kbp

Mar 6 2014, 11:30 AM

How ironic that LTC points out the $20,000/year family plan cost for 2016...

the POTUS election year!

Also, the "Julie Boonstra Strikes Back" commercial is worth taking a minute to watch (link in LTC's post above).

Quote:

 

http://www.nytimes.com/2014/03/06/opinion/in-health-care-choice-is-overrated.html?ref=opinion&_r=1

In Health Care, Choice Is Overrated

LAST spring, a 48-year-old mother of two young girls in Colorado discovered that she had colon cancer. Her surgeon and oncologist disagreed about whether she needed chemotherapy. So a friend recommended she go to MD Anderson Cancer Center in Houston for a second opinion. Just before she booked her plane ticket, a representative from MD Anderson called, informing her that its oncologists were outside her insurance company’s network and that she should bring $10,000 for the consultation.

Many Americans can relate to this. Last year, a Kaiser survey reported that almost all individuals and families with employer-sponsored health insurance have policies that come with at least some network restrictions. These plans steer us toward certain providers and away from others.

This saves a lot of money. Insurance companies can negotiate with in-network physicians and hospitals to accept lower payments in exchange for more patients. They can include in their networks only physicians who are more efficient — who order fewer unnecessary tests, use more generic drugs and tend to keep patients healthier and out of the hospital. As a result, they can ensure that they, and their customers, get more bang for the buck.

Despite the fact that so many Americans are already in selective networks, they are nervous that the Affordable Care Act, which I helped design as an adviser to the Obama administration, will further restrict their choice of doctors or make them pay higher out-of-network charges. There was a similar backlash in the 1990s, when managed care was on the rise.

But selective networks themselves are not a problem. The problem is that not all networks are of consistently high quality.

Millions of people enroll in top-flight managed care plans like Kaiser Permanente, limiting themselves to the physicians employed by these companies. Rarely do you hear Kaiser beneficiaries complain about the tyranny of their restrictive network. Why should they, when they have first-rate providers?

As more people enter the A.C.A.’s new insurance exchanges, they will get to choose between a bronze plan with a narrow network and lower premiums and a platinum plan with a broader network and higher premiums. Inevitably, some insurance plans will offer narrow networks with poor-quality providers.

However, there are four ways that we could reassure Americans that they are getting high-quality care despite choosing a narrow network.

First, the exchanges should require that networks meet a minimum level of adequacy — meaning there are sufficient numbers of each type of practitioner in every geographic area. The National Committee for Quality Assurance, a nonprofit group, has already created network adequacy standards that could be applied.

Second, we need more transparency. Insurance companies should have to publish the measures they use to select their “high performing” or “efficient” networks. This will discourage them from looking at price alone. And consumers should be able to easily find which doctors and hospitals are included in a network. The size of a plan’s network should be as transparent as its premium.

Third, we need more reliable ways of measuring the quality of networks and the doctors and hospitals within them. The N.C.Q.A. or Consumer Reports could develop a grading system, from A to F. When comparing different plans, no one should have to rely on U.S. News and World Report’s flawed rankings or hearsay from acquaintances.

Finally, insurance companies — which desperately want to avoid repeating the managed-care backlash — should incorporate a “safety valve” for patients like the mother with colon cancer in Colorado. They should allow any enrollee who develops a serious condition like cancer to obtain a second opinion at a recognized center of excellence (like Memorial Sloan–Kettering, for cancer, or the Cleveland Clinic, for heart disease) for the price of an in-network deductible or co-payment. The companies could negotiate good prices with these centers in exchange for a large volume of referrals. Patients want to know, and ought to be assured, that they are getting the best treatment possible.

In the end, the patient with colon cancer was able to get a second opinion at the University of Colorado Cancer Center, where the specialists were in her network. They reassured her that she didn’t need chemotherapy after all. She paid nothing out of pocket. She was lucky, because she was able to see a high-quality specialist despite her plan’s restrictions. But this shouldn’t come down to luck; it should be the basic standard of care.

Ezekiel J. Emanuel is an oncologist, contributing opinion writer and the author of “Reinventing American Health Care.”

Baldo

Mar 6 2014, 01:11 PM

Obama Promises Illegals: Obamacare Sign Up Info Won't Be Used for Deportation
Admits "prosecutorial discretion" on immigration has already stretched his "administrative capacity very far."

In a joint town hall with Telemundo and Univision, President Obama made a pledge that his administration will not use Obamacare sign up data to deport illegal aliens:

"Will we hear from you a pledge, a personal promise, that the information provided in the registration process will not be used for deportation purposes in this country?"

"Absolutely," Obama said, putting his hand down for emphasis.

"It's true that the undocumented are not eligible [for Obamacare], that's how the law was written, but if you are a U.S. citizen or you have a legal presence in this country, you are eligible," he said. "And none of the information that is provided in order for you to obtain health insurance is in any way transferred to immigration services. So that's something we've been very clear about. If you live in a mixed status family, then the son who could potentially be eligible for the children's health insurance program or some other mechanism to get health insurance, he needs to be signed up. And the mother should not be fearful that in any way that's going to affect -- of course I understand the fear."

Obama blamed Congress for deportations. And he said he has already stretched his "administrative capacity very far" by taking immigration actions using "prosecutorial discretion," but that he was "very confident that was the right thing to do."

The president finished answering this question by saying, "So, for everybody out there who's in a mixed family, there is no sharing of the data from the health care plan in to immigration services. You should feel confident that if somebody in your family is eligible, you should sign them up."

The questions were asked of Obama in Spanish and translated by an onsite translator.

http://www.weeklystandard.com/blogs/obama-promises-illegals-obamacare-sign-info-wont-be-used-deportation_784228.html

Obama Promises Illegals: Obamacare Sign Up Info Won't Be Used for Deportation
http://www.youtube.com/watch?v=MWA3xlmAZSY

wingedwheel

Mar 6 2014, 05:12 PM

Baldo

Mar 6 2014, 01:11 PM

Obama Promises Illegals: Obamacare Sign Up Info Won't Be Used for Deportation
Admits "prosecutorial discretion" on immigration has already stretched his "administrative capacity very far."

In a joint town hall with Telemundo and Univision, President Obama made a pledge that his administration will not use Obamacare sign up data to deport illegal aliens:

"Will we hear from you a pledge, a personal promise, that the information provided in the registration process will not be used for deportation purposes in this country?"

"Absolutely," Obama said, putting his hand down for emphasis.

"It's true that the undocumented are not eligible [for Obamacare], that's how the law was written, but if you are a U.S. citizen or you have a legal presence in this country, you are eligible," he said. "And none of the information that is provided in order for you to obtain health insurance is in any way transferred to immigration services. So that's something we've been very clear about. If you live in a mixed status family, then the son who could potentially be eligible for the children's health insurance program or some other mechanism to get health insurance, he needs to be signed up. And the mother should not be fearful that in any way that's going to affect -- of course I understand the fear."

Obama blamed Congress for deportations. And he said he has already stretched his "administrative capacity very far" by taking immigration actions using "prosecutorial discretion," but that he was "very confident that was the right thing to do."

The president finished answering this question by saying, "So, for everybody out there who's in a mixed family, there is no sharing of the data from the health care plan in to immigration services. You should feel confident that if somebody in your family is eligible, you should sign them up."

The questions were asked of Obama in Spanish and translated by an onsite translator.

http://www.weeklystandard.com/blogs/obama-promises-illegals-obamacare-sign-info-wont-be-used-deportation_784228.html

Obama Promises Illegals: Obamacare Sign Up Info Won't Be Used for Deportation
http://www.youtube.com/watch?v=MWA3xlmAZSY

Were we not originally promised illegals wouldn't get 0bamacare?