Posted on 03/14/2014 5:12:40 PM PDT by Oldeconomybuyer
The Obama administration is requiring health plans in Obamacare insurance marketplaces to include a more robust offering of care providers in 2015 after some early backlash over limited networks in the health care law's first year.
Health plans selling on the federal marketplaces in 2015 must include 30 percent of area "essential community providers," which are usually health centers and other hospitals serving mostly low-income patients. That's up from a 20 percent requirement in 2014, the first year of expanded overage under the health care law.
The federal Centers for Medicare and Medicaid Services, which oversees the marketplaces, will also take a much more active role in reviewing health plan networks. CMS, which outlined the new standards in a Friday night letter to insurers, will evaluate whether the plans include enough access to hospitals, primary care doctors, mental health providers and oncologists. The updated standards came after a Friday interview in which President Barack Obama acknowledged that pressure to keep down costs could mean consumers may not have access to their choice of doctor.
(Excerpt) Read more at washingtonpost.com ...
WAY OVER DUE.
The administration is acting like a pack of rabid weasels, doing anything they can to make the bad things stop.
Instead of making stuff up every week, I think they should make stuff up every day.
That little detail is what amazes me most. What we have here is a mass case of category error being committed by freepers who have bought the “senate won’t convict” meme.
Whether the senate convicts or not is for the senate to decide. The ONLY thing that matters in a constitutional government that people on the right claim to support is that the laws as they stand are faithfully executed.
When a President ignores a lay and acts to circumvent it, that is a “High crime/misdemeanor”. Freepers not believing this should go ignore or violate a law in front of a cop and report back with the result of violating said law. And yes it is the same thing. A law has enforcement mechanisms. If you punch a cop, the law calls for your arrest and trial. If you violate the constitution while President, the law says you are to be impeached.
People should note the law does not say, “Impeached only with guarantee of conviction”, Impeach only id President is not black”, or “Impeach only if no danger is presented electorally to party doing the impeaching”.
Now to the people pushing the ‘real world’ and ‘practicality’ crap, you’re doing exactly what got us into this mess. If you follow the law as written, those are not considerations. So pick a side. The law or your feelings.
I don’t disagree IF we were only talking law. But we aren’t only talking law, are we? We are talking the law AND politics.
The political wisdom that told us Obama and his suck ass Death Panel Law would destroy itself seems to be accurate...the question is, in my opinion, HOW to capitalize on that truth?
But in a purely legal sense, I think you are right on.
But that is my point with category error. Politics is not considered in the law for a reason. We got to where we are exactly BECAUSE politics was made a consideration. Because of politics, we say the things we say and make the excuses for why it’s bad/wrong/impossible/whatever...when the founders wrote the law as they did to EXCLUDE personal politics...specifically so we would not find ourselves in the situation we have created.
If we believe in constitutional governance, then by definition we have to govern Constitutionally. Seems obvious, but that is the one thing we are NOT doing by allowing ‘lesser evils’ like election concerns and ‘senate won’t convict’ thinking to supplant it.
Again, to be clear, we have a government that will not govern constitutionally -because- we accept them making the same excuses we do. If we STOP making excuses for following the law as written, and instead enforce the laws as written we will return to constitutional governance. And that means electing principled people who will enforce the laws in the constitution and holding those already elected to their oath of office.
Might take a while so we best get ta’ skippin.
The airlines could offer MRI trips for less including a free weekend vacation stay.
I agree. But, it does show us HOW MANY nut-less, ball-less politicians we have in WASH D.C.
No one does anything to rectify the situation or retaliate because NO ONE has the GUTS to hold ANYONE responsible.
"The dogs BARK.. but the CARAVAN moves on."
Why not make it 100%?
Ex USAF buddy works for a "non" profit hospital chain. Trust me they are not losing any money. They also make a hefty "profit"
We have those. They’re called Community Clinics, and while there’s some money for additional funding in Obamacare, much of the money they’ve wasted by trying to impose a system that attempts to accomplish with mandates a task that should have been left to the market would have been much more effectively spent on Community Clinics.
Obie’s just never been exposed to the concept that actions have consequences at any point is his special little community activist life. So the inevitable premium increases will be described as “unexpected”, and his response will be twofold:
1. Find someone to blame.
2. Issue an edict that consequences are prohibited.
Both actions will be precisely as effective as everything else he’s tried.
tELL HIM TO SCRE#W OFF!!
I don't doubt what your friend says, and I have absolutely no doubt that lots of “non-profit” hospitals (like lots of other non-profit enterprises) are making significant amounts of money. There are ‘non-profit’ universities with billions of dollars in endowment money, and non-profit hospitals that pay a significant number of hospital ‘administrators’ multi-seven figure incomes.
That said, what I wrote about MRI costs is an accurate reflection of the complexity of the system.
That is the mess that the ACA was supposed to fix. Hospitals will still be billing at outrageous rates.
With health care you really can’t comparison shop when you have a medical emergency. They can charge you any amount for any procedure.
At the rate that providers are dropping their practices, the networks will probably hit 30% of available providers solely through attrition; the ones who signed up are the ones who think they can make a go of it, so they’re more likely to hang in, while the non-signers don’t want any part of it and are more likely to hang it up over the hassle of joining the system.
Eventually the fines will increase to the point of the premium payment. Pay an outrageous premium or outrageous fine.
“That is the mess that the ACA was supposed to fix. Hospitals will still be billing at outrageous rates.”
What is happening is that competition between hospitals has diminished, as smaller hospitals are being consumed by larger hospitals and hospital corporations. Further, these large hospital systems are buying up the private practices around them - thus taking any competition from independent physician groups out of the equation.
They are, and will continue to cut ‘costs’ anywhere they can, while maintaining profit margins and administration salaries. This is a reality that will ultimately hurt patients. And, it’s not ‘competition’ as we generally envision it in our marketplace. Hospitals get paid at a higher rate than private physician groups and facilities can for the same tests. This was stipulated federally in the context of Medicare payments - and has been adopted by private insurers as well. So at baseline there isn’t fair competition.
We aren’t saving money, we are shifting payments to administrators and a growing bureaucracy, as always happens when government gets involved. As a consequence, patients as well as the caregivers in the trenches are getting the short end of the stick. Great plan..
Eventually this Clown Car administration will force the few doctors that remain to be slaves to nobamacare. They can do this by denying a license to practice to doctors if they refuse.
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