paul by 17, Christie by 13, and Cruz by 23.

    Parent

    Ted Cruz (5.00 / 1) (#39)
    by Ga6thDem on Wed Oct 02, 2013 at 12:19:14 PM EST
    has managed to drag the entire party down with him. LOL. I'm not surprised at that one bit.

    Parent
    Hopefully Ted's excellent adventure (none / 0) (#47)
    by CoralGables on Wed Oct 02, 2013 at 12:35:30 PM EST
    can drag them down enough to get Georgia to put Michelle Nunn in the Senate. She won't be liked around here but she'll be a huge step in the right direction in replacing the outgoing Saxby Chambliss.

    Parent
    They might (none / 0) (#50)
    by Ga6thDem on Wed Oct 02, 2013 at 12:39:42 PM EST
    not need Ted Cruz to implode the GOP chance's here in GA. Two of them that are running backed up Todd Akin in his statements. They might be self exploding.

    Parent
    Why did the Obama and the Dems (5.00 / 2) (#12)
    by MO Blue on Wed Oct 02, 2013 at 10:26:37 AM EST
    give in and adopt the Republicans label on their health insurance law?

    Even though Obama has adopted this label, I'm not sure that you can lay all the blame for this at his door. For whatever mysterious reason, the Democratic Party has a long held need to adopt and incorporate the Republicans negative labels and talking points into their rhetoric. Of course, now that they have adopted and incorporated much of the Republicans agenda into their policies and proposed legislation, this may be a plus rather than a minus for the Dems.

    The Republicans being determined to make sure this law fails combined with the reality that any and all changes to the law will be written by and for the benefit of the insurance industry and pharma give me little hope that any changes to law will provide people with good quality, affordable health care.

    If this health insurance law doesn't work, the failure will be used not to prove that this was a bad plan but that the government cannot and should not get involved and needs to get out of the business of providing health care altogether.

     

    Parent

    Insurance and pharma weighed in (5.00 / 1) (#13)
    by Militarytracy on Wed Oct 02, 2013 at 10:33:57 AM EST
    But the fact that my out of pocket cap went from 12,000 to 3,000 a year when we retire I can promise you is not something that the winner of the Tricare for Life insurer lobbied for.  And legislation has been passed that all forms of Tricare must be ACA compliant simply because right out of the gate last year with the covered children the for profit Tricare insurers started trying to phluck all of us.

    If one good fine thing comes from ACA will you ever be able to admit that?

    If Obama wins this standoff will he ever get credit for it or for doing anything worthwhile where the broken healthcare system he inherited is concerned or is he still an a-hole doomed to die that way?

    Parent

    I think (5.00 / 3) (#14)
    by Ga6thDem on Wed Oct 02, 2013 at 10:38:08 AM EST
    a lot of this comes from the point of view that the particular person is coming from. If you have been unable to afford insurance or get healthcare other than ER type care, this would be a boon for you. If you are someone with a chronic problem it might be a boon for you. For me it really makes no difference. For people who are in the individual insurance market this has not been helpful to them because the insurance companies have used it as excuse to jack up their rates EVEN MORE.

    Parent
    It could make a difference though (5.00 / 0) (#15)
    by Militarytracy on Wed Oct 02, 2013 at 10:54:23 AM EST
    I believe it will make a difference for you.  And we have already seen rates coming down right out of the gate, and voting power can now drive that.

    At this time many of us come from many points of view.  Many of those who have a good thing going are afraid of losing their good thing they have fanagled for.  Many sacrificed to jockey themselves into more reliable insurance coverage when we lived in the thunderdome.  All those sacrifices aren't worth as much now and I suppose there is a grieving process there.

    I see it in some of the military.  On post healthcare in the Army is awful but at least it's free which can be construed to be better than what you have.  I can go 80/20 and go into the outside market and I still enjoyed cost controls...and soon all of you will be joining us and our "sacrifice" is only worth a couple hundred a month on the open market.  This isn't as much fun for many broken psyche than watching the poor die because they "wouldn't" serve or weren't fit enough to serve.

     It's sad, but I know some people who have derived a superior feeling from the old horrible broken system and I'm sure it isn't only the military that have treated their available healthcare like a status symbol.

    If we are all in this together we are strong as hell at the ballot box.  Let's get strong.  As long as we are all divided we are conquered.

    Parent

    It is really (5.00 / 2) (#38)
    by Ga6thDem on Wed Oct 02, 2013 at 12:18:14 PM EST
    hard to say in my case because my husband got a job with a company with good benefits. He's only been there five months so I don't know if the benefits got worse or got better. At his previous job the tea party owner was blaming all the insurance problems on Obamacare and using it as an excuse to provide EVEN crappier insurance than he previously had offered. So it's not like I would trust the word of a tea party nut but I also have no basis for comparison with the new insurance though I do know the new insurance is now trying to deny claims.

    Parent
    How are you doing these days? (none / 0) (#44)
    by sj on Wed Oct 02, 2013 at 12:28:02 PM EST
    Is the new job helping?

    Parent
    Yes, (5.00 / 3) (#49)
    by Ga6thDem on Wed Oct 02, 2013 at 12:38:13 PM EST
    it is. Thank you so much for asking.

    Parent
    Oh, I'm very happy to hear that (none / 0) (#105)
    by sj on Wed Oct 02, 2013 at 07:31:12 PM EST
    At my last job I had your "name" on a post-it attached to my monitor to remind me to send blessings along at random times throughout the day .

    I said I would add you to my prayers, but is that TMI?  ;)

    Parent

    Prayers (none / 0) (#109)
    by Ga6thDem on Wed Oct 02, 2013 at 07:59:12 PM EST
    and good thoughts are both very much appreciated. It has been a very hard couple of years that hopefully are over. One of these days I wish I could meet all the TLer's in person. That would just be fantastic and Zorba could bring some of her food.

    BTW, Zorba, I would love to get your recipes again. I put them in a word document but did not print them out and my computer crashed on me and they were lost. :(

    Parent

    My email is (none / 0) (#111)
    by Zorba on Wed Oct 02, 2013 at 08:36:16 PM EST
    available on my profile.  If you feel comfortable doing so, email me, tell me what recipes you want, and I will send them along.
    There are probably too many for me to repost them all.
    Let me know, Ga.

    Parent
    All I gotta do... (none / 0) (#152)
    by kdog on Thu Oct 03, 2013 at 10:26:50 AM EST
    is hit Powerball, or even a measley Pick-6 with carryover, and the long awaited Talkleft Convention is on GA!

    Problem is I hardly gamble anymore...never bet the milk & honey money and that's all I'm working with lately.  

    Parent

    I'm so sorry about the new insurance denying (none / 0) (#52)
    by Militarytracy on Wed Oct 02, 2013 at 12:46:03 PM EST
    Claims.  How exhausting.  I don't all the protections that ACA provides on that.  I know a panel was supposed to be overseeing and outlining what insurers must cover/pay for, but the Republicans haven't allowed anyone to be appointed to it.  I don't know if the administration has a work around but imagine that they must because if we all end up with junk insurance we are forced to buy it will destroy them and ACA in the 2014 election.


    Parent
    This is (5.00 / 1) (#61)
    by Ga6thDem on Wed Oct 02, 2013 at 01:46:09 PM EST
    why I don't get too excited about the ACA. In the end we are still dealing with the flawed business model of the insurance companies. Teresa was saying that in WA the exchanges are like outsourced Medicaid. If that's the case then we are going ot have the worst of both worlds for everybody--insurance companies sucking up massive amounts of tax payer money and then denying care for these people who desperately need it.

    Parent
    Well Medicaid is what comes in second in this (none / 0) (#71)
    by Militarytracy on Wed Oct 02, 2013 at 02:37:02 PM EST
    Town, and every doctor takes it because there is so little insurance coverage period after BCBS.  I know all locations are different, different markets, different providers.  It will be failings that lead us to something resembling Medicare eventually.  I am okay with the flaws in model being exposed, and now everyone will be compelled to care, it may not get them to the ballot box but it is going to get a lot more of them there.

    I know everyone is worried, but I don't think we're all going to get ripped off.  That would be political suicide

    Parent

    If ripping off the public was .... (5.00 / 4) (#78)
    by Robot Porter on Wed Oct 02, 2013 at 03:03:35 PM EST
    "political suicide" the halls of congress and the executive branch would be mausoleums.

    They rip us off six ways to Sunday now.  Why would they stop?  Especially when they've been given a brand new way to rip us off some more.

    Parent

    I hope you are right. (none / 0) (#85)
    by Ga6thDem on Wed Oct 02, 2013 at 03:41:31 PM EST
    And, we are also called upon (5.00 / 1) (#23)
    by christinep on Wed Oct 02, 2013 at 11:15:13 AM EST
    to see beyond ourselves.  Beyond empathy ... it would make sense to see that what is good for those who have previously been excluded or denied will ultimately enrich all of us on many levels.

    Parent
    Man, I never ever ever (5.00 / 2) (#26)
    by Militarytracy on Wed Oct 02, 2013 at 11:21:19 AM EST
    Wish on a single soul the fight for Joshua's life we had to wage with Tricare when he was three and nurses told doctors what doctors were allowed to do for their patients.  I will go to my grave scarred by what my society was allowing to happen to human beings then.  I wish that experience on NOBODY EVER, happened to others though and lives were lost for insurance CEO bonuses.

    Parent
    I'm certainly (5.00 / 2) (#46)
    by Ga6thDem on Wed Oct 02, 2013 at 12:33:15 PM EST
    glad that people who have been excluded will now be able to actually get health care and the business part of me says this is not only better for them but probably better money wise since the ER is so expensive.

    Parent
    Josh's surgeon told us yesterday that (none / 0) (#28)
    by Militarytracy on Wed Oct 02, 2013 at 11:26:48 AM EST
    Under ACA, insurance billing codes are going from an existing 82,000 to around 144,000.  Probably for cost control purposes, but the legislation was so huge and encompassing it is difficult to comprehend it all at this time.

    Parent
    Your doctor is wrong (5.00 / 1) (#32)
    by vicndabx on Wed Oct 02, 2013 at 11:53:21 AM EST
    insurance billing codes are increasing because of a change from ICD-9 to ICD-10 which allows greater specificity in diagnosis and procedure codes.

    This change has been in the works for years and has absolutely nothing to do w/the ACA.

    See question #9 on the FAQ available here.

    Parent

    This write up by an insurance company (none / 0) (#36)
    by Militarytracy on Wed Oct 02, 2013 at 12:14:45 PM EST
    Says our surgeon is correct and you are wrong.

    ACA made ICD 10 a requirement for administrative simplification.

    link

    Parent

    You're both right in a way (5.00 / 1) (#42)
    by CoralGables on Wed Oct 02, 2013 at 12:24:23 PM EST
    ICD 10 wasn't put together by the ACA and it would have been implemented anyway with or without the ACA eventually. The ACA just gave them a drop dead date to implement.

    But I'd say your surgeon was misleading in his statement. Not wrong, just not entirely true.

    Parent

    Appreciate your link but (5.00 / 1) (#48)
    by vicndabx on Wed Oct 02, 2013 at 12:36:28 PM EST
    I do this for a living.  Administrative Simplification (AS) was part of the original HIPAA law passed back in 1996:

    To improve the efficiency and effectiveness of the health care system, the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Public Law 104-191, included Administrative Simplification provisions that required HHS to adopt national standards for electronic health care transactions and code sets, unique health identifiers, and security. At the same time, Congress recognized that advances in electronic technology could erode the privacy of health information. Consequently, Congress incorporated into HIPAA provisions that mandated the adoption of Federal privacy protections for individually identifiable health information.

    The ACA did not require use of ICD-10.  ICD-10 was already in the works by the industry because of the AS provisions of the original HIPAA laws.  Those laws required the use of certain code sets for use in electronic transactions.  ICD-9 and 10 are two of them and were required to be used.  ICD-10's date was pushed out to allow everyone time to implement.  This document details the AS requirements w/r/t to the ACA.  From the document:

    Require HHS to task the ICD-9-CM Coordination and Maintenance Committee to convene a meeting no later than January 1, 2011 to receive input on the crosswalk between ICD-9 and ICD-10 posted on CMS website and make recommendations on appropriate revisions to the crosswalk. Any revised crosswalks shall be treated as a code set for which a standard has been adopted.

    The crosswalk was already posted, i.e. the industry's move to ICD-10 was already in the works.  See the info here about transaction standards, specifically:

    Under HIPAA, HHS also adopted specific code sets for diagnoses and procedures to be used in all transactions.  The HCPCS (Ancillary Services/Procedures), CPT-4 (Physicians Procedures), CDT (Dental Terminology), ICD-9 (Diagnosis and hospital inpatient Procedures), ICD-10 (As of October 1, 2014) and NDC (National Drug Codes) codes


    Parent
    I think you are wrong just via reading (none / 0) (#53)
    by Militarytracy on Wed Oct 02, 2013 at 12:53:57 PM EST
    Understand that ICD 10 is being used in foreign countries right now, but the ACA did require its implementation in the United States and then they had to extend that requirement for another year because some insurance companies claimed they couldn't meet the Jan 1, 2013 deadline.

    From what I have read though, ICD 10 isn't some creation we came up with.  Other countries are already using it and it was created by the World Health Organization and is a superior system.

    Parent

    OK, MT (5.00 / 1) (#55)
    by vicndabx on Wed Oct 02, 2013 at 01:00:49 PM EST
    final shot at convincing you :-)

    On January 16, 2009 HHS published a final rule adopting ICD-10-CM (and ICD-10-PCS) to replace ICD-9-CM in HIPAA transactions, effective implementation date of October 1, 2013. The implementation of ICD-10 was delayed from October 1, 2013 to October 1, 2014 by final rule CMS-0040-F issued on August 24, 2012.

    Link

    ICD-10 is simply the latest version of a code set that classifies diagnosis and procedure codes.

    Parent

    More simply put (none / 0) (#54)
    by vicndabx on Wed Oct 02, 2013 at 12:54:18 PM EST
    ICD-10 is a code set, and code sets change all the time.  This just happens to be a huge one because it ties directly into provider reimbursement and rates.  That's probably what your doc is really bothered about (if at all). I.e. software headaches, reimbursement headaches, etc. etc.

    Parent
    With the exception of Republicans, (5.00 / 3) (#17)
    by MO Blue on Wed Oct 02, 2013 at 11:02:07 AM EST
    I think that everyone who thinks that this health insurance legislation is not very good will admit now that there is a few fine things in the legislation right now. The question is will these few fine things offset the things that are not anywhere close to fine.

    Obama "winning" this standoff has very little to do with whether or not this is good health CARE legislation or not or whether history will view this piece of legislation as beneficial or not. Exactly how Obama "wins" this and the upcoming standoff, what changes are made to this program and existing medical programs will definitely have an impact.

    BTW, you seem to have a need to put my dislike of this legislation as a personal dislike of Obama. I was around when this programs was first developed by the Heritage Foundation and I thought it was bad legislation then. IIRC Obama was promoting this plan back in the 90s.  

    Parent

    It's just that you never ever ever (5.00 / 1) (#19)
    by Militarytracy on Wed Oct 02, 2013 at 11:07:09 AM EST
    Have anything to say about what is positive about ACA.  It is as if you are determined to see it in only one light and you will only focus on fear-baiting.

    It is a free country though.  You are free to have and express whatever opinions you have just as I am free to notice patterns and express that I see a pattern.

    Parent

    It is not for MO Blue (5.00 / 3) (#41)
    by sj on Wed Oct 02, 2013 at 12:22:24 PM EST
    to find something positive about ACA. It is for those who actually see something positive to speak up. As you do occasionally, as Obama does almost never.

    We all view through the window of "how-we-are-affected". I'm not going to go out of my way to wade through the mountain of information and dis-information to find a kernel that might somehow be of benefit to somebody whose circumstances I know nothing about. If you think the ACA needs a proponent then for heaven's sake, be that. Hopefully without going down the "Obama haters" route.

    Parent

    I wanted the President to sell ACA better than (none / 0) (#56)
    by Militarytracy on Wed Oct 02, 2013 at 01:15:07 PM EST
    He did.  Gotta say though today with how rabid the Repukes are now, if he had tried to sell it earlier I think insurance companies would have fueled insane "political" commercials and constant crazy fighting all year until people just wanted ACA to go away.  Everytime a Dem figure says something positive about the ACA, wild insane flame throwers jump out of the bushes and start false equivalency discussions and fights, litter the floor with 400 million strawmen...I'm so tired it isn't funny.  They have pushed my buttons and pulled my trigger so many times I'm run ragged by what has transpired so far, can't imagine trying to survive a year of the administration selling it and all the raging war and fighting that would have brought on.  

    My husband is on orders and supposed to be preparing to leave his family for a time but he is on post today teaching because the civilians are gone now and some soldier instructors were going to have to lecture in classes 7 hours today with a lunch break.  My husband had reason and could have asked to be at home packing, but he is teaching and Phuck these b*st*rds.  I'm ready to fight them into the ground and I am so tired today.  We had to do a round trip to Atlanta yesterday so my son's surgeon could see him, and no matter...let's fight this scum into the ground!

    Parent

    Don't know who your House Rep is (5.00 / 1) (#57)
    by CoralGables on Wed Oct 02, 2013 at 01:21:04 PM EST
    but Rep. Mike Rogers, R-Ala is leaning yes to vote for a clean CR. Of course all this is just a warmuip lap in the preseason for 2 weeks from now when it happens again for bigger marbles.

    Parent
    I have that chick that I despise (none / 0) (#59)
    by Militarytracy on Wed Oct 02, 2013 at 01:35:08 PM EST
    Can't even remember her name I despise her so much :). She has two huge bases in her district and is teaclueless.  All the retired military who put her in office is sad now...and good...what a bunch of idiots.

    Parent
    Martha Roby (none / 0) (#62)
    by CoralGables on Wed Oct 02, 2013 at 01:55:01 PM EST
    Yes.....bleh! (none / 0) (#63)
    by Militarytracy on Wed Oct 02, 2013 at 01:55:54 PM EST
    And they are hurting on post (none / 0) (#64)
    by Militarytracy on Wed Oct 02, 2013 at 02:01:45 PM EST
    You can't believe how much they are hurting today.  I had no idea, I feel guilty that my husband had to go to Atlanta with me yesterday but he had to be there, we have to plan as a family for Josh...it wasn't a one person job yesterday. This isn't just civilians off one day a week though, they are so screwed right now.  I hope she eats dirt after this because most of Repukes who voted her in are furloughed right now and she doesn't even care about em.....again :). Do you military civilian employees get it yet?

    Parent
    You see it only in a positive light (5.00 / 2) (#79)
    by MO Blue on Wed Oct 02, 2013 at 03:04:35 PM EST
    That is your opinion as well as your pattern.

    You refuse to see any of the negatives that are involved in this insurance based system. Negatives that have been written about in depth  by others with extensive backgrounds in health care.

    Blind cheer leading and ignoring the parts that hinder rather than enhance actual health care will not result in getting a better system.

    Parent

    That should read (none / 0) (#91)
    by MO Blue on Wed Oct 02, 2013 at 05:45:41 PM EST
    I was around when this programs was first developed by the Heritage Foundation and I thought it was bad legislation then. IIRC Obama was not promoting this plan back in the 90s.  


    Parent
    Speaking for myself (5.00 / 2) (#37)
    by sj on Wed Oct 02, 2013 at 12:15:03 PM EST
    So far, (as I have mentioned before) you and ABG have said that you will experience a benefit from the (un)ACA. yay for Obamacare. Truly.

    For me personally, my rates are going up. I don't know yet how coverage will be affected. Since it is employer based, I think they will remain the same, but I can't be sure.

    To my personal knowledge, I believe one brother said he will now have to pay premiums while he pays out of pocket for his own health care. yay for Obamacare. Sardonically.

    As for this:

    If Obama wins this standoff will he ever get credit for it or for doing anything worthwhile where the broken healthcare system he inherited is concerned or is he still an a-hole doomed to die that way?
    What on Earth does the standoff have to do with being an a-hole? But since you mention it, so far, in my experience, with the people I know personally or have interacted with, it seems that once an a-hole, always an a-hole.

    I don't know O personally so I cannot comment on his particular a-holiness. I don't care much for his policies, though.

    Parent

    It is the general tone of most (4.25 / 4) (#40)
    by Militarytracy on Wed Oct 02, 2013 at 12:21:28 PM EST
    Of the posters around here anymore.  They get up every morning to read, dissect, and discuss in depth how Obama sucks.  For years everyone who blogged here has wanted Obama to stand up to crazy Republican and today he is.

    But to read here this morning is to only once again read about and drone on about what a miserable failure Obama is......over and over and over again.

    It is almost unhinged

    Parent

    I am (5.00 / 2) (#51)
    by Ga6thDem on Wed Oct 02, 2013 at 12:43:00 PM EST
    actually SO GLAD that I have seen ZERO caving so far. I'm almost in shock. LOL.

    Parent
    He Caved Before It Started (5.00 / 3) (#68)
    by ScottW714 on Wed Oct 02, 2013 at 02:27:24 PM EST
    On Monday he signed a bill to allow the military and it's contractors to get paid.

    IMO, as idiotic as starting the health care debate by taking single payer off the table.

    No way the Ted Cruz and Co would have voted the way they did had military pay been part of the equation.  But fortunately for them, Obama took it off the table before the shutdown.

    Right now the parts of the government that aren't being funded are basically the parts the GOP wouldn't mind disposing of.  All the crime and punishment areas are still function and the services sectors aren't.

    There is nothing shutting down that will hurt the GOP, it's why the did it.  

    Parent

    Which proves this all ... (5.00 / 1) (#80)
    by Robot Porter on Wed Oct 02, 2013 at 03:11:41 PM EST
    shadow puppet theater to distract the public.  And make it look like sweeping ideological battles are going on in our government.

    When, of course, nothing of the kind is happening.


    Parent

    Everybody needs a boogey-man... (5.00 / 2) (#66)
    by kdog on Wed Oct 02, 2013 at 02:14:26 PM EST
    that being said, he has generally sucked pretty bad;)  Not all his fault, not much ya can do in a totally dysfunctional & corrupted political system.

    Lets see how it plays out before we give the moderate republican praise for finally standing up to the far right extremists.  And lets be clear, he's holding his ground (so far) in defense of a republican health care reform plan circa 1994.

    Parent

    Just as you are free to see patterns, (4.25 / 4) (#58)
    by Anne on Wed Oct 02, 2013 at 01:21:15 PM EST
    so is everyone else, and the pattern of this president and much of the Democratic caucus is to talk tough for some period of time, and then slowly start leaking chatter about interest in "coming together" and "being willing to..." and "having no choice but to..." and that is why the kudos are being withheld or tempered.

    The patterns are the reason why the level of trust of the Dems' spinal stiffitude is relatively low - I truly don't know how you can blame people for not yet being convinced that "Lucy" isn't going to yank the football away at the last minute.

    Parent

    Yadda yadda yadda (1.00 / 3) (#60)
    by Militarytracy on Wed Oct 02, 2013 at 01:36:19 PM EST
    MT, we all see things through our own prisms (5.00 / 2) (#65)
    by shoephone on Wed Oct 02, 2013 at 02:05:42 PM EST
    --how things affect us personally. You should check out some of the comments from my fellow Washingtonian, TeresainSnow2, and the hell she's experiencing trying to put together a plan through the exchange that is anywhere comparable to the care she has currently. You might not be so dismissive.

    Then again, you just might. Because the ACA isn't affecting your life negatively, so, a pox on  anyone who isn't rah rah! about it.

    Parent

    I read some of what she posted (none / 0) (#69)
    by Militarytracy on Wed Oct 02, 2013 at 02:28:58 PM EST
    She posted hat Swedish hospital takes nothing offered by the exchanges, and that is a hospital that specializes in the joint problems Josh has so I checked their website and they had all sorts of info up about the exchanges.  

    After reading your comment here I read up on who is providing on the exchanges...that I harder to know without signing up, but Molina is on the exchange and Swedish hospital currently takes it.

    Parent

    She spoke to her provider --Premera-- (5.00 / 3) (#74)
    by shoephone on Wed Oct 02, 2013 at 02:40:52 PM EST
    and found out directly from them which hospitals are going to be in their network in the exchange. According to them, Swedish and a bunch of others -- UW, Seattle Cancer Care, and Teresa's current medical clinic, the Polyclinic -- will NOT be included.

    I think I'll wait to hear from Teresa what transpires and what she is able to work out. I doubt very much you know more about her insurance and her medical provider than she does.

     

    Parent

    That's fine by me (5.00 / 1) (#76)
    by Militarytracy on Wed Oct 02, 2013 at 02:44:35 PM EST
    But you were the one who brought it up.  It's day two of all this too.  Providers aren't all signed on yet either.  There is a pool of patients and reimbursements to receive now...believe me, if Medicare reimbursements pass muster I'm certain exchange reimbursements will too.

    Parent
    It's at least Day 1,095 since the ACA (5.00 / 3) (#77)
    by Anne on Wed Oct 02, 2013 at 03:00:33 PM EST
    was passed, so there is no reason on God's green earth why providers aren't on board and ready to participate; what? - are they waiting to see how many of the 30+ million people really, truly want insurance first?

    Or are people just supposed to blindly pick a plan and hope the doctors they want to see and the hospitals they want to use eventually sign on?

    Whose job was it to get out there and sign them up, sell them on the benefits of participating?  Because whoever was in charge of that part of this needs to be fired.  

    Parent

    Anne (5.00 / 1) (#83)
    by Ga6thDem on Wed Oct 02, 2013 at 03:36:20 PM EST
    with all due respect this is not surprising. We had a new insurance plan open up in one town that I lived in and very few providers signed on. There were NO pediatricians on the plan. According to the rep, all the pediatricians in town called each other and said don't go on the plan because of the reimbursement rate and they did not. However as time goes on, they began to lose patients or just the general loss of insurance in the general population made them sign on. So what is happening today in that area is not always indicative of what is going to happen in the future. Some wait until the last minute to sign onto things but honestly, I would think any provider that takes Medicare would end up being on the exchanges eventually. What might have to happen is those insurance companies might have to cut those multi million dollar bonuses and using some of it to get more doctors on board.

    Parent
    It is my understanding that all providers (none / 0) (#96)
    by Militarytracy on Wed Oct 02, 2013 at 06:15:02 PM EST
    who provide services for BCBS or another insurer usually must cover all of their participants through the exchanges as well, it's written in their contracts.

    Now some GP might decide to not take new patients, that could be a problem but it is already a problem here because we have a doctor shortage due to the existing chronic healthcare problems in this area.

    Parent

    I'm not (none / 0) (#97)
    by Ga6thDem on Wed Oct 02, 2013 at 06:20:31 PM EST
    sure how that is going to happen though because I have had doctors that would take one blue cross plan and not another. I'm sure there are some doctors that are going to take all BCBS patients and in some areas like SW GA where the only plan on the exchange is BCBS I'm sure the doctors are going to have to take the exchange patients or otherwise Blue Cross will pull their contract and if BCBS is pretty much the only game in town they are going to have to go along. Here they seem to be able to be more choosy about what kind of plan they take.

    Parent
    Providers are constantly changing (5.00 / 1) (#117)
    by BeDazzled on Wed Oct 02, 2013 at 10:27:31 PM EST
    There is a process of negotiation and contracts between all providers and the insurance companies. It takes time to get a provider into the system on a normal day, much less revising and re-entering every single provider once the rules of the ACA are figured out and plans designed to comply. And, yes, some are waiting to see how it's working for others before they get signed on. The providers will be changing constantly, just like they were

    Parent
    Uh-oh, another upset Regence customer (5.00 / 1) (#118)
    by shoephone on Wed Oct 02, 2013 at 10:31:17 PM EST
    People need to take copies of now and then (5.00 / 2) (#119)
    by BeDazzled on Wed Oct 02, 2013 at 10:37:55 PM EST
    changes and flood their Reps and Senators offices with mail overload so they can see exactly why their plan is an epic failure in giving everyone access to healthcare via insurance coverage. The designers of this mess obviously came from the insurance industry.

    Parent
    Bedazzled, I've emailed our governor (none / 0) (#122)
    by shoephone on Wed Oct 02, 2013 at 11:03:23 PM EST
    and my state senator. I think it's a good idea to start at the state level, since the state exchanges are under their purview. This doesn't mean I won't also be contacting our national reps, but they're second on my list. And I'm also waiting a couple of weeks to go perusing the possible plans for myself before finding out if they're going to be unaffordable in relation to the actual coverage (as I expect they will be). I want to have a chance of getting online without technological hiccups getting in the way.

    Parent
    Premera is accepted by Swedish (none / 0) (#93)
    by Militarytracy on Wed Oct 02, 2013 at 06:09:44 PM EST
    See here

    Parent
    Not only that (none / 0) (#70)
    by vicndabx on Wed Oct 02, 2013 at 02:32:53 PM EST
    the issue w/the provider of care not accepting any insurance from the exchange is not a problem w/the exchange - it is an issue w/the provider not wanting to accept (potentially) lower reimbursement rates.  You need to complain to the provider about that and take your business elsewhere in the meantime.  

    Parent
    You do this for a living (5.00 / 1) (#73)
    by Militarytracy on Wed Oct 02, 2013 at 02:39:08 PM EST
    So you know that all the providers who are going to take exchange insurance haven't even signed on yet.  They are getting their first look at all this too.

    Parent
    Exactly (none / 0) (#82)
    by vicndabx on Wed Oct 02, 2013 at 03:31:17 PM EST
    I bet you half the doctors don't even know they're in the network.  

    Parent
    So you assume that many will (none / 0) (#88)
    by Militarytracy on Wed Oct 02, 2013 at 04:26:22 PM EST
    refuse to take exchange insurance reimbursement rates?  Do you know what the reimbursement rates are?

    Parent
    Misunderstood (none / 0) (#100)
    by vicndabx on Wed Oct 02, 2013 at 06:36:54 PM EST
    I think many will, if they're not already, for precisely the same reasons you and GA6thDem have given in this thread.

    My point was more about the sometimes inefficient or under-informed staff that handles these matters on behalf of the MD(s) in the office.

    Parent

    I was under the impression (none / 0) (#110)
    by Militarytracy on Wed Oct 02, 2013 at 08:35:59 PM EST
    That most providers have contracts with insurance companies in the exchanges and will have to service those insured in the exchanges too or lose their entire contract with the insurance company.

    Parent
    I don't believe that's how it works (none / 0) (#139)
    by vicndabx on Thu Oct 03, 2013 at 07:30:33 AM EST
    but I am not on the contracting side of things.  Sounds like bad business practice, IMO.  Insurers need providers in their networks to service members and provide choice.  I suspect each product has its own network tied to reimbursement rates for that product.

    Parent
    This actually (none / 0) (#84)
    by Ga6thDem on Wed Oct 02, 2013 at 03:39:49 PM EST
    happened in one place I was living. The maternity coverage on this one plan was really good compared to all the other plans. It had a max out of pocket like $500.00 where as the other plans would cost at least $1,000.00 or not more to have a baby. So this one doctor who signed up was swamped and people were leaving the other OB's in town to go to this one because of the insurance. Lo and Behold the next year they had a lot more doctors on that plan.

    Parent
    That comment (5.00 / 2) (#94)
    by Zorba on Wed Oct 02, 2013 at 06:11:02 PM EST
    does not become you, Tracy.

    Parent
    Well I believe it fits the situation and (3.50 / 2) (#98)
    by Militarytracy on Wed Oct 02, 2013 at 06:25:36 PM EST
    The direction and tone around here anymore.  It is like a 24/7 Obama hatathon no matter what he does or when he does it.

    Parent
    Well (5.00 / 1) (#101)
    by sj on Wed Oct 02, 2013 at 06:54:47 PM EST
    I thought maybe a hint would work
    Hopefully without going down the "Obama haters" route.
    Oh well. You must need whatever it is that lets you look at O through rose colored glasses and the rest of us through a stink eye.

    Parent
    scuze me (4.00 / 3) (#102)
    by Militarytracy on Wed Oct 02, 2013 at 07:03:14 PM EST
    What is the hint that I'm supposed to take?  That I have to hate on Obama 24/7 too and get along on a site calling itself Talkleft or shut the hell up?

    Parent
    The hint is that (5.00 / 3) (#103)
    by sj on Wed Oct 02, 2013 at 07:23:20 PM EST
    there is a rabbit hole you take where you suddenly see any criticism of administration policies as an "Obama hatathon". When you get there, your comments start getting very ugly.

    And anyone who is really "left" (like, for example, union-loving, safety-net-supporting, tree-hugging, bleeding-heart liberals like me) can tell you definitively that if one is Talkin' Left they are supporting their values and not the head of a political party.

    It's your right to blindly support your President. I prefer to support my values.

    And if "shut the hell up" is the only alternative to ugly then I'm okay with that. Or, alternatively, you could show good manners and recognition that this is not a Facebook screamfest and present your viewpoint in a thoughtful rather than hostile way.

    I know you can do it. You almost never provide links, but you can be thoughtful. And then... there is the other side.

    Parent

    Nope, the tone around here (2.00 / 1) (#106)
    by Militarytracy on Wed Oct 02, 2013 at 07:35:09 PM EST
    is unhinged.  The constant focus on how everything is Obama's fault or you guys have nothing to talk about is unhinged.

    Parent
    If you are going (5.00 / 3) (#107)
    by sj on Wed Oct 02, 2013 at 07:37:42 PM EST
    by your own comments, I must agree with you. What a bizarre interpretation of policy disagreements. That is unhinged indeed.

    I'll go back to reading you when you have re-hinged yourself.

    Parent

    Your supposed macho (none / 0) (#125)
    by MKS on Wed Oct 02, 2013 at 11:17:03 PM EST
    enforcer routine is misplaced here...Do you think you are some self-appointed Zoro?

    I have no idea what you stand for.  I do not know a single position you have taken on anything.  Perhaps you have....But you strive to inject yourself and your supposed mores into every conversation.

    In spite of posting here for years, I cannot remember a single substantive position you have taken on anything.....You like to bash Obama supporters.    You like to support the Obama bashers...Aside from that, nada, senior.  

    Tracy has good reason to be concerned about the ACA.  And little reason to find false benefits....  

    Parent

    Everyone has good reason to be concerned (5.00 / 4) (#130)
    by nycstray on Thu Oct 03, 2013 at 03:23:10 AM EST
    about the ACA.

    Parent
    So you have a bad memory (none / 0) (#129)
    by sj on Thu Oct 03, 2013 at 02:57:47 AM EST
    What can I say?

    Parent
    So true, if they can't find fault or (none / 0) (#126)
    by MKS on Wed Oct 02, 2013 at 11:24:58 PM EST
    bash Obama, they really have nothing to say.

    Parent
    More than a little (none / 0) (#127)
    by MKS on Wed Oct 02, 2013 at 11:37:01 PM EST
    condescending--telling Tracy how to compose posts....

    Parent
    The hint that it isn't about hate, (5.00 / 4) (#104)
    by Anne on Wed Oct 02, 2013 at 07:28:57 PM EST
    and making it about hate and not about the specific and valid and rational points people are making reduces you to being sort of a petulant-with-a-dash-of-nasty cheerleader.

    Is that who you are?

    I mean, this little exercise you've been engaging in over Teresa's frustrating experience trying to find plans that include the providers she has relationships with is just mean and spiteful.  I looked at that link you posted, and I saw one Premara plan on the list at Swedish - is that an exchange plan?  Does it include Teresa's doctors?  

    I guess what bothers me is how you seem to be so invested in proving something about ACA that you're willing to pretty much call Teresa a liar for what she reported about her experience trying to find a plan that works for her.

    Why?  Do you "love" Obama that much, Tracy?  Oh, what - it's not about love?  Huh.  

    I have to say, it doesn't take much and it doesn't take long for you to flip the ugly switch; it's not a good look for you.

    Parent

    HahahahA (2.00 / 5) (#108)
    by squeaky on Wed Oct 02, 2013 at 07:39:48 PM EST
    Yes and when you dish it out it looks royal?

    please take the log out of your eye and stop making believe that you are better than everyone else, like some sort of purity den mother.

    When it comes to Obama, the TL groupies sound just about as rational as tea partiers.

    Parent

    My complaint.... (none / 0) (#92)
    by unitron on Wed Oct 02, 2013 at 05:51:23 PM EST
    ...is that the Charlie Brown in this scenario never realizes that yes, Lucy is going to pull the ball away this time, and the next, and the next...

    Parent
    Tracy, many here (none / 0) (#124)
    by MKS on Wed Oct 02, 2013 at 11:12:29 PM EST
    cannot bring themselves to admit anything positive about Obama.    They actually want the ACA to fail....

    On the other hand, there are those of us who need the ACA to get insurance.....There are millions of us....The posters here do not want to see that....

    Parent

    Not sure how you got such a sweet (none / 0) (#99)
    by MO Blue on Wed Oct 02, 2013 at 06:33:21 PM EST
    deal on the out of pocket cap. Many people will not be so lucky.

    NYT as of August 13, 2013

    WASHINGTON -- In another setback for President Obama's health care initiative, the administration has delayed until 2015 a significant consumer protection in the law that limits how much people may have to spend on their own health care.

    The limit on out-of-pocket costs, including deductibles and co-payments, was not supposed to exceed $6,350 for an individual and $12,700 for a family. But under a little-noticed ruling, federal officials have granted a one-year grace period to some insurers, allowing them to set higher limits, or no limit at all on some costs, in 2014.
    ...
    The grace period has been outlined on the Labor Department's Web site since February, but was obscured in a maze of legal and bureaucratic language that went largely unnoticed. When asked in recent days about the language -- which appeared as an answer to one of 137 "frequently asked questions about Affordable Care Act implementation" -- department officials confirmed the policy.
    ...
    Under the policy, many group health plans will be able to maintain separate out-of-pocket limits for benefits in 2014. As a result, a consumer may be required to pay $6,350 for doctors' services and hospital care, and an additional $6,350 for prescription drugs under a plan administered by a pharmacy benefit manager.

    Some consumers may have to pay even more, as some group health plans will not be required to impose any limit on a patient's out-of-pocket costs for drugs next year. If a drug plan does not currently have a limit on out-of-pocket costs, it will not have to impose one for 2014, federal officials said Monday. link



    Parent
    Tricare (none / 0) (#132)
    by TeresaInSnow2 on Thu Oct 03, 2013 at 05:34:41 AM EST
    Congress passed a law that Tricare was considered minimal essential coverage, but otherwise Tricare was excluded from the law.

    If you're experiencing something new and good, it has nothing to do with Obamacare.

    Parent

    On the contrary (5.00 / 1) (#151)
    by CoralGables on Thu Oct 03, 2013 at 10:22:01 AM EST
    What that means is Tricare would abide by all new minimum standards set by the ACA.

    Parent
    Do you have a link to how ACA affects Tri-Care? (5.00 / 1) (#153)
    by MO Blue on Thu Oct 03, 2013 at 12:43:54 PM EST
    This is what "CRS Report for Congress
    Prepared for Members and Committees of Congress
    Military Medical Care: Questions and
    Answers" has on the subject:

    12. How Does the Patient Protection and Affordable Care Act Affect TRICARE?
    In general, the Patient Protection and Affordable Care Act (ACA) 28 does not directly affect
    TRICARE administration, health care benefits, eligibility, or cost to beneficiaries.

    29
    Section 3110 of the ACA did open a special Medicare Part B enrollment window to enable certain individuals to gain coverage under the TRICARE for Life program.30

    The ACA also waived theMedicare Part B late enrollment penalty during the 12-month special enrollment period (SEP) for military retirees, their spouses (including widows/widowers), and dependent children who are 24 otherwise eligible for TRICARE and are entitled to Medicare Part A
    based on disability or end-stage renal disease, but have declined Part B. The ACA required that the Secretary of Defense to identify and notify individuals of their eligibility for the SEP; the Secretary of Health and HumanServices (HHS) and the Commissioner for SocialSecurity support these efforts administratively.
    Section 3110 of the ACA was amended by the Medicare and Medicaid Extenders Act of 2010
    31 to clarify that Section 3110 applies to Medicare Part B elections made on or after the date of enactment of the PPACA, which was on March 23, 2010. PDF link

    This is what Obama put in his proposed budget per Military. com dated 4/11/13 regarding Tricare:

    Obama Budget: Increase TRICARE Fees and Cap Pay

    Catastrophic Cap - The current cap on total out-of-pocket costs TRICARE costs of $3000 a year would be raised for retirees in two ways: by excluding any TRICARE enrollment fees from counting toward the cap; and by raising the cap annually by the percentage of retiree COLA.

    Officials hope tying the size of fees to level of retired pay will soften resistance in Congress.  Also, this year's plan would exempt from any fee increases the survivors of members who die on active duty and persons medically retired from service.  And the department no longer is asking that TRICARE fees be adjusted annually based on medical inflation.

    That concession to use retiree COLAs instead might be less than it appears.  The Obama budget proposes, as part of a larger debt-reduction deal, that all federal COLAs, including for social security, veteran benefits and retirement plans, switch to a "chain" Consumer Price Index to measure inflation.  This CPI would save the billions of dollars annually by shaving every COLA by a fraction of a percentage point.



    Parent
    Reposting my comment with the appropriate (5.00 / 1) (#29)
    by Militarytracy on Wed Oct 02, 2013 at 11:35:16 AM EST
    Form of  clusterfkery.

    All programs hit points of clusterfkery.

    I am so happy right now about the protections that ACA provides ALONG WITH a participation and investment that will drive Americans to the ballot box.  This all beats the hell out of the previous hopelessness and voicelessness and waiting to die that the "unlucky" were saddled with.

    Parent

    I'm certain (5.00 / 1) (#87)
    by TeresaInSnow2 on Wed Oct 02, 2013 at 04:24:12 PM EST
    that Bush's "Healthy Forest Initiative" was much more user friendly than if he'd called it the "Cutting Down the Trees" initiative.  

    People have no idea what the Affordable Care act actually is.

    Parent

    Charlie Pierce thinks the GOP is (5.00 / 3) (#10)
    by Anne on Wed Oct 02, 2013 at 10:10:34 AM EST
    getting exactly what it wants from the shutdown:

    Right now, even if their campaign of public vandalism ended at this very moment, the Republicans would still have three-quarters of a loaf because the status quo ante would be a federal budget at (or beneath) the spending levels mandated by The Sequester. Given that, what possible reason do the Republicans -- or, at least, those Republicans who are currently driving the strategy now -- have not to keep the government shut down not only through the upcoming debt ceiling fight, but for most of the rest of Barack Obama's term?

    [snip]

    This [people realizing they can live with a lot less government] is the unspoken subtext of what the vandalism is all about. This is the real motivation behind all the tricornered hats and the incantations about liberty and all the conjuring words that have summoned up the latest crisis in our democracy. Corporate money is the power behind all of it, and that corporate money has but one goal -- the creation of a largely subjugated population and a workforce grateful for whatever scraps fall from the table. To accomplish this, the corporate money not only had to disable the institutions of self-government that are the people's only real protection, it had to do so in such a way that the people expect less and less of the government and, therefore, less and less of each other, acting in the interest of the political commonwealth. (The dismantling of organized labor is a sideshow to the main event in that the goal there was to cripple organized labor's political power within the political institutions so that there would be no countervailing force that could be brought to bear against the destruction of its power in the workplace.) For all the endless bloviation about the dead-hand of government, what the vandals in Washington are shooting for right now is a subject population whose tattered freedoms depend on the whimsical ethics of the American corporate class. This is the really deep game being played here, and they're more than halfway to winning it.

    This had occurred to me, as well - that at some point, the GOP would begin to argue that, "see, we didn't really need this and this and this - we're getting along just fine without them - and look at how much money this is saving us!"

    Meanwhile, will they care that all these federal workers not getting paid is going to have a negative effect on the economy?  I'm guessing they think they can blame the Democrats and use it to their advantage, but even assuming there are enough reasonably sentient voters who see this for the BS that it is, it won't undo the damage.  And people already teetering on the edge, who managed to claw their way back to reasonably solid ground, are going to be tumbling into the hole again.  

    Maybe the only thing that gets their attention is if Wall Street starts to go sideways again - if their portfolios begin to lose value, maybe that brings them somewhere in the same zip code as their senses.

    I am not hopeful this is going to end well for any but those who always seem to land on their feet - and that won't be ordinary people, for sure.

    Read that too and was struck by (5.00 / 5) (#16)
    by ruffian on Wed Oct 02, 2013 at 10:58:55 AM EST
    this part near the end:
    For all the endless bloviation about the dead-hand of government, what the vandals in Washington are shooting for right now is a subject population whose tattered freedoms depend on the whimsical ethics of the American corporate class. This is the really deep game being played here, and they're more than halfway to winning it.

    On my trip last week I wanted a California book, so I brought with me Upton Sinclair's "Oil!", which I have had on my stack since the movie 'There Will be Blood' came out, based on it. It was written in 1926, about the 19-teens and twenties, and I swear some of the passages could be describing today. Charlie's passage above, and his references to the labor movement, could have come straight out of that book. Yet people refuse to see that they are being used, and robbed blind - AGAIN!  Ugh.

    Parent

    Without a Doubt (5.00 / 3) (#24)
    by ScottW714 on Wed Oct 02, 2013 at 11:15:41 AM EST
    They are trying to send bills to fund individual departments, clearly they are raking the worth of governmental employees/agencies.  If the D's bite, they are simply going to fund the ones they like and forgo the others.

    I thought it was a huge mistake for Obama to sign the bill funding the troops, he basically allowed the republicans to shut down some of the government, it should be all of not, otherwise this game is going to get played out year after year.  It will become an effective negotiation tool.

    I read today that 80% of federal employees are working, it was presented as something good.  I mean only 800,000 people with jobs not getting pay checks, great news.  I assume they are all eligible for unemployment, which will come form the fed and state budgets.

    What I find extremely annoying is that the politicians, who are federal employees, aren't effected in the least.  They should not collect paychecks, per diem, and their support cast, from janitors to drivers should not be at their disposal when the government is supposedly shut down.

    Parent

    Not going to happen (none / 0) (#27)
    by jbindc on Wed Oct 02, 2013 at 11:25:09 AM EST
    First of all, Congress is still working (if that's what you want to call it), so they are technically still eligible to receive a paycheck (I wouldn't say they are EARNING their paycheck, however).

    Second, and most importantly, the 27th Amendment specifically says that the compensation of Congress cannot be changed until after a Congressional election has past.

    But I agree with your sentiment.

    Parent

    This is exactly (5.00 / 3) (#90)
    by Zorba on Wed Oct 02, 2013 at 05:00:15 PM EST
    what I told Mr. Zorba yesterday:
    This [people realizing they can live with a lot less government] is the unspoken subtext of what the vandalism is all about. This is the real motivation behind all the tricornered hats and the incantations about liberty and all the conjuring words that have summoned up the latest crisis in our democracy.

    They are not shutting down Social Security or Medicare payments, they are not closing all the military bases and furloughing the military who are not in hotspots, they are not pulling the Border Patrol away from the borders, they are not furloughing the air traffic controllers and closing down air travel.  Maybe if they had done this, Americans might start to realize what it is that government does.  (And I'm betting that the Wall Street types would in particular be unhappy if they couldn't hop on airplanes and travel wherever they wanted to, even if they don't give a sh!t about Social Security.)
    But they didn't.

    Parent
    AN AXE LENGTH AWAY, vol. 145 (5.00 / 1) (#18)
    by Dadler on Wed Oct 02, 2013 at 11:04:16 AM EST
    Young Ted Cruz tells his grandmother the hard, ugly truth. For her own good, of course. (link)

    Volume 144
    Volume 143

    Happy Wednesday, folks. The government is a hopeless graft palace, and we have no Dems with any imagination in their political heads. Just as absurd a situation as old Ubu Roi...MERDE!!!

    Science and Cooking (5.00 / 2) (#22)
    by nycstray on Wed Oct 02, 2013 at 11:14:20 AM EST
    For the food folks here and because there was a discussion that mentioned Harold McGee, I thought I'd share this link to a free Harvard edX class online . . .

    Science & Cooking: From Haute Cuisine to Soft Matter Science

    yes yes yes (5.00 / 2) (#30)
    by squeaky on Wed Oct 02, 2013 at 11:40:50 AM EST
    Those lectures are amazing..  I know the ones prior, but have not seen the new series yet..

    And his books are great..  On Food and Cooking, the Science and  Lore of the Kitchen, is a cooking bible and a great read, and then there is a sweet set of essays in the Curious Cook

    Parent

    Ohhh . . (none / 0) (#35)
    by nycstray on Wed Oct 02, 2013 at 12:03:08 PM EST
    thanks for the link to the prior ones!  :)

    Parent
    I might have to do this - it sounds (5.00 / 1) (#31)
    by Anne on Wed Oct 02, 2013 at 11:51:11 AM EST
    fascinating.  

    Would be fun if a bunch of us signed up!

    Parent

    I already signed up :) (none / 0) (#34)
    by nycstray on Wed Oct 02, 2013 at 12:02:16 PM EST
    I love this stuff!

    Parent
    Oh My (5.00 / 1) (#45)
    by squeaky on Wed Oct 02, 2013 at 12:32:50 PM EST
    Dangerous...  the gadgets can set you back $$$...  but it is a fascinating approach to cooking..  as an artist I love it..  not so different from doing installation works..  except they get installed in the stomach.

    Sous vide is excellent way to cook, but you need a blow torch... which, by the way is a great all purpose kitchen gadget

    Also, for sous vide you need a vacuum sealer, which is also extremely useful for food storage.

    And then there is the centrifuge, vacuum oven, and roto-vap..
    I have a centrifuge, but the roto-vap and vacuum oven are high on my loooooong list..

    Parent

    Had the blow torch and sealer (5.00 / 2) (#131)
    by nycstray on Thu Oct 03, 2013 at 03:48:09 AM EST
    pre my life being stolen . . . {sigh} Oh well, kitchen purchases are one of my favorite spending habits, lol!~

    Never thought of the installation angle, but I like it :) I consider my kitchen one of my studios, the garden another . . .

    Parent

    The Government Shut-Down Strategy (5.00 / 4) (#43)
    by NYShooter on Wed Oct 02, 2013 at 12:27:12 PM EST
    makes a lot more sense if we understand what their goal really is.

    The Tea Party leaders who are driving this movement couldn't care less what damage they're causing, nor, what the general public thinks. Every one of them, thanks to the magic of redistricting, are in rock solid districts, so, what the country-wide opinion is doesn't matter to them. They are safe.

    They also understand that they can never be a National Party (they know the Presidency is unattainable) but, like a commenter here said yesterday, look how successful they've been being in the minority. For years now, they've been concentrating on State, and local, offices. So, with State-wide dominance, a Right-Wing Supreme Court, and a rabid, cohesive, cabal running The House, who needs the Presidency?

    No, these people are not simply an "opposition" Party, advocating for a certain set of political beliefs. They are traitors, willing to sacrifice the great majority of citizens in order to do the bidding of the 1%. And, this is not, simply, the  conclusion of a wide-eyed, Left Wing, Anarchist; some very smart political thinkers I know have come to the same conclusion.

    At the core, their strategy is brilliant. They have coalesced a nucleus of imbecilic, sociopathic, racists who are more than willing to sacrifice their own family's interests in order to institutionalize the concept that minorities, seniors, and the poor are sub-human. And, as such, they are the ultimate "takers," who deserve the results that their policy of "planned obsolescence" will deliver.

    The 1% have shown that they don't need a healthy, vibrant middle class in order to accumulate record profits. We are a Global economy, after all. And, with that in mind, if we look at the dynamics of the current turmoil, the strategy of chaos and destruction makes a lot more sense.

    In any event the battle is not over "Obama-care," it is over the question of whether a democracy can even exist in a 21'st Century, Global, "Free-Enterprise" System.


    The Tea Partiers (5.00 / 1) (#128)
    by MKS on Wed Oct 02, 2013 at 11:49:31 PM EST
    are also generally religious conservatives.....

    This an existential fight for them, not because they are consciously trying to help the 1%, but because they are desperately seeking validation. (The 1% have brilliantly co-opted them, though.) Modernity is hard on them.  Evolution, Global Warming, not being able to rely on being in the white majority, women who do not adhere to Biblical ideas of submissiveness, losing the Presidency to a Black Man, and the ignominy of gay rights and marriage equality.

    Conservatives are inherently authoritarian, so to not have the government validate them and their antiquated ideas is very painful.  And gay marriage will undo them.  They must destroy this government.  

    Parent

    Stock Market Shaken by Shutdown (5.00 / 3) (#81)
    by ScottW714 on Wed Oct 02, 2013 at 03:30:26 PM EST
    I have seen some form of that headline at nearly every news site I have visited in the past couple days.

    If only WS would just cooperate with the memo.
    S&P (.07%)
    DOW (.39%)
    NASDAQ (.08%)

    A bit better than one third of a percent is the most any of the major markets are down.  WTF, it's like they wrote the headlines last week and didn't bother to actually check the markets.

    I find this kind of hype/scare intolerable because it's simply not true in any sense of the word and so easily verified.  

    It's a complete lie, WS is not sweating jack about shutdown.

    No reason for the market to sweat yet (none / 0) (#86)
    by CoralGables on Wed Oct 02, 2013 at 03:43:33 PM EST
    like all other shutdowns it will reopen. But most of those headlines were written this morning when the Dow was down 140 pts.

    Parent
    Still Less Than 1%... (none / 0) (#89)
    by ScottW714 on Wed Oct 02, 2013 at 04:57:38 PM EST
    ...and still complete non-sense.

    Parent
    How screwed up are the House Republicans? (5.00 / 4) (#112)
    by CoralGables on Wed Oct 02, 2013 at 09:16:43 PM EST
    This from Rep. Marlin Stutzman (R-IN)

    "We're not going to be disrespected, We have to get something out of this. And I don't know what that even is."


    It is a given that they are (5.00 / 4) (#113)
    by MO Blue on Wed Oct 02, 2013 at 09:27:07 PM EST
    batsh!t crazy.

    Personally, I like the way Steve from the Left Coaster thinks:

    If Nancy Pelosi really wanted to stir things up right about now inside the House GOP caucus, she'd walk over to Peter King and whisper into his ear "Do you want 190 votes to be the new Speaker?"


    Parent
    Somebody should send that to her (5.00 / 3) (#115)
    by nycstray on Wed Oct 02, 2013 at 10:13:22 PM EST
    (or maybe we should do a petition! /s) The very least they could do for us these days is provide us with some amusement :P

    Parent
    Willie Brown did just that (none / 0) (#155)
    by MKS on Thu Oct 03, 2013 at 01:25:57 PM EST
    Once upon a time--before the Republicans went nuts with Prop 187 and anti-Latino hate--the Republicans gained a majority in the state legislature in California.

    Willie Brown, the former Democratic Speaker cut a deal with one or two Republicans, and remained speaker in spite of the fact that the Republicans had a majority.  The ride lasted until the Republicans recalled the two that Brown had turned.....Now of course the Dems have supermajorities in both chambers.

    Nancy and Willie know each other for decades....Run, Nancy, run.

    Parent

    My newly discovered wrinkle in the ACA (5.00 / 2) (#133)
    by TeresaInSnow2 on Thu Oct 03, 2013 at 05:50:56 AM EST
    The "Affordable" Care Act allows 2 tiers in deductibles and out of pocket maximums.  One is for in-network providers and one for out of network providers.

    For the in-network providers:  The in-network deductible and out of pocket max are subject to to cost-sharing subsidies.  The out of pocket max is capped at $6250.

    For out-of-network providers:  The deductible is not affected by cost sharing subsidies and can be quite large, in the realm of $10,000/$12,000 per person.  In addition, out of pocket maximums are not capped by the law and can be UNLIMITED.  And in the plans in my state, the caps are UNLIMITED (Completely unlimited for Blue Cross, unlimited for families for Blue Shield).

    It sounds fine.  Just see an in-network provider!  But when you consider that almost all of the hospitals in Seattle are out of network providers for Exchange plans, including the trauma center (Harborview) that accident victims are typically taken or flown to, this is a serious problem.  (See my other posts for the list).

    Bottom line: If you have an emergency and need to go to an out-of-network ER (which is most of the ERs in Seattle), your costs, even when insured, ARE NOT CAPPED.  This is worse than any individual market plan has ever been in our state in the 10 years I've been on the individual market.  

    So not only does Obamacare do very little to solve that problem of write-downs from people visiting emergency rooms, it will likely actually INCREASE them.  Ask me if you have questions.

    I know it's hard for you to believe.  You'll think that it just can't be.  But trust me. It is true.

    And (5.00 / 1) (#134)
    by TeresaInSnow2 on Thu Oct 03, 2013 at 06:01:27 AM EST
    This is going to be an incredible surprise for people when they come out of the ER and get their bill.

    Oh, one thing I forgot to address.  For out-of-network doctors and hospitals, the ACA allows the providers to collect the balance over what the insurance companies didn't cover. So if you get 50% co-insurance for out of network providers, and your insurance company has negotiated a lower pay rate to the provider, you are liable for

    1.  50% of the insurance plan negotiated rate
    2.  Whatever balance over the insurance negotiated rate that the doctor or hospital decides to collect from you.

    In other words, you would be liable for 75% of your care (typically) for an UNLIMITED amount of charges.  You can look at it as some kind of a discount card plan, but it's not insurance.

    Parent
    I think you are misunderstanding (5.00 / 1) (#145)
    by vicndabx on Thu Oct 03, 2013 at 08:54:31 AM EST
    If you have an emergency and need to go to an out-of-network ER (which is most of the ERs in Seattle), your costs, even when insured, ARE NOT CAPPED

    Searching on wahealthplanfinder.org, using annual income 37.5k, 68 yo female, I find 36 plans and 6 include harborview as in-network.

    Even those that have harborview as out of network have the same coverage as preferred/in-network for ER visits, $200-$250 copay either before or after deductible/coinsurance amount.  The cap would be the coinsurance percentage of the plan's allowed charges.  You are 100% correct about out of pocket max - there are none for out of network.

    Plans don't want you to go the ER in general.  You should be going to your in-network primary care doctor for anything but the most urgent things.

    I'm not understanding why you think it's reasonable to go any doctor that you want in these type of plans.  In all seriousness - considering varying levels of care and cost when the goal is to manage both to keep levels at a minimum standard?

    Not trying to stress you out w/an argument.  It seems to me that if a particular doctor is needed, consumers should encourage that doctor to join the network in question.

    Parent

    I did research on that same site today (none / 0) (#161)
    by BeDazzled on Thu Oct 03, 2013 at 09:37:08 PM EST
    and was actually quite pleased with what I saw in the plans that are being made available in my area. My goal is to find the plan that most fits my budget and my circumstances. It appears to me that Washington State has numerous plans that will suit me fine. Easy site to navigate, and I had no problems with its performance. I'm sure not going to raise my blood pressure getting stressed out on the "what if" list of things that will most likely never come to pass.

    I appreciate your sensible comments. When one has a determination to find the negative in things they generally end up completely misinformed and, through their self-fulfilling prophecy, get skewered just as they believed they would.

    Parent

    Do you have any current, chronic health (5.00 / 2) (#166)
    by Anne on Fri Oct 04, 2013 at 07:16:15 AM EST
    conditions for which you are being treated?  Do you have doctors who have been monitoring your health and your care for some period of time?  Are you currently taking medication?

    I ask those questions because not everyone looking to get insurance on the exchange is only concerned about the cost.  Yes, cost is a factor, one part of the picture.  The other part is whether the providers with whom they have relationships are participating in the plans, and whether, when all the factors are taken into consideration, the care they need will be accessible and affordable.  How many people are going to end up with "insurance," that, even with some subsidization, will, with the levels of cost-sharing - co-pays and deductibles and premiums - leave them still in a position where they can't actually afford the care they need?

    But the insurance companies will be in robust health, and that, apparently, is what really matters these days.

    Really, this legislation should have been called the "Kinda Affordable Insurance Act," not the "Affordable Care Act," because if the goal was for people to get affordable care, the emphasis wouldn't have been on insurance.  

    It's great if you can find a plan that works for you - I actually hope more people who really need care will be able to make this all work for them - but I think it's offensive not to appreciate that there are a lot of people dealing with health issues, who are intimately familiar with trying to coordinate insurance with providers and affordability and the ever-changing in-network/out-of-network traps, the barriers (no, you can't have the treatment your doctor wants you to have until you try these 14 other things first even though we all know they aren't going to solve your problem), and it isn't just a matter of picking a plan with the right price tag because all they ever need it for are routine physicals and screenings.

    Seriously, when you pick a plan, make sure they cover cranial colonectomy, because based on some of your comments, you seem in dire need of having your head removed from your a$$.

    Parent

    BCBS (none / 0) (#138)
    by Ga6thDem on Thu Oct 03, 2013 at 07:26:52 AM EST
    sucks. So i am not surprised that they wrangled a deal. However, you might want to wait and check back and see if more doctors/hospitals sign on because a lot of times that kind of thing changes and there is still a few months to go.

    Parent
    BCBS (none / 0) (#141)
    by TeresaInSnow2 on Thu Oct 03, 2013 at 08:32:35 AM EST
    is for all intent and purpose the only game in town.  And BTW, our BCBS providers are "non-profits" (LOL).

    So you think that 3 years after passage of Obamacare, these hospitals have come to the decision not to accept the insurance plans lightly and that they're going to change their minds? Wow, you are a whole lot more optimistic than I'll ever be.

    But I want you to know that I'm fighting. Nobody is talking very loudly about this problem, so I wrote to the Seattle Times and to the only major local TV station that doesn't 100% cheerlead for Obamacare.    I wrote the insurance commissioner.  I see no point in writing to cheerleaders Patty Murray and Maria Cantwell or to Mr. Repeal Reichert.  

    And.

    I am starting work today on an initiative campaign -- the RIGHT TO REFUSE CARE initiative.  Basically, it will state that if a person is unconscious at an accident or emergency scene; and has determined in advance that they refuse care at out of network hospitals for plans that have unlimited caps on out of network care;

    and if no in-network hospital is a feasible distance away; that the request to refuse care has to be honored or the cost of care is picked up by the state.  The advance directive would be recorded via the RF chip number that we have in our Enhanced Drivers' Licenses.  (We in Washington can get those).

    The way I see it, I'm 50 years old, not worth wracking up UNLIMITED medical bills because we victims of the Obamacare Exchange plans are essentially uninsured for out of network emergency care.  And add to that whatever bills are required for further care after the initial emergency and whatever disability work stoppage we might incur and it could be  a financial disaster.  I doubt that I'm alone in this feeling.

    The bottom line is that as of 2014, we in Washington State (and most other states in the country) no longer have health insurance on the individual market.  Instead, we have a limited network of reduced cost clinics.  The events that are considered catastrophies, the things that were traditionally covered by insurance, are all but not covered.


    Parent

    After having (5.00 / 2) (#147)
    by Ga6thDem on Thu Oct 03, 2013 at 09:02:56 AM EST
    spent over 20 years in the insurance industry, yes, the fact that it was passed three years ago did nothing. They are only concerned about when it goes into effect. I'm am pretty positive that insurance companies did very little ahead of time. We started a new insurance plan and no one signed up at first. So this does happen.

    The out of network stuff has been a problem for a long time.

    People have been being screwed over in the individual market for so long it's sad. I have been there done that where I was paying for a premium and then insurance that did not cover anything so having to pay medical bills on top of a premium.

    Parent

    Thanks for being the voice of reason (5.00 / 2) (#149)
    by CoralGables on Thu Oct 03, 2013 at 09:18:14 AM EST
    on health insurance. Out of network goes as far back as I can remember.

    Parent
    I really (5.00 / 3) (#150)
    by Ga6thDem on Thu Oct 03, 2013 at 09:45:00 AM EST
    understand where Teresa is coming from. There is no market that will screw you over more than the individual market and at least so far it seems that Obamacare has done nothing to alleviate that problem. I just kind of want people to take a deep breath too.

    Parent
    Agreed (none / 0) (#154)
    by sj on Thu Oct 03, 2013 at 01:12:58 PM EST
    Out of network has always been significantly more costly. Traditionally, however, there has been a cap the cost. If that goes away, yikes!

    Parent
    If you worked (5.00 / 1) (#156)
    by Ga6thDem on Thu Oct 03, 2013 at 01:54:50 PM EST
    for a larger company yes, but I have known of many people who had plans with no caps going back to the 90's. One person had a preemie baby and ended up paying 20K in hospital bills back then.

    Parent
    I've never seen that before (none / 0) (#157)
    by sj on Thu Oct 03, 2013 at 02:43:13 PM EST
    That's just wrong.

    Parent
    Heck (none / 0) (#158)
    by Ga6thDem on Thu Oct 03, 2013 at 02:57:41 PM EST
    yeah it's wrong but it has been happening before. A lot of it is with rising costs of insurance etc. people are looking for ways to save money so they get a plan without caps gambling on the fact that no one will get sick or if they do get sick, it won't raise their rates.

    Parent
    Good health (5.00 / 1) (#159)
    by sj on Thu Oct 03, 2013 at 03:35:50 PM EST
    is not necessarily an indicator that major health care services are unlikely to be required.  Most people with kids can understand that. I think it's easier to roll the dice if one is single.

    Parent
    Ever considered getting a job (1.83 / 6) (#160)
    by BeDazzled on Thu Oct 03, 2013 at 09:18:37 PM EST
    in a company that provides good health insurance so you aren't constantly at odds with this problem?

    Parent
    Gee. Maybe we should just all consider (5.00 / 5) (#163)
    by shoephone on Thu Oct 03, 2013 at 10:22:41 PM EST
    waking up tomorrow as millionaires -- and that way we won't be "at odds" with any of these health care problems!

    Yours is one of the most arrogant, patronizing comments I've read on this subject yet.

    Parent

    Why didn't anyone ever think of that (5.00 / 3) (#164)
    by MO Blue on Thu Oct 03, 2013 at 10:46:19 PM EST
    solution? Everyone should go out tomorrow morning and get a job that provides good health insurance and we can get rid of the need for Obamacare all together.

    There are at least 50 to 100 million jobs throughout the country that provide good health insurance just begging for people to apply so that they can hire them and provide them with great benefits. :o(

    Parent

    Gubby withdrew his efforts to take Premera (1.00 / 1) (#162)
    by BeDazzled on Thu Oct 03, 2013 at 09:49:14 PM EST
    public back in 2007- had it gone that way things would be so much worse for the subscribers. BCBS is not all WA has. Not at all.

    Parent
    "Gubby"? (5.00 / 2) (#165)
    by shoephone on Thu Oct 03, 2013 at 10:52:59 PM EST
    You're sounding downright Tea Party.

    And BCBS pretty much IS all you've got if you are self-employed.

    Parent

    Teresa, are you absolutely sure that (none / 0) (#146)
    by Anne on Thu Oct 03, 2013 at 08:57:12 AM EST
    emergency care is not handled as if it were rendered on an in-network basis?

    Every insurance plan I've ever had has waived those in/out-of-network restrictions in the event one has a medical emergency, because the liability to the insurance company that follows from someone not seeking care because of insurance requirements is probably far more than whatever amounts the company ends up paying to the provider for the care.  And that may be because the state mandates it - I don't know.

    I can see those restrictions coming into play once you've been stabilized in the ER and they want to admit you - then, I think, you'd have to insist on a transfer to an in-network facility, and probably directly from the ER.

    What's just so hard to fathom is that most people will have no idea what they are really signing up for, what their bottom-line costs are, and whether they really have "insurance" or just a nice laminated card that will return much less affordable care for the premiums paid.

    Please keep us posted on what you're finding out, and I will keep my fingers crossed that you can find a plan that works for you.  By the time the dust settles, I think a lot of people are going to feel like they wished they'd checked out the mental health provisions of these plans, as going through this process is going to make a lot of them feel like they've gone round the bend.

    Parent

    You are right. (none / 0) (#148)
    by Ga6thDem on Thu Oct 03, 2013 at 09:08:54 AM EST
    There needs to be some kind of emergency care exception or you should be able to sue the ambulance company for taking you to the wrong hospital. A few suits like that and I'm sure an emergency care exception would be made.

    Here in the metro Atlanta area I have never thought about it but honestly there are a lot of hosptials but they are all owned by three companies, Wellstar, Emory and Northside.

    Parent

    Clowns to the left of me, (none / 0) (#2)
    by Edger on Wed Oct 02, 2013 at 07:39:59 AM EST
    Obama to nominate former Romney adviser Chen to federal board
    It seemed like a timely stroke of bipartisanship: the White House announced Monday, on the eve of a government shutdown, that President Obama would nominate a top adviser to Republican Mitt Romney's campaign to an administration position.

    Obama intends to nominate Lanhee J. Chen -- the policy director on Romney's 2012 presidential campaign who, yes, repeatedly attacked Obama's Social Security plans -- to the Social Security Advisory Board, which advises the president as well as the Congress on Social Security policy.

    jokers to the right,
    Here I am, stuck in the middle with you.


    July 27, 2011 (5.00 / 3) (#3)
    by Edger on Wed Oct 02, 2013 at 08:37:42 AM EST
    At a press conference held by members of the House Out of Poverty Caucus Rep. John Conyers (D-Mich), the second most senior member of the U.S. House, was pointed in his criticism of the White House regarding jobs and cuts to Social Security the President put on the table last week.

    "We've got to educate the American people at the same time we educate the President of the United States.  The Republicans, Speaker Boehner or Majority Leader Cantor did not call for Social Security cuts in the budget deal. The President of the United States called for that," Conyers, who has served in the House since 1965, said. "My response to him is to mass thousands of people in front of the White House to protest this," Conyers said strongly.



    Parent
    Now if romney had been 'elected' (5.00 / 2) (#144)
    by Edger on Thu Oct 03, 2013 at 08:39:26 AM EST
    instead of obama, and was appointing Chen, it would be awful of course.

    Parent
    And (none / 0) (#95)
    by Militarytracy on Wed Oct 02, 2013 at 06:11:54 PM EST
    To educate myself, I decided to (none / 0) (#135)
    by Anne on Thu Oct 03, 2013 at 06:22:34 AM EST
    explore Maryland's exchange website, ...so far, I've found these helpful bits of information:

    Search for your physician. If you are interested in understanding which health plans a particular doctor participates in, please visit https://providersearch.crisphealth.org - a new service sponsored by Maryland Health Connection. For the time being, doctors and other providers are not yet available in Maryland Health Connection; therefore, if you choose to search for them on the website, you will receive a message that "no doctors are found" message.

    and

    The application's built in calculator may underestimate total out-of-pocket costs in some cases. Remember that if you are eligible for reductions in cost sharing, only silver plans will qualify. So a bronze plan might cost less in premium, but more in total out of pocket cost. We expect this to be fixed in the very near future, so if you would prefer, please check back in the next several weeks.

    Moving on...creating an account, which is the only way I can get access to see the plans...

    They should also say (5.00 / 1) (#143)
    by TeresaInSnow2 on Thu Oct 03, 2013 at 08:37:02 AM EST
    That if you're eligible for cost sharing subsidy, only IN-NETWORK providers apply.

    Out of network providers have a different deductible, copay and out of pocket max tier and they are NOT subject to cost-sharing subsidies.

    And as I've said about a dozen times, out of network providers consist of MOST of the major health care providers.

    Parent

    So far, been waiting 5 minutes to get (none / 0) (#136)
    by Anne on Thu Oct 03, 2013 at 06:28:27 AM EST
    past the Acceptance of Privacy Policy page...

    Parent
    Still waiting... (5.00 / 1) (#137)
    by Anne on Thu Oct 03, 2013 at 06:45:01 AM EST
    21 minutes now...

    Parent
    The sites (none / 0) (#142)
    by TeresaInSnow2 on Thu Oct 03, 2013 at 08:34:24 AM EST
    aren't working.  Except for the one that Mr. Obama demonstrated the other day.  He probably has a dedicated T1 link to his site.

    Parent