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United States Health Care Reform: Progress to Date and Next Steps

jama.jamanetwork.com

21–30 of 80 posts

Re: United States Health Care Reform: Progress to Date and Next Steps

#21
post #4

Sorry if OT but ... Anyone get a snicker out of putting JD by his name? "Barack Obama ... don't know the cat. Oh, he has a law degree? Hm, okay, I guess his opinion might matter then." It would be like seeing "Guido van Rossum, Dropbox Employee".

Funny how you adjusted your example to make it look ridiculous.

"Barack Obama, President of the United States of America" == "Guido van Rossum, Python's BDFL"

"Barack Obama, JD" == "Guido van Rossum, Software Engineer"

Which, I'm cool with.

Re: United States Health Care Reform: Progress to Date and Next Steps

#22

The worst piece of legislation ever to be passed in the United States of America. I am a physician. My personal health insurance rate for a family of 5 increased immediately by 66% (since I have an individual policy). I have resorted to using the Medishare healthcare cost sharing plan as traditional insurance became unaffordable. I have seen many patients lose their doctors because the doctors were not contracted wit…

I'm all for reasonable hyperbole, but you're doing your argument a disservice by claiming it's the worst piece of legislation ever passed in the United States. Just to start, we can all agree that the Fugitive Slave Act of 1850 was a worse piece of legislation that the PPACA.

Aside from that, do you have any suggestions for how to improve it? It sounds like you have a useful perspective.

Re: United States Health Care Reform: Progress to Date and Next Steps

#23

The worst piece of legislation ever to be passed in the United States of America. I am a physician. My personal health insurance rate for a family of 5 increased immediately by 66% (since I have an individual policy). I have resorted to using the Medishare healthcare cost sharing plan as traditional insurance became unaffordable. I have seen many patients lose their doctors because the doctors were not contracted wit…

Hey there! Long term Obama supporter (no longer) and healthcare consumer in the US. I agree with you mostly. Monthly premiums for my wife and I are ~$700/month (both healthy, early 30s, Blue Cross Blue Shield). When our daughter arrives shortly, that will increase to $1000/month. That's a high deductible plan where we're out of pocket for everything for the first $6000/year. I work remotely, so we're looking at movin…

Several large insurers are planning to withdraw from the marketplaces because they are losing money on the plans they offer there.

Re: United States Health Care Reform: Progress to Date and Next Steps

#24

The worst piece of legislation ever to be passed in the United States of America. I am a physician. My personal health insurance rate for a family of 5 increased immediately by 66% (since I have an individual policy). I have resorted to using the Medishare healthcare cost sharing plan as traditional insurance became unaffordable. I have seen many patients lose their doctors because the doctors were not contracted wit…

I completely agree with you about how terrible obamacare has been. I've been screwed by it in every way imagineable. so much so that, they've prevented me from being able to file my 2015 taxes and will most likely have to pay late fees and penalties because of their incompetence. At one point, they had my family of 4 in 2 separate groups and assigned 6 separate insurance plans (true story).

however, I was always under the impression that Electronic Health Records would result in a meaningful improvement care and record keeping. Can you elaborate on what problems will come from this?

Re: United States Health Care Reform: Progress to Date and Next Steps

#25

Earlier quoted context omitted.

Hey there! Long term Obama supporter (no longer) and healthcare consumer in the US. I agree with you mostly. Monthly premiums for my wife and I are ~$700/month (both healthy, early 30s, Blue Cross Blue Shield). When our daughter arrives shortly, that will increase to $1000/month. That's a high deductible plan where we're out of pocket for everything for the first $6000/year. I work remotely, so we're looking at movin…

Several large insurers are planning to withdraw from the marketplaces because they are losing money on the plans they offer there.

You're correct. They are losing money, and they are withdrawing from those markets in question.

Its important to note that the backstop payments those insurers were to receive from the federal government are being tied up by Congress, to stick a wrench in the ACA.

http://www.thefiscaltimes.com/2015/12/17/Congress-Weakens-Ob...

The elephant in the room is: How do we spend less on healthcare for everyone when so many people have vested interests in the status quo? Change must come from the outside, and must be applied with force.

Re: United States Health Care Reform: Progress to Date and Next Steps

#26

Earlier quoted context omitted.

Several large insurers are planning to withdraw from the marketplaces because they are losing money on the plans they offer there.

You're correct. They are losing money, and they are withdrawing from those markets in question. Its important to note that the backstop payments those insurers were to receive from the federal government are being tied up by Congress, to stick a wrench in the ACA. http://www.thefiscaltimes.com/2015/12/17/Congress-Weakens-Ob... The elephant in the room is: How do we spend less on healthcare for everyone when so many p…

I guess. Congress preventing Fed Gov from reimbursing insurance companies for their huge losses isn't really evidence that those companies are doing well though.

Re: United States Health Care Reform: Progress to Date and Next Steps

#27

The worst piece of legislation ever to be passed in the United States of America. I am a physician. My personal health insurance rate for a family of 5 increased immediately by 66% (since I have an individual policy). I have resorted to using the Medishare healthcare cost sharing plan as traditional insurance became unaffordable. I have seen many patients lose their doctors because the doctors were not contracted wit…

> The worst piece of legislation ever to be passed in the United States of America.

I don't think it competes with, just for two obvious, off-the-top-of-my-head examples, either the Indian Removal Act or the Alien and Sedition Acts.

> I have seen many patients lose their doctors because the doctors were not contracted with Covered California.

Covered California is the California state health insurance exchange, it does not contract with doctors at all. The individual health insurance plans offered by private companies on the exchange contract with doctors.

> The reason the doctors do not contract with Covered California is because at face value the plan appears to be just like the usual say PPO plan.

Covered California is not a plan, PPO or otherwise. It is the exchange on which plans are offered. A number of different plans, PPO and otherwise, are offered on the exchange.

> The problem with the government effectively taking over Health IT by way of forcing Electronic Health Records to abide by bureaucrats definitions for "meaningful use" is a completely different disaster that has resulted in marked decreases in productivity and worse care for patients.

"Meaningful use" of EHRs is voluntary; the government involvement is providing incentives for meaningful use within the Medicare and Medicaid programs, not penalties outside those programs.

(EDIT: clarification of the meaningful use comments)

Re: United States Health Care Reform: Progress to Date and Next Steps

#28
post #10

Earlier quoted context omitted.

Unbelievable that they publish a non-Doctor with so many potential conflicts of interest that he has to turn in a separate PDF http://jama.jamanetwork.com/article.aspx?articleid=2533698#A...

Where are the conflicts of interest that would affect this article? The linked form is his standard form as a government official, and lists various holdings. Actually, looking through it, his seems much more mundane than I expected—a 403(b) from when he was a professor, 529 accounts for his kids... The most interesting thing I saw was book royalties.

I was just being facetious. Usually financial disclosures are a couple of lines. President Obama, being the president and having to fill those forms out every year, just sent them his most recent filing (past years are linked from this blog post https://www.whitehouse.gov/blog/2016/05/16/president-and-vic...)

Re: United States Health Care Reform: Progress to Date and Next Steps

#29
post #20

The worst piece of legislation ever to be passed in the United States of America. I am a physician. My personal health insurance rate for a family of 5 increased immediately by 66% (since I have an individual policy). I have resorted to using the Medishare healthcare cost sharing plan as traditional insurance became unaffordable. I have seen many patients lose their doctors because the doctors were not contracted wit…

ACA is the best legislation in my lifetime. It has allowed me the luxury of being able to purchase individual insurance as a cancer survivor, allowing me to spend more time with my young family instead of being chained to a 8-5 corporate job. See, I can anecdote too.

I think this is the real win here. Like most legislation ACA is a complex combination of good and pad parts, but the fact that people with pre-existing conditions or terminal illnesses can still get health insurance for treatment is a huge step forward for our society as a whole.

Like the report said, there's still progress to be made.

Re: United States Health Care Reform: Progress to Date and Next Steps

#30
He published a single author paper even though he acknowledges in the end "I thank Matthew Fiedler, PhD, and Jeanne Lambrew, PhD, who assisted with planning, writing, and data analysis". In my field, those people probably would have deserved a place on the authors list ;)
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