The whole law is going to be struck down. We'll have to wait for final decision, but I don't see any other way.
I do find it humorous that Kagan is trying to be a legislator by saying we can find a core tenet of the bill unconstitutional, then decide which other parts are effected. That's legislating. And that's not what the Supreme Court is supposed to be doing. Either the law is unconstitutional or it is not. The Supreme Court MUST leave it at that. Anything else is impinging on the legislative branch.
It would then be up to Congress to pass a NEW law for any valid pieces of the legislation.
It is beyond me how Kagan was not forced to recuse herself from this case in the first place.
Whether you agree with this outcome or not, I think you have to agree that once the provision is struck down, it is not up to the Supreme Court to decide which pieces are still valid.
Sorry. The world doesn't work the way you tell it to.
The whole law is going to be struck down. We'll have to wait for final decision, but I don't see any other way.
I do find it humorous that Kagan is trying to be a legislator by saying we can find a core tenet of the bill unconstitutional, then decide which other parts are effected. That's legislating. And that's not what the Supreme Court is supposed to be doing. Either the law is unconstitutional or it is not. The Supreme Court MUST leave it at that. Anything else is impinging on the legislative branch.
It would then be up to Congress to pass a NEW law for any valid pieces of the legislation.
It is beyond me how Kagan was not forced to recuse herself from this case in the first place.
Whether you agree with this outcome or not, I think you have to agree that once the provision is struck down, it is not up to the Supreme Court to decide which pieces are still valid.
I called in February to try to get an appointment with a specialist. I was told their next available appointment is in 2013. And before I can schedule that, I need to see my primary care provider for a referral. His next available appointment is in June.
That's all I'm gonna say about the U.S. healthcare system right now.
0
brianlux
Moving through All Kinds of Terrain. Posts: 42,428
I called in February to try to get an appointment with a specialist. I was told their next available appointment is in 2013. And before I can schedule that, I need to see my primary care provider for a referral. His next available appointment is in June.
That's all I'm gonna say about the U.S. healthcare system right now.
I'm sure many of us have had that same experience. Need to see a specialist, need the referral, wait several weeks or more to get in, wait and wait and wait in the waiting room to get in. They say they were booked, sorry for the wait but you see no one else leaving the place. You finally get in there and they whisk you through a short series of questions. They give you a prescription or send you to physical therapy.
By the time you finally either get the problem fixed or learn to live with it, other stuff starts falling apart. So you figure- the hell with it-- go out and buy some super glue and duct tape. That ought to hold you together for a while.
Yes, health care in America. What else can you say?
"Pretty cookies, heart squares all around, yeah!" -Eddie Vedder, "Smile"
I called in February to try to get an appointment with a specialist. I was told their next available appointment is in 2013. And before I can schedule that, I need to see my primary care provider for a referral. His next available appointment is in June.
That's all I'm gonna say about the U.S. healthcare system right now.
I'm sure many of us have had that same experience. Need to see a specialist, need the referral, wait several weeks or more to get in, wait and wait and wait in the waiting room to get in. They say they were booked, sorry for the wait but you see no one else leaving the place. You finally get in there and they whisk you through a short series of questions. They give you a prescription or send you to physical therapy.
By the time you finally either get the problem fixed or learn to live with it, other stuff starts falling apart. So you figure- the hell with it-- go out and buy some super glue and duct tape. That ought to hold you together for a while.
Yes, health care in America. What else can you say?
But keep the government out of it - it works just fine!
To be honest, at this point my family has great health insurance. My support of Obamacare is really in case something terrible happens down the road. Without PPACA it's so easy to be up shit's creek, or one medical emergency from financial ruin.
Spectrum 10/27/09; New Orleans JazzFest 5/1/10; Made in America 9/2/12; Phila, PA 10/21/13; Phila, PA 10/22/13; Baltimore Arena 10/27/13; Phila, PA 4/28/16; Phila, PA 4/29/16; Fenway Park 8/7/16; Fenway Park 9/2/18; Asbury Park 9/18/21; Camden 9/14/22; Las Vegas 5/16/24; Las Vegas 5/18/24; Phila, PA 9/7/24; Phila, PA 9/9/24; Baltimore Arena 9/12/24
Tres Mtns - TLA 3/23/11; EV - Tower Theatre 6/25/11; Temple of the Dog - Tower Theatre 11/5/16
I called in February to try to get an appointment with a specialist. I was told their next available appointment is in 2013. And before I can schedule that, I need to see my primary care provider for a referral. His next available appointment is in June.
That's all I'm gonna say about the U.S. healthcare system right now.
I'm sure many of us have had that same experience. Need to see a specialist, need the referral, wait several weeks or more to get in, wait and wait and wait in the waiting room to get in. They say they were booked, sorry for the wait but you see no one else leaving the place. You finally get in there and they whisk you through a short series of questions. They give you a prescription or send you to physical therapy.
By the time you finally either get the problem fixed or learn to live with it, other stuff starts falling apart. So you figure- the hell with it-- go out and buy some super glue and duct tape. That ought to hold you together for a while.
Yes, health care in America. What else can you say?
This is a ridiculous distortion of facts and the problem with the whole debate. What kind of specialist is he looking for? That one is the only one of its kind? C'mon.
a) This has nothing to do with insurance
b) This would only get worse (if anything) with a National plan
Regardless, the point is, if you had a MANAGED CARE coverage, and you let them know the issues you were having, they'd help you. More healthy members provide greater profit (if that's what you think their sole motive is), not lingering ones that exacerbate. And if your PCP is not seeing you, that's most likely a contractual no-no that your plan would like to know about.
Both issues raised here are problems with PROVIDERS, not the carriers. Those providers become gov't workers (in effect) under a national plan. Do you think that creates greater incentive for them to work or less?
I don't see how the referral you both are alluding to has effected anything since you both say the providers you want to see won't see you. Isn't that the problem? What does that have to do with the referral?
Sorry. The world doesn't work the way you tell it to.
Dude managed care is garbage. When I was in an HMO it was impossible to get anything done. Now in a PPO and see whoever I want and it's great. There's a reason people rebelled against HMO's in the 90s.
Also the savings that managed care generated were a one-time thing, and once it was implemented their health inflation was the same or worse than traditional plans and PPO's.
Spectrum 10/27/09; New Orleans JazzFest 5/1/10; Made in America 9/2/12; Phila, PA 10/21/13; Phila, PA 10/22/13; Baltimore Arena 10/27/13; Phila, PA 4/28/16; Phila, PA 4/29/16; Fenway Park 8/7/16; Fenway Park 9/2/18; Asbury Park 9/18/21; Camden 9/14/22; Las Vegas 5/16/24; Las Vegas 5/18/24; Phila, PA 9/7/24; Phila, PA 9/9/24; Baltimore Arena 9/12/24
Tres Mtns - TLA 3/23/11; EV - Tower Theatre 6/25/11; Temple of the Dog - Tower Theatre 11/5/16
Dude managed care is garbage. When I was in an HMO it was impossible to get anything done. Now in a PPO and see whoever I want and it's great. There's a reason people rebelled against HMO's in the 90s.
Also the savings that managed care generated were a one-time thing, and once it was implemented their health inflation was the same or worse than traditional plans and PPO's.
Wrong and wrong. Trend in the HMOs are at similar levels to PPOs. But, 2 things"
1) It's starting from a lower number (i.e. 10% of 200 is less than 10% of 400)
2) Regulation has gotten in the way of actually doing effective things for patients. If you knew the amount of beuracracy put on Managed Care plans, you'd blanche.
I will re-iterate - the DEMOCRAT Governor of NY State has determined that Mandatory Managed Care is the most cost efficient delivery of care for Medicaid members.
Impossible to get anything done? Give me 1 example. Please.
And BTW, PPO's have FAR Greater profit margins than HMOs. HMOs have their margins regulated via mandatory minimum Medical Loss Ratios (ie the percent of medical cost vs Premiums must be a certain level). PPOs have no such thing. Additionally, because PPOs have larger premiums, even if the %'s were the same, the profit would be greater. Plus, less overhead. So, have at it. Insurance companies love folks like you. It's like lamb to a slaughter.
They get the easy contracting of discounts (vs. hard rates), and pass the "losings" on to their premium paying customers.
My guess is what most folks see as HMO's are really bastardized versions due to the regulations and ridiculous encumberances.
Sorry. The world doesn't work the way you tell it to.
Anyone see Scalia talking about the Cornhusker Kickback. Which didn't even make it to the final PPACA bill. Time to retire old man.
Spectrum 10/27/09; New Orleans JazzFest 5/1/10; Made in America 9/2/12; Phila, PA 10/21/13; Phila, PA 10/22/13; Baltimore Arena 10/27/13; Phila, PA 4/28/16; Phila, PA 4/29/16; Fenway Park 8/7/16; Fenway Park 9/2/18; Asbury Park 9/18/21; Camden 9/14/22; Las Vegas 5/16/24; Las Vegas 5/18/24; Phila, PA 9/7/24; Phila, PA 9/9/24; Baltimore Arena 9/12/24
Tres Mtns - TLA 3/23/11; EV - Tower Theatre 6/25/11; Temple of the Dog - Tower Theatre 11/5/16
Dude managed care is garbage. When I was in an HMO it was impossible to get anything done. Now in a PPO and see whoever I want and it's great. There's a reason people rebelled against HMO's in the 90s.
Also the savings that managed care generated were a one-time thing, and once it was implemented their health inflation was the same or worse than traditional plans and PPO's.
Wrong and wrong. Trend in the HMOs are at similar levels to PPOs. But, 2 things"
1) It's starting from a lower number (i.e. 10% of 200 is less than 10% of 400)
2) Regulation has gotten in the way of actually doing effective things for patients. If you knew the amount of beuracracy put on Managed Care plans, you'd blanche.
I will re-iterate - the DEMOCRAT Governor of NY State has determined that Mandatory Managed Care is the most cost efficient delivery of care for Medicaid members.
Impossible to get anything done? Give me 1 example. Please.
And BTW, PPO's have FAR Greater profit margins than HMOs. HMOs have their margins regulated via mandatory minimum Medical Loss Ratios (ie the percent of medical cost vs Premiums must be a certain level). PPOs have no such thing. Additionally, because PPOs have larger premiums, even if the %'s were the same, the profit would be greater. Plus, less overhead. So, have at it. Insurance companies love folks like you. It's like lamb to a slaughter.
They get the easy contracting of discounts (vs. hard rates), and pass the "losings" on to their premium paying customers.
My guess is what most folks see as HMO's are really bastardized versions due to the regulations and ridiculous encumberances.
What companies even offer HMO's anymore? It's either an expensive PPO or a cheaper consumer directed plan.
You're clearly exaggerating with your 400 vs 200 thing.
Ok, want an example? I was trying to get my feet looked at. Went to the PCP, asked for a referral. Was "capitated" (there's an HMO term :roll: ) to one guy. Got an appt months later. Show up in the crazy crowded waiting room. Go back, he says, "where's your x-rays?" Um, nobody told me to get x-rays ass hole. I can't do anything without x-rays. Why doesn't your secretary tell me this? Come back with x-rays - good bye.
I just gave up and eventually (maybe a year later) my feet got better. I self diagnosed that some soccer shoes I was wearing caused the problem. Good thing it wasn't serious
Spectrum 10/27/09; New Orleans JazzFest 5/1/10; Made in America 9/2/12; Phila, PA 10/21/13; Phila, PA 10/22/13; Baltimore Arena 10/27/13; Phila, PA 4/28/16; Phila, PA 4/29/16; Fenway Park 8/7/16; Fenway Park 9/2/18; Asbury Park 9/18/21; Camden 9/14/22; Las Vegas 5/16/24; Las Vegas 5/18/24; Phila, PA 9/7/24; Phila, PA 9/9/24; Baltimore Arena 9/12/24
Tres Mtns - TLA 3/23/11; EV - Tower Theatre 6/25/11; Temple of the Dog - Tower Theatre 11/5/16
What companies even offer HMO's anymore? It's either an expensive PPO or a cheaper consumer directed plan.
You're clearly exaggerating with your 400 vs 200 thing.
Ok, want an example? I was trying to get my feet looked at. Went to the PCP, asked for a referral. Was "capitated" (there's an HMO term :roll: ) to one guy. Got an appt months later. Show up in the crazy crowded waiting room. Go back, he says, "where's your x-rays?" Um, nobody told me to get x-rays ass hole. I can't do anything without x-rays. Why doesn't your secretary tell me this? Come back with x-rays - good bye.
I just gave up and eventually (maybe a year later) my feet got better. I self diagnosed that some soccer shoes I was wearing caused the problem. Good thing it wasn't serious
Your first point is a valid one, and one I was sort of making. That's part of the problem (though I don't think we need TRUE HMO's, but let's not digress since it appears we're making progress). The 200 vs 400- both are way too low. And, obviously, the relativity depends on where you are. There are actually places that HMO per se doesn't necessarily work. But, 10% is still greater for 400 than 380 (or whatever you want to choose). The point is the same.
As for the X-Rays - again - what does that have to do with the HMO? You pointed out yourself you ended up at an icompetent office. But - did you ask if you needed anything when you showed up at your appointment? At what point do we take responsibility for ourselves? Which gets us to the last point -
Why should my tax dollars have to pay b/c you buy boots that are too small or don't fit properly? So, you didn't need a medical opinion after all. How does that prove your point that the health care system is broken? It seems it proves that there's unnecessary over utilization clogging the system. The Managed Care company was stupid (in hind sight) for granting the approval. They should have denied your ass and said - hey, dummy - get better cleats (don't really mean that. Just pointing out that you got a referral approved for something that turned out to be non-medical in nature. So, how was that limiting care?)
The only think you can point to is the capitated network. So, the issue is - doctors looking for profit by not participating? Isn't that what we are disparging the insurance carriers for? This is Podiatry. With all due respect to the specialty - they are a dime a dozen. (And no, don't start the Seinfeldian pimple popping thing. Podiatrists are critical to care especially for diabetics and the like. But, there are a lot of them).
Sorry. The world doesn't work the way you tell it to.
And the capitated network is garbage. If podiatrists are a dime a dozen why can't I pick out a good one? Yeah, I should've asked what I needed to bring beforehand, and should've bought better cleats. You asked for an example.
I feel like we're arguing about something that's 10-20 years old - HMO's are an endangered species. Companies that are interested in containing health inflation are using consumer directed, which is a Republican idea that I support, in theory at least.
One HUGE issue I have with RomneyCare/ObamaCare - purchasing a castrophic policy doesn't satisfy the indiv mandate (at least in Mass). I have no problem with saying I'm just going to pay out of pocket for all this dinky shit that comes up, but if I break my leg in a car accident then THAT's when I need medical insurance. Democrats don't seem to exactly understand what "insurance" means.
Spectrum 10/27/09; New Orleans JazzFest 5/1/10; Made in America 9/2/12; Phila, PA 10/21/13; Phila, PA 10/22/13; Baltimore Arena 10/27/13; Phila, PA 4/28/16; Phila, PA 4/29/16; Fenway Park 8/7/16; Fenway Park 9/2/18; Asbury Park 9/18/21; Camden 9/14/22; Las Vegas 5/16/24; Las Vegas 5/18/24; Phila, PA 9/7/24; Phila, PA 9/9/24; Baltimore Arena 9/12/24
Tres Mtns - TLA 3/23/11; EV - Tower Theatre 6/25/11; Temple of the Dog - Tower Theatre 11/5/16
Alright, getting into this late. What is the consensus? From reading (and I have been very sick for most of the week so it hasn't been enough), we came into the thing assuming it would be easily upheld but things have gone downhill. I don't really take the tough questioning as a negative, that's their job to get to the bottom of it and figure out how and if it is acceptable. Plus, how much do the oral arguments really matter? It's not as much the argument as it is the actual law, sure a great performance could help but what it comes down to is the bill itself.
So I think may agree that if the mandate fails a lot of the rest will fail. It will cripple insurance companies too much.
That said, is there any chance that if this does fail, single payer is back on the table at somepoint since the Republicans have brought absolutely ZERO alternatives to the table? Especially if Obama gets a second term. We can't go on with 50 million uninsured Americans.
I also read a commentary that the timing of this is perfect for Obama, there will be 5 to 6 months of the election cycle left when the decision comes down which is an eternity and Romney can't debate him on healthcare as it is so it isn't a huge deal for is reelection as it may seem.
My gut tells me they're being tough but it gets through.
And the capitated network is garbage. If podiatrists are a dime a dozen why can't I pick out a good one? Yeah, I should've asked what I needed to bring beforehand, and should've bought better cleats. You asked for an example.
I feel like we're arguing about something that's 10-20 years old - HMO's are an endangered species. Companies that are interested in containing health inflation are using consumer directed, which is a Republican idea that I support, in theory at least.
One HUGE issue I have with RomneyCare/ObamaCare - purchasing a castrophic policy doesn't satisfy the indiv mandate (at least in Mass). I have no problem with saying I'm just going to pay out of pocket for all this dinky shit that comes up, but if I break my leg in a car accident then THAT's when I need medical insurance. Democrats don't seem to exactly understand what "insurance" means.
actually if you have car insurance it probably covers this if you don't have medical...at least my policy does.
that’s right! Can’t we all just get together and focus on our real enemies: monogamous gays and stem cells… - Ned Flanders
It is terrifying when you are too stupid to know who is dumb
- Joe Rogan
And the capitated network is garbage. If podiatrists are a dime a dozen why can't I pick out a good one? Yeah, I should've asked what I needed to bring beforehand, and should've bought better cleats. You asked for an example.
I feel like we're arguing about something that's 10-20 years old - HMO's are an endangered species. Companies that are interested in containing health inflation are using consumer directed, which is a Republican idea that I support, in theory at least.
One HUGE issue I have with RomneyCare/ObamaCare - purchasing a castrophic policy doesn't satisfy the indiv mandate (at least in Mass). I have no problem with saying I'm just going to pay out of pocket for all this dinky shit that comes up, but if I break my leg in a car accident then THAT's when I need medical insurance. Democrats don't seem to exactly understand what "insurance" means.
actually if you have car insurance it probably covers this if you don't have medical...at least my policy does.
Yeah, good point. Ok, how about you get diagnosed with cancer.
Spectrum 10/27/09; New Orleans JazzFest 5/1/10; Made in America 9/2/12; Phila, PA 10/21/13; Phila, PA 10/22/13; Baltimore Arena 10/27/13; Phila, PA 4/28/16; Phila, PA 4/29/16; Fenway Park 8/7/16; Fenway Park 9/2/18; Asbury Park 9/18/21; Camden 9/14/22; Las Vegas 5/16/24; Las Vegas 5/18/24; Phila, PA 9/7/24; Phila, PA 9/9/24; Baltimore Arena 9/12/24
Tres Mtns - TLA 3/23/11; EV - Tower Theatre 6/25/11; Temple of the Dog - Tower Theatre 11/5/16
Alright, getting into this late. What is the consensus? From reading (and I have been very sick for most of the week so it hasn't been enough), we came into the thing assuming it would be easily upheld but things have gone downhill. I don't really take the tough questioning as a negative, that's their job to get to the bottom of it and figure out how and if it is acceptable. Plus, how much do the oral arguments really matter? It's not as much the argument as it is the actual law, sure a great performance could help but what it comes down to is the bill itself.
So I think may agree that if the mandate fails a lot of the rest will fail. It will cripple insurance companies too much.
That said, is there any chance that if this does fail, single payer is back on the table at somepoint since the Republicans have brought absolutely ZERO alternatives to the table? Especially if Obama gets a second term. We can't go on with 50 million uninsured Americans.
I also read a commentary that the timing of this is perfect for Obama, there will be 5 to 6 months of the election cycle left when the decision comes down which is an eternity and Romney can't debate him on healthcare as it is so it isn't a huge deal for is reelection as it may seem.
My gut tells me they're being tough but it gets through.
I think there may be a media overreaction to what looked like a couple bad days for PPACA. I like your optimism about bringing back single payer if it's overturned. I just don't see it happening. I think we'd go on like we were for another 30-40 years before somebody else tried to tackle it. Republican obstruction on this issue has been going on for almost a century (if you count Social Security).
When it's off the table everybody loves single payer, but then when somebody tries to actually pass it all of a sudden it's the end of the fucking world.
Spectrum 10/27/09; New Orleans JazzFest 5/1/10; Made in America 9/2/12; Phila, PA 10/21/13; Phila, PA 10/22/13; Baltimore Arena 10/27/13; Phila, PA 4/28/16; Phila, PA 4/29/16; Fenway Park 8/7/16; Fenway Park 9/2/18; Asbury Park 9/18/21; Camden 9/14/22; Las Vegas 5/16/24; Las Vegas 5/18/24; Phila, PA 9/7/24; Phila, PA 9/9/24; Baltimore Arena 9/12/24
Tres Mtns - TLA 3/23/11; EV - Tower Theatre 6/25/11; Temple of the Dog - Tower Theatre 11/5/16
And the capitated network is garbage. If podiatrists are a dime a dozen why can't I pick out a good one? Yeah, I should've asked what I needed to bring beforehand, and should've bought better cleats. You asked for an example.
I feel like we're arguing about something that's 10-20 years old - HMO's are an endangered species. Companies that are interested in containing health inflation are using consumer directed, which is a Republican idea that I support, in theory at least.
One HUGE issue I have with RomneyCare/ObamaCare - purchasing a castrophic policy doesn't satisfy the indiv mandate (at least in Mass). I have no problem with saying I'm just going to pay out of pocket for all this dinky shit that comes up, but if I break my leg in a car accident then THAT's when I need medical insurance. Democrats don't seem to exactly understand what "insurance" means.
actually if you have car insurance it probably covers this if you don't have medical...at least my policy does.
Yeah, good point. Ok, how about you get diagnosed with cancer.
well actually if you get diagnosed in your car I think you will be covered
sorry, don't know why I did that, I understood your point, I hate when people do that...
I have never fully understood catastrophic or major medical and what they cover...I would think that would be catastrophic but I think like a normal person...not an insurance company...I had major medical for a time but thankfully never had to use it
I am very disappointed that the members of congress didn't take the time to figure out that by creating this mandate it may be unconstitutinal, they were putting in jeopardy all of the parts of the legislation that are good and that people already depend on. Selfish, butt covering pricks
that’s right! Can’t we all just get together and focus on our real enemies: monogamous gays and stem cells… - Ned Flanders
It is terrifying when you are too stupid to know who is dumb
- Joe Rogan
And the capitated network is garbage. If podiatrists are a dime a dozen why can't I pick out a good one? Yeah, I should've asked what I needed to bring beforehand, and should've bought better cleats. You asked for an example.
I feel like we're arguing about something that's 10-20 years old - HMO's are an endangered species. Companies that are interested in containing health inflation are using consumer directed, which is a Republican idea that I support, in theory at least.
One HUGE issue I have with RomneyCare/ObamaCare - purchasing a castrophic policy doesn't satisfy the indiv mandate (at least in Mass). I have no problem with saying I'm just going to pay out of pocket for all this dinky shit that comes up, but if I break my leg in a car accident then THAT's when I need medical insurance. Democrats don't seem to exactly understand what "insurance" means.
Well, if you break a leg in a car accident, the health insurer shouldn't pay anyway. That's a property/casualty coverage called...auto insurance.
As for the network - that's my point. If the other podiatrists accepted the rate the capitated ones did, they'd all be in the network. Therefore, there are podiatrists looking for higher rates than the market will bear. Isn't that the definition of profiteering? Again, I'm not begrudging anyone. But, how does the gov't fixing rates help the podiatrists that were unwilling to enter the network in the first place?
And you can pick out a "better" one - pay for it. Those other Podiatrists are not the insurance you purchased. Nobody's stopping you. And, you even indicated you don't mind paying the small stuff. So, where's the issue? It sounds like you made a wise Insurance purchase. You just didn't execute your decision to its fullest. Saying, everyone's on board does not solve that issue (it would just drive up your insurance premium). You may have ended up with a crappy podiatrist anyway. I am sure there were other pods in the network you could have chosen that would not have treated you that way. Who's fault was it for not researching the podiatrist?
And CDHP are dead. Yeah, there's a pocket of them. But, if they were going to take over, they would have already. That concept is over 10 years old, and it has very little market share. It doesn't work b/c it's lipstick on a pig (the pig being Indemnity plans). Long term actuarial projections will tell you CDHP drive up cost, not decrease them. The only decrease you see is in the first year maybe. After that the cost shoot past exisiting Indemnity/PPO plans.
Post edited by EdsonNascimento on
Sorry. The world doesn't work the way you tell it to.
And the capitated network is garbage. If podiatrists are a dime a dozen why can't I pick out a good one? Yeah, I should've asked what I needed to bring beforehand, and should've bought better cleats. You asked for an example.
I feel like we're arguing about something that's 10-20 years old - HMO's are an endangered species. Companies that are interested in containing health inflation are using consumer directed, which is a Republican idea that I support, in theory at least.
One HUGE issue I have with RomneyCare/ObamaCare - purchasing a castrophic policy doesn't satisfy the indiv mandate (at least in Mass). I have no problem with saying I'm just going to pay out of pocket for all this dinky shit that comes up, but if I break my leg in a car accident then THAT's when I need medical insurance. Democrats don't seem to exactly understand what "insurance" means.
actually if you have car insurance it probably covers this if you don't have medical...at least my policy does.
Yeah, good point. Ok, how about you get diagnosed with cancer.
Well, your HMO would cover that.
Sorry. The world doesn't work the way you tell it to.
well actually if you get diagnosed in your car I think you will be covered
sorry, don't know why I did that, I understood your point, I hate when people do that...
I have never fully understood catastrophic or major medical and what they cover...I would think that would be catastrophic but I think like a normal person...not an insurance company...I had major medical for a time but thankfully never had to use it
I am very disappointed that the members of congress didn't take the time to figure out that by creating this mandate it may be unconstitutinal, they were putting in jeopardy all of the parts of the legislation that are good and that people already depend on. Selfish, butt covering pricks
Well, let's be fair - nobody gave them time to read it before passing it. So, there's only a handful you can say that about. The rest that voted Aye! without reading you can just call incompetent.
Sorry. The world doesn't work the way you tell it to.
Alright, getting into this late. What is the consensus? From reading (and I have been very sick for most of the week so it hasn't been enough), we came into the thing assuming it would be easily upheld but things have gone downhill. I don't really take the tough questioning as a negative, that's their job to get to the bottom of it and figure out how and if it is acceptable. Plus, how much do the oral arguments really matter? It's not as much the argument as it is the actual law, sure a great performance could help but what it comes down to is the bill itself.
So I think may agree that if the mandate fails a lot of the rest will fail. It will cripple insurance companies too much.
That said, is there any chance that if this does fail, single payer is back on the table at somepoint since the Republicans have brought absolutely ZERO alternatives to the table? Especially if Obama gets a second term. We can't go on with 50 million uninsured Americans.
I also read a commentary that the timing of this is perfect for Obama, there will be 5 to 6 months of the election cycle left when the decision comes down which is an eternity and Romney can't debate him on healthcare as it is so it isn't a huge deal for is reelection as it may seem.
My gut tells me they're being tough but it gets through.
The whole thing is off the table if this falls. Nobody's touching this in an election year, and the next Administration will be uniterested. Obama b/c he'd have a divided Congress, and been there, done that. The Republican b/c whoever is going to basically run on the failure of this (and not the issue itself - just the failure).
There may be some small pieces that find their way back through (coverage for children to age 26, etc). But the issue of single payer, etc. will be 2 administrations away.
Sorry. The world doesn't work the way you tell it to.
Well, if you break a leg in a car accident, the health insurer shouldn't pay anyway. That's a property/casualty coverage called...auto insurance.
Yeah we covered that.
I forgot what we're debating. I guess we'll adjourn in June when the decision (hammer?) comes down.
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Alright, getting into this late. What is the consensus? From reading (and I have been very sick for most of the week so it hasn't been enough), we came into the thing assuming it would be easily upheld but things have gone downhill. I don't really take the tough questioning as a negative, that's their job to get to the bottom of it and figure out how and if it is acceptable. Plus, how much do the oral arguments really matter? It's not as much the argument as it is the actual law, sure a great performance could help but what it comes down to is the bill itself.
So I think may agree that if the mandate fails a lot of the rest will fail. It will cripple insurance companies too much.
That said, is there any chance that if this does fail, single payer is back on the table at somepoint since the Republicans have brought absolutely ZERO alternatives to the table? Especially if Obama gets a second term. We can't go on with 50 million uninsured Americans.
I also read a commentary that the timing of this is perfect for Obama, there will be 5 to 6 months of the election cycle left when the decision comes down which is an eternity and Romney can't debate him on healthcare as it is so it isn't a huge deal for is reelection as it may seem.
My gut tells me they're being tough but it gets through.
I think there may be a media overreaction to what looked like a couple bad days for PPACA. I like your optimism about bringing back single payer if it's overturned. I just don't see it happening. I think we'd go on like we were for another 30-40 years before somebody else tried to tackle it. Republican obstruction on this issue has been going on for almost a century (if you count Social Security).
When it's off the table everybody loves single payer, but then when somebody tries to actually pass it all of a sudden it's the end of the fucking world.
Yeah, I hear you. I just feel like there is so much momentum that if Obama gets reelected that it would have to be a big initiative for him. He doesn't have to play political games anymore after he gets reelected and he will have his base fighting for him. I don't know. Probably way too optimistic on that.
Yeah, I hear you. I just feel like there is so much momentum that if Obama gets reelected that it would have to be a big initiative for him. He doesn't have to play political games anymore after he gets reelected and he will have his base fighting for him. I don't know. Probably way too optimistic on that.
Agreed.
They would need to take the House back. Not sure if that's gonna happen. Looks like some loser is running for Dem in my House district (PA-7). :roll:
Here's something depressing. Since I'm an actuary I can figure these things out. There's a 66% chance all 5 conservative Supreme Court Justices survive to 2017.
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well actually if you get diagnosed in your car I think you will be covered
sorry, don't know why I did that, I understood your point, I hate when people do that...
I have never fully understood catastrophic or major medical and what they cover...I would think that would be catastrophic but I think like a normal person...not an insurance company...I had major medical for a time but thankfully never had to use it
I am very disappointed that the members of congress didn't take the time to figure out that by creating this mandate it may be unconstitutinal, they were putting in jeopardy all of the parts of the legislation that are good and that people already depend on. Selfish, butt covering pricks
Well, let's be fair - nobody gave them time to read it before passing it. So, there's only a handful you can say that about. The rest that voted Aye! without reading you can just call incompetent.
you are right with your last sentiment...but to be fair the people that either didn't read it, or when writing deliberately avoided the tax discussion because they were pussies are not just incompetent, they were thinking of career first, country second; which is exactly what you want out of elected leaders ...how anyone supports fools like that in general elections is beyond me...the two major parties have coerced their constituencies to vote against the other guy. This is what happens when your entire strategy to get elected is based on making the other guy look like a worse option. Incompetent party liners on both sides are ruining this proud republic.
Anyone find it odd that with so many lawyers in congress and such a gigantically important bill, they didn't even stop to find out if how it was written could pass constitutional review? They had the majority in the house and a filibuster proof majority in the senate and yet they didn't have the stones to call it a tax. Instead they had gotten so used to abusing the commerce clause they thought..."heck, we can do this...just say commerce clause...that seems to work with everything"...
This bill, and the entire process from start to finish, just illustrates exactly why people have zero confidence in our leadership in Washington. We have lawmakers who didn't read the bill, basically say we will have to pass it find out what is actually in it...great legislating by the way...they are now so used to punting and passing on any major decisions they actually have put way more pressure on the Supreme Court than necessary...they have decided it is better to make 9 un-elected justices make the tough decisions because they are too scared to lose their next election...the only good name for most of the people in the legislature is dirtball fucker...
that’s right! Can’t we all just get together and focus on our real enemies: monogamous gays and stem cells… - Ned Flanders
It is terrifying when you are too stupid to know who is dumb
- Joe Rogan
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I called in February to try to get an appointment with a specialist. I was told their next available appointment is in 2013. And before I can schedule that, I need to see my primary care provider for a referral. His next available appointment is in June.
That's all I'm gonna say about the U.S. healthcare system right now.
I'm sure many of us have had that same experience. Need to see a specialist, need the referral, wait several weeks or more to get in, wait and wait and wait in the waiting room to get in. They say they were booked, sorry for the wait but you see no one else leaving the place. You finally get in there and they whisk you through a short series of questions. They give you a prescription or send you to physical therapy.
By the time you finally either get the problem fixed or learn to live with it, other stuff starts falling apart. So you figure- the hell with it-- go out and buy some super glue and duct tape. That ought to hold you together for a while.
Yes, health care in America. What else can you say?
This is a ridiculous distortion of facts and the problem with the whole debate. What kind of specialist is he looking for? That one is the only one of its kind? C'mon.
a) This has nothing to do with insurance
b) This would only get worse (if anything) with a National plan
Regardless, the point is, if you had a MANAGED CARE coverage, and you let them know the issues you were having, they'd help you. More healthy members provide greater profit (if that's what you think their sole motive is), not lingering ones that exacerbate. And if your PCP is not seeing you, that's most likely a contractual no-no that your plan would like to know about.
Both issues raised here are problems with PROVIDERS, not the carriers. Those providers become gov't workers (in effect) under a national plan. Do you think that creates greater incentive for them to work or less?
I don't see how the referral you both are alluding to has effected anything since you both say the providers you want to see won't see you. Isn't that the problem? What does that have to do with the referral?
I was looking for an endocrinologist. There are three that are in-network for my (relatively good) insurance plan. They work in the same practice & it was a year wait to get in to see anyone at that practice.
This is about our healthcare system as a whole & the kind of untimely care that people get even with good insurance - even with managed care coverage. They do not help you. It may seem logical that they should, but they won't. Nothing about our current healthcare system is based in logic. And, no, this is not a contractual no-no that my plan would like to know about. They already know. I'm sure they're sick of hearing it. My PCP is seeing as many people as is humanly possible - all of the PCPs who are in-network are. The contractual problem lies with the fact that who I see is limited by my insurance coverage.
This would only get better with a national health plan. I'd be able to see anyone. I'd be able to call around until I found the doc who could see me first. This would create greater incentive for the providers. The providers would NOT be government employees under a national health plan. That bears repeating: The providers would not be government employees under a national health plan - not any more than they're health insurance employees now.
The research clearly shows that health care & health outcomes - and healthcare expenditures - improve with national programs.
I was looking for an endocrinologist. There are three that are in-network for my (relatively good) insurance plan. They work in the same practice & it was a year wait to get in to see anyone at that practice.
This is about our healthcare system as a whole & the kind of untimely care that people get even with good insurance - even with managed care coverage. They do not help you. It may seem logical that they should, but they won't. Nothing about our current healthcare system is based in logic. And, no, this is not a contractual no-no that my plan would like to know about. They already know. I'm sure they're sick of hearing it. My PCP is seeing as many people as is humanly possible - all of the PCPs who are in-network are. The contractual problem lies with the fact that who I see is limited by my insurance coverage.
This would only get better with a national health plan. I'd be able to see anyone. I'd be able to call around until I found the doc who could see me first. This would create greater incentive for the providers. The providers would NOT be government employees under a national health plan. That bears repeating: The providers would not be government employees under a national health plan - not any more than they're health insurance employees now.
The research clearly shows that health care & health outcomes - and healthcare expenditures - improve with national programs.
You do not have a good insurance if they only have 1 practice of Endocrinologists in your network. So, let's start there. Why are there no other Endocrins in the network? Because the insurance company absolutely, positively only wants 1 group? Ummm. That makes no sense. I work on the inside and I know that's not the case. But, feel free to answer.
2nd - if your insurance is unwilling to help you, again - you do not have good insurance. You get what you pay for. My company would most certainly help you. Then, again, we would never BE ABLE TO (read that again) BE ABLE TO get away with contracting with 1 group for that type (or any type) of specialty. And, as an employer, I would most certainly never purchase such insurance for my employees (and as an individual consumer, I'd never purchase such a thing). Why are we better consumers for our cell phones than our health care?
You think there's no logic because you are uneducated about it. And your last statement is a fabrication. Kaiser has the best outcomes for the lowest cost of pretty much any health care system in the world. And it's a very tight lock in HMO.
And anyone who thinks access to providers will improve under National Health care, do a little research. That is the single biggest issue. And, it also doesn't eliminate a tiered system. It makes it worse. The wealthy get their services faster b/c they purchase consierge insurance plans with THE BEST doctors while everyone else waits for their non-emergent care (not every single visit. Just like in the US it's not EVERY single visit your examples speak of. I go to an Endocrin, and I never have an issue getting an appointment. I guess mine just likes me better).
Sorry. The world doesn't work the way you tell it to.
Comments
I do find it humorous that Kagan is trying to be a legislator by saying we can find a core tenet of the bill unconstitutional, then decide which other parts are effected. That's legislating. And that's not what the Supreme Court is supposed to be doing. Either the law is unconstitutional or it is not. The Supreme Court MUST leave it at that. Anything else is impinging on the legislative branch.
It would then be up to Congress to pass a NEW law for any valid pieces of the legislation.
It is beyond me how Kagan was not forced to recuse herself from this case in the first place.
Whether you agree with this outcome or not, I think you have to agree that once the provision is struck down, it is not up to the Supreme Court to decide which pieces are still valid.
That's all I'm gonna say about the U.S. healthcare system right now.
I'm sure many of us have had that same experience. Need to see a specialist, need the referral, wait several weeks or more to get in, wait and wait and wait in the waiting room to get in. They say they were booked, sorry for the wait but you see no one else leaving the place. You finally get in there and they whisk you through a short series of questions. They give you a prescription or send you to physical therapy.
By the time you finally either get the problem fixed or learn to live with it, other stuff starts falling apart. So you figure- the hell with it-- go out and buy some super glue and duct tape. That ought to hold you together for a while.
Yes, health care in America. What else can you say?
-Eddie Vedder, "Smile"
But keep the government out of it - it works just fine!
To be honest, at this point my family has great health insurance. My support of Obamacare is really in case something terrible happens down the road. Without PPACA it's so easy to be up shit's creek, or one medical emergency from financial ruin.
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This is a ridiculous distortion of facts and the problem with the whole debate. What kind of specialist is he looking for? That one is the only one of its kind? C'mon.
a) This has nothing to do with insurance
b) This would only get worse (if anything) with a National plan
Regardless, the point is, if you had a MANAGED CARE coverage, and you let them know the issues you were having, they'd help you. More healthy members provide greater profit (if that's what you think their sole motive is), not lingering ones that exacerbate. And if your PCP is not seeing you, that's most likely a contractual no-no that your plan would like to know about.
Both issues raised here are problems with PROVIDERS, not the carriers. Those providers become gov't workers (in effect) under a national plan. Do you think that creates greater incentive for them to work or less?
I don't see how the referral you both are alluding to has effected anything since you both say the providers you want to see won't see you. Isn't that the problem? What does that have to do with the referral?
Also the savings that managed care generated were a one-time thing, and once it was implemented their health inflation was the same or worse than traditional plans and PPO's.
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Wrong and wrong. Trend in the HMOs are at similar levels to PPOs. But, 2 things"
1) It's starting from a lower number (i.e. 10% of 200 is less than 10% of 400)
2) Regulation has gotten in the way of actually doing effective things for patients. If you knew the amount of beuracracy put on Managed Care plans, you'd blanche.
I will re-iterate - the DEMOCRAT Governor of NY State has determined that Mandatory Managed Care is the most cost efficient delivery of care for Medicaid members.
Impossible to get anything done? Give me 1 example. Please.
And BTW, PPO's have FAR Greater profit margins than HMOs. HMOs have their margins regulated via mandatory minimum Medical Loss Ratios (ie the percent of medical cost vs Premiums must be a certain level). PPOs have no such thing. Additionally, because PPOs have larger premiums, even if the %'s were the same, the profit would be greater. Plus, less overhead. So, have at it. Insurance companies love folks like you. It's like lamb to a slaughter.
They get the easy contracting of discounts (vs. hard rates), and pass the "losings" on to their premium paying customers.
My guess is what most folks see as HMO's are really bastardized versions due to the regulations and ridiculous encumberances.
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What companies even offer HMO's anymore? It's either an expensive PPO or a cheaper consumer directed plan.
You're clearly exaggerating with your 400 vs 200 thing.
Ok, want an example? I was trying to get my feet looked at. Went to the PCP, asked for a referral. Was "capitated" (there's an HMO term :roll: ) to one guy. Got an appt months later. Show up in the crazy crowded waiting room. Go back, he says, "where's your x-rays?" Um, nobody told me to get x-rays ass hole. I can't do anything without x-rays. Why doesn't your secretary tell me this? Come back with x-rays - good bye.
I just gave up and eventually (maybe a year later) my feet got better. I self diagnosed that some soccer shoes I was wearing caused the problem. Good thing it wasn't serious
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Your first point is a valid one, and one I was sort of making. That's part of the problem (though I don't think we need TRUE HMO's, but let's not digress since it appears we're making progress). The 200 vs 400- both are way too low. And, obviously, the relativity depends on where you are. There are actually places that HMO per se doesn't necessarily work. But, 10% is still greater for 400 than 380 (or whatever you want to choose). The point is the same.
As for the X-Rays - again - what does that have to do with the HMO? You pointed out yourself you ended up at an icompetent office. But - did you ask if you needed anything when you showed up at your appointment? At what point do we take responsibility for ourselves? Which gets us to the last point -
Why should my tax dollars have to pay b/c you buy boots that are too small or don't fit properly? So, you didn't need a medical opinion after all. How does that prove your point that the health care system is broken? It seems it proves that there's unnecessary over utilization clogging the system. The Managed Care company was stupid (in hind sight) for granting the approval. They should have denied your ass and said - hey, dummy - get better cleats (don't really mean that. Just pointing out that you got a referral approved for something that turned out to be non-medical in nature. So, how was that limiting care?)
The only think you can point to is the capitated network. So, the issue is - doctors looking for profit by not participating? Isn't that what we are disparging the insurance carriers for? This is Podiatry. With all due respect to the specialty - they are a dime a dozen. (And no, don't start the Seinfeldian pimple popping thing. Podiatrists are critical to care especially for diabetics and the like. But, there are a lot of them).
I feel like we're arguing about something that's 10-20 years old - HMO's are an endangered species. Companies that are interested in containing health inflation are using consumer directed, which is a Republican idea that I support, in theory at least.
One HUGE issue I have with RomneyCare/ObamaCare - purchasing a castrophic policy doesn't satisfy the indiv mandate (at least in Mass). I have no problem with saying I'm just going to pay out of pocket for all this dinky shit that comes up, but if I break my leg in a car accident then THAT's when I need medical insurance. Democrats don't seem to exactly understand what "insurance" means.
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So I think may agree that if the mandate fails a lot of the rest will fail. It will cripple insurance companies too much.
That said, is there any chance that if this does fail, single payer is back on the table at somepoint since the Republicans have brought absolutely ZERO alternatives to the table? Especially if Obama gets a second term. We can't go on with 50 million uninsured Americans.
I also read a commentary that the timing of this is perfect for Obama, there will be 5 to 6 months of the election cycle left when the decision comes down which is an eternity and Romney can't debate him on healthcare as it is so it isn't a huge deal for is reelection as it may seem.
My gut tells me they're being tough but it gets through.
actually if you have car insurance it probably covers this if you don't have medical...at least my policy does.
It is terrifying when you are too stupid to know who is dumb
- Joe Rogan
Yeah, good point. Ok, how about you get diagnosed with cancer.
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I think there may be a media overreaction to what looked like a couple bad days for PPACA. I like your optimism about bringing back single payer if it's overturned. I just don't see it happening. I think we'd go on like we were for another 30-40 years before somebody else tried to tackle it. Republican obstruction on this issue has been going on for almost a century (if you count Social Security).
When it's off the table everybody loves single payer, but then when somebody tries to actually pass it all of a sudden it's the end of the fucking world.
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well actually if you get diagnosed in your car I think you will be covered
sorry, don't know why I did that, I understood your point, I hate when people do that...
I have never fully understood catastrophic or major medical and what they cover...I would think that would be catastrophic but I think like a normal person...not an insurance company...I had major medical for a time but thankfully never had to use it
I am very disappointed that the members of congress didn't take the time to figure out that by creating this mandate it may be unconstitutinal, they were putting in jeopardy all of the parts of the legislation that are good and that people already depend on. Selfish, butt covering pricks
It is terrifying when you are too stupid to know who is dumb
- Joe Rogan
Well, if you break a leg in a car accident, the health insurer shouldn't pay anyway. That's a property/casualty coverage called...auto insurance.
As for the network - that's my point. If the other podiatrists accepted the rate the capitated ones did, they'd all be in the network. Therefore, there are podiatrists looking for higher rates than the market will bear. Isn't that the definition of profiteering? Again, I'm not begrudging anyone. But, how does the gov't fixing rates help the podiatrists that were unwilling to enter the network in the first place?
And you can pick out a "better" one - pay for it. Those other Podiatrists are not the insurance you purchased. Nobody's stopping you. And, you even indicated you don't mind paying the small stuff. So, where's the issue? It sounds like you made a wise Insurance purchase. You just didn't execute your decision to its fullest. Saying, everyone's on board does not solve that issue (it would just drive up your insurance premium). You may have ended up with a crappy podiatrist anyway. I am sure there were other pods in the network you could have chosen that would not have treated you that way. Who's fault was it for not researching the podiatrist?
And CDHP are dead. Yeah, there's a pocket of them. But, if they were going to take over, they would have already. That concept is over 10 years old, and it has very little market share. It doesn't work b/c it's lipstick on a pig (the pig being Indemnity plans). Long term actuarial projections will tell you CDHP drive up cost, not decrease them. The only decrease you see is in the first year maybe. After that the cost shoot past exisiting Indemnity/PPO plans.
Well, your HMO would cover that.
Well, let's be fair - nobody gave them time to read it before passing it. So, there's only a handful you can say that about. The rest that voted Aye! without reading you can just call incompetent.
The whole thing is off the table if this falls. Nobody's touching this in an election year, and the next Administration will be uniterested. Obama b/c he'd have a divided Congress, and been there, done that. The Republican b/c whoever is going to basically run on the failure of this (and not the issue itself - just the failure).
There may be some small pieces that find their way back through (coverage for children to age 26, etc). But the issue of single payer, etc. will be 2 administrations away.
Yeah we covered that.
I forgot what we're debating. I guess we'll adjourn in June when the decision (hammer?) comes down.
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Yeah, I hear you. I just feel like there is so much momentum that if Obama gets reelected that it would have to be a big initiative for him. He doesn't have to play political games anymore after he gets reelected and he will have his base fighting for him. I don't know. Probably way too optimistic on that.
Agreed.
They would need to take the House back. Not sure if that's gonna happen. Looks like some loser is running for Dem in my House district (PA-7). :roll:
Here's something depressing. Since I'm an actuary I can figure these things out. There's a 66% chance all 5 conservative Supreme Court Justices survive to 2017.
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you are right with your last sentiment...but to be fair the people that either didn't read it, or when writing deliberately avoided the tax discussion because they were pussies are not just incompetent, they were thinking of career first, country second; which is exactly what you want out of elected leaders
Anyone find it odd that with so many lawyers in congress and such a gigantically important bill, they didn't even stop to find out if how it was written could pass constitutional review? They had the majority in the house and a filibuster proof majority in the senate and yet they didn't have the stones to call it a tax. Instead they had gotten so used to abusing the commerce clause they thought..."heck, we can do this...just say commerce clause...that seems to work with everything"...
This bill, and the entire process from start to finish, just illustrates exactly why people have zero confidence in our leadership in Washington. We have lawmakers who didn't read the bill, basically say we will have to pass it find out what is actually in it...great legislating by the way...they are now so used to punting and passing on any major decisions they actually have put way more pressure on the Supreme Court than necessary...they have decided it is better to make 9 un-elected justices make the tough decisions because they are too scared to lose their next election...the only good name for most of the people in the legislature is dirtball fucker...
It is terrifying when you are too stupid to know who is dumb
- Joe Rogan
Whoa - check out what the GOP did to my district - I don't know if I'm even in this district anymore?
http://www.washingtonpost.com/blogs/the-fix/post/name-that-district-contest-pennsylvanias-7th-district/2011/12/19/gIQAWaPI7O_blog.html
Phila, PA 4/28/16; Phila, PA 4/29/16; Fenway Park 8/7/16; Fenway Park 9/2/18; Asbury Park 9/18/21; Camden 9/14/22;
Las Vegas 5/16/24; Las Vegas 5/18/24; Phila, PA 9/7/24; Phila, PA 9/9/24; Baltimore Arena 9/12/24
Tres Mtns - TLA 3/23/11; EV - Tower Theatre 6/25/11; Temple of the Dog - Tower Theatre 11/5/16
Gerrymandering at its finest. It's all part of the game.
I was looking for an endocrinologist. There are three that are in-network for my (relatively good) insurance plan. They work in the same practice & it was a year wait to get in to see anyone at that practice.
This is about our healthcare system as a whole & the kind of untimely care that people get even with good insurance - even with managed care coverage. They do not help you. It may seem logical that they should, but they won't. Nothing about our current healthcare system is based in logic. And, no, this is not a contractual no-no that my plan would like to know about. They already know. I'm sure they're sick of hearing it. My PCP is seeing as many people as is humanly possible - all of the PCPs who are in-network are. The contractual problem lies with the fact that who I see is limited by my insurance coverage.
This would only get better with a national health plan. I'd be able to see anyone. I'd be able to call around until I found the doc who could see me first. This would create greater incentive for the providers. The providers would NOT be government employees under a national health plan. That bears repeating: The providers would not be government employees under a national health plan - not any more than they're health insurance employees now.
The research clearly shows that health care & health outcomes - and healthcare expenditures - improve with national programs.
You do not have a good insurance if they only have 1 practice of Endocrinologists in your network. So, let's start there. Why are there no other Endocrins in the network? Because the insurance company absolutely, positively only wants 1 group? Ummm. That makes no sense. I work on the inside and I know that's not the case. But, feel free to answer.
2nd - if your insurance is unwilling to help you, again - you do not have good insurance. You get what you pay for. My company would most certainly help you. Then, again, we would never BE ABLE TO (read that again) BE ABLE TO get away with contracting with 1 group for that type (or any type) of specialty. And, as an employer, I would most certainly never purchase such insurance for my employees (and as an individual consumer, I'd never purchase such a thing). Why are we better consumers for our cell phones than our health care?
You think there's no logic because you are uneducated about it. And your last statement is a fabrication. Kaiser has the best outcomes for the lowest cost of pretty much any health care system in the world. And it's a very tight lock in HMO.
And anyone who thinks access to providers will improve under National Health care, do a little research. That is the single biggest issue. And, it also doesn't eliminate a tiered system. It makes it worse. The wealthy get their services faster b/c they purchase consierge insurance plans with THE BEST doctors while everyone else waits for their non-emergent care (not every single visit. Just like in the US it's not EVERY single visit your examples speak of. I go to an Endocrin, and I never have an issue getting an appointment. I guess mine just likes me better).