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There's a lot of ignorance of the facts demonstrated in online discussions of ACA. One of the many benefits now afforded to tens of millions of people are in the area of preventive care. All insurance plans must now cover the following: Men are elibible for one-time abdominal aortic aneurism screening if they've ever smoked; alcohol misuse screening; aspirin for use to prevent cardiovascular disease for insureds of of certain ages; blood pressure screening; cholesterol screening; colorectal cancer screening for everyone over 50; depressing screening for adults; Type 2 Diabetes screening; diet counseling for at-risk adults; HIV screening for everyone 15-65; immunizations for: Hepatitis A & B, Herpes, human aapillomavirus, flue shots, measels, mumps and rubella, menigococcal, pneumococcal, tetanus, diptheria and pertusis and varicella; STD prevention and counseling and tobacco use screening. These are just some of the things everone is entitled to receive without additional cost.
As a healthcare provider I wanted to chime in on some preventive tests. Most "screenings" based on costs per lives saved need to be re examined. Why do you think there was huge protest when they tried to move screening mammogram back to age 50 for most women.
Routine chest x rays for smokers don't prevent or detect early stages of lung cancer.
As for AAA screening. It's really only recommended for those who smoke starting at age 65. Considering most people are eligible for Medicare at age 65. What use is the ACA than? And guess what. The screening excludes non smokers and all women. I thought Obama said we shouldn't discriminate against women with healthcare? Women get AAA also especially smokers. Just had 58 year old woman die from AAA rupture 2 months ago. That woman wouldn't have benefited from the screening because 1. She's a woman. 2. She's under age 65
The point I wanted to make is most of these screenings are dirt cheap (immunizations, diabetes screening, cholesterol testing, alcohol etc). They just include them to sugar coat the ACA to make it look like people are getting "real value" from their health plans.
But the more expensive screening like mammograms, and colonoscopy were already included in the vast majority of insurance plans prior to the ACA. And here's a little secret. Don't tell anyone. Those HSA plans most democrats hate and almost want to get rid of. Listen. Those HSA plans bush 43 signed into law covered preventive services where there was zero cost to the patient and didn't apply to their deductible.
So it's not like the ACA re invented the wheel with these "free preventive services".
Most state laws prohibit balance billing by insurers who are "in network". Still, I think the one of the failing of the ACA is that while it did address this practice in out of network cases, it did not go far enough in dealing with it. I wish the obstructionists in the Republican party would focus on fixing some of the problems and unforeseen consequences of the ACA instead of making political hay by repeatedly and futilely calling for repeal.
Remember it takes two to tango. The Dems went at the ACA alone. They didn't care. They rammed it through.
If the law is a problem as some democratic lawmakers acknowledge including one president Obama. Than they need to come up with "fixes"
Themselves first. I've heard quite a few other democrats acknowledge there are holes in the ACA. Yet not one has even brought up legislation to introduce a fix.
And no. You can use the excuse the repubs control the house and bills have to originate in the house. That excuse doesn't work. Because we all know how the ppaca was passed without the back door legislation passed through the Democratic controlled us senate.
So if Democrats got a solution (fix) they need to introduce the bill through Harry Reid and the US Senate. I am thinking Reid is the one who knows he doesn't have a fix to the ACA. Everyone knows it. The only fixes involve more taxes to increase subsidies.
The way the law is written. Insurers, hospitals, big pharma, and device markers made sure they get their cute of the health cAre dollars. The Dems know that they can't back stab their donors. That's why they do anything about the law.
Just ask the tens of millions of Americans with pre-existing conditions who were previosly denied portability of insurance coverage when they changed jobs and status but who now continue to have coverage for those diseases/conditions whether or not they're happy. I'm a cancer and heart surgery survivor who is mighty grateful. Also ask the tens of millions of Americans who've saved money by being allowed to keep their children on the family health insurance policy beyond the point where they were previously cut-off and the families/children had to obtain insurace separately and more expensively. And there are scores of other areas where we are better off now than two years ago. Focusing on a screwed-up website is narrow thinking. Focus on the big picture ... the expanded protections for tens of millions of people. That's what I'm focusing on.
Tens of millions? Total enrollment is pegged at 8 million, and most of them are Medicaid. Of those who are not Medicaid, only about 10% were previously uninsured. And in total, about 1 in 5 hasn't paid his first premium yet.
WASHINGTON (AP) — You just might want to pay attention to the latest health insurance jargon. It could mean thousands of dollars out of your pocket.
The Obama administration has given the go-ahead for a new cost-control strategy called "reference pricing." It lets insurers and employers put a dollar limit on what health plans pay for some expensive procedures, such as knee and hip replacements.
Some experts worry that patients could be surprised with big medical bills they must pay themselves, undercutting financial protections in the new health care law. That would happen if patients picked a more expensive hospital — even if it's part of the insurer's network. My Way News - Cost-control plan for health care could cost you
So premiums and deductibles have soared while insurers restrict provider networks forcing consumers to pay out of pocket if they want to keep their doctor, and today the AP reports that another part of ObamaCare policy could render insurance inadequate altogether — and consumers won’t know it until the bill hits.
No wonder Obama and the Democrats had to lie so much about Obamacare. If they'd been honest about ACA, the American public would've rejected it overwhelmingly. Hey Democrats, isn't it nice how Obamacare makes full medical care available only to the rich? Like Obama will be when he gets out of office...too bad he doesn't have to live with this $hitty medical flop.
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I am sorry, but I didn't see any one stopping a person from getting the services they need. If they want to go to the more expensive hospital with the same results, then they are free to pay the difference. This is the free market working. You get to shop around and compare prices. I am surprised the right isnt championing this, since they love the free market. And if the insurer doesn't cover your expensive care, you can shop around with another insurer on the exchange. FREE MARKET BABY!
(I actually prefer single payer where things like this do not have to be worried about, but go ahead and continue to say how terrible single payer is )
Quote:
Originally Posted by HappyTexan
Consierge medicine folks with catastrophic plans in place for hospital emergencies.
This is what happens when you get rid of the insurance administration and simplify the billing process. As well, the doctor now no longer has to file insurance paperwork and fight with insurers to get reimbursement. This allows him to be focused on the patient. If only there was a way were we could get rid of the insurance companies and simplify the process
Quote:
Originally Posted by HappyTexan
It's not FREE. It's now all built into the higher premiums and out of pocket costs.
It's nothing more then "spread the wealth" and socializing the costs.
Why does every single American have to have maternity coverage ?
Half of the US births are paid for by medicaid for crying out loud.
Lets see, single payer nations have no such thing as deductibles and lower costs for their country
Quote:
Originally Posted by southbel
Meanwhile, back to the actual topic of the thread. Am I to understand this will allow balance billing on procedures? What's to stop an insurer from deciding to only pay $500 on a $5000 MRI and then the patient is responsible for the remaining $4500? This added to the already more expensive premiums and higher deductibles? Obamacare can have all sorts of provisions in it for pre-existing conditions but if it's wholly unaffordable to use for most Americans, then hasn't it defeated it's primary purpose? Let me remind you what that's supposed to be (psst it's in the name) - affordability.
That is not how it will work. The insurance company will list how much an average MRI goes for and the cost it gets charged for wherever you get the MRI done. If you go to a place that is more expensive, you pay the difference. And Whats wrong with shopping around. Because of consumer demand, the places that charge and arm and a leg would have to lower costs, right?
I am sorry, but I didn't see any one stopping a person from getting the services they need. If they want to go to the more expensive hospital with the same results, then they are free to pay the difference. This is the free market working. You get to shop around and compare prices. I am surprised the right isnt championing this, since they love the free market. And if the insurer doesn't cover your expensive care, you can shop around with another insurer on the exchange. FREE MARKET BABY!
(I actually prefer single payer where things like this do not have to be worried about, but go ahead and continue to say how terrible single payer is )
This is what happens when you get rid of the insurance administration and simplify the billing process. As well, the doctor now no longer has to file insurance paperwork and fight with insurers to get reimbursement. This allows him to be focused on the patient. If only there was a way were we could get rid of the insurance companies and simplify the process
Lets see, single payer nations have no such thing as deductibles and lower costs for their country
That is not how it will work. The insurance company will list how much an average MRI goes for and the cost it gets charged for wherever you get the MRI done. If you go to a place that is more expensive, you pay the difference. And Whats wrong with shopping around. Because of consumer demand, the places that charge and arm and a leg would have to lower costs, right?
That is going to be new for people..shopping around for healthcare services.
Most have no clue what anything costs outside of their "$15 copay".
That is going to be new for people..shopping around for healthcare services.
Most have no clue what anything costs outside of their "$15 copay".
Quite true. Plus, if there is only one hospital that takes their Obamacare insurance and that hospital isn't using this 'recommended' price (and let's be honest, who will?), then they will have an even greater out of pocket cost besides the large premium and large deductible.
Quite true. Plus, if there is only one hospital that takes their Obamacare insurance and that hospital isn't using this 'recommended' price (and let's be honest, who will?), then they will have an even greater out of pocket cost besides the large premium and large deductible.
This is what they wanted. And rather than hold their own party responsible you see posts like "What are the Republicans going to do to fix it ?" LOL...the Republicans didn't create this mess, the Dems did.
Go ask Harry Reid and Nancy Pelosi what they are going to do to fix it.
Neither one will talk about Obamacare anymore.
This is what they wanted. And rather than hold their own party responsible you see posts like "What are the Republicans going to do to fix it ?" LOL...the Republicans didn't create this mess, the Dems did.
Go ask Harry Reid and Nancy Pelosi what they are going to do to fix it.
Neither one will talk about Obamacare anymore.
I find that rather interesting as well. They are basically saying 'Yeah, the Democrats screwed this up big time but if the Republicans don't fix it, the failure of Obamacare is all their fault!'. Um no. This is owned - lock, stock and barrel - by the Democrats. They created this boondoggle. They shut out the Republicans to create it. They passed it without a single Republican vote. And now, with the multitude of problems, they cannot blame a single thing on the Republicans - even though they are trying hard to!
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