Never Saw that Coming…

Yeah, right… 🙂

Thirty-four percent fewer healthcare providers are available to Obamacare patients — backing up “anecdotal reports that exchange networks contain fewer providers than traditional commercial plans,” a new report says.

According to an analysis by Avalere Health, the Washington-based advisory firm, the Obamacare networks offer an average of 42 percent fewer heart and cancer doctors — along with 24 percent fewer hospitals and 32 percent fewer primary care physicians for patients to choose from.

Less Choice, Higher Premiums. 🙂

Preliminary 2016 premiums for benchmark silver plans in exchanges grew by 4.4 percent in major metropolitan areas in 11 states, including the District of Columbia, according to analysis by the nonpartisan Kaiser Family Foundation. While this is much lower than the numbers being tossed around the Senate floor, it’s a sharper increase than last year, which saw premiums climb by 2 percent nationwide.

An Avalere Health analysis released this month found similar results. Silver plans on exchanges (the plans of choice for more than two-thirds of enrollees) are expected to increase 5.8 percent in the eight states that Avalere examined.

In a House Ways and Means subcommittee meeting Wednesday, lawmakers pointed to instances where insurers were seeking drastic increases. For example, in Maryland, two of eight options in the individual market are seeking more than a 30 percent increase, and a third option is seeking a 26.7 percent premium hike.

“Many of the proposed increases are eye-poppingly huge,” said subcommittee Chairman Peter Roskam.

“These rates are premised on the assumption that the court will side with the government. If the court signs with the challengers, all bets are off,” Levitt said. “There’s no doubt that we’d see some insurers pulling out of the market and the ones that stay would raise rates significantly next year.”

And they did. I wonder if that really why? 🙂

But most importantly, the Affordable Care Act’s restrictions on out-of-pocket costs by patients do not apply to healthcare services outside the plan’s network.

“Out-of-network care does not accrue toward out-of-pocket maximums, leaving consumers vulnerable to high costs if they seek care from a provider not included in their plan’s network,” said Elizabeth Carpenter, Avalere’s vice president. “Patients should evaluate a plan’s provider network when picking insurance on the exchange.

Overall, however, the limited choices are seen as a way of keeping patient costs down, said Dan Mendelson, the firm’s CEO.

“Plans continue to test new benefit designs in the exchange market,” he said. “Given the new requirements put in place by the ACA, network design is one way plans can drive value-based care and keep premiums low.”

Republicans and other health professionals have long charged that Obamacare has reduced healthcare coverage and choices for Americans.

“The American people are not happy on this birthday,” Sally Pipes, president and CEO of the Pacific Research Institute, told Newsmax TV as the law marked its fifth anniversary in March.

The report was based on a study of large healthcare networks in Florida, California, Texas, Georgia, and North Carolina, Avalere said. (Newsmax and more)

Forbes: June 2015

Texas Blue Cross stands out. The health plan commented in its federal government rate filings that it covered 730,833 Obamacare individuals in 2014 with premium of $2.1 billion and claims totaling $2.5 billion––for a medical loss ratio of 119%. The plan further commented that, after the “3Rs” reinsurance adjustments, they lost 17% to 20% of premium in 2014–that would be about $400 million. And, they are only asking for a 20% rate increase.

While we won’t see all of the rates in all of the states for a few months, some state regulators have begun to make the 2016 rate actions public:

• CareFirst Blue Cross of Maryland is asking for a 34% rate increase on its PPO plan and a 26.7% rate increase for its HMO. CareFirst has an 80% market share in the Obamacare exchange and only 30% of the eligible Maryland market has signed up on the exchange.

• In Oregon, where less than 35% of the eligible have signed up on the exchange, the biggest insurer with 52% of the market, Moda, has asked for a 25.6% increase. Lifewise, with a 19% market share, has asked for a 38.5% increase.

• Blue Cross Blue Shield of Tennessee, with a 165,000 members making up 70% of the Obamacare exchange is asking for a 36.3% increase. The second biggest player, Humana HUM +1.18%, is asking for a 15.8% increase. Less than 40% of the eligible exchange market signed up in Tennessee.

• Georgia is the second biggest Obamacare market for Humana, having enrolled 254,000 people out of a total market of 479,000, and Georgia “maybe its biggest misstep”. Its CEO has said about Georgia, “We can’t have one business being subsidized by another business.” Humana is asking for 2016 individual plan rate increases from 14.8% to 19.44%.

• In Iowa, with the lowest enrollment rates in the country, and where its biggest Obamacare insurer went broke last December, Wellmark Blue Cross, which only sells off the exchange, is asking for a 43% increase on its Obamacare compliant policies. Coventry, which has 47,000 Obamacare customers, is asking for an 18% increase for its on-exchange business.

• The Kansas insurance department has not made its rate increases public yet but has said that plans will increase by as much as 38%. Less than 40% of the eligible have so far enrolled.

• Pennsylvania is not encouraging with market leader Highmark asking for increases ranging from 13.5% to 39.65% and the Geisinger HMO asking for increases from 40.6% to 58.4%. Pennsylvania enrolled 50% of the potential exchange market in 2015.

So let the politicking of your health continues.

We are from the Government, we are here to Help you…  🙂

Political Cartoons by Gary Varvel

Filtered

It’s not relevant if Dictatorship and oppression is your goal…

If Liberals have to even ponder the question you know there’s trouble!

Independence Day provides all Americans with an opportunity to celebrate  the many freedoms that make our country both great and unique. Our Declaration of Independence  was breathtaking in scope and written in precise, plain, unequivocal  language. When read in townships across the Colonies, crowds listened in  hushed silence and then broke out in applause when the reading was complete. Our Founding Fathers felt no need to dilute or cloak their intentions to form a government.

As you celebrate the 4th, it might be appropriate to contrast the  straightforward language of our founders and other great American  leaders with the weasel words now emerging from Washington, and all too  frequently, from President Obama, who prefers euphemism-laden,  convoluted, pixilated flummery. 

A quick review of Obama’s speeches  reveals his most common euphemisms seem to show a pattern of deception,  obfuscation and misdirection. In President Obama’s lexicon, words have  different meanings; to decipher the message and understand what the  President is saying requires a special Washington Dictionary. Here are  some samples from President Obamas special dictionary: 

Investment is the president’s word for government spending.  When he says we need to invest more, he really means he wants to  increase spending on some special project. Obama knows that the word  investment is reassuring to most Americans and implies that at some  point in time a good investment will return a decent profit. But, no  return is envisioned with Obama’s “investments”. In fact, to Obama all  government spending is an investment.

Millionaires and Billionaires Obama often talks about the  need to increase taxes on the millionaires and billionaires. Of course,  what he really means is higher taxes on any family making more than  $250,000. Obamas math skills must be sufficient to understand that  there is a huge mathematical difference between 250,000 and a billion,  but he chooses to ignore the difference to better stoke class  resentment, all while hoping that average Americans are too stupid to  understand.

Working People is invoked to demonstrate commitment to average  Americans. Of course, what Obama really means is that he supports the  primacy of unions over other American workers.  According to Obamas  definition, the vast majority of Americans, including small business  owners, are not working people at all, regardless of how many thousands  of hours they work. In Obamas dictionary, only union members are  working people and deserving of special preferences and consideration. 

Spending Reductions in the Tax Code  means more tax increases. President Obama likes to wear the mantle of  spending cuts, but lacks the courage to call a tax increase what it  really is.

Paying Their Fair Share is the president’s phrase for wealth  redistribution. What Obama really means is that entrepreneurs and other  successful business owners are not paying high enough taxes, and that  all of the money they earn should be “contributed” to the government for  wealth redistribution to those that Obama considers worthy. Of course,  Obamas supporters, the bulk of whom do not seem to pay income tax, are,  according to this definition, already paying a fair amount of tax  (zero). It is the rest of America that is not paying their fair share.  Obama offers no criteria to what is fair or not, so that is why he  seems to think it is perfectly acceptable to require 20% of American to  pay 78% of the taxes and then criticize them for not paying their “fair  share”.

Green Jobs and Green Economy these are the jobs that President  Obama believes are more important and more valuable than any others,  even if creating a “green job” that pays $40,000 actually costs the  taxpayers $300,000 to create. Moreover, if creating one magical “green  job” results in the loss of 10 or more jobs that were dependent upon  cheap, reliable power, that too is of no consequence. A green job has  magical properties that do not conform to economic principles.

Unprecedented. Perhaps Obama’s favorite word, which he uses to  describe most of his actions. This word has no meaning to Obama, but  reflects his belief that he is so special that everything he does or  says must be admired. Obama is so, fundamentally, unaware of American  history that he thinks that the challenges and issues that he faces are  unique. (Move over George Washington!)

Unfortunately, our President seems unaware that the dangers of repeated,  euphemistic bastardization of the English language erodes his  credibility. Increasingly, Americans know they cannot trust what Obama  says. 

And so, President Obama is likely to tell Americans:

“In response to an unprecedented challenge we must provide more aid to working people by increasing investments in green jobs. We will implement savings in the tax code that will only impact millionaires and billionaires who are not currently paying their fair share“.     

And yet what Obama really means is:

My policies have failed. The stimulus was a disaster, and the country is  broke. We need more money to keep the Unions, and my special  constituents who pay very little or no taxes, happy, so I need everyone  else to pay more, otherwise I won’t get re-elected. 

Americans have a reputation for being straightforward and for plain  speaking and are only slowly becoming aware of the vague, expansive, and  misleading words in President Obama’s unique dictionary.  Our Founding  Fathers said: “we hold these truths to be self-evident”.  With Obama,  none of his words are self-evident.(Lurita Doan)

Except the deceit and dishonesty and complete disingenuousness that is not only self-evident, it’s self-serving.

Political Cartoons by Glenn Foden

Behind the Times

The Obama administration, headed up by a liberal dogma that has been trying to create it’s socialist utopia since Woodrow Wilson is not going to give up it’s sole dream of controlling everyone and everything ‘for their own good’ and “fairness”.

But it is curious that the Europeans who already went down this road in large part are starting to go back in our former direction.

It’s kind of like driving towards a massive accident and seeing people coming back from it bloodied and hurt, but you decide it can’t happen to me so you keep going anyhow.

That’s National Health Care now nearly 5 months after it was crammed down the throats of the American public in the single most partisan vote in memory.

Damn The Torpedoes! Full Steam ahead!

LONDON — Perhaps the only consistent thing about Britain’s socialized health care system is that it is in a perpetual state of flux, its structure constantly changing as governments search for the elusive formula that will deliver the best care for the cheapest price while costs and demand escalate.

Even as the new coalition government said it would make enormous cuts in the public sector, it initially promised to leave health care alone. But in one of its most surprising moves so far, it has done the opposite, proposing what would be the most radical reorganization of the National Health Service, as the system is called, since its inception in 1948.

Practical details of the plan are still sketchy. But its aim is clear: to shift control of England’s $160 billion annual health budget from a centralized bureaucracy to doctors at the local level. Under the plan, $100 billion to $125 billion a year would be meted out to general practitioners, who would use the money to buy services from hospitals and other health care providers.

The plan would also shrink the bureaucratic apparatus, in keeping with the government’s goal to effect $30 billion in “efficiency savings” in the health budget by 2014 and to reduce administrative costs by 45 percent. Tens of thousands of jobs would be lost because layers of bureaucracy would be abolished. (London Times)

So like the G20 Summit where “austerity” was the watchword by the Europeans and Obama stood there stamping his foot demanding people spend even more.

Not only are the Democrats and their dream out of date they are out of step even with the people they still want to dance with.

They wanted to be them.

Now it’s too late.

But that won’t stop them, of course.

Zealots who have been waiting 80 years+ for this will not be so easily deterred.

But the effects of this are beginning.

MANDEVILLE, La.—Mark Baumann, a 44-year-old uninsured diabetic, sees in the Obama administration’s health-care law a future with stable coverage to pay for his insulin shots and blood tests.

That’s likely to come indirectly at the expense of his mother’s generous health-care plan.

Humana Inc., Mary Baumann’s insurer, intends to pare her “Medicare Advantage” plan to make up for the smaller government payments it will soon receive as a result of the new law, leaving her with higher costs or fewer services. On the table are beefed-up co-payments and premiums, as well as the loss of perks such as her free membership at a health club.

Most Americans know the overhaul is designed to cover the uninsured, a decades-long goal of Democrats. But it also represents a change in how the government spreads its social safety net underneath Americans. Already, it’s creating tensions that are a harbinger of debates to come.

Since the creation of Social Security and Medicare, younger workers have funded programs for the elderly. It’s a compact in which workers paid for retirees with the understanding that they’d be looked after by the generation behind them.

The health overhaul diverges by tapping a program for the elderly to help provide insurance to 32 million Americans of younger generations. Nearly half the funding for the law is supposed to come from paying lower fees to hospitals, insurers and other health-care providers that participate in Medicare, the federal insurance program for Americans age 65 and older, as well as younger disabled people.

The 44 million Americans on Medicare won’t see changes to their guaranteed benefits under the law. But of those, 11.3 million on Medicare Advantage plans, a public-private hybrid of the type used by Ms. Baumann, who is 79, are likely to begin seeing extra benefits go away as soon as next year. Medicare Advantage cuts are slated to pay for 15% of the health-care law’s tab.

The trims mark the leading edge of a spending shift that could broaden as lawmakers grapple with a deficit expected to hit $1.47 trillion this year. Left unchanged, Medicare and Social Security will consume half of all federal spending by 2035, up from about one third today, according to the Congressional Budget Office.

And remember, by recess appointment an NHS-loving administrator is the head of Medicare.

And if, as predicted by many, including me, that private health insurance is driven completely to extinction then you’ll have health cost also in that GDP soup and with already half the people in this country not paying any taxes it does very bleak.

But at least it’s “fair”. 🙂

And, of course, the solution that will be published after the election by Obama’s “deficit commission” is a forgone conclusion, The VAT TAX and other taxes.

Then came Financial “reform” where one of the biggest cause of the problem, just like in Health Care (Trial Lawyers anyone?), were ignored because of partisan politics — Fannie Mae and Freddie Mac.

And then with the massive tax increases, even on the poor, slated for Jan 1,2011 you have the perfect storm.

But the Democrats will not change course. You know that. I know now that. They know that.

Damn the Torpedoes! Full Steam ahead!

They don’t care how many European train wrecks occur.

It’s their time and they will do it anyhow!

For “fairness” and “equality” and “social justice”! 🙂

Meanwhile, the rationing the Democrats say will not happen here are happening in their beloved NHS, acocrding to the  liberal Sun Telegraph newspaper:

Some of the most common operations — including hip replacements and cataract surgery — will be rationed as part of attempts to save billions of pounds, despite government promises that front-line services would be protected.

Patients’ groups have described the measures as “astonishingly brutal”.

An investigation by The Sunday Telegraph has uncovered widespread cuts planned across the NHS, many of which have already been agreed by senior health service officials. They include:

* Restrictions on some of the most basic and common operations, including hip and knee replacements, cataract surgery and orthodontic procedures.

* Plans to cut hundreds of thousands of pounds from budgets for the terminally ill, with dying cancer patients to be told to manage their own symptoms if their condition worsens at evenings or weekends.

* The closure of nursing homes for the elderly.

* A reduction in acute hospital beds, including those for the mentally ill, with targets to discourage GPs from sending patients to hospitals and reduce the number of people using accident and emergency departments.

* Tighter rationing of NHS funding for IVF treatment, and for surgery for obesity.

* Thousands of job losses at NHS hospitals, including 500 staff to go at a trust where cancer patients recently suffered delays in diagnosis and treatment because of staff shortages.

* Cost-cutting programmes in paediatric and maternity services, care of the elderly and services that provide respite breaks to long-term carers.

And now back to US…

We badly need to, over time and very gradually, reallocate resources from the elderly to younger families and their children,” said Isabel Sawhill, senior fellow at the liberal-leaning Brookings Institution.

“I’m sure that some of those additional benefits have been nice,” Nancy-Ann DeParle, who runs the White House’s Office of Health Reform, says of Medicare Advantage plans. “But I think what we have to look at here is what’s fair and what’s important for the strength of the Medicare program long term.”

Sun Telegraph: The Government has promised to protect the overall budget of the NHS, which will continue to receive above-inflation increases, but said the service must make “efficiency savings” of up to £20 billion by 2014, which would be diverted back to the front line.

Brother from another socialist mother? 🙂

Dr Peter Carter, the head of the Royal College of Nursing, said he was “incredibly worried” about the disclosures.

Dr Carter said: “Andrew Lansley keeps saying that the Government will protect the front line from cuts – but the reality appears to be quite the opposite. We are seeing trusts making job cuts even when they have already admitted to being short staffed.

Trust boards are the ones who make the health care calls now.

Much like the National Coordinator of Health Information Technology  that was in the Stimulus Bill.

And we won’t even go over the Food Police again this time.

Sun Telegraph: On Thursday, the board of Sutton and Merton primary care trust (PCT) in London agreed more than £50 million of savings in two years. The plan included more than £400,000 to be saved by “reducing length of stay” in hospital for the terminally ill.

As well as sending more patients home to die, the paper said the savings would be made by admitting fewer terminally ill cancer patients to hospital because they were struggling to cope with symptoms such as pain. Instead, more patients would be given advice on “self management” of their condition.

Bill Gillespie, the trust’s chief executive, said patients would stay at home, or be discharged from hospital only if that was their choice, and would be given support in their homes.

The president told the {New York Times in 2008}magazine that the chronically ill and elderly represent 80 percent of American healthcare costs, and said, “(T)here is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place.”

“And that’s part of why you have to have some independent group that can give you guidance,” he added.

That “independent group” turns out to be the government, now run by him. Funny how that worked out. 🙂

But the president questioned whether his now-deceased grandmother should have received her hip replacement while suffering a terminal illness.

Recounting the dilemma, Obama said, “(T)he question was, does she get hip replacement surgery even though she was fragile enough that they weren’t sure how long she would last (or) whether she could get through the surgery.”

“I think families all across America are going through decisions like that all the time,” Obama said.

This was not the first time the president had used his grandmother to illustrate his point on health care. In an April 2008 interview with The New York Times Magazine, Obama suggested much of the cost of health care in America comes from the elderly and those with chronic illness.

“That’s where you get into some very difficult moral issues,” Obama said – specifically considering whether “in the aggregate, society making those decisions to give my grandmother, or everybody else’s aging grandparents or parents, a hip replacement when they’re terminally ill is a sustainable model, is a very difficult question.”

This was BEFORE he became president mind you. But the Journo-List inspired Media was not going to let you dwell on it.

2009 Newsweek article on the “The Five biggest Lies in the Health Care Debate”:

What we can say is that there is de facto rationing under the current system, by both Medicare and private insurance. No plan covers everything, but coverage decisions “are now made in opaque ways by insurance companies,” says Dr. Donald Berwick of the Institute for Healthcare Improvement.

Donald Berwick? Where have I heard that name recently.

Oh yeah, he’s the guy who was appointed by Obama as Head of Medicare and Medicaid without Senate approval by a recess appointment and he’s an admitted lover of the NHS.

Gee, that couldn’t be a coincidence now could it? 🙂

The {Health Care} law will spend $938 billion over a decade, mostly to expand coverage to lower-income Americans. To finance that, there will be $455 billion coming from cuts in government payments to health-care providers that serve patients on Medicare and two other federal programs. The hardest hit—to the tune of $136 billion—will be private insurance companies that run Medicare Advantage plans.

The payment cuts to Medicare Advantage begin in 2012.

“With the president being younger, my biggest concern is that we don’t mean anything,” said Sandy Reed, a 61-year-old who has a Medicare Advantage plan because she qualifies as disabled. “We’re disposable.”

‘Death Panels’ indeed…

And it has come out on the Daily Caller in their further investigation of the Journo-List scandal that the Mainstream media were in full bore mode of destruction when Gov. Palin was announced as McCain’s running mate.

All that savagery was plotted out.

So what you do when your opponent speaks the truth to power, destroy her.

So that’s why the ‘death panels’ comment was so widely and uniformly from left mocked, dismissed and discredited.

To this very day she is the most hated woman in America by the Left.

Most of the rest will be funded by new levies, including taxes on health-care companies, a higher Medicare payroll tax for wealthy Americans and a tax on high-value insurance plans. Critics of the law say its total cost is likely higher than advertised.

But it’s not like the Democrats actually care.

Their one and only shot at injecting their socialist cancer, that they’ve been waiting since their grandparents time in many cases, is all that matters.

Those who don’t learn from history are doomed to repeat it.

But at least it’s “fair”. 🙂