A Hail Mary pass to save Obamacare: Obama calls for the Public Option

[SirLinksALot]

SOURCE: AMERICAN THINKER

URL: http://www.americanthinker.com/blog/2016/07/obama_calls_for_obamacare_public_option.html

by: Rick Moran


In an article published in the AMA Journal, President Obama called for establishing a public option for Obamacare websites.

The reason for the public option is simple: the spectacular failure of Obamacare state co-ops that were supposed to be a lower-priced alternative to private insurance.  To date, 13 of the 23 state co-ops established when Obamacare was rolled out have since failed, with more collapses expected by year's end.

Two more state co-ops bit the dust in the last few days.  InHealth Mutual, Ohio’s co-op, is closing shop after losing $129 million of taxpayer funds.  And Oregon's beleaguered co-op is also going under.  That  collapse follows the spectacular failure of the Oregon Obamacare health insurance portal that cost taxpayers more than $300 million and whose website was so dysfunctional that it never signed up a single customer.

Reuters:

"Now, based on experience with the ACA, I think Congress should revisit a public plan to compete alongside private insurers in areas of the country where competition is limited,” the president wrote.

Public programs like Medicare often deliver care more cost effectively by curtailing administrative overhead and securing better prices from providers, Obama said.

Republicans and some Democrats opposed the inclusion of a government-run plan similar to Medicare in the original Obamacare law, and the so-called "public option" did not make it into the final legislation.

Since the ACA became law, the uninsured rate has declined to 9.1 percent in 2015 from 16 percent in 2010. Most enrollees live in counties with at least three policy issuers, which helps keep down costs, Obama said.

However, 12 percent of those enrolled in plans through the exchanges live in areas with only one or two issuers. Adding a public plan in such areas would give consumers more affordable options, he said.

Obama also called on Congress to increase financial assistance to purchase coverage, which he said would help middle class families who are stilling struggling with premiums.

Obama said spending on prescription drugs, which rose 12 percent in 2014, remains a problem, and he urged Congress to act on his proposal to increase transparency around manufacturers' production and development costs. He said the federal government should be given the authority to negotiate prices for certain high-priced drugs.

Spending more taxpayer money to get a public option up and running, increasing subsidies due to soaring costs for insurance companies, browbeating drug companies to reveal why it takes a billion dollars to get a drug to market – does this sound like a program that's thriving and successful?

CLICK ABOVE LINK FOR THE REST....

[SZonian]

Uhm, wasn't the "public option" the plan for 0bamacare all along?

Anyone with half a brain knew this was not sustainable and that there would be massive refusals to enroll...

[ScottinVA]

Uhm, wasn't the "public option" the plan for 0bamacare all along?

Anyone with half a brain knew this was not sustainable and that there would be massive refusals to enroll...

And the left will use Obamacare's gross failure to call for single-payer.

Because increasing government's role when its previously increased role failed always works.

[Stosh]

Wow, if only someone somewhere had warned us Obozocare would be an unmitigated disaster....wait, every Republican in Congress and the Senate did....never mind

[kjam22]

Honestly, the more I deal with health insurance companies the more I'm beginning to support a government system.    My mother passed away recently.  Now the insurance company is refusing to pay for the two weeks in the hospital because allegedly the hospital didnt properly get approval to admit her.   Ummmm she had a stroke and a heartattack and was unconcious for two weeks after getting out if intensive care?    Were they seriously going to deny admitance?    It's Humana.   They are more crooked than Hillary.   Mom's policy was a medicare replacement policy.  RUN from these

[geronl]

95% of the present system was created by government or a response to government regulation

[Just_Victor]

Honestly, the more I deal with health insurance companies the more I'm beginning to support a government system.    My mother passed away recently.  Now the insurance company is refusing to pay for the two weeks in the hospital because allegedly the hospital didnt properly get approval to admit her.   Ummmm she had a stroke and a heartattack and was unconcious for two weeks after getting out if intensive care?    Were they seriously going to deny admitance?    It's Humana.   They are more crooked than Hillary.   Mom's policy was a medicare replacement policy.  RUN from these

Having the system fully run by the government would only make the situation worse.  For starters with government, there is no recourse for you.  The government's decisions are final, and you can't sue them.

[kjam22]

95% of the present system was created by government or a response to government regulation

So government came up with the loop hole that let's an insurance company deny a 135k claim when a death was involved?   I don't believe that

[kjam22]

Having the system fully run by the government would only make the situation worse.  For starters with government, there is no recourse for you.  The government's decisions are final, and you can't sue them.

My mther in law had medicare and my mother had a private plan.  There is zero doubt which was better.   You'll have to save that argument fr somene without first hand experience

[Just_Victor]

My mther in law had medicare and my mother had a private plan.  There is zero doubt which was better.   You'll have to save that argument fr somene without first hand experience

You are entitled to believe as you wish.  But my first hand experience would dictate the opposite.

[To-Whose-Benefit?]

Yes, a complete government takeover was the plan from the start.

LBJ's Medicare made Obamacare inevitable. It raised prices to the point where individuals were hard pressed to buy their own health insurance.

Ted Kennedy then tacked every condition he could onto the program to further worsen the situation.

Take 3 Doctors.

#1 is incompetent and word is out. So #1 has trouble getting customers.

#2 is run of the mill, average. He's not getting rich but he's surviving.

#3 is a very hard working, intelligent Doc whose patients sing his praises.

#1 can't charge much.

#2 charges the going rate.

#3 can charge top dollar because #3 is worth top dollar.

Enter Medicare where the government sets and caps the rates for all Doctors in this trio's field of practice.

All 3 are now guaranteed the Same money for substandard, standard, and above average work.

#1 remains a bum, but his rates shoot up.
#2 may remain average but will probably become #1 because there is now no incentive to improve.
#3 has to Lower both Rates and Quality (time and attention invested in each patient) just to stay in business.

SO, the field becomes clogged with expensive (the Medicare set rate) incompetents.

Government medicine isn't just the price increase. It's a decrease in the quality of services Doctors provide.

[kjam22]

You are entitled to believe as you wish.  But my first hand experience would dictate the opposite.

Humana has denied the claim from someone who had a heart attack and stroke and spent two weeks in the hospital before dying while saying the hospital did not acquire approval for admittance.  This is the fact, and i would be glad to scan and upload their most recent denial letter.    Maybe they are not all like that but certainly Humana is.   Is Humana operating a death pannel?   Would they really have denied her admittance?   The hospital is in their approved network?   Sure I can sue them.   That sounds fun

[Just_Victor]

Humana has denied the claim from someone who had a heart attack and stroke and spent two weeks in the hospital before dying while saying the hospital did not acquire approval for admittance.  This is the fact, and i would be glad to scan and upload their most recent denial letter.    Maybe they are not all like that but certainly Humana is.   Is Humana operating a death pannel?   Would they really have denied her admittance?   The hospital is in their approved network?   Sure I can sue them.   That sounds fun

I'm not going to defend the insurance company.  I hate them all too.  But my experience with my mother-in-law on Medicare/Tricare is worse than any private insurance that I've ever had to deal with.


Another option to consider instead of suing that frequently works with private companies is public shaming.  Take the evidence to the local news, or even Facebook.  Guaranteed that never works with government, as they have no shame.

[To-Whose-Benefit?]

I'm not going to defend the insurance company.  I hate them all too.  But my experience with my mother-in-law on Medicare/Tricare is worse than any private insurance that I've ever had to deal with.


Another option to consider instead of suing that frequently works with private companies is public shaming.  Take the evidence to the local news, or even Facebook.  Guaranteed that never works with government, as they have no shame.

That option omits a vital part of the equation.

Medicine has been so co-opted by government takeovers that it has become the government.

Government bought it, and government owns it.

[sinkspur]

Honestly, the more I deal with health insurance companies the more I'm beginning to support a government system.    My mother passed away recently.  Now the insurance company is refusing to pay for the two weeks in the hospital because allegedly the hospital didnt properly get approval to admit her.   Ummmm she had a stroke and a heartattack and was unconcious for two weeks after getting out if intensive care?    Were they seriously going to deny admitance?    It's Humana.   They are more crooked than Hillary.   Mom's policy was a medicare replacement policy.  RUN from these

Was your Mother's policy Medicare Advantage?

[kjam22]

Was your Mother's policy Medicare Advantage?

I think so.   I'm just told it was a Medicare Replacement Policy.   

[kjam22]

Was your Mother's policy Medicare Advantage?

I'm just saying if Obammy executive ordered Humana shut down.... I would cheer for him...... and I detest that *&^% president we have.

[Neverdul]

Humana has denied the claim from someone who had a heart attack and stroke and spent two weeks in the hospital before dying while saying the hospital did not acquire approval for admittance.  This is the fact, and i would be glad to scan and upload their most recent denial letter.    Maybe they are not all like that but certainly Humana is.   Is Humana operating a death pannel?   Would they really have denied her admittance?   The hospital is in their approved network?   Sure I can sue them.   That sounds fun

First of all, my condolences.

Was your MIL admitted through the ER? Was she taken there by ambulance?

I don’t know about now, can’t say for sure, but it used to be that pre-authorization/pre-approval for going to the ER was not required in a medical emergency/life or death situation. I would think admittance to the ICU in that situation would also not require pre-approval/authorization, but check the policy.
 
You may want to check if Humana has an ombudsman or consumer advocate. Same with the hospital if they did indeed screw up on not requesting the approval for admittance. First contact the hospital’s billing office, ask to speak with a manager and if that doesn’t get you anywhere, most hospitals have an ombudsman.
 
Not sure if this will help since it references the “policy holder” and they because of HIPAA, may not discuss with you.  But that might also depend on if your husband had a POA and or medical POA.

https://www.humana.com/individual-and-family-support/guidelines/rights

http://archive.ahrq.gov/news/columns/navigating-the-health-care-system/031709.html

I would also make the case that your MIL was incapacitated and not able to contact Human herself for the approval and make the case to the hospital that if this was something they should have done, they are on the hook for what Humana is not paying, not your MIL’s estate.

If that doesn’t work, contact your state’s insurance commissioner.

You may also want to contact an attorney. That’s not to say you have to sue but perhaps a strongly worded letter from an attorney will be enough to get them to reconsider.

[skeeter]

SOURCE: AMERICAN THINKER

URL: http://www.americanthinker.com/blog/2016/07/obama_calls_for_obamacare_public_option.html

by: Rick Moran


In an article published in the AMA Journal, President Obama called for establishing a public option for Obamacare websites.

The reason for the public option is simple: the spectacular failure of Obamacare state co-ops that were supposed to be a lower-priced alternative to private insurance.  To date, 13 of the 23 state co-ops established when Obamacare was rolled out have since failed, with more collapses expected by year's end.

Two more state co-ops bit the dust in the last few days.  InHealth Mutual, Ohio’s co-op, is closing shop after losing $129 million of taxpayer funds.  And Oregon's beleaguered co-op is also going under.  That  collapse follows the spectacular failure of the Oregon Obamacare health insurance portal that cost taxpayers more than $300 million and whose website was so dysfunctional that it never signed up a single customer.

Reuters:

Spending more taxpayer money to get a public option up and running, increasing subsidies due to soaring costs for insurance companies, browbeating drug companies to reveal why it takes a billion dollars to get a drug to market – does this sound like a program that's thriving and successful?

CLICK ABOVE LINK FOR THE REST....

Was always the plan.

This b*stard always knew we'd lose our shirts under "Obamacare", then cry for Uncle Sam to come save us.

&^$* that. Give us back the system we had four years ago.

[bilo]

Let me throw something out there that most people don't consider. Pay as you go and insure for catastrophic only. Obamacare doesn't allow for this, but most of you could probably do what I've done.

My Blue Cross plan was cancelled when Obamacare went into effect. My old premium was about $670.00 month for me, my wife and 2 children. The new plan that they offered me was just under $1,400.00 a month. I signed up with Medi-Share (A Christian Healthcare co-op) with a $10,000 deductible. The premium was about $370.00 a month. I then found a concierge doctor who does not take insurance, but provides annual physicals, tests, as many visits you want per year and is available by phone 24 hrs per day and guarantees appointments within 24 hours at a cost of $300.00 per month.

Now what we do when we need tests done such as a colonoscopy we call doctors and negotiate pricing. I just had a colonoscopy done last year and found a doctor who only charged $1,600.00. It took a lot of phone work because hospital personnel only know how to quote insurance codes, but when you get to doctors directly and they find out you will pay that day they are willing to negotiate.

In a couple years medicare premiums will be deducted from my social security, whether I want it or not, but I will retain my concierge doctor not only because of the higher caliber of care I receive but also because he works for me.

[kjam22]

First of all, my condolences.

Was your MIL admitted through the ER? Was she taken there by ambulance?

I don’t know about now, can’t say for sure, but it used to be that pre-authorization/pre-approval for going to the ER was not required in a medical emergency/life or death situation. I would think admittance to the ICU in that situation would also not require pre-approval/authorization, but check the policy.
 
You may want to check if Humana has an ombudsman or consumer advocate. Same with the hospital if they did indeed screw up on not requesting the approval for admittance. First contact the hospital’s billing office, ask to speak with a manager and if that doesn’t get you anywhere, most hospitals have an ombudsman.
 
Not sure if this will help since it references the “policy holder” and they because of HIPAA, may not discuss with you.  But that might also depend on if your husband had a POA and or medical POA.

https://www.humana.com/individual-and-family-support/guidelines/rights

http://archive.ahrq.gov/news/columns/navigating-the-health-care-system/031709.html

I would also make the case that your MIL was incapacitated and not able to contact Human herself for the approval and make the case to the hospital that if this was something they should have done, they are on the hook for what Humana is not paying, not your MIL’s estate.

If that doesn’t work, contact your state’s insurance commissioner.

You may also want to contact an attorney. That’s not to say you have to sue but perhaps a strongly worded letter from an attorney will be enough to get them to reconsider.

Thanks much.   Actually,  it was my mother.  We found her non responsive and transported her to the hospital ER.  She was moved from ER to Intensive Care that same night....and then eventually a room.   We presented her insurance cards at the time she was admitted into ER.   Either the hospital dropped the ball or Humana missed it (I don't really know which)... but I think you're right..... at the end of the day one of them is going to be responsible.  I'm not using estate money to pay 135k until a court tells me I have to. 

As it pertains to the insurance company..... Even if the hospital did not notify..... on what circumstance would they have denied her admission???  Seriously??   I get it if she had a broken foot or something.  But she had a heart attack, a stroke, and eventually died.  Is there anyway they don't admit her???? 

[kjam22]

Let me throw something out there that most people don't consider. Pay as you go and insure for catastrophic only. Obamacare doesn't allow for this, but most of you could probably do what I've done.

My Blue Cross plan was cancelled when Obamacare went into effect. My old premium was about $670.00 month for me, my wife and 2 children. The new plan that they offered me was just under $1,400.00 a month. I signed up with Medi-Share (A Christian Healthcare co-op) with a $10,000 deductible. The premium was about $370.00 a month. I then found a concierge doctor who does not take insurance, but provides annual physicals, tests, as many visits you want per year and is available by phone 24 hrs per day and guarantees appointments within 24 hours at a cost of $300.00 per month.

Now what we do when we need tests done such as a colonoscopy we call doctors and negotiate pricing. I just had a colonoscopy done last year and found a doctor who only charged $1,600.00. It took a lot of phone work because hospital personnel only know how to quote insurance codes, but when you get to doctors directly and they find out you will pay that day they are willing to negotiate.

In a couple years medicare premiums will be deducted from my social security, whether I want it or not, but I will retain my concierge doctor not only because of the higher caliber of care I receive but also because he works for me.

I have been wondering about Medishare for my wife and I for a while now....   Do you recommend it??   Is it a good deal?

[bilo]

I have been wondering about Medishare for my wife and I for a while now....   Do you recommend it??   Is it a good deal?

I love it!

My premiums go to help other Christians. I can have a deductible of $10,000 which gives me the lowest premium possible. I don't use the coverage for annual physicals or prescriptions, but you can if you want. Because my premium (I believe it's called monthly contribution) is so low I  pay for medical services myself. Once you get into the habit of negotiating with doctor's offices it's surprising how much you can save.

You should check their web site to get all the details. It's outside the control of the ACA (obamacare) so you don't pay for things like abortions and sex changes and because you're outside obamacare it undercuts it's viability. The negative is it is a co-op. IOW payment is not guaranteed if they don't have the money, but in 30 years I don't believe they have ever failed to cover an approved claim.

[To-Whose-Benefit?]

To Skeeter

"Give us back the plan we had 4 years ago."

It's worse than it appears.

Ain't no going back because built into this ACA Act of Perfidy was the destruction/crippling of those existing Insurance networks.

There's been too much financial upheaval and damage done to them by this illegal mandate crap.

We can't just turn the ship around now without a lot of work just to repair the then existing infrastructure.

[bilo]

To Skeeter

"Give us back the plan we had 4 years ago."

It's worse than it appears.

Ain't no going back because built into this ACA Act of Perfidy was the destruction/crippling of those existing Insurance networks.

There's been too much financial upheaval and damage done to them by this illegal mandate crap.

We can't just turn the ship around now without a lot of work just to repair the then existing infrastructure.

There is a mindset in the USA today that all the big issues in an individual's life should be overseen by the fed govt and other people should pay for it.

When this mess started with obamacare I was fortunate to find a way to be outside the system. I passed on this information to a lot of people at church and most didn't want to do what I did. I am so glad I followed this path. Medical services in the USA are in decline. The best answer is to learn how to be an independent operator and to even travel outside the USA for medical care not to be dependent on a govt run program.