Health insurance markets open; succes...

Health insurance markets open; success to be seen

There are 139 comments on the Yahoo! story from Oct 1, 2013, titled Health insurance markets open; success to be seen. In it, Yahoo! reports that:

Millions of Americans will be able to shop for the first time Tuesday on the insurance marketplaces that are at the heart of President Barack Obama's health care reforms, entering a world that is supposed to simplify the mysteries of health coverage but could end up making it even more confusing, at least initially.

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sheepleloveroyal ty

Pottstown, PA

#130 Oct 3, 2013
incredulous wrote:
<quoted text>Were you in the exam room with these seniors? Are you privy to their medical histories? Could they be at risk of stroke if they engage in the wrong or unsupervised exercise? Many seniors need to be supervised when they begin an exercise program. Many don't have the funds for this. Many physicians are very much in tune with the importance of exercise and how it helps with memory, fights depression, diabetes and a number of other maladies associated with the elderly. You really have no idea what went on in the exam room except that you are one of those who enjoys complaining about doctors. As I said, there are excellent, good, average, below average and bad doctors just as there are the same ratios of competency in every profession.
First, you don't know if the doctors suggested activity or not unless you are in the exam room with everyone you talk to. I would be willing to bet, this was discussed. Compliance is usually the issue in the majority of cases. Many just want a pill to do the work for them....it's a two way street. So before you jump to conclusions, you really need to think about what you are saying.
Rant Alert

Yes I have been in the room during a doctor's visit and have driven them to and from the doctors for their 2 minute visit-which I've experienced as well from a different doctor told me write down your questions or I'm done! We asked them and they say their doctor never recommended a fitness program. We offered gym memberships, classes(Y's have a lot of good senior fitness programs), private physical trainer or therapist sessions and they don't even use the doctor said I couldn't do it excuse. We beg them ask you doctor/s about somekind of program. They look at you like it's voodoo-to me that's a tell that a serious discussion or pursuit of a fitness never really took place. Yet the doctor put enough fear of god into them to take their bp meds on time and go into a panic when they run out. But when they were hospitalized for fatigue/flu the hospital with held their bp meds until it went up-3 days later.

With many seniors in the family using this doc which is now his specialty because of the age of his practice and time in the business only one bothered with anything resembling a regular fitness program over the years. This doc is old enough to be from the era where fitness or physical therapy wasn't really looked at as a tool for non athlete problems other than rehab from a physical injury. They might publically advocate fitness but what they prescribe and/or discuss with their patients in private is another story. I get the impression most docs just want to make seniors comfortable and domestically functional. This is what I've seen first hand.

I know people who had a nurse come visit their mom a couple times a month and the nurse recommended therapy-and it worked. Be she also told him if an elderly patient isn't sick enough for the hospital many doctors won't do or recommend squat.

You are right there some difference or disparity in the quality of doctors or care. And for the prices we pay, the training they get and the services they give I expect a lot more. This is just one reason I don't want to throw money at the health care industry via the ACA.

1 post removed
sheepleloveroyal ty

Pottstown, PA

#132 Oct 3, 2013
Eric Gustafson wrote:
The Insurance company does exactly what you believe the Government will do now.
Your doctor doesn't determine the treatments you receive, and the Doctor doesn't set his own reimbursements from the Insurance Company. And the Insurance company determines if you are limited in what treatments you receive and how many.
And there is no system of appeal. The Insurance industry didn't have regulations and patients were left at the mercy and discretion of the decisions of a bean counter in the Insurance company in a windowless office in the basement.
At least with Single Payer your representative in Congress has say to give you protections on your treatment and services, with the Insurance company you have zero say and right of appeal.
<quoted text>
Insurance being a optional voluntary form of payment dictates terms because you are voluntarily using their product. If a provider voluntary agrees to let a patient pay with a particular insurance company they basically entered a defacto contract with that patient and insurance company. This is where the providers really gamed the system especially in the past.

Not too many practices do it anymore because its been declared illegal but I've had to sign waivers agreeing to pay the doctor's fee in full regardless of what the insurance company reimbursed them or determined what the charge should be. The doctor's fee is not the insurance companies pre determined price. They say stuff like 'unpaid balance" or "balance due" since they can't say deductibles or co pays. People think they are signing simply to pay the bill but in reality they just agreed to over pay the bill.
Eleanor

Vernon Hills, IL

#133 Oct 4, 2013
Cat74 wrote:
Government owned Healthcare? Yes, it is socialism. That is why most people won't touch it. You can't get to it anyway. It is a mess.
The only government owned healthcare is Medicare/Medicaid.

What the government is doing for the Affordable Care Act is being PURCHASERS of insurance from private insurance on behalf of private citizens (by re-imbursing MANY for much of the cost).

Not sure what it is called when the government decides to buy (pay for) a product/service on behalf of SOME people, to the detriment of others.

The word TYRANNY comes to mind.
Eleanor

Vernon Hills, IL

#134 Oct 4, 2013
Anonymous of Indy wrote:
<quoted text>Progressive Republican President Dwight D. Eisenhower signed the law officially declaring "In God We Trust" to be the nation's official motto and this was the start to the end of the seperation of Church and State too and was not a good thing for the US either.
In God we trust
"In God we trust" was adopted as the official motto of the United States in 1956 as an alternative or replacement to the unofficial motto of E pluribus unum, adopted when the Great Seal of the United States was created and adopted in 1782.
http://en.wikipedia.org/wiki/In_God_we_trust
<LOL>

In God we Trust .... everyone else has to PAY CASH!!

<LOL>
Eric Gustafson

Virginia Beach, VA

#135 Oct 4, 2013
So, if I am following the original discussion, you interpret that the Commerce Clause makes the United States a Socialist nation because the Government has the power to regulate Commerce throughout the land?

Without the Commerce Clause there may have been created a King. The right commercial minds could collaborate and eliminate all competition in a particular market.

Before the Senator Sherman propose the Sherman Act individual states had already in place similar limitations on corporations dominating markets.
Anonymous of Indy wrote:
<quoted text>I am talking about the founding of the US & the US Constitution became our form of Government besides its the US Constitution's (Article 1, Section 8, Clause 3) Commerce Clause which is what allows the Federal Government to get involved economically in the US economy and was the bases and justificaton of the Sherman Anti-Trust Act which goes against Capitalism because Monopolies are inherit part of Capitalism and a Capitalist Society and it was the Republican's Sherman Anti-Trust Act that was used to go after John D. Rockefeller Sr.
Sherman Antitrust Act
The Sherman Antitrust Act (Sherman Act, July 2, 1890, ch. 647, 26 Stat. 209, 15 U.S.C.§§ 1–7) is a landmark federal statute on United States competition law passed by Congress in 1890. It prohibits certain business activities that federal government regulators deem to be anticompetitive, and requires the federal government to investigate and pursue trusts, companies, and organizations suspected of being in violation. It was the first federal statute to limit cartels and monopolies, and today still forms the basis for most antitrust litigation by the United States federal government. However, for the most part, politicians were unwilling to refer to and enforce this law until Theodore Roosevelt's Presidency (1901–1909) and beyond.
http://en.wikipedia.org/wiki/Sherman_Antitrus...
Eric Gustafson

Virginia Beach, VA

#136 Oct 4, 2013
Because you don't have 100% coverage and your insurance company should have consulted you before the purchase and acceptance of the premium of that plan on out of pocket expenses.

All Health Care insurance is not the same.

Some people have discount program cards they mis-interpret as Health Care insurance. The doctor's invoice makes certain you understand if the insurance company doesn't pay in full you're on the hook for the remainder.

That has a lot to do with consumers not being aware of their plans, co-pays and out of pocket expenses. Some people aren't knowledgeable with how they spend their money.
sheepleloveroyalty wrote:
<quoted text>
Insurance being a optional voluntary form of payment dictates terms because you are voluntarily using their product. If a provider voluntary agrees to let a patient pay with a particular insurance company they basically entered a defacto contract with that patient and insurance company. This is where the providers really gamed the system especially in the past.
Not too many practices do it anymore because its been declared illegal but I've had to sign waivers agreeing to pay the doctor's fee in full regardless of what the insurance company reimbursed them or determined what the charge should be. The doctor's fee is not the insurance companies pre determined price. They say stuff like 'unpaid balance" or "balance due" since they can't say deductibles or co pays. People think they are signing simply to pay the bill but in reality they just agreed to over pay the bill.

Since: Aug 11

Location hidden

#137 Oct 4, 2013
Eric Gustafson wrote:
So, if I am following the original discussion, you interpret that the Commerce Clause makes the United States a Socialist nation because the Government has the power to regulate Commerce throughout the land?
Without the Commerce Clause there may have been created a King. The right commercial minds could collaborate and eliminate all competition in a particular market.
Before the Senator Sherman propose the Sherman Act individual states had already in place similar limitations on corporations dominating markets.
<quoted text>
Exactly which is why Karl Marx Labeled the US as a Socialist Society since Socialism is the Foundation of Captialism and Communism which society will determine that path and the US was changing during Lincoln and the US Civil War which Lincoln and the Republicans preferred Communism over Captialism which Democrats preferred but that all changed with Lincoln's assassination.

An Unfinished Revolution: Karl Marx and Abraham Lincoln

The impact of the American Civil War on Karl Marx, and Karl Marx on America.

Karl Marx and Abraham Lincoln exchanged letters at the end of the Civil War. Although they were divided by far more than the Atlantic Ocean, they agreed on the cause of “free labor” and the urgent need to end slavery. In his introduction, Robin Blackburn argues that Lincoln’s response signaled the importance of the German American community and the role of the international communists in opposing European recognition of the Confederacy.

The ideals of communism, voiced through the International Working Men’s Association, attracted many thousands of supporters throughout the US, and helped spread the demand for an eight-hour day. Blackburn shows how the IWA in America—born out of the Civil War—sought to radicalize Lincoln’s unfinished revolution and to advance the rights of labor, uniting black and white, men and women, native and foreign-born. The International contributed to a profound critique of the capitalist robber barons who enriched themselves during and after the war, and it inspired an extraordinary series of strikes and class struggles in the postwar decades.

In addition to a range of key texts and letters by both Lincoln and Marx, this book includes articles from the radical New York-based journal Woodhull and Claflin’s Weekly, an extract from Thomas Fortune’s classic work on racism Black and White, Frederick Engels on the progress of US labor in the 1880s, and Lucy Parson’s speech at the founding of the Industrial Workers of the World.

http://www.versobooks.com/books/954-an-unfini...

Since: Aug 11

Location hidden

#138 Oct 4, 2013
Eleanor wrote:
<quoted text>
<LOL>
In God we Trust .... everyone else has to PAY CASH!!
<LOL>
if you read the Treaty of Tripoli Article 11 you will understand and it states that the US is not founded on the Christian Religion in anyway and really what Eisenhower and Congress did in the 1956 is really unconstitutional.

Treaty of Tripoli

Art. 11. As the Government of the United States of America is not, in any sense, founded on the Christian religion,—as it has in itself no character of enmity against the laws, religion, or tranquility, of Mussulmen [Muslims],—and as the said States never entered into any war or act of hostility against any Mahometan [Muslim] nation, it is declared by the parties that no pretext arising from religious opinions shall ever produce an interruption of the harmony existing between the two countries.

http://en.wikipedia.org/wiki/Treaty_of_Tripol...
sheepleloveroyal ty

Pottstown, PA

#139 Oct 4, 2013
Eric Gustafson wrote:
Because you don't have 100% coverage and your insurance company should have consulted you before the purchase and acceptance of the premium of that plan on out of pocket expenses.
All Health Care insurance is not the same.
Some people have discount program cards they mis-interpret as Health Care insurance. The doctor's invoice makes certain you understand if the insurance company doesn't pay in full you're on the hook for the remainder.
That has a lot to do with consumers not being aware of their plans, co-pays and out of pocket expenses. Some people aren't knowledgeable with how they spend their money.
<quoted text>
You are right that many INSURANCE plans are different but they are optional or voluntary to use/accept. But that's the point the ACA is making INSURANCE the only choice. Now the provider has no incentive to price under the price caps/limits.

I thought many insurance companies had stipulations that included if you accept their plan you had to price with in their limits. In other words even with co pays and deductables their fee couldn't go beyond a certain price. So if a practice normally charges 300 and the insurance company says you can't charge beyond 200.They could only collect a total of 200 from the patient.

“JESUS WOULD IMPEACH THE GOP!!!”

Since: May 09

Lake Success, N.Y.

#140 Oct 4, 2013
inbred Genius wrote:
Chicopee, you'll have to excuse Tony, he can't help it, he was brought up to be that way towards women and people he deems inferior to him. You should see how he treats me, and i'm not even anti Italian.
Forever clueless you are buddy told you I'm not Italian, but does that get through your thick skull?

Nope - and Catnip74 is an idiot - if it offends someone, then simply don't read what I've posted, and move on.

I at least provide links to supplement my position - you have never, in almost 5 years, provided a single link. But what have YOU provided all this time? Your disdain for;

college educated individuals;
hippies;
Starbucks;
all northerners;
People of color;
Mexicans;
Liberals;
Progressives;

The list on you goes long and deep, so stop the BS with this nonsense post.
1 post removed
Cat74

United States

#142 Oct 4, 2013
So 4 days into Government reform, and still no real crisis. Still have jobs, food, gas for the vehicles, military checks out on time. All is right with the world. They need to shut the schools. Children aren't learning anything anyway, Private schools don't get government monies.

Since: Aug 11

Location hidden

#143 Oct 4, 2013
Obama sued for 'illegal' Obamacare move

'Politics do not trump the Constitution or the rule of law'

http://www.wnd.com/2013/10/obama-sued-for-ill...

Since: Aug 11

Location hidden

#144 Oct 4, 2013
Judge rejects Obamacare-lawsuit delay

Refuses administration request to suspend case over government shutdown

http://www.wnd.com/2013/10/judge-rejects-obam...
Cat74

United States

#145 Oct 4, 2013
This is going to be so good. The Obama Government is unraveling by the day. Where is the President? Still making speeches. I want him out there front, and center for the whole world to see. So where is little Michelle? Doesn't she have some recommendations for school lunches? Las I heard more of the lunches were going into the garbage cans then into any of those little stomachs,
Chicopee

New Fairfield, CT

#146 Oct 4, 2013
sheepleloveroyalty wrote:
<quoted text>
I just heard a report today that exercise can help heart disease as much as other treatments.
http://www.reuters.com/article/2013/10/02/us-...
Doctors and medical community have been poo pooing exercise for decades. I know seniors, non disabled non impaired seniors that are given scripts and 30 dollars worth of bandanges,socks & wraps for 300 dollars(insurance accepted) for swelling in the legs/edema-poor soul their heart can't pump hard enough to move that fluid. OR could it be the loss of leg muscle tone which assists the heart in moving blood and fluids around the body. Yet I know injured people with swelling in the leg given simple things like toe raises and flexibility exercises to get rid of their swelling-no prescription anti-inflammatories or industrial size ice packs. Point being yes alternatives do work or are the practical choice. But if a patient pays 1000 a month for insurance and a doctor gets 200 dolllars a visit to 'monitor' and talk to the patient for 2 minutes why not give premium treatments.
INSURANCE of anykind can cause inflation because it's viewed as somebody else's money.
Time and bed rest...especially bed rest, will see us through most common illnesses. But few of us have the time to seek bed rest. We're too busy working full time, commuting to and from our jobs and raising children to be able to get bed rest.

In fact, we don't have time to have the common cold, the flu or those nasty stomach bugs. We further think that modern medicine should prevent us from having to endure them. So, we run to the doctor over almost any little thing, though I think insurance has contributed to this mindset. Some of really think we need to see a doctor over every little malady. We'd think differently if we had to pay the full cost.

So, we go to a doctor, many of whom prescribe OTC medicines or antibiotics, even when those antibiotics aren't called for. Some doctors hand those things out like candy. But many don't feel like we got our moneys worth unless the doctor did something.

Edema is a condition that is a little more complex, for it has many causes, some rather minor, yet others can be very serious. In some cases, and depending on the cause, exercise and movement can help to alleviate it, as will lower fluid intake and cutting out salt intake.

In other cases, exercise and movement will only stress the condition that is causing it, which can be related to heart problems, lung problems, certain maladies involving the endocrine system, diabetes, liver, pancreas and certain medications. Edema can become so severe that fluid fills the lungs and patients literally can't breath air in (congestive failure), and it can cause kidney failure because those organs can't keep up with the demand of filtering and ridding the body of so much fluid. This will also foul up the liver.

In the case of many elderly patients, it is the weakening of the ticker, sluggish blood flow due to plaque build up and hardening of the arteries, both of which are a natural condition of aging. So, in many cases, the socks, bandages and wraps are necessary, mostly to prevent stroke. It would be decided case by case if moderate exercise would help or actually worsen the condition.

Sorry. Didn't mean to go on about edema, but I understand your point. We expect medicine, gadgets and treatments in many cases that require nothing but time and a little self help.

“Hillary, thirty years of lying”

Since: Nov 08

Paris

#147 Oct 5, 2013
Your Ex wrote:
<quoted text>Colorado's working just fine.
But then, we don't go with the okie definition of internet, 2 calculators connected by a string....;)
Nice recall you all had. Hahahahahahhahha
1 post removed
Cat74

United States

#149 Oct 5, 2013
When can we see that success? Anytime soon? Obamacare is a joke. It will appeal to the same useless bunch of people looking for freebies. Won't they be surprised to see it will cost them more then they are paying now? The joke is on them!!
incredulous

Carmel, IN

#150 Oct 6, 2013
sheepleloveroyalty wrote:
<quoted text>
..ust want to make seniors comfortable and domestically functional. This is what I've seen first hand.
I know people who had a nurse come visit their mom a couple times a month and the nurse recommended therapy-and it worked. Be she also told him if an elderly patient isn't sick enough for the hospital many doctors won't do or recommend squat.
You are right there some difference or disparity in the quality of doctors or care. And for the prices we pay, the training they get and the services they give I expect a lot more. This is just one reason I don't want to throw money at the health care industry via the ACA.
Uh, speaking of rants.......you can't possibly speak for the care provided by all or most doctors. If you think medicare ....the govt. forced healthcare plan is ok, just wait when oscumma care kicks in. It will be a sht show for everyone.

You have an experience with a lousy doctor....go to another. Unfortunately, if we are talking about govt. health insurance, good luck. Seniors should be able to get their own health plans but thanks to govt. interference, it will doubtful such a thing would ever happen.

I have worked with many geriatric, internists, gp's who are fabulous with seniors.These are practices that have more private pay which allows them to treat the selected few who have crappy insurance like medicare. If doctors had mostly medicaid/medicare patients, you will get the two minute exam at best. It's the only way they can cover the overhead.

Many of the good doctors are using holistic means first and staying away from the drugs although if there is high blood pressure, they are obligated to prescribe meds or get sued. Certainly, depending on the patient's medical history, diet and exercise is almost a no brainer for discussion. I helped a family who had a dad that was diabetic, a drinker, ex smoker, triple bypass, almost deaf, and a number of other problems. Every time the guy went in to see the doctor, they told him the same thing: diet, exercise, quit drinking, take meds, etc. He didn't comply. This is not unique, it is a problem with the elderly which is why it is always best for a family member or caregiver to go along.

Some doctors are stuck in the medicaid/medicare rut and have no choice but to run them through like cattle. These are the practices that are tied mostly to the govt. which is why obamacare is NOT going to be good for anyone...not seniors, not anyone....except perhaps someone who didn't want to pay for healthcare.

While fitness is certainly ideal, in this litiguous society, the doctor can get sued for recommending a fitness plan if the patient dies from a stroke or heart failure or a fall. Many assisted living communities offer various fitness opportunities for seniors. The YMCA , churches and the like have been offering senior exercise programs. Water aquatics is big because it is kind on the joints. In some communities, businesses and churches have sponsored low cost classes for the elderly.

If you're unhappy go somewhere else or ask the doctor why he/she isn't promoting fitness. If you are in the exam room, why don't you ask? If the answer isn't what you want, leave the practice.
incredulous

Carmel, IN

#151 Oct 6, 2013
Chicopee wrote:
<quoted text>
Time and bed rest...especially bed rest, will see us through most common illnesses. But few of us have the time to seek bed rest. We're too busy working full time, commuting to and from our jobs and raising children to be able to get bed rest.
In fact, we don't have time to have the common cold, the flu or those nasty stomach bugs. We further think that modern medicine should prevent us from having to endure them. So, we run to the doctor over almost any little thing, though I think insurance has contributed to this mindset. Some of really think we need to see a doctor over every little malady. We'd think differently if we had to pay the full cost.
So, we go to a doctor, many of whom prescribe OTC medicines or antibiotics, even when those antibiotics aren't called for. Some doctors hand those things out like candy. But many don't feel like we got our moneys worth unless the doctor did something.
Edema is a condition that is a little more complex, for it has many causes, some rather minor, yet others can be very serious. In some cases, and depending on the cause, exercise and movement can help to alleviate it, as will lower fluid intake and cutting out salt intake.
In other cases, exercise and movement will only stress the condition that is causing it, which can be related to heart problems, lung problems, certain maladies involving the endocrine system, diabetes, liver, pancreas and certain medications. Edema can become so severe that fluid fills the lungs and patients literally can't breath air in (congestive failure), and it can cause kidney failure because those organs can't keep up with the demand of filtering and ridding the body of so much fluid. This will also foul up the liver.
In the case of many elderly patients, it is the weakening of the ticker, sluggish blood flow due to plaque build up and hardening of the arteries, both of which are a natural condition of aging. So, in many cases, the socks, bandages and wraps are necessary, mostly to prevent stroke. It would be decided case by case if moderate exercise would help or actually worsen the condition.
Sorry. Didn't mean to go on about edema, but I understand your point. We expect medicine, gadgets and treatments in many cases that require nothing but time and a little self help.
Times have changed which is why few doctors are writing scripts for antibiotics like candy any more. They are not indiscriminately writing scripts for pain meds or for every little ailment either. Holistic medicine is beginning to take hold and the better doctors work more collaboratively with their patients now. Socialized medicine will be problematic and it will decrease the quality of care. We will lose good doctors and nurses.

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