The Sad Case of the Patient Protection and Affordable Care Act

[MinnFan]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Let me give you a personal example of how this works in people's lives.
We recently changed health care providers at work to a southern based firm. This company is extremely profitable. They have a terrible reputation locally and most providers don't accept them. So I go in for a mandated procedure due to family history. The charge was over 5000 dollars. Under the old provider my responsibility was about $1200. Under this provider, my responsibility was the whole amount. The insurance company said it owed nothing on a covered event, so even though they accepted the insurance, the provider got nothing and of course billed me. So yes I have benefits, but no in reality I don't.

Now, wouldn't it be nice if you were able to buy your own policy from whatever company you wanted and you got to choose to have that particular procedure covered and have it deducted from your taxes? Further, you would be able to purchase this policy from any state in the country so that (assuming your a man) you wouldn't have to pay to be covered for pregnancy.

[MinnFan]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Interesting article from a Mass state healthcare insurance person. Now only if we knew a medical professional who could comment on it for us....

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GUEST OPINION: Commonwealth Care rates go tumbling downBy Glen Shor
Massachusetts Health Connector.
Posted Apr 19, 2012 @ 02:54 PM



There was plenty of reason to celebrate on April 12. Not only did it mark the sixth anniversary of Massachusetts health reform, but it also provided more solid evidence that health care reform is working.......

Nobody is saying that states can't do this either. If it works so well in Mass. then you'd see plenty of other states mirror it in the future.

BTW, whats the waiting time to see a doc in Mass?

[Rover]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Nobody is saying that states can't do this either. If it works so well in Mass. then you'd see plenty of other states mirror it in the future.

Ummm...if that's true how come 6 years on no other states have done so?

[leswp1]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Nobody is saying that states can't do this either. If it works so well in Mass. then you'd see plenty of other states mirror it in the future.

BTW, whats the waiting time to see a doc in Mass?

Ummm...if that's true how come 6 years on no other states have done so?

Primary care is a mess in Mass. I am glad to hear that the plan is working so well but unfortunately not everyone can access it.

The reason no one else is doing it is the insurance companies stepped up the lobbying in spades. They have no interest in this sort of thing unless forced. They make way more $ without it.

[dxmnkd316]

Re: The Sad Case of the Patient Protection and Affordable Care Act

The major components of the $200 million saved last year were $59 million from oxygen supplies and equipment, $51 million from mail-order diabetic supplies, and nearly $40 million from power wheelchairs and similar devices.

It should come as no surprise that these are the three most common products hawked on commercials and late-night infomercials.

[pirate]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Nobody is saying that states can't do this either. If it works so well in Mass. then you'd see plenty of other states mirror it in the future.

BTW, whats the waiting time to see a doc in Mass?

Before I'd conclude anything I would also ask if MA was at the national average before the change, if the companies involved are just MA companies or if they are balancing costs across their entire footprint, what political affiliations this organization has, define what cost efficient treatment centers means, adjust satisfaction ratios for the incremental people who went from nothing to something on somebody else's dime, if they are really attributing a 36 percent reduction in cervical cancer to a 6 year old change in medical insurance availability that appears to have increased insurance availability by 173k people, for that matter what is the definition of more?. I'd also like to know what percent of all people in the state are covered by this program, how many have/were households covered by other plans before the change and how they adjusted for people switching in and out of this plan when compiling statistics.

Regardless of your political bent, this type of document would need a lot of vetting before I'd conclude anything.

[leswp1]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Before I'd conclude anything I would also ask if MA was at the national average before the change, if the companies involved are just MA companies or if they are balancing costs across their entire footprint, what political affiliations this organization has, define what cost efficient treatment centers means, adjust satisfaction ratios for the incremental people who went from nothing to something on somebody else's dime, if they are really attributing a 36 percent reduction in cervical cancer to a 6 year old change in medical insurance availability that appears to have increased insurance availability by 173k people, for that matter what is the definition of more?. I'd also like to know what percent of all people in the state are covered by this program, how many have/were households covered by other plans before the change and how they adjusted for people switching in and out of this plan when compiling statistics.

Regardless of your political bent, this type of document would need a lot of vetting before I'd conclude anything.

These are all excellent questions. Anecdotally (small suburban practice) the plan works very well altho they arbitrarily don't cover odd things. I would rather work with that plan than a lot of the products the same insurances offer commercially. Those are like trying to slog thru frozen molasses sometimes. The usual culprits for this state offer the insurance. The screening sure has increased regardless of what the outcome because people can now come for the screening/other visits they couldn't afford before. Most of the pts in our practice who are covered by this just ran with no insurance before. Many of these people are the working poor who have a few kids and both parents work one or more jobs. The plans have become more workable in the last few yrs. The first few were a CF.

[Rover]

Re: The Sad Case of the Patient Protection and Affordable Care Act

What Mass has done correctly is solved the big first step, which is everybody has coverage. Once that is in place, they can then go out and attack the problems of accessability and cost. Otherwise a state is like a dog chasing its tale trying to figure out is it the uncovered people causing the problem, crappy insurance policies that don't cover anything, ignorance of benefits available to people, etc.

People who are in favor of this odd "Repeal and Replace" without any indication of what "replace" means are rewarding cowardice. Not necessarily your intent, but that's the effect. At some point you have to address this issue in a more thoughtful way than the Paul Ryan generational pay off to his supporters. If all 50 states wanted to come up with their own way of doing this, be my guest but the problem is there doesn't seem to be a lot of effort to do so. Take the first big step, get people covered, and then attack the other issues. In fairness I don't think the Mass experience necessarily translates to a much larger state, such as CA, TX, or FL. However, why exactly can't either low population states in the Plains and Mid West, Alaska with its oil revenues, the other New England states, or wealthier states of similar population such as NJ, VA, or MD do so? I find it hard to believe that Mass is that unique.

[Kepler]

Re: The Sad Case of the Patient Protection and Affordable Care Act

People who are in favor of this odd "Repeal and Replace" without any indication of what "replace" means are rewarding cowardice.

It's opportunism. When health care was just a hugely expensive societal problem you couldn't pin it on a political entity. The first people to actually put a mechanism in place to solve it are wide open to opportunistic sniper attacks that invoke the broader problems (expense, finite resources, difficult prioritization decisions) as if they were somehow caused by the attempted solution.

The equivalent would be attacking the fire department because they are present at a lot of bad fires. Nobody says "repeal the fire department." We work to improve fire department training, coverage, response time, but we recognize that the problem the fire department exists to solve is the real threat.

[FreshFish]

Re: The Sad Case of the Patient Protection and Affordable Care Act

The first people to actually put a mechanism in place to solve it.

Are you suggesting that the PPACA actually does "solve it?" Perhaps, leaving aside all partisan politics, if one merely examines PPACA solely on its merits and drawbacks, one might find that it does not "solve" anything??

[Kepler]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Are you suggesting that the PPACA actually does "solve it?" Perhaps, leaving aside all partisan politics, if one merely examines PPACA solely on its merits and drawbacks, one might find that it does not "solve" anything??

I'm saying it's trying to address it. That would have been a better way to put it.

My point is those critics who are just going to jump on any attempt and rip on its deficiencies while suggesting no alternative are doing politics, not policy.

[FreshFish]

Re: The Sad Case of the Patient Protection and Affordable Care Act

I'm saying it's trying to address it. That would have been a better way to put it.

My point is those critics who are just going to jump on any attempt and rip on its deficiencies while suggesting no alternative are doing politics, not policy.

It seems to me that most of the people responding here have made thoughtful and genuine suggestions that provide a much better alternative than the PPACA itself.

Not only is the PPACA itself flawed, there also were serious concerns about the process by which it was rammed through on a purely partisan basis passed into law in the first place. Most legislation of this magnitude is done in a series of steps, that are described in plain English, with widespread agreement. Some of these laws were passed only after an enabling Constitutional amendment was ratified first.


I also find your standard ironic: "those critics who are just going to rip on deficiencies while suggesting no alternative are doing politics, not policy." Do you actually mean for that standard to apply to both "sides" of our debates? How critical are you of the absense of alternatives on spending restraint from the Dems? Sure one may disagree with the Reps on their proposals; I hear nothing at all from the Dems regarding any alternatives at all.



I'd really like to have a credible choice put forward by both parties; the Dems have nothing to offer on spending restraint and hire look-alikes to push old ladies over the edge of a cliff; while the Reps offer little on healthcare for people currently under age 55.

[Kepler]

Re: The Sad Case of the Patient Protection and Affordable Care Act

It seems to me that most of the people responding here have made thoughtful and genuine suggestions that provide a much better alternative than the PPACA itself.

From the tenor of your subsequent remarks it seems pretty clear to me you are taking my remarks as directed at you personally. I assure you this is in no way the case. I was talking about the political chorus among Republican office seekers. Few if any of them talk about the problem of undercovered/uncovered people and how to address it -- they just run "Repeal Obamacare" ads with scare music.

[pirate]

Re: The Sad Case of the Patient Protection and Affordable Care Act

What Mass has done correctly is solved the big first step, which is everybody has coverage. Once that is in place, they can then go out and attack the problems of accessability and cost. Otherwise a state is like a dog chasing its tale trying to figure out is it the uncovered people causing the problem, crappy insurance policies that don't cover anything, ignorance of benefits available to people, etc.

People who are in favor of this odd "Repeal and Replace" without any indication of what "replace" means are rewarding cowardice. Not necessarily your intent, but that's the effect. At some point you have to address this issue in a more thoughtful way than the Paul Ryan generational pay off to his supporters. If all 50 states wanted to come up with their own way of doing this, be my guest but the problem is there doesn't seem to be a lot of effort to do so. Take the first big step, get people covered, and then attack the other issues. In fairness I don't think the Mass experience necessarily translates to a much larger state, such as CA, TX, or FL. However, why exactly can't either low population states in the Plains and Mid West, Alaska with its oil revenues, the other New England states, or wealthier states of similar population such as NJ, VA, or MD do so? I find it hard to believe that Mass is that unique.

If I were president, I'd hire a secret panel of people from other countries to come in and do a separate assessment of the issues and then make recommendations as a control for the obviously biased versions either party would propose or any mamby-pamby half-way solutions that both parties hold their nose and vote for.

This is an issue of long-term strategic importance to this country and we're making decisions based on solutions from people who run for re-election every few years and are aided by special interest groups.

Since there are no more statesmen, I'd go with people from a mix of other countries. (at least ones with healthcare) I'd likely find some inappropriate way to push the non-partisan version into place and I'd then lose my re-election bid. But, they wouldn't repeal it since the data coming out would be compelling and for the following 100 years, they'd look back and say "that was the right way to do it".

[Kepler]

Re: The Sad Case of the Patient Protection and Affordable Care Act

We're Americans. We don't believe in other countries.

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