Cuts Could Mean Loss Of Dialysis Care For Thousands Of Americans

[Hemodoc]

Sorry Bill, I am talking about premium increases. The data is clear, they have gone up substantially and will continue to escalate BECAUSE of Obamacare. Adding in the fact that health care costs had stabilized, the premium increases under Obamacare since passed in 2010 speaks to the fact that Obamacare is anything but affordable.

http://www.nytimes.com/2013/01/06/business/despite-new-health-law-some-see-sharp-rise-in-premiums.html?pagewanted=all

[cattlekid]

A couple of comments. I'm sure I'll get flamed to death but I feel compelled to make my thoughts known:

1.  Due to some of the provisions of the ACA, the benefits provided through my employer-based health insurance have had to expand from previous levels ("free" birth control, covering "children" up to age 26 are two that I can think of off the top of my head).  We already had no lifetime maximum on benefits.  Our HR department, when presenting the new premiums for 2013, specifically told us that the increases in premiums were due to the ACA and its new provisions. 

2.  I was directly asked yesterday to sign a petition to go to CMS to ask Congress to repeal the cuts to dialysis providers.  I replied to the individual who asked that UNTIL the day when I see LDOs step up and indicate that they will be cutting administrative costs and salaries (including the extremely bloated executive level salaries) instead of fearmongering on cuts to services, I do not plan on being the shill for an LDO.  I'm sure the response I get to that one will be interested.  I bet I will be accused of being willing to kill off Grandma and Grandpa.

[NDXUFan]

Short version: The payment your center receives for each treatment and each drug will be cut by some percentage. The centers will have to find a way to make some money even though each patient is paying less. They could get less trained staff, cut back on the drugs you get, cut back on your treatment time, try to not take the worst patients, be cheap with supplies, etc. you imagine the options. In the long run, some centers may go too deeply into the whole to survive and will close. Other centers may never open.

In case, you have not noticed, Davita and Fresenius are too cheap, already.

[KarenInWA]

1.  Due to some of the provisions of the ACA, the benefits provided through my employer-based health insurance have had to expand from previous levels ("free" birth control, covering "children" up to age 26 are two that I can think of off the top of my head).  We already had no lifetime maximum on benefits.  Our HR department, when presenting the new premiums for 2013, specifically told us that the increases in premiums were due to the ACA and its new provisions. 

I'm no expert on this particular topic, but here is how I see it: Not every woman on a private health plan is going to suddenly start taking the pill, so all in all, it really isn't going to cost that much more in the long run. Also, being on the pill is a hell of a lot cheaper than being pregnant and adding a newborn to the plan - who may or may not be healthy at the time of birth.  A lot of women are on the pill for reasons other than contraception. I was on it during dialysis to control my period and hopefully not need as much epo, for example. And as for the kids up to age 26 - MOST of them (but certainly not all) are healthy - so the insurance company is getting a break by collecting premiums for them and little out-go in healthcare dollars. People that age are the "creme-de-la creme" in their eyes, so I am willing to bet they LOVE this part of the deal. If they are charging companies more for that gift the ACA gave them, then that is due to them wanting to make bank. Yes, there are exceptions to that rule, of course. There always is. I just feel that those who are the exceptions deserve to have healthcare rather than what the alternative is in our society - make them poor and desitute so they qualify for Medicaid and live a sad, depressing sick life. I hate what our country does to those who are sick, I really do.

KarenInWA

[Sydnee]

I know our health premiums have gone up the last 2 years. they deduct $202.40 from each pay check there are 26 pay checks a years. That is for BCBS of Alabama, Cigna dental and some eye program (the dental and Eye is less than $27 a paycheck)

BCBS has a $35 copay for Dr. office visits, a $500 deductible at which point they pay 75%, and finally a $8000 out of pocket max per person with a 3 per person max per family. (this is the best insurance Lowe's now offers, there are 3 choices now)

Lowe's switched us to this from our wonderful local insurance 2 years ago

Winhealth (a local wyoming company) is what we had before it was $127 a paycheck for just Ed and I. If we had chosen family it would have been $168.90 a paycheck. Doctors visit copay was $30, they paid 75% of everything until you met your deductible of $500 dollars, then after deductible they pay %100. plus they were nice and easy to get answers from.

It is unclear whether Lowe's current plans will change next year, they do not meet the ACA requirements but if Lowe's had these plans in effect (somewhere in the company) before 2010 they will be "grandfathered in" HR rep is checking for us.

Our family is low income and our children were covered by medicaid and still are. I wish Wyoming would extend the medicaid because then Ed would be on medicaid also. I got on SSI and thus got medicaid in April. I couldn't imagine $16000 in hospital expenses between Ed and I.     

[ChrisEtc]

 

Sorry Bill, I am talking about premium increases. The data is clear, they have gone up substantially and will continue to escalate BECAUSE of Obamacare. Adding in the fact that health care costs had stabilized, the premium increases under Obamacare since passed in 2010 speaks to the fact that Obamacare is anything but affordable.

http://www.nytimes.com/2013/01/06/business/despite-new-health-law-some-see-sharp-rise-in-premiums.html?pagewanted=all

Did you actually read your link?  It doesn't sound like it.

[ChrisEtc]

Hmmm...I couldn't access that article for some reason.  I have to either pay for a subscription or open an account, which I am loathe to do as it just adds to those who want to send me e-mails asking me to spend money.  LOL!

I'm truly not trying to get into a debate.  I really am curious as to why Group Health has made your premium skyrocket.  Is it really because of the ACA, or do you suspect they might be using its implementation as an excuse to raise your premium?  What reason did they give you?  Whenever I hear that insurance premiums are going to go up, I just can't shake off this feeling that, once again, Corporate America is doing sneaky things and blaming it all on anything other than their own greed.

Sorry, I don't have those answers for Group Health. I just recently sold our CA home and now am no longer a Kaiser patient. Kaiser is paying for my Group Health as part of my health care for life benefit in my retirement package with my medical group. The $35,000 is what Kaiser is contracted to pay to Group Health. I have no clue why it has sky rocketed specifically, but the promise that the "Affordable Health Care Act" would reduce premiums has never materialized. Just the opposite in fact. By 2016, I have read that the average premium for a family will be $20,000.

http://www.huffingtonpost.com/2012/05/15/health-care-costs-record_n_1516380.html

I know that when I am 65 if God willing I live that long, I will have to strongly consider giving up my Kaiser lifetime coverage and go with Medicare and Medigap coverage I will purchase if either are still available. Otherwise, I will on paper look like a wealthy retiree, when in fact, the majority of my taxable income will instead by my health care coverage alone. My accountant explained that the ACA will make that common for people who have health care benefits in one state and then move out of state where they will also be taxable income. There is a reason why Obamacare hired thousands of new IRS agents as part of the "health care" deal.

It doesn't sound like you actually read this link either.  Reading is really fundamental.

[Hemodoc]

Hmmm...I couldn't access that article for some reason.  I have to either pay for a subscription or open an account, which I am loathe to do as it just adds to those who want to send me e-mails asking me to spend money.  LOL!

I'm truly not trying to get into a debate.  I really am curious as to why Group Health has made your premium skyrocket.  Is it really because of the ACA, or do you suspect they might be using its implementation as an excuse to raise your premium?  What reason did they give you?  Whenever I hear that insurance premiums are going to go up, I just can't shake off this feeling that, once again, Corporate America is doing sneaky things and blaming it all on anything other than their own greed.

Sorry, I don't have those answers for Group Health. I just recently sold our CA home and now am no longer a Kaiser patient. Kaiser is paying for my Group Health as part of my health care for life benefit in my retirement package with my medical group. The $35,000 is what Kaiser is contracted to pay to Group Health. I have no clue why it has sky rocketed specifically, but the promise that the "Affordable Health Care Act" would reduce premiums has never materialized. Just the opposite in fact. By 2016, I have read that the average premium for a family will be $20,000.

http://www.huffingtonpost.com/2012/05/15/health-care-costs-record_n_1516380.html

I know that when I am 65 if God willing I live that long, I will have to strongly consider giving up my Kaiser lifetime coverage and go with Medicare and Medigap coverage I will purchase if either are still available. Otherwise, I will on paper look like a wealthy retiree, when in fact, the majority of my taxable income will instead by my health care coverage alone. My accountant explained that the ACA will make that common for people who have health care benefits in one state and then move out of state where they will also be taxable income. There is a reason why Obamacare hired thousands of new IRS agents as part of the "health care" deal.

It doesn't sound like you actually read this link either.  Reading is really fundamental.

Balderdash!


Health Care Costs To Exceed A Record $20,000 Per Year For Families With Insurance, Study Says

Health care costs for a family of four covered by workplace health insurance will exceed $20,000 for the first time ever this year -- $20,728 to be precise -- according to a new study released Tuesday. That's $1,335 more than in 2011.

[Bill Peckham]

Sorry Bill, I am talking about premium increases. The data is clear, they have gone up substantially and will continue to escalate BECAUSE of Obamacare. Adding in the fact that health care costs had stabilized, the premium increases under Obamacare since passed in 2010 speaks to the fact that Obamacare is anything but affordable.

http://www.nytimes.com/2013/01/06/business/despite-new-health-law-some-see-sharp-rise-in-premiums.html?pagewanted=all

Health Care Costs To Exceed A Record $20,000 Per Year For Families With Insurance, Study Says

Health care costs for a family of four covered by workplace health insurance will exceed $20,000 for the first time ever this year -- $20,728 to be precise -- according to a new study released Tuesday. That's $1,335 more than in 2011.

So which is it, total healthcare spending? Or premiums? Because as the Huffpost article states the cost to the "typical" family of four is $5,114 in premiums for a preferred provider organization plan along with $3,470 in out-of-pocket costs. The article also points out "Family health care costs grew by 6.9 percent between 2011 and 2012, slower than in previous years" which is good and the news about federal healthcare costs are even better, as the links I provided report.

Pick one - healthcare costs to families - about $8,500/year - or healthcare cost to society from total spending point of view or the federal/state government's point of view?

[Rerun]

The topic is:  Are we going to get cut off from dialysis or not?

 

[Hemodoc]

Sorry Bill, I am talking about premium increases. The data is clear, they have gone up substantially and will continue to escalate BECAUSE of Obamacare. Adding in the fact that health care costs had stabilized, the premium increases under Obamacare since passed in 2010 speaks to the fact that Obamacare is anything but affordable.

http://www.nytimes.com/2013/01/06/business/despite-new-health-law-some-see-sharp-rise-in-premiums.html?pagewanted=all

Health Care Costs To Exceed A Record $20,000 Per Year For Families With Insurance, Study Says

Health care costs for a family of four covered by workplace health insurance will exceed $20,000 for the first time ever this year -- $20,728 to be precise -- according to a new study released Tuesday. That's $1,335 more than in 2011.

So which is it, total healthcare spending? Or premiums? Because as the Huffpost article states the cost to the "typical" family of four is $5,114 in premiums for a preferred provider organization plan along with $3,470 in out-of-pocket costs. The article also points out "Family health care costs grew by 6.9 percent between 2011 and 2012, slower than in previous years" which is good and the news about federal healthcare costs are even better, as the links I provided report.

Pick one - healthcare costs to families - about $8,500/year - or healthcare cost to society from total spending point of view or the federal/state government's point of view?

So, the cost of employee health insurance premiums to employers is unimportant and not in that mix Bill?

Where is the promise of your president that premiums would go down. Not true, up every year since signing the ACA.

[Bill Peckham]

So, the cost of employee health insurance premiums to employers is unimportant and not in that mix Bill?

Where is the promise of your president that premiums would go down. Not true, up every year since signing the ACA.

Pick a topic premiums or total spending, and see if your world view can be supported by data. Show me the link where anyone promised premiums would go down as opposed to grow less fast.

Total costs are growing less fast, the ACA requires insurance companies to spend at least 80% of their incoming premiums on medical care, thus as total costs increase at a slower rate premiums will increase at a slower rate. It is a clear signal that you've lost perspective Peter when you write [premiums are] "up every year since signing the ACA" intending it as some sort of argument in support of your position. As if premiums and medical costs were in such a state of perfection prior to the ACA. You're suggesting premiums never went up prior to 2010, which is an incredible stance to take. Overall there is blindness evidenced in the President's political opponents, a blindness to the world as it existed and I would say as it exists. Historians will have to explain it someday.

[Hemodoc]

"Well, it’s been an interesting week in health care land. For a while now, independent analysts—and conservative critics—have raised concerns that Obamacare will dramatically increase the cost of individually-purchased health insurance for healthier people. This would, of course, contradict President Obama’s promises that “if you like your plan, you can keep it” and that the cost of insurance would go down “by $2,500 per family per year.” What’s new is that liberal columnists, facing reality, are conceding that premiums will go up for most people in the individual market. But they’re justifying it by saying that “rate shock” will help a tiny minority of people who can’t get insurance today. If they had said that in 2009, would Obamacare have passed?"

http://www.forbes.com/sites/theapothecary/2013/06/03/democrats-new-argument-its-a-good-thing-that-obamacare-doubles-individual-health-insurance-premiums/

[Hemodoc]

Obamacare in Georgia: Sticker shock
Posted: August 1, 2013 - 10:22pm  |  Updated: August 2, 2013 - 12:01am


GEORGIANS WHO will be forced to buy health insurance under Obamacare later this year should be prepared to dig deeply into their wallets — then hold on for dear life.

That’s because of heart attack-inducing sticker shock.

The premiums for the five health insurers that will be offering policies in Georgia’s federally run insurance exchange are “massive,” according to Georgia Insurance Commissioner Ralph Hudgens.

http://savannahnow.com/opinion/2013-08-01/obamacare-georgia-sticker-shock#.UgCH4Ryez88

[Hemodoc]

'Cheapest' ObamaCare Plans Aren't So Cheap After All
By John Merline, INVESTOR'S BUSINESS DAILY
 Posted 08/02/2013 05:42 PM ET
 
The average price for the lowest-cost ObamaCare "bronze" plan in eight states is 122% higher than the cheapest plan currently available in those states, according to an IBD analysis of rate filings and a recent Government Accountability Office report.

The late July report, largely overlooked by the press, provides detailed information on insurance plans today in all 50 states, from the cheapest plans offered to a 30-year-old nonsmoker to the most expensive plans 55-year-old couples can buy.



Read More At Investor's Business Daily: http://news.investors.com/politics/080213-666235-cheap-obamacare-twice-as-costly-as-existing-plans.htm#ixzz2bADx07KP
Follow us: @IBDinvestors on Twitter | InvestorsBusinessDaily on Facebook

[Bill Peckham]

Judging by your links, let make sure I understand - your main complaint is that healthy young people males without preexisting conditions will now have to pay more for a basic policy than before in some states, if they're among those that buy their own insurance on the open market. And even though the plans these health young hipsters could buy today "often include higher deductibles and skimpier benefits than ObamaCare allows" and with Obamacare plans they'll have insurance that stays in effect when they get sick, this is a big problem. You're saying this is the main problem with Obamacare: it will impose higher costs to healthy young males who buy their own insurance (women are never included in these complaints because now their premiums have to be set at the same rate as males so they pretty much benefit across the board, even in Georgia).

[Bill Peckham]

I was wondering what exactly the Forbes articel referenced with their quote saying the promise was premiums would be lowered by “by $2,500 per family per year.” ANd ther e is a youtube video withthe President repeting hte promise over and over again http://youtu.be/_o65vMUk5so but you'll notice all instances of him saying this was during the 2008 campaign when he was talking about his plan for healthcare. BTW his plan for healthcare didn't include a mandate either Clinton's plan included a mandate, it was the primary policy difference between the two candidates.

As it turned out Congress sent a plan a lot more like Clinton's to his desk to be signed. So is that the complaint, that you wish the ACA had been more like Obama's plan that he campaigned on? In any case an average family of four that earn less than $50,000/year (average yearly household income) they'll be getting about $2,500 in subsidies though the exchanges and in the effect of slower growth in premiums.

[Hemodoc]

I was wondering what exactly the Forbes articel referenced with their quote saying the promise was premiums would be lowered by “by $2,500 per family per year.” ANd ther e is a youtube video withthe President repeting hte promise over and over again http://youtu.be/_o65vMUk5so but you'll notice all instances of him saying this was during the 2008 campaign when he was talking about his plan for healthcare. BTW his plan for healthcare didn't include a mandate either Clinton's plan included a mandate, it was the primary policy difference between the two candidates.

As it turned out Congress sent a plan a lot more like Clinton's to his desk to be signed. So is that the complaint, that you wish the ACA had been more like Obama's plan that he campaigned on? In any case an average family of four that earn less than $50,000/year (average yearly household income) they'll be getting about $2,500 in subsidies though the exchanges and in the effect of slower growth in premiums.

Yes, and my taxes will continue to go up to pay for those subsidies even though my only taxable income is my Social Security and now my lifetime  health care benefits. Sorry Bill, I am no fan of Obamacare. When it is fully implemented, I suspect a majority of folks will feel the same. When I am 65, I will likely have to drop my Group Health coverage and pay for a Medigap plan with my Medicare if it is not bankrupted yet. I simply won't be able to afford the taxes on my healthcare plan since I am still considered a partner of Kaiser from the IRS perspective. So, my higher taxes to pay for those subsidies will ironically cause me at some point to lose my own healthcare. Great system Bill.

[jeannea]

Rerun, I think you got ignored. I wish I knew what will happen to people on dialysis. Will our treatment be cut? What I personally wish is that more families would look honestly at whether their relatives should be on dialysis. There were always some patients in my center for whom it didn't make sense. If you're brought in on a stretcher and don't really know where you are, is dialysis really helping you live your life? So many are in denial about death. Grandma's life needs to be extended by that torturous year on dialysis. If as a society we get honest about that sort of thing, there might be enough money left to treat the rest. I don't mean "death panels." I mean doctors being willing to say the truth.

[Rerun]

Jeannea, Amen Sister!!  But, as long as you have a pulse you are a money maker for these Dialysis Centers.  Hamster on a wheel generating money.  Sad but true. 

Will these Dialysis Centers who make millions off sick people and Medicare really close their doors?  We would start dropping dead after about a week.  Are they really going to do this?  I'm sure if they cut ALL Medicare they would close their doors and someone would step in but not in time.  You know how fast Congress works.

Those on Home Dialysis better start hoarding supplies.  The rest of us won't have a chance.   

         

[okarol]

Everyone is screaming at Medicare and begging Congress for help.
Am I the only one who thinks this is crazy?
http://ihatedialysis.com/forum/index.php?topic=29448.0 The companies are doing well.
I'm pretty sure they'll have to repeal Obamacare to get us out of this mess.
The money to pay for it is coming from ESRD patient care.
I think anyone can see that the gravy train has been very lucrative and it's an area that can afford cuts.
Sadly, the health providers are not going to cut their profit margins, they have shareholders they have to answer to.
It's the patient's who will end up shortchanged.

[cattlekid]

No.  As I mentioned upthread, I have blatantly ignored all of the cries for "advocacy" from all of the shill organizations for the LDOs. 

Until the day comes where I see the top brass at an LDO publicly state that they are going to cut bloated administrative salaries or live with a lower profit margin (notice that I did NOT say "lose money", I said "lower profit") then they can go pound sand for all I am concerned.  I am not their puppet and refuse to be used as such.

CMS still has a set of rules that all dialysis providers have to live by and these aren't changing to my knowledge.  So instead of running around begging Congress for money, it might be time to brush up on the Conditions for Coverage and holding our clinics' feet to the fire instead.  Don't let them get away with their scare tactics.

Everyone is screaming at Medicare and begging Congress for help.
Am I the only one who thinks this is crazy?

[okarol]

Thanks cattlekid, I had missed your earlier post. 

[Hemodoc]

Jeannea, Amen Sister!!  But, as long as you have a pulse you are a money maker for these Dialysis Centers.  Hamster on a wheel generating money.  Sad but true. 

Will these Dialysis Centers who make millions off sick people and Medicare really close their doors?  We would start dropping dead after about a week.  Are they really going to do this?  I'm sure if they cut ALL Medicare they would close their doors and someone would step in but not in time.  You know how fast Congress works.

Those on Home Dialysis better start hoarding supplies.  The rest of us won't have a chance.   

         

Actually, the two issues are quite related and intertwined. Those that opposed Obamacare to start with warned that Obama was going to raid Medicare and that cuts to the seniors would come shortly. The fact that we see these cuts beginning is not a surprise. Obama gutted Medicare to "pay" for the ACA.

http://www.breitbart.com/Big-Government/2013/02/20/With-Election-Over-Obama-Announces-Medicare-Cuts-To-Fund-ObamaCare

[Bill Peckham]

I'm pretty sure they'll have to repeal Obamacare to get us out of this mess.
The money to pay for it is coming from ESRD patient care.

This isn't the case. Obamacare was paid for when the legislation passed - through some taxes and cuts to Medicare Advantage and payment rate growth decreases to large providers on the hospital side, taking note that the ACA has also extended the projected life of the Medicare trust Fund from 2016 (as was reckoned prior to 2010) to 2028 (as it is reckoned today), and as of next year the Part D Donut hole will be closed because of the ACA.

These cuts being proposed to the bundled dialysis rate was part of the Fiscal cliff deal in January. The savings that come from the duts are being spent on deficit reduction not on anyone's healthcare. Everything that happens in this world is not because of Obamacare and we aren't in much of a mess. Or at least I would say the mess is less than it has as been at any other time this century. Medicare has never been in better shape.

Dialysis has it's own problems. Problems with roots that go back to the seventies and the inception of the ESRD benefit. This particular cut, cuts care to what was being paid in 2011. Was care so terrible then? Was aaccess limited? The mistake the providers made in 2012 was to not bundle private payers when the Medicare bundle came in, most will make up the cuts by increasing charges to private payers. And the sky will not fall.