I Hate Dialysis Message Board
Off-Topic => Political Debates - Thick Skin Required for Entry => Topic started by: Bill Peckham on September 30, 2013, 10:26:39 PM
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The federal government has shut down (http://www.washingtonpost.com/politics/washington-braces-for-the-first-shutdown-of-the-national-government-in-17-years/2013/09/30/977ebca2-29bd-11e3-97a3-ff2758228523_story.html), and today is the day that people can begin to enroll in the healthcare exchanges.
I can't see this in a good light from any angle. Federal workers, and particularly those serving in the armed services will shoulder most of the immediate pain from the shut down but its effects will spread pretty quick. One thing not effected directly will be the roll outs of the health insurance exchanges since they are in the hands of the states.
My view is that the problem is in the House of Representatives, with thirty or so Reps (http://washingtonexaminer.com/how-30-house-republicans-are-forcing-the-obamacare-fight/article/2536611). Politically I can't see how this ends well for Republicans but what ever happens here and then with the debt limit next it's the country that is being harmed.
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http://www.huffingtonpost.com/2013/09/30/obamacare_n_4006242.html
today we get to FINALLY SIGN UP FOR THE AFFORDABLE HEALTH CARE ACT - its about bloody time :bandance; :clap; :yahoo; :flower; :cheer:
you can now sign up via your state's health care exchange for health insurance if you are not on medicare - gripe all you want about its problems but personally I am thrilled that post transplant I wont have to worry about if i have a job and how to pay for extremely expensive pre exisiting condition health care when my medicare benefit runs out
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"It truly doesn't matter which party you support or which political party you blame for the current budget impasse in Washington, D.C. The budget process is a mess, it has been a mess for years, and both sides are trying to convince you the other party is completely responsible for the troubles that might lead to a government shutdown...."
http://www.ajc.com/weblogs/jamie-dupree/2013/sep/29/budget-mess-congress/ (http://www.ajc.com/weblogs/jamie-dupree/2013/sep/29/budget-mess-congress/)
The shut down is not part of any budget process, the messiness of coming up with the federal budget is an ongoing circus both sides sustain but the shut down is a result of the republican Congressional caucus and republican political calculation. The republican party is leaderless and rudderless; we're all going to pay a price.
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"It truly doesn't matter which party you support or which political party you blame for the current budget impasse in Washington, D.C. The budget process is a mess, it has been a mess for years, and both sides are trying to convince you the other party is completely responsible for the troubles that might lead to a government shutdown...."
http://www.ajc.com/weblogs/jamie-dupree/2013/sep/29/budget-mess-congress/ (http://www.ajc.com/weblogs/jamie-dupree/2013/sep/29/budget-mess-congress/)
The shut down is not part of any budget process, the messiness of coming up with the federal budget is an ongoing circus both sides sustain but the shut down is a result of the republican Congressional caucus and republican political calculation. The republican party is leaderless and rudderless; we're all going to pay a price.
Nothing more than meaningless political gamesmanship playing to their respective bases. Did you really expect the GOP to vote to fund Obamacare? Nothing new that we haven't seen a dozen times over in the last six years. And it won't last long. My guess, a deal will be done by the end of this week or by next week. Just that way that these political shows always go. Like I said, meaningless tactics. As far as I am concerned, put Obamacare in place. That is the best GOP campaign strategy at this time and let folks know what is really in this monster.
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Not Federal "Retirees"!!
:cheer:
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Yes, some sort of deal will be reached in the next couple of weeks. We do, however, need a federal budget, since it has not been balanced in ohhhhhh, an awfully long time. I for one hope Obamacare is ousted. Way too many loose ends .
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I for one hope Obamacare is ousted. Way too many loose ends .
What are the loose ends you are talking about?
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This isn't just another round of political posturing, this aptly describes the situation (http://quod.lib.umich.edu/l/lincoln/lincoln4/1:268.1?rgn=div2;view=fulltext): "What is our present condition? We have just carried an election on principles fairly stated to the people. Now we are told in advance, the government shall be broken up, unless we surrender to those we have beaten, before we take the offices. In this they are either attempting to play upon us, or they are in dead earnest. Either way, if we surrender, it is the end of us, and of the government. They will repeat the experiment upon us ad libitum. "
There can not be any negotiation in the sense the republicans require. And I don't think there will be.
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http://www.huffingtonpost.com/2013/09/30/obamacare_n_4006242.html (http://www.huffingtonpost.com/2013/09/30/obamacare_n_4006242.html) today we get to FINALLY SIGN UP FOR THE AFFORDABLE HEALTH CARE ACT - its about bloody time :bandance; :clap; :yahoo; :flower; :cheer:
you can now sign up via your state's health care exchange for health insurance if you are not on medicare - gripe all you want about its problems but personally I am thrilled that post transplant I wont have to worry about if i have a job and how to pay for extremely expensive pre exisiting condition health care when my medicare benefit runs out
And people diagnosed with CKD, not yet on dialysis, will be able to get insurance coverage and thereby work to slow the progression of their CKD. And if it does progress they will be able to get a permanent access placed or choose how they transition into using dialysis. I'll be watching the rate of fistulas at first treatment over the next couple of years. Another interesting number to watch will be the percent wanting a transplant. I think the how to afford your meds post transplant question was a large issue holding many people back from pursuing a transplant.
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Well, at least they've got their priorities straight (http://thinkprogress.org/politics/2013/10/08/2748461/members-only-congressional-gyms-deemed-essential-remain-open-during-shutdown/).
Head Start programs have been shuttered, small businesses can’t get loans and hundreds of thousands of federal government employees are furloughed. But the exclusive gyms available only to members of Congress have remained open throughout the shutdown.
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The House gym features a swimming pool, basketball courts, paddleball courts, a sauna, a steam room and flat screen TVs. While towel service is unavailable, taxpayers remain on the hook for cleaning and maintenance, which has been performed daily throughout the shutdown. There are also costs associated with the power required to heat the pools and keep the lights on.
Who elected these clowns?
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With Affordable Care Act, Canceled Policies for New York Professionals
The New York Times
http://www.nytimes.com/2013/12/14/nyregion/with-affordable-care-act-canceled-policies-for-new-york-professionals.html?hp&_r=0
December 13, 2013
By ANEMONA HARTOCOLLIS
Many in New York’s professional and cultural elite have long supported President Obama’s health care plan. But now, to their surprise, thousands of writers, opera singers, music teachers, photographers, doctors, lawyers and others are learning that their health insurance plans are being canceled and they may have to pay more to get comparable coverage, if they can find it.
They are part of an unusual informal health insurance system that has developed in New York in which independent practitioners were able to get lower insurance rates through group plans, typically set up by their professional associations or chambers of commerce. That allowed them to avoid the sky-high rates in New York’s individual insurance market, historically among the most expensive in the country.
But under the Affordable Care Act, they will be treated as individuals, responsible for their own insurance policies. For many of them, that is likely to mean they will no longer have access to a wide network of doctors and a range of plans tailored to their needs. And many of them are finding that if they want to keep their premiums from rising, they will have to accept higher deductible and co-pay costs or inferior coverage.
“I couldn’t sleep because of it,” said Barbara Meinwald, a solo practitioner lawyer in Manhattan.
Ms. Meinwald, 61, has been paying $10,000 a year for her insurance through the New York City Bar. A broker told her that a new temporary plan with fewer doctors would cost $5,000 more, after factoring in the cost of her medications.
Ms. Meinwald also looked on the state’s health insurance exchange. But she said she found that those plans did not have a good choice of doctors, and that it was hard to even find out who the doctors were, and which hospitals were covered. “It’s like you’re blindfolded and you’re told that you have to buy something,” she said.
The people affected include not just writers, artists, doctors and the like, they said, but also independent tradespeople, like home builders or carpenters, who work on their own.
Some have received notices already; others, whose plans have not yet expired, will soon receive letters in the mail. It is unclear exactly how many New Yorkers are affected; according to state health officials, as many as 400,000 independent practitioners get health insurance through job-related group plans, but that number also includes people who receive coverage through their spouses’ employers.
The predicament is similar to that of millions of Americans who discovered this fall that their existing policies were being canceled because of the Affordable Care Act. The crescendo of outrage led to Mr. Obama’s offer to restore their policies, though some states that have their own exchanges, like California and New York, have said they will not do so.
But while those policies, by and large, had been canceled because they did not meet the law’s requirements for minimum coverage, many of the New York policies being canceled meet and often exceed the standards, brokers say. The rationale for disqualifying those policies, said Larry Levitt, a health policy expert at the Kaiser Family Foundation, was to prevent associations from selling insurance to healthy members who are needed to keep the new health exchanges financially viable.
Siphoning those people, Mr. Levitt said, would leave the pool of health exchange customers “smaller and disproportionately sicker,” and would drive up rates.
Alicia Hartinger, a spokeswoman for the Centers for Medicare and Medicaid Services, said independent practitioners “will generally have an equal level of protection in the individual market as they would have if they were buying in the small-group market.” She said the president’s offer to temporarily restore canceled polices applied to association coverage, if states and insurers agreed. New York has no plans to do so.
Donna Frescatore, executive director of New York State of Health, the state insurance exchange, said that on a positive note, about half of those affected would qualify for subsidized insurance under the new health exchange because they had incomes under 400 percent of the poverty level, about $46,000 for an individual.
But many professionals make too much money to qualify for the subsidies, and even if they are able to find comparably priced insurance, the new policies do not have the coverage they are accustomed to.
David Rubin, vice president of Teiget, the Entertainment Industry Group Insurance Trust, which had served as a broker for about 1,000 members of creative guilds, said a big complaint was that in New York City and much of the state, the new individual plans both on and off the exchange did not allow patients to go to doctors out of network. “All these people had these customized plans which are better than most of the things out there, and most of them are saving only a small amount of money,” he said.
Roy Lyons, managing director of Marsh U.S. Consumer, an insurance brokerage, said he had heard complaints from physicians, lawyers, pharmacists and optometrists. “At first they think it’s the bar association making the decision or the insurance company doing it,” he said. “We have to explain that this is the Affordable Care Act; that’s what was put into law. Once they understand, they’re less emotional, but they’re not happy with it.”
Among those affected are members of the Authors Guild; the Advertising Photographers of America; the Suzuki Association of the Americas, a music teachers organization; the Society of Children’s Book Writers and Illustrators; the New York City Bar Association; and the New York County Medical Society. (One group, the Freelancers Union, negotiated a one-year exemption with the state. )
“One of the reasons to join a society is to get health insurance,” said Dr. Paul N. Orloff, president of the New York County Medical Society. Even doctors pay a lot for coverage, he said, because the days of trading medical care with colleagues are long gone. “In the old days, professional courtesy was the norm,” he said.
The medical society has not yet formally notified its solo practitioners, because their insurance plans do not expire until April. But those letters will be going out soon, officials said.
It is not lost on many of the professionals that they are exactly the sort of people – liberal, concerned with social justice – who supported the Obama health plan in the first place. Ms. Meinwald, the lawyer, said she was a lifelong Democrat who still supported better health care for all, but had she known what was in store for her, she would have voted for Mitt Romney.
It is an uncomfortable position for many members of the creative classes to be in. “We are the Obama people,” said Camille Sweeney, a New York writer and member of the Authors Guild. Her insurance is being canceled, and she is dismayed that neither her pediatrician nor her general practitioner appears to be on the exchange plans. What to do has become a hot topic on Facebook and at dinner parties frequented by her fellow writers and artists.
“I’m for it,” she said. “But what is the reality of it?”