LOL! So true.

Hey, it isn't like our politicians read it until now, anyway....

Gary Cohen denies this. “Absolutely, we will be ready. There will be an exchange in every state open for business on October 1 of next year,” he said.

The crits are correct, they will not be ready October 1st. There are still a ton of details to work out.

For example: How do they determine if a household is 400% above the poverty line? They are going to check our SSN against last years taxes to determine your income. Should this include grandma and your 25 year old son who lives with you? What if they didn't file any taxes? What are the pelalties for employers who do not offer health insurance?

I would think it will be on your tax form, and since your last year's income is also on that form, along with your dependents, it should be pretty easy.

Determining income has been around since someone first wanted to borrow money.

We finally got health insurance available to everyone but the different types of plans seem confusing. The people who buy the Bronze plan don't have money for any other plan so how can they pay the 40% cost added?

Still ACA is a good thing.

How is any of this new? These reform rules were all announced when the AHA was passed in 2010.

Many, many people that voted for Obama and want AHA have no idea that they are now required to buy insurance. Slowly but surely sh!+ going to hit the fan.

one big difference between Democrats and Republicans...

Democrats assume people are smart enough to make their own choices, and Republicans assume people are incapable of making their own choice (hence instructed what to choose). One of the inherent differences which often comes down to education and inform.

Isn't amazingly clear when you read the vine, and immediately realize the viner's affinity without even talking about politics?

Many, many people that voted for Obama and want AHA have no idea that they are now required to buy insurance. Slowly but surely sh!+ going to hit the fan.

I would say that could not be further from the truth... the mandate was the most controversial and widely publicized part of the law. You'd have to be living under a rock to have missed that. What most people who voted for Romney have no idea is that many people are RELIEVED to have the opportunity to buy insurance, since many of us could either not afford it, or were denied due to pre-existing conditions, which Obamacare will abolish in 2014.

Funny that many people who voted for Romney also missed all the benefits of Obamacare: 80/20 rule, guaranteed issue for children has already been in effect for 2 years, adult children up to 26 staying on the plan, lowered cost of certain medications, free preventative care services, etc. Just the preventative care services alone will save untold millions of dollars, since people can now get the care they need up front before they end up in the Emergency Room. They seem to only focus on money, money, money, how much will it cost? Not how much it will save us in the long run. Short-sighted and stupid Republicans.

Many, many people that voted for Obama and want AHA have no idea that they are now required to buy insurance. Slowly but surely sh!+ going to hit the fan

Umm ... do you realize that was a Republican idea right? It was included as a way to appease the GOP during the negotiations and create a bipartisan plan, of course at the 11th hour the GOP pulled out of negotiations and stonewalled the bill. Still most of the law is actually Republican wrote, hence open markets, no single payer option, no government price setting and so forth.

"Mandatory coverage" was a Republican demand, plain and simple.

and please tell us that when everyone who has preexisting conditions or catastrophic illnesses deplete the insurance companies reserves and the insurance company goes bankrupt where will you get your insurance or care from? BY the way I have government healthcare(TRICARE) and my children ARE NOT covered up until 26 years of age. You will get what you deserve and I hope our country will survive it

ROFL! theturd actually said this: "Democrats assume people are smart enough to make their own choices, and Republicans assume people are incapable of making their own choice"

Turd, cut the crap. Democrats don't even think people are capable of obtaining photo ID much less their own insurance. This entire program is forced on us because gimmecraps supposedly can't take care of their own healthcare.

William as a former serviceman and now physician let me say that I am sorry that your insurance sucks. The hard working men and women who serve need the best that money can buy but TRICARE is a joke.

I guess they try to care but they don't. Imagine this scenario. Your child decides to graduate high school and join the service at 18. He or she serves 6 years and gets out to go to college. But since he/she served to age 24 he is not eligible for Coverage. Sad that we take better care of our Medicaid patients than our people in need. For the rest of us there is Obama Care and I am happy to say I have seen people age out of the old system and get put right back in when Obama care took effect.

Kudos to Obama care so far in my office.

I would like to see Trycare dismantled. Three Presidents of the United States have mandated Chiropractic Coverage be made available to all Active Duty and all Vets. Yet TRY care refuses the same basic benefits that are offered to the most disadvantaged citizens in our country.

Our government will provide subsidies of up to $6,000.00 to those under 4-times the poverty level. So can anybody tell me what our individual final tax bill will be for this plan? Obama said this is not a tax after Justice Roberts said the only thing that makes the ACA constitutional is that it is a tax. Tell us Dems, how much is this going to cost each of us? The government subsidies will be paid for on the backs of the taxpayers once again.

You know it used to be that people who didn't have insurance just went to the ER and got care. The Federal government claimed it was a drain on our taxes. So now that we are going to pay directly for health care what's going to happen to all that money they are still taking in taxes?

And....what if people still goto the ER when they don't have healthcare.

We are so f*ked with this.

OK. Now what do we do about medical school enrollment which is at a 30 year low and doctors retiring left and right. Personally our pediatrician promised he would retire and close his practice once Obamacare came full tilt. My GP, barely 40, said he wasn't sure he'd ever be able to pay off his student loans from what he's heard about in terms of rate structuring.

So we may all have insurance, but might not end up getting any service, unless of course you go out and pay top dollar to have your own physicians on retainer. We'll be right back to where we started, except things will cost more and we'll have fewer resources to deliver these services.

When will our elected leaders be required to have a basic understanding of elementary economics?

Proceeded by none - you are the stupid one. Did the insurance industry need some regulating - yes no one disagreed with that but you and others like you seriously miss the boat on this. Those who didnt have insurance because they couldnt afford it, are still not going to be able to afford it - only now they will be hit with a big fat tax penalty for not buying it. Talk about irony. Oh an by the way people have always been able to insure their children up to age 26 as long as that child was in college.

Oh and one more added note - conception is covered at 100% only as long as the person holding the office of president decides to cover it at that.

I meant contraceptive not conception.

There is already "rate structuring" from all the insurance plans and PPOs. If doctors decide to retire, that might just be because doctors too are part of the baby boom. Higher education coverage and loan forgiveness for medical professionals might become part of the plan if you vote for it; that might require some taxes, but it would be worth it if doctors don't have to worry about their education loans. There are programs right now that offer such things; not through private schools though.

Compare this to the Republican "plan" which would still leave doctors without any more pay at all, and a lot more people defaulting on medical bills (what do you think happens when somebody dies). And the Republican "vouchers" would have caused elderly to pay much more or die for lack of care, because the vouchers pay only a fraction of what Medicare pays.

Multi-millionaires never had to worry about any of this anyway; they just write the checks out of their accounts, and can pay extra for more care. If doctors will only serve the rich and not the rest of us, then at that point their licenses to practice should come under review.

Why is Congress exempt from this?

Why are the unions exempt from this?

Why are muslims exempt from this?

Why are illegal aliens exempt from this?

I love the part about no preexisting conditions can be priced in...except you can be charged 3x for age and incrementaly more each year (assuming the ACA doesn't kill you off altogether) and if you smoke? Wham! Charge them extra! What a joke - if I'm a smoker I head to my nearest courthouse - ever hear of equal protection? How about heroin addicts, alcoholics or deraged (Democrats)?

Everyone will eventually get some kind of ACA card but they won't be receiving healthcare. The hospitals and docs simply won't be available to perform 'it'. Second, SCOTUS said states do NOT have to set up exchanges...so how do all of the lemmings get a policy if in a non-conforming state? Hmmm, the Fed will set up and exchange in those states? But the 'waivers' are state issued, not federal. Change the law - not. Oops.

Moronic law. Mornic and evil people perpetrating it for nefarious reason(s). There simply isn't enough $ to do this, period.

It'll be interesting to see what happens with costs over the next 5 to 10 years. If we don't take steps to restrain cost increases (such as increasing the supply of doctors and facilities, tort reform, etc.), my prediction is they will continue to increase...but time will tell...

Just a note about healthcare exchanges...there are a lot of Republican governors that were looking into doing this before the act was passed. I'm not sure why the national Republican party is so against this portion of the bill...(other than it being a federal mandate - which I can understand not liking)

Obamacare will bankrupt this country plain and simple...

"More than 18 million of them will qualify for a federal subsidy averaging $6,000 a year per person. People earning up to four times the federal poverty level can get a subsidy: that’s an income of $92,000 a year for a family of four."

This is just the beginning of scheme to go to single payer and single payer will bankrupt the country!!

Oh and this comment is just a balded faced lie...

" "Mandatory coverage" was a Republican demand, plain and simple."

Hate to tell you this Ace but the republicans had NO say in the making of Obamacare ...none at all!!

It was a republican "idea" in the 70's but Obamacare is a Democrat only law and to say it was a "mandatory coverage was a republican demand" is just a balded faced lie!!

Democrats own Obamacare lock stock and barrel and when it bankrupts this country it will be clearly the democrats who did it... period!!

Don't the liberal unintelligent realize that if insurance companies no longer can deny insurance to those already sick it is no longer insurance? That is like getting in a car accident THEN calling Allstate and demanding a policy. How long do you think Allstate can stay in business? They can't.

And health insurance will be the same way and CAN'T stay in business with that business model (BTW, which is the intention of the Affordable Care Act - to push all insurance companies out of business THEN we will be "forced" into a single-payer system). So if an insurance company cannot deny coverage based on pre-existing condition or currently sick then why would anybody bother having "insurance" now? When this gets implemented why not cancel your health insurance? Then, if a person has an appendix attack or diagnosed with cancer THEN simply buy "insurance" then?

Don't you realize that the private health care system CANNOT survive with the ACA? But that was the plan by the Democrats anyway. Take a picture because our country cannot survive with the anti-business climate and a forced "Affordable Care Act" that cannot sustain itself financially so will collapse within just a few years after full implementation.

Congratulations, the uninformed have been able to do in the last four years what our enemies have not been able to do in over 200 years: To collapse the United States of America.

MAX171717, it is absolutely accurate that I wrote "one big difference between Democrats and Republicans...

Democrats assume people are smart enough to make their own choices, and Republicans assume people are incapable of making their own choice (hence instructed what to choose). One of the inherent differences which often comes down to education and inform.

Isn't amazingly clear when you read the vine, and immediately realize the viner's affinity without even talking about politics?"

I believe you just proved my point. As a Republican, you clearly believe people are incapable of obtaining ID so that people can do thing about the neighborhood (including voting)... In reality, the argument that the Democrats possed was why must people carry Photo ID? Why are people forced to be carry photo ID at all times? Why are the people forced to obtain a photo ID? Photo ID is simply an attempt to suppress voter, because the voting demographics. The 2 main groups that generally do not carry photo ID are young adults and seniors. Reasons being they have limited physical access and ability. Although it is politically motivated, but cleary Democratic attempt is to broaden the view of people, while Repbulican simply take the attitude of "If I can then why not you.".... So please tell me how a 90 year old who live in a home can get a photo ID (such as drivers license)? Or are you going Republican style and simply deny him the vote (until the next time you need his vote)?

Obviously you have limited or capped in your view of the world, but it would be suggested that you view the world through others once in awhile.

ProBusiness: "And health insurance will be the same way and CAN'T stay in business with that business model (BTW, which is the intention of the Affordable Care Act - to push all insurance companies out of business THEN we will be "forced" into a single-payer system)."

WOW, how do you respond to BS like that??? CAN"T stay in business??? Hmmm... let me see... I would then say, GOOD, if you can't run a smart business then GET THE F OUT OF THE WAY, to let people who can make a living running a business do it.

REALLY?? Is that why Healthcare companies have been seen their biggest increase in their stock value since the HEALTHCARE debate/back-and-forth??? Is that why healthcare and Insurance remain as one of the better value investment on WallStreet.

The only reason why you're probusiness is because you're their lackey, who simply redistribute their BS. Let me know how it smell from back there...

I'm interested in the first person or company that doesn't go along with this and the Government tries to penalize them and it goes to the Supreme Court and they tell them it's Illegal and we told you, you have to tax them and the person or company tell the Government you can't do that it's not a tax the health care bill is illegal and your actions are illegal according to the Supreme Court. Stuff it. Or is this an Obama, Pelosi lie?

?lie? 5-4, the Supreme Court gave it approval. So how is it a lie? Perhaps it is in your interpretation of Healthcare Act.

The supreme court gave handling of medicare to the states, of which 30 have repub. governors.

Anyone who thinks PPACA (aka Obamacare) means "free" healthcare (and I know some fairly well-educated people who thought that before I informed them otherwise...) has not been paying attention... at all. The public option was eliminated in negotiations before any legislation was passed.

However, $6000 for families with total household income < 4x poverty will cover a significant fraction (if not all) of a participant's annual premium, but not total healthcare expences... You will still have coinsurance, copays, and deductibles (which have been trending upward with consumer-driven health plans and the increasing popularity of HSA's).

It was never promoted as 'Free', simply affordable, and even that will depend on an individual's financial status. But half a loaf is better than none and for those with any sort of health issue that either prevented them from getting insurance or couldn't get coverage for a particular problem, this will go a long ways.

Despite all the RWNJ drivel about how 'our system is the best in the world!', the facts are still that we pay the most for healthcare and our life expectancy rating is 17th (and dropping)...

Crazy

It may not have been promoted as free, but that is what people think it is when government is involved. They were very quick to see the part where if your income was low enough you would get help from the government. People for some reason thinks that that means "free".

This misconception is why this system is doomed to failure. Too many people looking for something for nothing or next to nothing.

Steve,

Can you tell what is and is not counted in that life expectancy rating and do all countries use the exact same factors?

If our health care system is not the best, where would you rather go for your care...not insurance?

Obesity is one of the biggest factors in life expectancy, Danno. It is believe that the younger generations will not live as long as the precedent generations due to the incredible obesity that exists in the country.

This misconception is why this system is doomed to failure.

Makes no sense. On the contrary, the fact that it is not free is one of the reasons why it could actually work to help reduce healthcare costs in the long run. More healthy people in the system reducing risk and the effects of adverse selection, making consumer-driven health related decisions, incentivizing routine and preventative medicine, and shared expense with insurance companies.

These are all things that have downward influence on healthcare costs and just because many people don't fully understand these concepts doesn't change the fact.

Danno's fishing for an opening he can attack you through- he's critical of anything that reduces corporate profit...you know, regulations, ethics, charity, and so on, especially if any of it threatens to come out of his pocket. As a natural corollary, he's solidly behind anything that puts money into it. He decries the entitlement mentality while completely ignoring entitlements for the corporate citizen, In fact, his swaggering, one-sided braggadocio reminds me of a line from Peter Gabriel's 'Big Time': "Always get a laugh, when I bring them round my room, to my bed- I had it made like a mountain range- with snow white pillows for my big fat head". If there's an obesity problem in his world, it's likely all above the neck.

DB Akron - "This misconception is why this system is doomed to failure. Too many people looking for something for nothing or next to nothing." - By this logic, the bank bailouts and farm subsidies shouldn't work either...

FeO2, the question was simple. If you are not using an exact comparison, the numbers are meaninigless. If one country does not count infant deaths under 1 year old, their life expectancy rate will be higher. The same holds true with education comparisons. If one country doesn't allow students to attend school beyond the 8th grade and no longer counts them, it will skew their level of education.

As to the rest of your rant, yes, I do belive the free market is a much better economic system than a government controlled or influenced system. I do not believe that government should be the decider of who is and is not worthy of charity. I do believe that it is better for me to keep more of my own money than it is to send it to government to decide the best way to spend it. I prefer to donate to the charities which I believe will best help.

Regarding your insult that I have a fat head...whatever...

@bill0000 said

"Wait until those that think its FREE find out that $6000 won't even pay for bottom plan where you must pay 40% of the bill. All this is going to do is get a bunch of people buying the lowest cost plan and then screaming its not fair I can't afford my medical bills.

Obamacare doesn't give you income it gives you health insurance. It still can't cure dumb.

I think that when people find out just how much they have to pay out for this, they're going to flip. They No. 1 reason people gave for not having insurance to begin with was they couldn't afford it. Well, not only will they still not be able to afford it, but the price will go up.

Anyone who thought this law was a good deal were either fools or just plain stupid. (Actually, I'm betting on the latter.)

As to the rest of your rant, yes, I do belive the free market is a much better economic system than a government controlled or influenced system. I do not believe that government should be the decider of who is and is not worthy of charity. I do believe that it is better for me to keep more of my own money than it is to send it to government to decide the best way to spend it. I prefer to donate to the charities which I believe will best help.

How, then, do you propose one counters greed and corruption that is almost universally inherent in the free market? History is an example that if the markets are left without constraints, the repercussions will be wide and dire. Calvin Coolidge was an ardent believe in de-regulation of all industry, going so far as to install individuals in to regulatory positions, who would not enforce the current laws on private enterprise. The result, after 4 years, was the Great Depression. How do you propose to prevent the abuses of the past?

The market may be slower to react, but it still reacts. If you produce an inferior product, people will no longer buy it because it doesn't work.

I am not saying their is no need for any regulation. I am saying that we have overburdensome regulation. Even George McGovern realized this after he left the comforts of the US Senate to try to run a business. He learned about all of the costs associated with overburdensome regulation.

What need to be done next is to open the market for prescriptions from Canada, EU, .. and if the cost still do not go down, then open the market to European health insurance providers. At the same time we have to check the overburden of high Doctors insurance cost, Frivolous Suits and a better system to rate doctors to protect from medical malpractice.

How the cost of insurance in Europe is $3500 and in the USA is $8500 a year?? all of the Above..

The biggest impact this will have is on the root cost of healthcare by way of the uninsured. I work at a hospital and the 2 biggest bites we take are the uninsured who do not pay their bills, and malpractice insurance. We see a huge amount of patients with no coverage who will not pay their bills, this amounts to socialized healthcare. These uninsured pay nothing for healthcare, not even premiums (medicaid?). The insured end up paying for it by paying ever increasing costs for charges. Then the residents of the county pay our institution's net loss. A doc who makes $300K a year is likely paying about $100K in malpractice insurance. Guess why he wants more pay? A small mistake that can be fixed relatively easy can cost him a mint, unless he pays that exhorbinant malpractice premium.

If they pass laws for tort reform along with this, healthcare costs will nosedive. OR providers, doctors and facilites, income will skyrocket OR, more likely a balancing adjustment of both.

If we require all motorists to pay for car insurance in case they hit someone, then why not require all users of health care to have insurance in case they get injured or sick and need care. OR should we just let them die in the street outside the hospital? No! Since we as a community decide to care for them, we need to decide if they should chip in on their bill. OR should we just keep paying their bill for them?

This brings me to Medicare and Medicaid, they are TOO BIG (not unnecessary), too many people are covered who never should have been and plenty who didn't absolutely need it. Yet the gov't keep growing the pool to cover even more all on taxpayer's dime, and because the gov't is in charge it's ripe for corruption. How about a million $ a week to just one hospital just for illegal immigrants? Think I'm kidding? TP30!

Everyone should get the care they need, but they need to pay their fair share! Again, it's another thing disproportionately weighing on the middle class.

Gneisenau - I think that when people find out just how much they have to pay out for this, they're going to flip.

Utter nonsense. Obamacare has already helped my small business significantly since our premiums went up less than 5% this year, unlike the 20%-30% it has every year for the last decade.

They No. 1 reason people gave for not having insurance to begin with was they couldn't afford it.

Those who can't afford to pay will have subsidized insurance.

The market may be slower to react, but it still reacts. If you produce an inferior product, people will no longer buy it because it doesn't work.

I am not saying their is no need for any regulation. I am saying that we have overburdensome regulation. Even George McGovern realized this after he left the comforts of the US Senate to try to run a business. He learned about all of the costs associated with overburdensome regulation

Here is the problem with that statement, the term "overburdensome" can be quite subjective. Take the MSDS requirement for companies that store onsite chemicals. Some would think the requirement to have the requirement to have MSDS for all onsite chemicals to be and overburdensome requirement. Same for proper waste disposal. Or response policies. Or environmental clean up. Or records keeping. Any more the terms "overburdensome" and "free market" are euphemisms for mass deregulation, and elimination of regulatory entities to eliminate a public obligation to safety all in the name of the lowest bottom line.

Personally I challenge you to provide specific examples of what regulatory issues were the problem for the growth of businesses(for the record I have worked in two industries that are subjected to heavy regulation, regarding chemical storage and disposal, as well as the mortgage industry).

If our health care system is not the best, where would you rather go for your care...not insurance?

Healthcare is absolutely sh!t in the USA. Thankfully I'm an expat working overseas and therefor don't need to rely on it. I live in South Korea where the government has national health insurance. As I'm working for an American company I do not qualify for the government insurance and must pay full rate, yet even at full rate the cost of healthcare over here is 1/10 to 1/4 the cost of what it is in the USA.

It's absolutely sad that a country that was a pile of ruble 50 years ago now has a better healthcare system then the country that liberated it.

The market may be slower to react, but it still reacts. If you produce an inferior product, people will no longer buy it because it doesn't work.

Free market rules do not work with healthcare and the healthcare / biopharms know this. Simply put, your life / good health is one of if not ~the~ most valuable thing you have. It's above all other consumer needs and occupy the very top priority for disposable income.

How much is your life worth?

How much is your good health worth?

At what point do you say "that's too expensive, I'll just die instead"?

Thus the cost of healthcare is infinite, or all of your disposable income, whichever is less. As the cost of supply is based on demand + cost of production, you end up with supply being infinite + production cost. Knocking 90% off the cost of production will still result in infinite costing of healthcare, or all your disposable income. That is why healthcare costs have been rising at 2x the rate of inflation, it's still trying to find a ceiling for the market.

Guys, healthcare companies are not moral nor under any obligation to work towards the public good. They exist to make maximized profits for their investors, just like every other company in the world. Their cost to you will be based on maximizing profits, not giving you affordable costs, they don't care about affordability, that's your problem not theirs. That is why heavy government regulation is needed here, any free market company is incentivized to NOT provide you healthcare.

My husband has pretty good health insurance, but we pay $4000 a year hospital expenses, plus doctor visit co-pays for him that are about $650 a year, plus co-pays on meds, etc. That is the current insurance through his employer, because he has cancer. Obamacare is going to be better than this.

We are at a fiscal cliff, we are going to subsidize this with what money? People without money who can't make ends meet now can pay 40% how? Bought the jive! Now you'll pay for it, and you vote him in a second time, good luck we will need it, hope you get your jobs package, he sure shoveled the Sh!@.

It's too expensive to get sick. The best health insurance policy is good health.

Well sometimes we get diseases like cancer and the expenses can't be helped. My melanoma treatments cost tens of thousands of dollars. And I've barely started them. I am very relieved that HCR is there to protect me and millions of other Americans suffering from various conditions.

lib 50...So your care costs tens of thousands of dollars without insurance...If you can't afford tens of thousands is the cost of care going to truly be closer to grasp after you pay a deductible and then face 40% of the cost?

What is really going to suck for may people is that through their work they have access to gold and platinum plans. Now the premiums are paid by the company for the employee and then there is a premium cost for dependents. The out of pocket costs are then calculated based on income and is graduated. The lower pay scale out of pocket cost is 10% and the out of pocket cost goes up to 40% for higher paid individuals. So what is going to happen when the Federal Government expects all to be equal? What will happen is that new hires and those on the lower end of the earning scale in a company are not going to be able to afford for things to be equal. Democrat logic I suppose. Make everyone hurt a long as they can gouge those just trying to make their way in this world.

lib 50...So your care costs tens of thousands of dollars without insurance...If you can't afford tens of thousands is the cost of care going to truly be closer to grasp after you pay a deductible and then face 40% of the cost?

And you can thank your state and fellow congressmen for that. The Democrats wanted single payer, regulated healthcare, you Republicans wanted free market absolutely no regulation healthcare. As a compromise the Dems agreed to that mandatory system, then the Republicans walked away when it looked like there was enough bipartisan support to pass it.

~You~ are part of the problem.

theotherguy....Single payer health care is not the answer for the United States. Unless you would wish to import even more health care professionals from over seas than we have now. Who do you think will be regulating single payer health care...well the Congress of course with their combined consciousness of medical expertise and protocol.

As for:

you Republicans wanted free market absolutely no regulation healthcare.

That is just simply not true. The Republicans also were working on a measure for health care and guidelines that would support The American People. I do think it is funny though that you perceive the Democrats as compromising and that it seems you would like to step away from from Obama care. Seems that the Democrats were willing to sing the praises of this legislation even without reading it...

You voted for the problem and now American will suffer for it.

txmom32 - Single payer health care is not the answer for the United States

Sounds like you don't mind wasting so much money on administrative overhead and insurance company profit, something which contributes nothing whatsoever to healthcare.

It's one thing to support profits for doctors, nurses, and medical appliance manufacturers, but quite another to support profits for an industry which exists solely to leach money out of the healthcare system......and does so in part by denying healthcare to the insured.

txmom, I DO have insurance. Never been without it. I don't pay tens of thousands, but I do pay enough - my ins company pays the rest. My melanoma was further along because I waited until we got a better policy before I did anything. Might be stupid, but this happens across the country. And by the way, the ACA IS a republican plan. I can't wait for a single payer though, it is superior to our current system. We waste a almost a fifth of our GDP on health costs. And you are fine with that?

skrekk....I have lived under a single payer system. Single payer is not designed to find answers rather a system designed to treat symptoms.

lib50...

I was responding based on the information you provided. from 3.3

Well sometimes we get diseases like cancer and the expenses can't be helped. My melanoma treatments cost tens of thousands of dollars. And I've barely started them.

Now you change the details...3.7

My melanoma was further along because I waited until we got a better policy before I did anything.

Now this is just a head shaker. Why would anyone delay treatment for something that is potentially devastating? There are any number of ways to deal with treatment costs if you are under insured. Instead you played the system?

And by the way, the ACA IS a republican plan. I can't wait for a single payer though, it is superior to our current system.

So is this now the talking point for progressives? Prior to what Obama care ended up to be many of the goals were certainly Republican priorities...couldn't be denied for preexising conditions, exchanges across states, consortiums for small business to join so they could purchase insurance for imployees as part of a larger pool. But there was nothing in a Republican plan that targeted individuals or businesses for additional penalities or taxes for choosing not to have insurance. That whole idea of inflicting pain on the producers of this country is pure progressive devisive BS.

I can't wait for a single payer though, it is superior to our current system.

Again I have lived under a single payer system and there is nothing superior about it over our current system. What you will find is that we dump a bunch of people into a single payer system and those who wish to have access to good medical care will still purchase private health insurance. We will have a divided system of poor care vs good care. To place it in real terms those currently on medicare who actually do have access to the Dr of their Choice and facilities of their choice will be limited to long lines and rationed care. Add to that system individuals and families that are currently in an emerging economic class who will be placed in a system that will be further burdened without enough Medical expertise to treat need. Then consider the number of current physicians and other medical specialists who will not elect to work in the single payer system keeping their practices and clinics private because the documentation needs and standards of a single payer system will not allow them to make a descent living. Then consider those physicians who currently cheat the medicaid and medicare systems having a golden goose to exploit for any number of opportunities from fake diagnosis to create a need for patients to come back often to a perfect system to provide prescriptions under shady circumstances. So how much of the GDP do you think will go into this double standard of care. Not to mention the delays in care that will put honest patents at risk for a worsening condition.

txmom32 - Again I have lived under a single payer system and there is nothing superior about it over our current system.

The facts prove otherwise since the single payer systems used by other industrialized countries achieve significantly better outcomes at half the cost.

I waited because the policy we had was awful and I didn't want to be stuck paying THOUSANDS on my own. At the time my husband was unemployed and we had to pick up our own coverage, even that terrible policy cost us over 800/mo. You'd be surprised how many people try to improve their coverage before they are stuck FOREVER (at least before ACA) with policies that suck after a diagnosis. And countries with single payer are great, the care is there and the costs are half of ours. Win win.

Dictator? Really? I consider him a protector. Thank GOD he won.

Obama killed the twinkee - he is a dictator.

Hold your horses, Wyo2, the Twinkie isn't dead yet!

It's been on the website for months, Navy. I guess you weren't concerned enough to actually look for it.

Umm, sorry Pedestrian, maybe the ACA was--but NOT the HHS regulations that are written to implement the bill.

Here's the simple fact: Congress passes the legislation, but the appointed bureaucrats write the actual regulations. The OSH Act, for example, was a few pages--its regulations, thousands. Big difference.

With the Government involved in it can this be anything but the best ;-}

Everyone can now get treated ! What, there are no more Doctors. But, but Oblama, Oblama. Nancy, Harry. Where are the Doctors? I thought this was a cure-all. Where are the Doctors? Why have they retired early? Why is there a dramatic decrease in medical school applicants?

But, but Oblama. Where do I get my free treatment? There are no Doctors.

My self employed inlaws whom had health insurance lost their house due to extremely high health care bills. Breast cancer set them back 80k in out of pocket debt, and then allowed the health ins company to cancel them. If you can't see the flaw in the way the OLD system worked, you need a reality check.

No more doctors? There are plenty of doctors. There are not enough doctors going into general practice, because many of them are specializing. However, that has nothing to do with Obamacare.

Change can be scary, especially for people who are afraid of changing. Just relax, it's good change.

God, can the right tell the truth about ANYTHING? I get so sick of the bs pulled out the collective asses of the republicans, who don't seem to understand the issues.

IF this was true reform they would have tort reform - oh but the Pres and most of Congress is attorney's.

Clotho,

Yes, if, like a good little liberal, you live on the coasts there are generally enough physicians. Not so much if you live in the center of the country. In many communities in the heartland, if you are new to the community, it may take you 6 months to a year to find a physician within a reasonable driving distance.

Medical practice has been moving toward specialization for most of the last 2 decades for a couple of reasons. The growth of medical knowledge makes a deep understanding of all aspects of medical practice impractical if not impossible so specialists are necessary. We have an illness system, not a health system and specialists treat illnesses rather than focusing on keeping people healthy. And then of course, there is the money.

The other trend is the growing refusal of family practitioners to accept new patients with Medicare. It doesn't pay enough. You are correct that these trends are not the result of Obamacare, but the ACA may make the problem worse. Since the only tool the Independent Payment Advisory Board has to control healthcare costs is to cut Medicare reimbursement, Obamacare seems unlikely to help these trends.

The other trend is the growing refusal of family practitioners to accept new patients with Medicare. It doesn't pay enough. You are correct that these trends are not the result of Obamacare, but the ACA may make the problem worse. Since the only tool the Independent Payment Advisory Board has to control healthcare costs is to cut Medicare reimbursement, Obamacare seems unlikely to help these trends.

I don't see how ACA can make the problem worse. More people insured = more people going to the doctor = more money coming in to the hospitals & clinics, which will also help spur the already growing demand for nurses & doctors. But I'm sure conservatives will somehow spin the demand for jobs as a "shortage" of something. Always looking for a way to sabotage the system, just so they can "prove" Obama failed.

You wanted JOBS, JOBS, JOBS! Well now you have them.

Why are we complaining that there is a need for doctors?

It depends on how you count the costs. Due to the sheer number of uninsured / nonpaying / canceled people in the country there was a staggering cost being transferred to the government and private citizens. By at least getting these people on the books you can balance out that cost, especially if you can get preventative care, which is by far the most important part. For the uninsured person they would have to pay with non-existent money out of their empty pockets for preventative care, yet would get emergency care for free as no hospital can refuse them. Cheaper for them, more expensive for everyone else.

Anyhow the most important part of this chance is the little talked about HSA. HSA's change ~everything~ and will radically alter the way healthcare is paid for. Currently health insurers take more money then they give, it's a basic fact that to run a profit you need a higher income then expenses and their running record high profits. For every $1000 you pay in premiums they would have to provide less then $500 in healthcare. Think about that, your paying someone $1000 to get less then $500 back, why not just pay the costs yourselves.

That's what HSA's are. They act exactly like IRA's in that the money you put in is before taxes and counts as a deductible. The money stays in the account until you use it and gains interest if you chose to treat it like an investment (suggested to be a slow growth, low risk investment). Your employer may contribute to this account, and again their contribution is tax free. You can use any money in this account to cover any health related expense, no need to file any paperwork, through for tax purposes you may want to keep the receipts. Essentially it's tax free cash that slowly grows and stays with you your entire life and can be used to pay for anything. What people find is that if you offer cash up front most doctors / hospitals will slash their price anywhere from 20 to 50%, HSA's act as cash.

Now for people who are already older this won't matter much, but for young people just entering the workforce it's a huge deal. Putting as little as 50$ per payday into a HSA will have dramatic effects twenty or thirty years later when they get into the part of their life where most illness's start appearing. And when you reach retirement age any money left in the account is available to be used for whatever you want, its treated like an IRA by the IRS. Plans with HSA's tend to have higher deductibles though as they want you to pay for things with your HSA, at least in part prior to resorting to insurance plans. Though they also have lower premiums due to the higher deductible.

Just because there are many job openings for doctors, doesn't mean they'll get filled. Many who are tired of malpractice insurance are retiring, fewer are entering the pipeline, and it takes years to become qualified. Put on your thinking cap then guess what will happen to your appointment dates and waiting room time when demand very suddenly exceeds supply (of qualified docs) in 2014.

No, I don't believe that Medicaid requires work...at least not yet.

Umm, no? It provides a marketplace for individuals who currently do not have insurance to go and buy it (and as an incentive, penalizes those who choose not to participate). It doesn't touch individuals who already have insurance, e.g. through their employer. And yes there is a cost, just as today there is the hidden cost for stealth health care provided to the uninsured at emergency rooms, subsidized today by paying customers and those of us who already pay health insurance premiums.

"It doesn't touch individuals who already have insurance, e.g. through their employer". WRONG!! It does and will. I have already made plans to dump health care for some and just pay the penality. Many bigger corps will do the same. It's about the bottom line, MONEY. Not people, those can be replaced.

Viktor, wrong again. Plus, no Doctors.

Viktor ....you forgot to mention skyrocketing premiums for those who already have insurance......Don't forget that little tidbit ....

Premiums are skyrocketing mainly because of two reasons. Law suits, and uninsurred sick people who get the free medical room visits.

hjack and PValdes - are you making predictions based upon evidence, or are you merely hoping this will fail?

No, it does not penalize...it taxes. This may be semantics but since that was the crux of the reasoning behind why the USSC found it within the powers of congress, it makes a difference.

As for that subsidized statement...a George Mason University study found that at most, the cost increase in premium to cover the uninsured is about 1.7%.

For those who complain about premium increases (which have been going on for decades), do you finally accept a single payer option? Because THAT is how prices will really go down. It is totally unacceptable for our healthcare costs to stand at over 17% of our GDP and our results are inferior. I don't think you really get this at all.

Amen, lib50 :)

oreo, you can dump your plan and pay the tax. However, you as a business need to compete with others for employees and in an improving economy. Go ahead, stiff you employees out of spite and see how long you stay in business.

How will a single payer system bring down the cost of care? Can you explain how this will happen? It seems like you are saying if we pay doctors and hospitals less, they will then have to charge less. If this is the case, lets all start paying $1.50 per gallon of gas rather than the $3.20+ that is being charges. After all, if we are paying less, they prices will have to come down...

Oreo is right. I am actually in the insurance business, health included. I do commercial and small business plans. All I have been hearing from our insured's (the small businesses and corporations) is that they will be dropping healthcare for their employees and take the fine. Taking the fine will save them hundreds of thousands of dollars in some cases. My company will be doing the same. Companies won't have to compete to keep their employees if everyone is doing it.

Thanks I need a good laugh! "Improving economy", please tell me another. Stiff my employees? How am I stiffing my employees?? Most voted for what they will get, not just at my shop but all around this country. I'm Not stiffing anybody, I'm running a business that must make a profit and Obamacare threatens my profits. Out of spite? God I love liberals, too funny!! Why can't liberals get that? I'm not paying the tax, I'll cut hours to under 30 per person then hire more part timers if I need too. I do need to get rid of a few to get under the 50 employee mandate but I'll make sure they are Obama supporters who voted for and want this.

oreo-1091576, you have just shown you know nothing about the new health care law. The way the penalty is structured for a company not covering their employees health care is such you will pay FAR MORE in the penalty than actually covering your employees. They actually thought about ignorant, spiteful employers who would screw their employees when they wrote the law.

Sandy, you're completely wrong. The fines are far less.

Premiums will increase for EVERYONE in 2014, because they will start being deducted from our paychecks post-tax, not pre-tax like they currently are. In my case with having a single plan it will mean about $180 less per month in my take home pay. Those paying for a Family Plan will feel a MUCH bigger hit to their wallets. Oh yea, and we are all Middle Class people that Obama raised taxes on via Obamacare.

RPJ, Why don't you want to buy health insurance? Do you think others should have to foot the bill for your emergency room visits? Requiring all to participate is what will bring the cost down.

Sandy - WORNG!! $2,000 fine compaired to over $10,000 per family plan now. Please, get educated. You pay FAR LESS in fines. But I can just go under 50 employees also. Dems never think there's where your wrong. I love the ignorant, siptful thing, very funny. You have NEVER owned a business have you? It's called BUSINESS!

It won't take too long before the part time loophole is fixed. Chalk that up to giants like Olive Garden who were stupid enough to announce way in advance what their tactics were going to be. Greedy idiots who think like Oreo and can't get past the profit motive are just going to get steamrolled and out of business. American has woken to the fact that excessive profit mongering isn't good for our country or society. Maybe those folks in love with profit should have let a little more trickle down. They killed their own golden goose.

Oreo the 10k was a deduction, the 2k isn't. You do the math.

God I love liberals, too funny!! Why can't liberals get that? I'm not paying the tax, I'll cut hours to under 30 per person then hire more part timers if I need too. I do need to get rid of a few to get under the 50 employee mandate but I'll make sure they are Obama supporters who voted for and want this.

Punishing people for their political beliefs? Wow, sounds like you'd be right at home in communist China. You know less than nothing about this health care reform. We'll see who's laughing when your business goes under.

Yes bookem, but the Supreme Court lied. Its not a tax, its a penalty. Everyone having a certain level of income has to pay taxes - that's a tax. You pay the healthcare "tax" only if you refuse to do what the government says - that's a penalty. Just because John Roberts misapplied, misdirected, and misinterpreted the Constitution and lied to the American people doesn't change the facts, it only changes the law.

Why would the republicians want to change any part of Obamacare?? They now can sit back and watch Obamacare FAIL. Nothing will get done to fix Obamacare, the Republicians will use that to their advantage in the next election. Obama OWNS it! " People who think like Oreo and can't get past the profit motive are just going to get steamrolled and out of business". HAHAHAHA Business is for PROFIT get used to it! I love all the Dems, stiff employees, profit motive, HAHAHA. There's a reason your not a business owner you do not understand why you are in business, for PROFIT! I'm stating FACTS, you may not like the way I'm doing it but those are the FACTS!

I was recently informed that my premiums would be going down next year thanks to the 20/80 rule and this year received a rebate...true story.

The only "business" you are in Oreo is the business of giving people the business. Mowing lawns doesn't count and your deep knowledge of business practices and the fact that you are on here and not making money leaves me with the feeling that you have ZERO credibility.

joemike, I agree that it is not a tax. The "tax" argument started long before the case was presented to the USSC. I was at a conference in DC in March where Senator Max Baucus was asked if the penalty were a tax and he mumbled and bumbled to say that the intent was that the penalty was intended as a tax.

They didn't say that in the language of the law because they knew it was a non-starter and would not get passed. This is how our politicians operate....they are too clever by half.

For those who argue that the premiums will go up, guess what, the premiums have been skyrocketing the past ten years and more! Every year our company's HR Director struggles to find us a similar level of care for what we have been paying, but it's impossible. She does pretty well though and I applaud our company for having her make the effort. Our company pays 100% of employee insurance, as in nothing comes out of our paycheck, but we still have to pay premiums, copay, etc. I was put on part-time for a year and had to pay for my own health insurance $500 a month--totally broke me. The ACA is a cause for celebration--nobody has been able to reform healthcare until Obama made it happen. Didn't neurological research show that Republicans were more afraid of change? Yes, it did. And we see it on full display in the comments. Think people. Why would Democrats reform health care if it was going to *hurt* their constituents? Let's give it a chance before bashing it. As a woman, reading about the changes makes me so grateful. If not for my job, I literally would not be able to purchase insurance for any amount of money. I too have already received a rebate from my insurance provider because they spent over the allowed amount on administrative costs last year--it went to the company, which is fine by me! Teh awesum!

...and by so doing, they will then have their exchanges set up at the federal level. So, go ahead, states! You'll bring us single-payer health care by being stubborn.

Right Viktor .....and this will be the biggest debacle in the history of the United States of America. We can only give the Federal Government so many things to screw up ......This may be the final one ....

Viktor, that has been the goal all along...single payer system. The law and the rules implemented by the many departments are designed to bring single payer to us...

Danno - yes, which is as it should be.

PValdes...after having just gone through a major market crash and recession...then unjustified billions GIVEN to banks basically as charity with no stings attached...then those banks handing this free money over to their CEO's and shareholders and PAC's that advocate less regulation and getting BIG GUBMIT out of their business.....Obamacare is the biggest debacle in the history of the United States, really?

For those of you who think the Feds will screw up healthcare ask your mom, dad, grandparents that are on Medicare, or perhaps a vet (in the VA system) how they feel about their government insured healthcare plan.

Actually, I AM a vet and the VA system works just fine for my needs, thank you very much.

Exactly my point. The government does healthcare well.

For those of you opposed to a non-profit single payer system (Medicare for All) please give the reasons for your opposition. Thanks.

Well, chuckzul, I've got to wonder what VA you're at. The VA hospitals around me are the worst, most dilapidated, and poorly run facilities. The level of care is much lower-the quality of doctors, nurses, staff-and most vets actually get much LESS care than they truly need or have to fight/wait for it. Those severly wounded in Bethesda or Walter-Reed of course are getting the best of the best, but beyond that area, it goes down hill very fast.

bb6317,

Yes, you are correct. It is dependent on the location of the facility and there are some that are truly in need of a serious refurb. I go to the VA in both Wichita and KC and the care (and condition) of the hospital is generally pretty good.

Over the past 12 years I worked for a Medicare contractor... the last 9 years as a provider educator. It amazes me how little many people have educated themselves about PPACA (Patient Protection and Affordable Care Act). The healthcare providers in this country have been writing off (and passing on to the insured) an incredible amount of the costs forservices provided to the uninsured... and yes, those unpaid for costs have been passed on to the insured and those paying for the services received. If you've been insured, you've already been paying for the uninsured through higher healthcare insurance premiums... do you really think the insurance companies are actually absorbing those costs? Get real! The profits made by insurance companies has been absolutely disgusting... and I know, all Medicare contractors are subsidiaries of the insurance companies. As an employee, we were updated on a quarterly basis on the state of the company's bottom line and stock profits... so I DO know what I'm talking about. I've read a LOT, but not all, of the legislation as it was part of my job to educate providers on the upcoming changes.

What most of you probably have NO idea about is that the diagnostic coding system is changing, and because of the change from ICD9 to ICD 10. Because we didn't go to a single payer system, diagnostic codes will be quadrupled... and many experienced coders may decide to bail. If you're looking for a job with high demand, that takes little time to train (approximately 6 months... but certainly NOT easy)... get your coding certification from the AAPC (American Association of Professional Coders).

One of the issues that needs reformed is that the insurance exchanges are not going to cross over state lines... now you may have a state with only 2 insurance exchanges (and very high rates); the next state over they may have very health competition with dozens of insurance exchanges, which will drive competition, and much lower costs for purchasing insurance. Nobrainer, people! It's imperative to allow health exchanges to cross over state lines to ensure real competition and lower profits for the insurance companies... not higher profits for them! Hey, I benefited from some damn nice bonus's and to be honest felt it wasn't right when it was at the expense of the customer... and honestly, we were paid very nicely.

One very good thing written into the law was that because there are limited slots in medical schools to keep the profession(s) highly paid, there was a concern about a shortage of medical personnel. Part of the solution is that if a teaching facility goes out of business, the slots for those students can be picked up by another teaching facility. Ask any premed student how incredibly difficult it is to get into medical school and you'll find out just how difficult it can be. We also need to do something about the incredible debt incurred in obtaining a medical license.

Another thing many of you have NO idea about is that there are incentives written in to the law for healthcare professionals to serve rural and other under served areas. I totally agree with all comments regarding tort reform... malpractice insurance costs are entirely out of control.

And last point that I can think of this second, just remember that it's MUCH less expensive to provide preventive screening services and treat a problem early on... than to ignore a problem and then go for treatment after the disease has progressed and more aggressive treatment is necessary. Also, if people can afford to take their medicine, it prevents complications and admissions to hospitals for an exacerbation of the condition (think amputation for a diabetic vs. proper management of the disease... or open heart surgeries vs. management of high blood pressure, high cholesterol and so on).

It's all about common sense, compassion, and intelligent use of our healthcare dollars.

Btw, for those of you who said children could be covered up to age 26 before ACA... bull@!$%#... that's just stupid and totally untrue. I was able to REinsure my daughter during her last year of college after I had to drop her from my insurance as I wasn't ABLE to insure her before. Get your freaking facts straight before you post!

at the cost of your parents and yourself losing ssi

get ready to pay for their meds and healthcare

good luck with your 'co-pay'

Exactly, DingleB. In typical government fashion, they concieved a much worse issue that existed, turned it into a major crisis and then proceeded to carpet bomb the problem where a 4-man assault team would have been sufficient.

But, if they don't keep creating these problems, why would we need to keep them around to fix the problems?

Oh yes, this was so easily solved, which is why nothing had been done about it before. And certainly anything that strives to provide health insurance to those who lack it and to simultaneously hold down the costs of health insurance generally would have been easily resolved with your "4-man assault team" approach.

Funny thing, history.

Viktor...if only a small percentage of people were without insurance, why did we need sweeping legislation that affected the majority who aready had coverage? Why not just address those who did not already have it? That is carpet-bombing a single vehicle instead of using an assault team.

if only a small percentage of people were without insurance, why did we need sweeping legislation that affected the majority who aready had coverage?

It was a HUGE percentage of people who were (mostly still are, until 2014) without of insurance. Nearly 50 million people. We needed sweeping legislation because private health insurance companies were corrupt and keeping health care away from the people who needed it most, driving millions into poverty when they got sick, and jacking up the price of health care to the point where only the wealthiest could afford to get sick without taking a hit. Where have you been for the last 15+ years?

The article states that according to Census information it is around 15%. As Dingle points out, those covered add up to 96%, which actually leaves 4% without insurance. If only 4% have no insurance, it is a small percentage of the population.

The numbers are now 48 million. They have been as low as 30 million during the debate on healthcare reform.

Figures don't lie, but liars figure.

The article states that according to Census information it is around 15%. As Dingle points out, those covered add up to 96%, which actually leaves 4% without insurance. If only 4% have no insurance, it is a small percentage of the population.

The numbers are now 48 million. They have been as low as 30 million during the debate on healthcare reform.

Figures don't lie, but liars figure.

If you don't think 15% of people going without insurance isn't a huge chunk of the population, you need to get your head checked. Or, by your "reasoning", I guess 8% unemployment is just a "small" percentage, so why bother doing anything about it?

Use your math skills to figure out the fiscal consequences of 48 million people going without insurance and having to declare bankruptcy to pay their doctor bills.

About 55 percent of Americans are covered through an employer; 31 percent have a public insurance plan such as Medicare or Medicaid, and 10 percent buy their own health insurance.

These figures are for the population of Americans who have insurance. But good job getting 96%, that's how 96% of insured Americans get their insurance. 15% DON'T HAVE ANY.

Danno,

When you take the four percentages, why do you assume it's the uninsured that is wrong? Maybe those who get their insurance through work were actually 44%, not 55%.

It seems you took the one you don't like and made it lower to benefit your argument.

Dingle,

So, this whole mess of Obamacare will benefit roughly 7% of the population??

Did you only read that part of the article? Because the rest of it lays out several other benefits to the insured, such as no lifetime cap, the 80/20 rule and the fact that the insurers must cover:

Ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, including behavioral health treatment, prescription drugs, rehabilitative services and devices, laboratory services, preventive and wellness services and chronic disease management and pediatric services, including oral and vision care.

You are assuming that 48 million people will have large or any claims every year...they do not. How many people who are uninsured actually have large or any claims in a given year. Use your math skills to say what percentage of that again, not 15% will have any claims in the year.

I was not assuming that all 48 million people would have large claims. Even a small portion of those 48 million is, and has been, disastrous for our economy. Not to mention that those people who don't have insurance but are healthy could be paying in to the health insurance pools if they did have coverage and making rates go down for everyone else--thus the necessity for the mandate.

People who don't have health insurance and contract cancer and other incredibly costly diseases through no fault of their own DIE because of lack of coverage. You can't show up at the emergency room for chemotherapy. A medical disaster can happen to anyone at any time--car accident, cancer, you name it.

Also, it may add 48 million people to the number of insured. Good luck to them in finding a doctor that is accepting new patients, and good luck to those trying to recruit people to careers in medicine when potential recruits realize they will become government employees.

Most of the rest of the world doesn't have a problem with this. i don't see why its an issue with us.

Most of the rest of the world doesn't have a problem with this

The rest of the world doesn't provide universal healthcare through a for-profit insurance based system.

Personally, I'm not for government provided health care, but if you're going to do it, there has got to be a more efficient way.

The provider's cost of compliance is huge. For example in a standard skilled nursing facility, the Business Office Manager, Contracted Medicare Biller, the Health Information Manager, the Medicare Nurse, and the MDS coordinator all spend a good portion, if not all, of their time ensuring compliance with Medicare regulations. And everytime you turn around the regulations are getting more complex.

Add to that the cost to the taxpayers for managing these incredibly complex and redundant systems, and we have an incredibly over-regulated, inefficient, bureaucratic, money wasting cluster @!$%# of a health care system. Just on the federal level, health benefits are paid out through several different Medicare plans, federal Medicaid funding, VA benefits, military retiree and active military benefits, federal employee benefits, and I'm sure I'm missing a few.

Again, not for government provided health care, but single-payer has got to be better than what we're doing now.

This is a very expensive way to attempt to attempt to deliver universal healthcare.

This is NOT, I repeat, NOT A WAY TO DELIVER UNIVERSAL HEALTH CARE. Obamacare is a way to expand the opportunity to purchase health INSURANCE to those who were not able to obtain it before, mostly because they had pre-existing conditions or couldn't afford it. Universal health care systems do not rely on private, for-profit insurance companies. Anyone who tries to tell you this is socialist/communist/government run is an idiot. We are still very much at the mercy of the insurance companies.

i totally love this

wheeeeeeeeeeee

That's exactly how I felt when I read the article too.

couldn't agree more!

hahahaha - and you're unemployed ash will what? sit on the sofa, eat deep-fried sticks of butter, and complain about your welfare check beoing taxed?

Oreo, this guy is a master of blaming someone else. This will now turn out to be the fault of Doctors, nurses, hospitals, and various ghosts. The federal welfare clowns who voted for this clown in order to get all their free money will eventually regret this fiasco.

Unfortunately, the working people who didn't vote for him will have to pay the price also.

I agree. I will be cutting hours to under 30 per week. It only effects about 25 people at my shop but they will NOT be happy. When I tell my employees of the change I will make sure I BLAME OBAMA!

"your shop" nice one! you're an unemployed welfare recipient, you weigh 430 pounds and eat sticks of butter like potatoe chips

And your 25 employees will continue to use the ER to take care of their hang-nails and sniffles. Then they will claim poverty and dodge the bills. Then your private coverage will go up to cover the losses that the ER is taking. So, basically, it all just comes back around. At least requiring insurance is effecient and transparent.

oreo-1091576 your a hypocrite, you cant possibly know how this will effect your business yet, no one does. Each state will have different rules, all we know is some broad strokes yet you already hate something that will help your fellow countrymen in a big way. YOU are whats wrong with america these days, money before people. Good luck in your endeavors,you will need it.

Hypocrite?? Why? I can't know that paying much much much more out of my profits is going to make me less money? WOW, you are a true Dem.I'm in business to MAKE MONEY! That's it! help my fellow countrymen. VERY FUNNY. HAHAHA

Oreo, you're not fooling anyone. We all know that even if it were free to you, you wouldn't provide health insurance to your employees. You're one of those Republicans who sabotages the system you know nothing about, just so you can appear "right", and then blames any one else for your failures. People like you and businesses like yours are the reason this economy is in trouble in the first place. Given your greed, hypocrisy, stupidity, and lack of foresight, it's only a matter of time before your corrupt business goes under. I'm sure you'll blame Obama, but it won't stop us liberals from laughing at you.

Precedede - So let me get this right. You and your young, black and hispanic voters by voting for a socialist you can make me take home less money and pay for others health care?? Really. WOW, I'm looking around and YES this is still America dumb ass. I can not and will not pay for cheap labors health care, NEVER! Now, if I weren't taxed at a higher rate also I may be able to afford some of the costs but you want me to lay out thousands of my money, NOT YOURS, MY MONEY for dummies that can't think for themselves yet vote for gifts. HAHAHAHA I don't think so, who do you think you are?? " and then blames any one else for your failures". NO, that would be OBAMA and the libs!!

Was that last comment intended to be self-referential, or does it just work out that way?

wwwhhhhhhhhhheeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee

Patse, how soes Aetna, Humana, Met, etc. make money when they have to pay $5K per day of inpatient care. If you are paying $6 - $8,000 per year in premium, and have two nights at $5,000, the insurer is at a 125% loss ratio. This means they have paid 25% more in claims than they collected in premium.

You blame the insurer, but don't question how much the hospital's costs were to charge that $5K per day.

The mandate was a concession to the insurance companies. If they have to cover people with pre-existing conditions, they need to also have "healthy" people paying in to offset the costs.

It probably would have been less of an issue if they allowed people to buy into the Medicaid system, or some other single-payer option. The insurance companies hated that because they'd either have to compete with the Medicare/Medicaid "premiums", which would probably be less since there's no profit involved. Hopefully, we'll move to a single-payer option eventually and take the profit out of the equation. No for-profit company should be making decisions as to who gets what level of care. It's immoral.

I think that that series of statements in the article was poorly written. I believe that they meant to say that 15% of the populace are uninsured, while 85% have some type of coverage. Of those persons who *have* health insurance, 55% are covered through an employer plan, 31% publicly insured, and 10% buy their own (total = 96%, so probably 4% "other").

If the insurers could implement the same reimbursement rules, it would be a "fair" system, but they can't. They can't dictate how much they will pay. That is negotiated between the provider and the insurer.

If you want to really know what is driving up insurance premiums, it is the little that government pays providers. They make that amount up by charging insurance companies a much higher amount than their actual cost.

Then you should have voted for single payer.

We weren't given the option to vote. If we had, the insurance companies and their lap dogs in Congress would have been out of luck.

I am required to buy car insurance whats the difference? You would think republicons would be all for this as it makes everyone pay now.

We really should call it ObamnyCare to remind Republicans that they came up with the idea first.

@ Crushedu - everyone else can see the plain differences.

1. The federal government doesn't require you to buy car insurance. States rights and all that.

2. You are not required to buy a car. This is a citizenship tax. The first one in history that I can see. Thanks dems - @!$%#s.

There is far too much to answer on this forum, but this web site should answer most of your questions.

http://www.healthcare.gov/law/index.html

A few important points, are that there are no more lifetime caps on insurance, and at least 80% of your premiums MUST go toward actual medical treatment. There are limits on how much your premiums can go up (as opposed to the past, when they doubled between 2000 and 2008.

But even if your premiums DO go up, you get a refund if less than 80% is spent on actual medical care.

Thank you Clotho! :)

You have been helpful. Also, thank you for the link.

It could mean that. I have been told that some companies are basing what you pay out of your check for insurance on how much you make (CSC and Lockheed Martin are going to be doing this). Those who make less pay less for the same insurance policy as those making more.

It may not be an issue if you live in a high cost of living state in 2018 once the "Cadillac Tax" goes into effect. Your employer may drop your plan and dump you into the individual market.

My employer uses that system MG. It is ok if you are salaried, but if you are hourly a few hours of overtime can cause your premium to raise for that month costing you the benefit of the overtime. I'm not sure it is the best approach.

ILuvUSMC, Depending on your employer, you do not actually have health insurance. Your employer, if over 100 employees (and many of those smaller), is probably self-funded. This means that between you (your contributions) and your employer, you are paying for all of your health services. Your increases and decreases are factored based on the usage over the prior coverage period. An underwriter will assess the costs of the employer group against the amount collected and factor in the upward trend in the cost of care. Those items will determine how much your costs will increase.

Well what I found out now is that we can only put $2500 in our FSA! That sucks as we have over 6K a year in health care costs.

Without the ACA, our FSA contributions had a yearly cap already--yours were open-ended?

IluvUSMC--some other improvements: if you are a woman, you currently pay more than men for private insurance--that ends under the new law. If you come down with a medical condition requiring expensive care, your insurance company can no longer just dump you from their plan, as they can currently. If you have pre-existing conditions, you will still be able to purchase an insurance plan you can afford. Insurance companies won't be able to deny coverage to those who have pre-existing conditions. Honestly, I wonder if those who are against this new program have had to rely on their health insurance for more than just simple checkups and procedures, because the current system is a complete mess--talk about rationed care!! That's what we have now.

well.... not if you've invested in the pharma medications that are going to be higher costs - those related to morbid obese conditions - like diabetes, copd and heart related diseases.

Your a transvestite queen, you no nothing about business. Dope!

hahahahah - peanut comments from a pencil penis

you seriously need to rein in your 'anger' at blacks; they're not the reason you're stupid and uneducated, you should have stayed in school instead of dropping out of middle school

Yea, what about people that drink booze, drink soda, eat greasy food. Yea, what about people that have life styles that put them in danger, skiing comes to mind, how about riding motorcycles, para-shooting and skin diving. Where do you draw the line? As far as smoking, the last thing you want is to have the smokers stop, my state gets $3.00 per pack tax, if that stopped the last thing you need to worry about is how much smokers add to health care costs, the lost revenue will be put on all us by increased taxes somewhere else.

Patse,

You need to stop staring in the mirror so much

hahaha - let the peanut pencil dicks blather

Yea, what about people that have life styles that put them in danger, skiing comes to mind, how about riding motorcycles, para-shooting and skin diving. Where do you draw the line?

Agreed, Henry. I was an underwriter for a health insurance company for two years. In our Underwriting Manual, we had a list of occupations and hobbies that we could decline coverage for, including fishing, hunting, motorcycle riding, parachuting, and more. Of course the insurance companies could only find out if you claimed this on your insurance application, but if you lied and then later you were in a motorcycle accident, the company could "rescind"your coverage, making it as if you never had coverage with them. Your premiums were refunded, less any amount already paid in claims, and you were stuck with the rest of the bills.

So Republicans, please keep talking about how health insurance doesn't need to be reformed or regulated, I'd love to hear more.

I hope by fishing, you didn't mean swinging a fly at a trout on a little stream could get you denied insurance coverage! :)

Does your coverage have an in and out-of-network benefit - meaning the payment is higher if you use an in-network provider? If so, there would be no additional costs to you. The clerical paperwork, tongue depressors, etc. are part of the cost of the office visit (CPT code 992XX). If the provider is balance billing you, you are more than likely out-of-network. If this is the case, you are paying for the charges in excess of usual, customary and reasonable charges. In other words, you doctor is charging more than the average for the services in your area.

I thought the health care industry was told they need to cover 80% medical coverage and 20% for them to run the company

Not the health care industry.. .health insurance companies. 80% of premiums must be used towards paying claims. If less than 80% is used, than policy holders get a refund. It has nothing to do with what hospitals and clinics bill for. If your insurance plan has a deductible, you will still have to pay out-of-pocket until that deductible has been met, as has ALWAYS been the case for health insurance plans. Isn't the free market just grand?

Henry Limpet, it does suck--that happens quite often in larger cities where doctors and health care services tend to be more expensive and insurance won't pay the full cost. Our Human Resources director encouraged us to ask *before* using their services and find out what the costs will be and what is covered. It's a hassle, but if we become more discriminating, those charging higher costs will get less business.

My health insurance at my office has a $5,000.00 for my wife and I, plus I pay $180.00 per week for the two of us. That's $780.00 per month!!

@Henry Limpet I don't know what that means. Is that good?

MG, does your plan qualify as a High Deductible Health Plan? Can you open a Health Savings Account to save the difference between what you used to pay and what you are now paying in that account? Does your employer contribute to your Health Savings or Health Reimbursement Account - many do?

The cheapest plans are generally purchased by those who have very little risk and rarely go to the doctor. If you think you might need more regular health care, are older, etc., there is a certain percentage of income that it is assumed you can afford, and it's more than $80 unfortunately. You can still get a lot of services with just a copay, and if something really horrible happens, $2,900 is next to nothing compared to the bills you would rack up being hospitalized. So, you try to find some balance, but the deductibles go up and up and up every year, which is part of the problem. There is no real competition in the health insurance industry in many places.

What middle of the road family can afford that?

This is the difference between health insurance and healthcare. Even if you have insurance you still may not be able to afford or access care. It is one of the reason ObamaCare will fail if the goal was to provide universal healthcare.

Rob

We will not be moving forward. The insurance, pharmaceutical, and for-profit hospital industry got most of what they wanted out of this. They own a lot of politicians. If this thing collapses under its own weight as I think it might do the chances of real healthcare reform will be ruined for decades.

Rev.....if you are right. Sure, if this thing fails, healthcare reform won't be touched by pols against for prolly another generation. But.....I think you are wrong.

As I said, this is far from perfect. There should have been a public option. I think that could end up being a serious problem....especially in controlling costs.

BUT, you are taking an extreme negative look at this reform. There are MANY good things in this new law that Americans who feel good affordable healthcare is a RIGHT are going to be very happy with. It think it's going to be an excellent first step. A great foundation to build upon.

It never ceases to amaze me at what people have become to believe is a "right" instead of a privelage. Morally, if care exists for illnesses then I agree it should be made available to those who need it without breaking one's personal life financial savings however it is not a right. The privelidge part comes in when you consider the time in history in which we live and that these miracles exist at all. Next you will believe living in someone else's home because they are wealthier than you is a right. I will tell you the first item to consider in health care is the individual and their needs. Grouping people into categories and then creating a one size fits all cure is the first step toward failure of any program designed for the masses. Next would be deciding who has created their poop health condition through bad lifestyle choices versus those who have done things right but for reasons beyond their control they have become ill. Do not exempt anyone from a universal program. No elitists, no unions, no individuals. Everyone including the Commander in Chief and public sector employees. That is a fair start. Costs? Well that's another issue isn't it.

MikeeV....the ol' "slippery slope" argument. a favorite of those who really have no real valid argument.

And I'll say it again.....good affordable healthcare in a country such as ours is a right, not a privilege. It's about time we started acting like it.

good affordable healthcare in a country such as ours is a right, not a privilege.

That's where you are flat out wrong. It's a right in your mind and other weak minded people. It has never been a right. It only became a law because the dems had to come up with a new bribe to their voters. They flat out bought you. You sold your vote. Congrats, you sold your soul. I wonder how long before you realize you are now even more a slave to the left?