holding out for more pay. Right now, they can get away with it because the number of insured in the exchange plans are relatively small.

There's a lot of greed in the system that has to be dealt with at some point. It may get ugly for awhile.

these fuckers need to be stopped!

licensed to do business in their state to cover ANY hospital? Surely States have a say in at least part of this.

One thing they could do is mandate that every policy must include at least 60% of the providers in the ares.

Or a better solution would be to offer the public option -- essentially a Medicare buy-in option, and use rates that providers will find acceptable.

anytime in the near future, short of a miracle and the Koch brothers run out of money. (fat chance)

In the meantime, can't the State legislature tackle this problem?

talking about the improvements that are still needed to Health Care.

Why should anybody vote for any Democrat? What are they committed to? What are they promising to work for? What will they promise to do if American voters return Democrats to control of the House and retain control of the Senate?

As far as I can tell, the answer is a big fat NOTHING. And if so, they deserve to lose.

We need a meaningful platform. Here is a good start
http://www.dailykos.com/story/2013/12/22/1263930/-A-Democratic-contract-with-America-How-to-retake-the-House-and-combat-economic-inequality

but you will notice there isn't one damn word about health care.

Democrats are damned cowards when it comes to health care, which is almost 20% of our economy. There is no justification for this cowardice.

They are also cowards about the NSA/Defense complex, which is another 8-10% of our economy.

Exactly what part of our economy are they not cowards about? Social Security. I'll give them that. But that isn't enough.

There are VERY few dems in the house and the senate. A whole shit load of republican infiltrators calling themselves Dems, but very few actual Dems.

You have to give people something to vote FOR.

But unfortunately, when you look at that Daily Kos list, almost all of the items are things that the big Wall Street players funding Democrats would hate. So none of that Kos list has a prayer of being a rallying point.

This is what happens when special interests own everybody.

We can argue that the special interests that own the Democrats are morally superior to the special interests that own the Republicans. But in the end, they are mostly the same.

The only difference between the parties is that there are a few more Democrats that act with some independence -- but not nearly enough to get anything done of a progressive nature.

We can take some small consolation that the appointe4es that Obama makes are only somewhat right-wing and not full batshit right-wing, which is what you get from Republicans.

Better than nothing -- but does it really change anything?

(Too Big to Give A Shit)

the president. Since they are planning to run on the unmitigated success of aca, pointing out the flaws in it would be a nonstarter.

It isn't an attack on Obama if he is leading the parade. And that completely disarms the Republicans. They fail every time you make them play defense.

Without Obama leading we get nowhere. And frankly, he doesn't seem to give a shit whether we win back the House.

It is bullshit what is going on. In my area (Indianapolis, which happens to be the HQ of Anthem), there are 18 policies on the exchange for my age group. 16 are from Anthem and the other 2 are from a no-name provider canned MDwise.

I had an Anthem policy last year. It had a decent provider network. The premiere hospitals in our area are under the banner of the Indiana University system, but this strangely includes Methodist Hospital, which has always been one of the top ones. I don't know how you legally merge a religious order with the state-supported university, but that's a question for another day. The fact is that is where you need to go if you have any disease that is at all out of the ordinary. These hospitals and most of the docs practicing there were in my pre-ACA Anthem plan.

With the ACA, Anthem saw an opportunity to apply the SHOCK DOCTRINE. Whenever there is a moment of change or crisis, this creates a fog that allows predators to step in and do what they have been wanting to do all along. But the shock is what allows them to get away with it. And make no mistake, Anthem is one of the kings of the predators.

Every one of those Anthem policies -- all 16 of them, use this completely bogus provider network. What people don't understand is that providers have to CHOOSE to be in a network, and that basically boils do to how low they are willing to go on their fees. Well, just for the ACA, Anthem is offering the doctor's equivalent of minimum wage for services on an ACA exchange plan. And consequently, almost no docs bought in. No problem. Anthem signed a deal with the Community Health Network, which is the lowest rated hospital system in the area -- and the one that does most of the Medicaid and indigent care. Only about 10% of the docs in the area are in this network and none of the hospitals I would ever go to.

So 16 of the 18 plans were completely out of the question. None of my doctors were in Anthem's ACA network.

This other company (MDwise) is interesting. They have been in business 18 years, but nobody ever heard of them because they were basically a Medicaid servicer for the State of Indiana and didn't really deal with the public. Their two policies are about the same price as the Anthem ones, and they have a GREAT network. It includes the IU hospital network and any doctor I am likely to want to see. That's it. Only 2 competitors -- one is the big gorilla on its home turf and the other is a company nobody ever heard of.

In the end, I decided to extend my pre-ACA Anthem policy through 2014 because I was concerned that MDwise might have problems their first year dealing with the public. The key point is that the pre-ACA Anthem policy reimburses at rates docs are willing to accept. Anthem's ACA policies are garbage. Only the bottom feeders are in network. And I don't mean "bottom feeder" in a derogatory sense. I know some of those Docs and they are good people. They would be just fine for any routine stuff, but that's not where you go if you have unusual problems.

That pre-ACA policy probably won't be offered after November 2014, so I'll have to go without insurance in December 2014 and then hope there are better choices in the exchange for 2015.

you still have it privatized... Poor america...You must feed the elite insurance corporations and screw your working people .

Our privatized system is deliberately inefficient and ineffective in order to maximize profits. Obamacare is actually a retooling of an old Republican plan designed by a conservative think tank that had as its primary mission the enrichment of the insurance industry.

Even so, some people are covered who would not otherwise be, etc.

Because of the tight grip the Big Money Guys have on our government, it will just about take a revolution before we restore humane principles to the commons.

And while I'm at it, you Canadians had best keep a lookout as well; they're also after everything good that you have: health care, good pensions, good environment, etc.

I doubt Harper will run in the next election. and I doubt that the PC will be a majority party agai. He has too many scandals outed now and I am sure there will be more outed this year.

Our health care is on the table again this year 2014 to be negotiated. right now the Feds pay 80 percent and the provinces 20 percent. the PC government wants it 50 /50....Well there will be a fight. and like the Social Insurance premiums inccrease it will be a big one.
Seniors are still a big voting group....They will not stand for health care being cut and they certainly know the importance of social insurance . Many seniors would be dead without it.



As for the USA health Care , Michael Moore said it all here. This is the year for the Big Fight.. on both sides of the border.

http://www.nytimes.com/2014/01/01/opinion/moore-the-obamacare-we-deserve.html

All eyes are on Vermont’s plan for a single-payer system, starting in 2017. If it flies, it will change everything, with many states sure to follow suit by setting up their own versions. That’s why corporate money will soon flood into Vermont to crush it. The legislators who’ll go to the mat for this will need all the support they can get: If you live east of the Mississippi, look up the bus schedule to Montpelier.

So let’s get started. Obamacare can’t be fixed by its namesake. It’s up to us to make it happen.

In the meantime, Bridgespan is another possibility. They cover only 50% of out of network costs, but with a yearly maximum of $12,500. This might work for some people.

a serious accident could cost, that would be better than having unlimited out-of-network costs. A $12K bill is an amount a person could conceivably work their way out of, if they didn't have savings.

A family could easily run up that amount each year.


How many times do I have to explain this to you?

You obviously do not understand how most people live. You really don't.

the difference between "some" and "all"?

Forget about being in network or not... providers find themselves being squeezed by the insurance companies too.

So some providers are deciding not to contract with an insurance company that they feel are giving them the worst deal. The NP who I see for medicine management advised me of this - she dropped out of network from the insurance company I have through work. Her partner, also a doctor in the practice, has turned down the same insurance company's request that he contracts with them... saying that they don't pay enough. It's not as if they don't take insurance... they do but just not that company.

So between the insurance companies and the medical providers... you're not getting coverage. You don't get to keep seeing the same doctors with your insurance plan if the contracts change for in-network benefits. For some, it's find a new doctor. For others it's thinking whether they can afford to see the same doctor out of network.

you can keep your doctor.

I give up,
what is the problem here?