Tech In the Hot Seat For Oct. 1st Obamacare Launch 326
bednarz writes "In four days, the health insurance marketplaces mandated by the Obama administration's Affordable Care Act are scheduled to open for business. Yet even before the sites launch, problems are emerging. Final security testing of the federal data hub isn't slated to happen until Sept. 30, one day before the rollout. Lawmakers have raised significant concerns about the ability of the system to protect personal health records and other private information. 'Lots and lots of late nights and weekends as people get ready for go-live,' says Patrick Howard, who leads Deloitte Consulting's public sector state health care practice."
Testing Starts Day Before Go-Live (Score:3)
How many times have you guys been told by a project manager that QA testing starts on Wednesday and Go-Live is on Friday? I had a meeting once where a manager said we needed to improve our planning so we weren't constantly doing bug fixing on Thursday and Friday morning, and was willing to put in place so many new procedures, workflows, and documentation but never give more time between the start of QA and product roll-out.
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When you computerize chaos,
you get computerized chaos.
Well tell that PM that new procedures are more tim (Score:2)
Well tell that PM that new procedures are more time over all and more man power if you are getting done / ready for finale / RC QA testing just days before go live.
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Well tell that PM that new procedures are more time over all and more man power if you are getting done / ready for finale / RC QA testing just days before go live.
Oh that is cute, thinking that a PM with such ridiculous opinions can be reasoned with. Many people did try, but eventually it was only fixed when higher level management got fed up and fired the PMs in question.
But now that I work as a consultant, I find these kinds of PMs all over the place. Luckily now it is easier to just not work with these kinds of people, or at least keep racking up billable hours fixing the problems caused by their ridiculousness.
Let's be real... (Score:5, Informative)
Translation... (Score:3)
>> Lots and lots of late nights and weekends as people get ready for go-live
Translation: "We've been sandbagging hours with folks in India and newbies right out of college for months. Now we may need to actually pull some of our senior guys off sales and deep-end pissed-off customer calls and see if they remember how to program again."
One day, or ongoing? (Score:2)
The security testing mentioned, do you think they will stop just because it goes live?
Or will they have a constant, dedicated intrusion detection/prevention team?
2700 pages of legislation (Score:5, Interesting)
"You have to pass the bill to know what's in it." - Nancy Pelosi [heritage.org]
And this representative from California was re-elected. Huh. Well as Ron White says "You can't fix stupid."
If you wanted to fix the US Healthcare system by making care affordable for all and allowing people with pre-existing conditions to get insured, then it wouldn't take 2700 pages of other crap that's in the legislative package. What we didn't get was:
1) No direct influence over rising expenditures for Medical Care. You have a system which doesn't abide by market forces and hospital administrators get paid millions of dollars in salaries and benefits. [ctpost.com] When you're seriously ill, you don't usually have the time to shop around so whatever they charge you (or your insurance) is what's charged. Sure, there's negotiations and maximums that insurance companies negotiate but that drives further business through insurance companies, forcing you to deal with them.
2) There was no discussion on tort reform so thousands of ambulance chasers can still sue the doctors and hospitals when your scars comes out a little bit strange. [huffingtonpost.com] A big component to care is the necessary malpractice insurance which can cost upwards of $200,000 in some high cost states. [ehow.com] Add that to office staff, paying the Nurse, the building costs and the medical coder to bill the insurance companies correctly and you can see easily why it costs a lot to see a doctor over a routine sniffle.
3) The Drug companies were let largely intact. There are a few costs they'll have to put up with but they're still expected to rake in Billions in profits under the ACA. [forbes.com] Ask yourself why that pill you're taking is $5 and why, if it was allowed, you could get it for $.25. Sure the drug industry will claim that "these are inferior" but really it's a smokescreen.
4) The Single Payer system died. Nobody wanted to go against the big Insurance Firms and their lobbyists so we love big business in this country, so why not throw a few billion dollars their way. Well, they do now have to spend more on direct costs for Insurance which is good but allowing interstate competition and other market driven forces into the process would have been much better. That's what the exchanges are supposed to do but here we have the US Government trying to create markets rather than creating incentives with appropriate regulatory oversight for markets to flourish. Oh wait, considering the Financial Collapse, the Regulatory Process failed, so DC can't be trusted with that.
To be honest, you could have taken this 2700 pages, cut out the BS, the Pork like the "Exchanges" which Deloitte is now merrily feeding upon it seems and done away with it and had legislation that was no more than 10 pages long. Starting next year you'll hear more pigs in DC all lining up because the Feds have just blessed one industry with unlimited monopoly powers and you have to pay what they want to charge you. You have no choice, so invest in big Pharma, Hostpital chains and big medical concerns because they'll be raking it in even more.
Re:Is there really any point to this? (Yes) (Score:5, Insightful)
Yes, there is a point to this.
It may well be a long time before the Republicans have enough votes to get a repeal through the Senate. The way Demographics are headed, the Republican party of today will have to evolve significantly to stay relevant beyond this decade. And what Republicans fear about Obamacare more than anything else is that once it's implemented, people will decide that they like it, making it impossible for them to repeal it (much like Medicare and Social Security).
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if by "evolve" you mean "lean further libertarian instead of continuing to be basically the laziest Democrats ever", I agree with that part.
As far as the "decide that they like it" part, I'd say it will be more along the lines of "dislike it but fear the disappearance of what few scraps it throws them"
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Laziest democrats? Nixon was a socialist compared to todays republicans. If they leaned any further right they would fall over.
Barry Goldwater was a prophet. The religious right now owns the Republican party.
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I'm neither going to defend Nixon nor today's GOP. Neither deserves the defence. The few that deserve defence are the ones the GOP "leadership" (if you want to call it that) already hate.
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Religious right most definitely does not own the Republican party. It has moved more to the right fiscally, but it has become less religious.
Sorry, I was there (Score:3, Informative)
You must be too young to have 1st-hand experience in this bit of history.
First, Nixon was very far to the left in the Republican party (he implemented wage & price controls and created the EPA while hugging Communist China and trying to make nuclear arms deals with Russia that favored the Russians) but he got the support of the GOP base because [1] he had a history of fierce anti-communist action earlier in his career and [2] in each election cycle he cozied up to the social conservative base... not ver
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The idea of having affordable health care as opposed to being told sorry but you must just go die someplace as quietly as possible does tend to make it more than likely it will succeed. In year's time this will be old news and the GOPTP will be whining about something else, looking for another hostage to take to get their agenda passed.
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Too bad for you 0bamacare's shaping up to be anything but affordable [forbes.com]. Even that is assuming they can crunch the numbers, which isn't a valid assumption [jammiewf.com] either.
On an anecdotal note, my employer switched from a PPO plan to an HMO plan to keep its costs somewhat under control. You have the option to stay in a PPOish plan, b
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Before clicking on any health care related article in Forbes, you need to ask yourself "am I about to read something written by Avik Roy?" If so, just stop. He spews crap. Now, I have not actually clicked on your link yet, but I am about to. And we will see if my powers of prediction are at all accurate.
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It wasn't an argument, it was an observation. Feel free to disregard it if his brand of propaganda scratches your itch.
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So you think because it has "affordable" in the name, that it actually is affordable. Don't you know of the tradition of that bills in congress are given names that are exactly opposite of the bill's effects?
Re:Is there really any point to this? (Yes) (Score:4, Informative)
What do you mean by demographics? The Us population is getting older, which is traditionally more Republican demographics. Oh, you mean the huge influx of Latinos. Right, I understand now. Only, in their own countries Latinos tend to elect fairly conservative governments so once the Democrat deception regarding the immigration issue stops working, things might change.
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Lol.. That's a real funny lie I hear all the time. There is no war on women or poor people. Its a difference in approach about certain things.
Poor people should get a hand up not a hand out. It is more expensive to get a job for the poor right now then it is to stay on welfare and milk the public tit. Of course welfare is the reason why minimum wage is being paid at almost every job in larger cities with large concentrations of poor people. It is the ultimate business subsidy where they do not have to pay
Re:Is there really any point to this? (Score:5, Insightful)
Re: Is there really any point to this? (Score:3)
"Don't judge a philosophy by those who misapply it."
I'm sure that's a quote, but of whom I don't know.
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The "tea party" isn't a philosophy. It's a bunch of idiots and corporate patsies. At one point it had an underlying philosophy which, while fundamentally flawed, was at least consistent. Now it's just a bunch of reactionary Obama haters.
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Obviously you have never looked into the issues or spent any time dealing with the tea partiers.
Your description couldn't be farther from the truth. Obama has nothing to do with what they are pissed at other then him currently being the one trying to implement the stuff they are pissed at.
With the Affordable Care Act, you are now obligated to purchase something from a third party simply for being born in America or residing in it. Never before has anything like that ever happened in the US or any so called
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In hindsight letting it be called obamacare is probably the only mistake the democrats made.
The teapartiers will never carry a placard with a pro-statement next to a democrat president's name.
Obama should have named the Reagan Memorial Health Care Act, shortended to ReaganCare... now that's something tea partiers can get behind 5 years from now.
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People did try to call it Romneycare, but maybe the magic underwear made it less convincing.
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I know, but Obama approved and took ownership of the name, so it is often reported as obamacare even by neutral and pro-democrat sources now, planting the name much more firmly.
Had it been left only as the term used by the extreme right-wing mouth breathers as a term of derision it would be more likely to fade away, especially if the act itself gains popularity in the future.
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Quite now.. let him have his delusions for a bit longer. Companies are laying people off, refusing to offer spousal coverage if they work somewhere, reducing hours of employees to not be forced into providing coverage. Unions are complaining that it increases the costs of their coverage- most of which will have to pay the Cadillac health care taxes, but more importantly, this is going to be so expensive, Obama and the senate democrats worked out a deal where the government slushes money from one department
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That remains to be seen. After the law has been in place for a year or two, it may turn out to be a very good decision.
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Tea Party is in favor of reforming SS, Medicare etc. It is typical of the deceptive way liberals operate to take the placard held by some idiot to represent an entire movement. Do you also take everything every junkie wrote on a cardboard during the occupy protests as representative of the liberal policies?
Re:Is there really any point to this? (Score:5, Informative)
Of course it's not a party but that doesn't mean that it doesn't have a platform. This list is a good start seeing that most Tea Party groups endorse it and most Tea Party congressmen have signed up to it:
From http://contractfromamerica.org [contractfromamerica.org]
1. Require each bill to identify the specific provision of the Constitution that gives Congress the power to do what the bill does. (82.03%)
2. Stop costly new regulations that would increase unemployment, raise consumer prices, and weaken the nationâ(TM)s global competitiveness with virtually no impact on global temperatures. (72.20%)
3. Begin the Constitutional amendment process to require a balanced budget with a two-thirds majority needed for any tax hike. (69.69%)
4. Adopt a simple and fair single-rate tax system by scrapping the internal revenue code and replacing it with one that is no longer than 4,543 wordsâ"the length of the original Constitution. (64.90%)
5. Create a Blue Ribbon taskforce that engages in a complete audit of federal agencies and programs, assessing their Constitutionality, and identifying duplication, waste, ineffectiveness, and agencies and programs better left for the states or local authorities, or ripe for wholesale reform or elimination due to our efforts to restore limited government consistent with the US Constitutionâ(TM)s meaning. (63.37%)
6. Impose a statutory cap limiting the annual growth in total federal spending to the sum of the inflation rate plus the percentage of population growth. (56.57%)
7. Defund, repeal and replace the recently passed government-run health care with a system that actually makes health care and insurance more affordable by enabling a competitive, open, and transparent free-market health care and health insurance system that isnâ(TM)t restricted by state boundaries. (56.39%)
8. Authorize the exploration of proven energy reserves to reduce our dependence on foreign energy sources from unstable countries and reduce regulatory barriers to all other forms of energy creation, lowering prices and creating competition and jobs. (55.51%)
9. Place a moratorium on all earmarks until the budget is balanced, and then require a 2/3 majority to pass any earmark. (55.47%)
10. Permanently repeal all tax hikes, including those to the income, capital gains, and death taxes, currently scheduled to begin in 2013. (53.38%)
Only if unsuccessful (Score:5, Interesting)
The Republicans can only get rid of it if it is unsuccessful, which is why they tried so hard to get rid of it before it was enacted. Even so, repealing it would take a Republican president and simple majority in both the house and senate, which is much harder.
Luckily for the Republicans they will always be able to find some metrics that show that it was a failure. Health care premiums will continue to rise no matter what until we serious talk about rationing care, so any health care plan written by either party will always leave room for complaints.
Re:Only if unsuccessful (Score:5, Interesting)
The reason we pay so much for health care is because the recipient doesn't know and/or doesn't care how much it costs, namely because they don't pay for it. Likewise, they don't shop around. So even though it is all privatized, there isn't really much of a free market system.
Every doctor I've known (which admittedly isn't many) who has worked in a country with a nationalized health care system always talks about how it is problematic because as the end of the year approaches they have to stop caring for their patients because the money has run out. In addition to that, the pay is crap compared to here, which results in a brain drain (notice how when a foreign country needs the *best* care for a particular patient, they pay to have them shipped here for their operation. Always here. In the US resides the world's top centers for cancer, neurology, cardio, and numerous other medical disciplines, and this didn't happen by accident.)
Rationing is a horrible idea because it just reproduces that problem, in addition to putting you on long ass waiting lists for even basic operations, and making the medical field less attractive as a career choice. It's already bad enough that we have waiting lists for organ transplants (Which by the way this problem is very solvable - have a look at how Iran does transplants. With as much shit as that country gets wrong, they shockingly nailed that one better than anybody else.)
Anyways, find a way to get the patient to actually care about the cost of their medical services, and you'll see the prices go down. This socialized medicine shit is absolutely NOT without its set of problems, and price ceilings and rationing have always resulted in more problems than they solve, especially for products with inelastic demand (in the 70's we did both for gasoline, and the result was shitty. And that's just for gasoline - the notion that people want to try it with health care - basically playing with people's lives - is stupid.)
Re:Only if unsuccessful (Score:4, Insightful)
Rationing is a horrible idea because it just reproduces that problem, in addition to putting you on long ass waiting lists for even basic operations, and making the medical field less attractive as a career choice. It's already bad enough that we have waiting lists for organ transplants (Which by the way this problem is very solvable - have a look at how Iran does transplants. With as much shit as that country gets wrong, they shockingly nailed that one better than anybody else.)
That is only if you have a central body such as the government doing the rationing. You could also ration care the free market way by making poor people unable to pay for certain care. Regardless of the method, we need to understand that as we continue to make new medical breakthroughs we simply cannot spend all of our resources on keeping people alive forever.
If we finally start making breakthroughs that increase our healthy age (the age where you can work) then it isn't as much of a problem. But currently all we are doing is keeping people barely alive and spending a fortune to do it.
Re:Only if unsuccessful (Score:5, Insightful)
Anyways, find a way to get the patient to actually care about the cost of their medical services, and you'll see the prices go down.
No, you won't. In fact, you'll see prices rise.
There are two cases in which someone would seek medical help -- life-threatening situations, and non-life-threatening.
In the vast majority of life threatening situations, people aren't going to care about the cost. You've heard about the stages of grief, right? Well bargaining's a big one. Most people will do ANYTHING to get just a few more years, or months, or days. They'll throw money away on homeopathic crap and colloidal silver and psychic voodoo. People don't generally go gently into that good night, and shifting more of the cost on to them won't change that.
But in non-life-threatening situations, people will look at the price tag, and decide that they don't need to see the doctor so bad after all. And so curable illnesses go untreated, and become far more dangerous. They might be contagious and spread their illness. They might lose a limb and end up unable to work and on the public dole. They might die. That might reduce costs in the short term, but in the long run the cost to society is far higher.
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> The reason we pay so much for health care is because the recipient doesn't know and/or doesn't care how much it costs, namely because they don't pay for it. Likewise, they don't shop around.
It's hard to shop around when in some cases they can't even tell you the costs.
I had to go to the ER for a bad cut. As they were stitching me up, the finance person came in with a clipboard to have me sign things. I asked, "how much is all this going to cost?" She laughed--laughed!--and said I'd find out in a few mo
Re:Only if unsuccessful (Score:5, Interesting)
The reason we pay so much for health care [blah blah blah, untested opinions and unproven hypotheses]. ...
- basically playing with people's lives is stupid.)
Bullshit.
Here, have another vantage point to consider, fool: Say you're an individual who has a serious medical problem..... "Nice life you have there, would be terrible if something happened to it. Better pay whatever the fuck we say, or you die." Given that folks who CAN pay WILL pay whatever it takes to not die, which direction do you expect such "free market" forces to direct the price regardless of cost to provide? Even if folks DO CARE how much living costs... So, I think there should probably be SOME kind of collaborative interest on the individuals' side because alone they have likely have little leverage when it comes to health care and that whole "divide and conquer" thing.
Personally, I'm not an absolutist. I'm a scientist. I think we should try a few systems out, maybe a few hybrid ones, in various smaller test areas. Gather some evidence as to what seems to work, and roll forward making examinations and modifications as we go along. However, governments and politicians and their moronic divisionist supporters are all NOT scientists and IRRESPONSIBLY roll out huge changes to entire countries without any fucking evidence at all.
So, when it comes to this sort of thing: Any change is at least an opportunity to SEE WHAT WORKS. Unlike you morons I don't have preconceived notions about what's best. I wait for time to tell. Sadly you all want to take the slowest and most dangerous route to country-wide or world-wide possible harm or success in every fucking debate.
TL;DR: Fuck all of you morons.
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Personally, I'm not an absolutist. I'm a scientist. I think we should try a few systems out, maybe a few hybrid ones, in various smaller test areas. Gather some evidence as to what seems to work, and roll forward making examinations and modifications as we go along.
The rest of the world did you research for you. As it turns out, every other system of paying for health care works more efficiently than the pre-Obamacare U.S. system and 36 of those systems deliver better quality of care.
Pick any. You can't lose.
Re:Only if unsuccessful (Score:5, Interesting)
The reason we pay so much for health care is because the recipient doesn't know and/or doesn't care how much it costs, namely because they don't pay for it. Likewise, they don't shop around. So even though it is all privatized, there isn't really much of a free market system.
That's not true. There are countries with government-run insurance, like Canada and Germany, and government-run socialized medicine, like the UK, where patients don't know how much it costs, or care (except to the degree that a good citizen doesn't like to see tax money wasted), and they spend roughly half what we do.
Most of the difference is in the insurance system. For every $1 you pay in health insurance premiums, 15 cents of that right off the top goes to the insurance company (look up a health insurance company financial statement under "loss ratio"), and for every 85 cents that your doctor gets, another 15 cents goes for the administrative costs of dealing with the insurance companies. Another difference is in our use of expensive medicines (erythropoetin for kidney dialysis was Medicare's single most expensive drug, and the dialysis centers, which made a profit on it, were overusing it to the point that they were actually killing people with it), and high-tech equipment (such as CAT scans, which are so overused that they're causing a significant number of radiation-associated cancers). Specialists make around $300,000 a year. Malpractice is about 2% of the health care dollar, so there's no big savings there.
Patient choice has almost nothing to do with it. The doctor has to agree on a treatment (and the more expensive procedures they do, the more money they make). A doctor tells you, "You have to do this now or you can die." What choice do you have?
Here's an example of an unusually well-informed patient, a physician assistant himself, who got appendicitis, did his research, and wanted to be treated with antibiotics, rather than surgery (which can actually be safer):
http://www.kevinmd.com/blog/2013/09/77-percent-success-good-guy-insurance.html [kevinmd.com]
A 77 percent success rate is good enough for a guy without insurance
Andrew T. Gray, PA-C
September 26, 2013
How many patients know enough to resist a doctor's sales pitch: "You have to do this immediately or you could die"?
Every doctor I've known (which admittedly isn't many) who has worked in a country with a nationalized health care system always talks about how it is problematic because as the end of the year approaches they have to stop caring for their patients because the money has run out. In addition to that, the pay is crap compared to here, which results in a brain drain (notice how when a foreign country needs the *best* care for a particular patient, they pay to have them shipped here for their operation. Always here. In the US resides the world's top centers for cancer, neurology, cardio, and numerous other medical disciplines, and this didn't happen by accident.)
Well, I've talked to a few doctors from the UK, Canada, Germany, Sweden, and a few other countries, and I've read the studies that compare their outcomes for standard indicators like infant mortality and life expectancy, and for common procedures like cancer and heart disease. Basically the outcomes in all the developed countries are about the same. I wouldn't disparage American medical research, but if you read the New England Journal of Medicine every week, as I do, you'll see that some of the most important studies are also done in Europe, Australia, and elsewhere, The American studies are often done to get an expensive new drug approved, but the foreign studies are often done to test whether a common treatment actually works (for example this week an Australian doctor wrote an article about whether IV fluids do more harm than good). We didn't discover the AIDS virus; Luc Montagnier of France did. We didn't discover s
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I would tell you that it doesn't matter if a Republican president gets elected, he still has to implement the laws that Congress has passed.
Although if the current presidency is any indication, I guess that's no longer true.
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What are you on about?
That statement has been true at least since Andrew Jackson defied the Supreme Court.
Re: Is there really any point to this? (Score:2)
I wept bitter tears at your post.
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then some should do a sick kids sick out on the ca (Score:2)
and then then some should do a sick kids sick out on the capitol steps and tell the kids don't get and in jail under cruel and unusual punishment and others laws they must give you medical care or you can just go to the ER.
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Assuming a Republican could even get elected after the party trashes the economy (yet again), it wouldn't be easy to unwind ACA. For one thing, they have time to fix the technical glitches. They'd have a shot at fixing the programmatic glitches if the Republicans would stop acting like spoiled brats. Every entitlement has always required programmatic fixes, this will be no different. And those fixes would happen were the Republicans not hell bent on screwing Obama. I don't recall the Republicans being so wo
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Actually, I long ago got the impression that the sole reason for the existence of the post-2008 Republican party is to ensure that every thing Obama ever did is completely and permanently erased forever as though they had never been.
Obama certainly has a lot to answer for and no few things that richly deserve erasing, but they started even before he took the oath of office.
Politics [Re:Is there really any point to this?] (Score:3)
I was under the impression that "Obamacare" is one of the first things that's going to be axed as soon as the USA gets its next Republican president... which is inevitable at some point in the future, given a two-party system.
Not at all clear-- the president can neither pass nor repeal legislation. Even a Republican president would have to work through Congress to do so, and unless both chambers are also Republican, this may be difficult.
In any case, though, the reason that Republicans are trying to repeal the Affordable Care Act so urgently is that they believe that once it is in place, people will like it so much that it will be impossible to repeal. So if this is true, then no.
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The new resident cant do it alone, it will require a cooperative congress.
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By the time the next Republican gets elected President "Obamacare" will be so embedded it will be practically impossible to repeal it, just like it's politically impossible to axe Medicare. That's why they're so desperate to stop it from really getting started now.
Re:Is there really any point to this? (Score:4, Informative)
Um, no, it's not fully hands off. The Medicare act is Federal legislation that sets certain criteria for how the Provinces run their healthcare systems. The Provinces are given some latitude, but key aspects must be respected by the Provinces.
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The healthcare act sets out "how" the system should be. And what min. level of care should be. Provinces decide "how" to do it. In the US, the ACA determines "how" states should do it, and even "how" to implement it. See the difference now?
Re:Is there really any point to this? (Score:5, Informative)
Yes, the Provinces decide how, but the parameters are not all that wide, and because the system is in considerable aspects Federally proscribed, you don't see that much variance between Provinces. And, in fact, the Feds have on occasion flexed their muscle and have sent warning shots to provinces who have traveled too far off the line.
Here's the facts. I am a resident of British Columbia. I pay about $127 per month in Medical Services Premiums. For that I won't be given a bill at any hospital or any doctor if I have a medical issue. If I need a scan or some other diagnostic test, I will not be billed. Furthermore, if I end up needing healthcare in Prince Edward Island, I will still be protected.
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Here's the facts. I am a resident of British Columbia. I pay about $127 per month in Medical Services Premiums. For that I won't be given a bill at any hospital or any doctor if I have a medical issue. If I need a scan or some other diagnostic test, I will not be billed. Furthermore, if I end up needing healthcare in Prince Edward Island, I will still be protected.
Shoot, that sounds fantastic! Why can't we get something like that here in the U.S.?
Re:Is there really any point to this? (Score:5, Insightful)
Here's the facts. I am a resident of British Columbia. I pay about $127 per month in Medical Services Premiums. For that I won't be given a bill at any hospital or any doctor if I have a medical issue. If I need a scan or some other diagnostic test, I will not be billed. Furthermore, if I end up needing healthcare in Prince Edward Island, I will still be protected.
Shoot, that sounds fantastic! Why can't we get something like that here in the U.S.?
Because we got FREEDOMS!!!!
Re:Is there really any point to this? (Score:4, Funny)
Here's the facts. I am a resident of British Columbia. I pay about $127 per month in Medical Services Premiums. For that I won't be given a bill at any hospital or any doctor if I have a medical issue. If I need a scan or some other diagnostic test, I will not be billed. Furthermore, if I end up needing healthcare in Prince Edward Island, I will still be protected.
Shoot, that sounds fantastic! Why can't we get something like that here in the U.S.?
Because we got FREEDOMS!!!!
Especially the freedom to bend over and take it...
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Only if you can afford the FREEDOMS.
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That's right and I want:
- Freedom from having to pay my mortgage ... [insert any expense]
- Freedom from making payments on my car
- Freedom from paying for my groceries (single payer groceries!)
- Freedom from paying
Just need to vote for other people to pay for it and I'll be all set.
Re:Freeeeedumb! (Score:5, Insightful)
These "freedoms" and more are available... but they come at a price.
For instance? No problem...
The county where I live offers an anus-puckering discount on poor families wanting to buy a home (imagine this - being offered a decent home in a neighborhood full of $250k homes for a mere $27k at 0% interest. No, that's not a typo.) Only thing is, the county gets to stop by and make sure you're still poor during the 5-year 'mortgage' period, else the rates and total price rises accordingly. Oh, and CPS gets to check in on your kids any time they want, among other governmental visits that would otherwise demand a warrant.
Groceries? No problem, present an appropriate sob story and proof that you lack income, and most states will lavish you with an EBT card. 'course, unless you get creative about how you dodge it, there's an approved list of foods you can and cannot buy.
Car payments? Well, most metro areas do subsidize free mass transit if you make less than a certain income level... but really - it's mass transit. That means you're stuck with living within walking distance of it, and no further.
How does this relate to healthcare? Well, there are folks already demanding that people be forced to wear health activity monitors [zdnet.com] if they want that subsidized health-care... but you're forced to buy the subsidized plan if you cannot otherwise afford it on your own, so guess what happens if you have the misfortune to be impoverished? Yup - the government now owns your health.
Long story short, the "freedom"s are there, but the dependencies and (IMHO) conditions you subject yourself to in order to receive them are, well... about to become rather dehumanizing.
Re:Is there really any point to this? (Score:4, Interesting)
Actually they're quite wide. Go and read the healthcare act then look at the provinces. In fact those "warning shots" have been at Quebec most of the time, because they simply dump the money direct into general revenue, then take it back out. In order to claim that the money came directly from their own general fund. Aka useless BS Quebec type stuff.
And to highlight difference, in Ontario I pay nothing. I don't pay for any tests or diagnostics out of pocket. I pay for notes from my doctor, and that's it. And if I end up in another province, I still won't be billed--because OHIP will cover it.
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90 days waiting room, costs $1,000 - $1,300 /month (Score:3, Insightful)
In Canada:
A married couple with no children pay, on average, $11,381 in government healthcare premiums.
Those premiums cover 70% of healthcare costs.
The other 30% of costs are paid out of pocket.
89% of the time, the time for an appointment is less than 90 days.
11%of the time, you have to wait more than 3 months.
For any doctor other than a GP, the average wait time is longer than 30 days.
Patients are not permitted to pay for faster service.
Patients are not permitted to pay for higher quality care.
Patients may
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A married couple with no children pay, on average, $11,381 in government healthcare premiums.
Wow, that's basically the same as the US. I didn't realize it was so high.
Re:90 days waiting room, costs $1,000 - $1,300 /mo (Score:5, Informative)
It's a misleading number. It comes from this study [fraserinstitute.org] by the Fraser Institute. Basically, they said "the government spends X% of it's income on health care, therefore we can take X% of each citizen's tax bill as the amount that they paid for health care". This is perfectly reasonable on its own, but the GP cherry-picked the number for a married couple with no kids because they have the highest tax bill. This makes Canadian health care costs seem higher than they truly are.
If you do an apples to apples comparison, the Canadians have a clear advantage.
Single adult: $3780 in Canada, $5884 in US
Family of four: $11320 in Canada, $16351 in US
Canadian numbers are from the Fraser Institute study, US numbers are from this study [kff.org] by KFF.
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My wife has been through several surgeries as well. I have health insurance through my employer that I pay about 300 dollars every two weeks for. I usually, due to her medical condition, spend about 4500 dollars out of pocket every year. It's a lot of money but it's better than losing my wife. We went through several doctors before we found what was wrong and frankly, if I was stuck with the idiots we started with she'd be dead. It's nice to pick and choose doctors as I've had to fire a few. The hard
Re:fist pumping? US system? (Score:4, Insightful)
Insurance is not really capable of being competitive in the same ways manufacturers are. Insurance companies are more like middle management who go between the employees doing the work and the bosses wanting the work done. The differences in costs and coverage between states is likely due to requirements imposed by the states and the risks inherent in the cultures of the people within those states. That being said, there is a little room for competition to create savings or better services. The ACA will get around much of the state regulatory issues which is why we are seeing a lot of states insurance costs actually increasing. But even though the ACA has provisions in it requiring insurance providers to refund the differences if their profit is a certain amount over the coverage paid out, those same insurance providers will still be required to collect and have the ability to pay out for a worst case scenario developed by their actuaries and approved by the government. That is where the real costs of insurance comes from- they are required to keep a certain amount of capitol liquid and available to cover their obligations. Competition cannot get around that.
Insurance is also not health care. The main reason the health care is so expensive in the US is because the government became involved in it. In 1965, the US created medicare and was so overwhelmed by the costs of it, they created HMOs in an attempt to reduce their costs. They gave people with less of a medical education then your typical EMT, Paramedic or nurse the power to deny procedures in the name of cutting costs. Of course this morphed into a mandatory payment schedule where instead of paying the health care costs that are billed, they average the costs billed for an area and pay the average. This means that if one doc charged $10 for an office visit and another charges $30, the average is $20 and both doctors get reimbursed $20 for the visit. This is despite one office being in a rural town and the other being in a large city where overhead just for having the office might be 3 or 4 times as much as in the rural location. Now this cost billed can also be different than the costs billed to an insurance provider too. Well, what happened is that the medical industry who were getting more then expected, increased their rates to $20 and those getting less increased theirs to $60 so the average is now $40.
After a while, this proved to be way to expensive on the government side (granted, insurance providers at the same place might be charged $40 or less but the discounted rates were never part of the average) so the government started paying a percentage of the average. This meant that while the payment average should have been $40, they would only pay 80% meaning only $32 would be paid out. This was acceptable to some as long as they could bill the patient for the non-covered amounts. Well, that caused a lot of outrage and a law was passed saying they had to accept the payment as payment in full and couldn't go after the difference from the patient. People in the health care industry knew that if their costs were higher, the average would be higher and they would get what they wanted again, so they moved their costs up and the doc visit is now $120 or more. Rinse and repeat as this happened in some form close enough to this to call it accurate several times until the ACA was finally passed.
The Affordable Care Act simply doesn't have any mechanism to reduce costs of health care and by all indicators, it has increased the costs of most health insurance. It might even get worse because insurance companies cannot negotiate steep discounts for in network providers the same way as before. Cutting costs might be easier done if instead of average billing, we paid out a costs plus scheme (actual cost of providing the care plus a percentage of that as profit) on the government side. There will be no easy fix for the insurance side and it might get a lot worse.
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Re:Is there really any point to this? (Score:5, Insightful)
And what, you don't think the US system has a ton of horror stories. My run-in with serious illness was my wife's thyroid cancer, and the only real delay was because the initial symptoms aped salivary gland blockage. Within days that that specialist figured out that it was a probable tumor (initially they thought a carotid body tumor), we were driving to Victoria to see an ENT (ear-nose-throat specialist) whose specialization was cancerous tumors. She had surgery a few weeks later, which identified it as a thyroid tumor, and the big delay for removing the thyroid gland (total thyroidectomy) was that she had to heal sufficiently from the initial surgery.
Yes, there are delays and rationing, but really that happens in any system. In the US, in many places, rationing is basically defined by the size of your wallet. In Canada and other countries with universal systems, it's defined by utilization.
The public health system saved my wife's life, and other than her need to take thyroid replacement hormone for the rest of her life, she has fully recovered. Furthermore, I was laid off right in the middle of this nightmare, and the end result was that there was no bankruptcy or loss of our house.
I'll take the odd delay in treatment over no service at all or going bankrupt to save my loved ones' lives. If you like the American system so damned much, I urge you to move there.
Re:Is there really any point to this? (Score:4, Informative)
Two hours for an X-Ray sounds short for the US. Note that all those people who can't afford health care wait until they're really sick and then the clog up the emergency rooms. Which means that if you have a broken bone you sit and wait while the person next to you is coughing from the flu.
Also you'll be able to get care for that back in the future. In the US this won't happen if you can't afford insurance, you'll get emergency care only followed by a string of bill collectors calling to threaten you. The US system only works so far as you've got stable employment at a medium sized company or larger. If you're a food services worker then forget it, you will probalby never be offered health insurance or be able to afford it and just have to hope that your spouse gets insurance on the job.
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If only you guys didn't have snow and your surfing was better, I'd move up there.
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Since it would be replaced with the option to die in the gutter I think axing is a bad move.
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We have that option in Canada too, but at least you're usually in an ambulance.
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So said, funding = telling provinces how to do it. Gotcha, can you tell me when the last time the federal government dictated where to build a hospital in Ontario, Alberta, or even Quebec? Right. How about the number of doctors that need to be hired in each specific province. Right. And let me know when you get around to reading the federal healthcare act again, which should take you all of about 8 minutes. I'll see you sometime next year when you're done reading the ACA.
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you obviously don't know what you're talking about. $92 a year? Bullshit. For me it will cost an addition $8,000 dollars for health insurance, PLUS the cost of my diabetic wife's insulin, needle, test strips, etc have all doubled in price. For a grand total of almost $14,000 a year. I don't know where you got your $92 quote but it's WAAAAAAAY off. btw, I make less than 100k a year.
As for the second part, people in this country don't get turned away because they're poor, they get medicare or medicaid (depend
Alternative, you can just die (Score:4, Informative)
As for the second part, people in this country don't get turned away because they're poor, they get medicare or medicaid (depending on age).
Some do. Some don't. Some have too much money for medicaid, but not enough to pay for a big hospital bill. Some charge hospital bills on their credit cards, and then go bankrupt when they can't pay them (sticking you and me with the bill). Some can't get credit cards, and use the Emergency Room for health care. Some just die.
http://www.reuters.com/article/2009/09/17/us-usa-healthcare-deaths-idUSTRE58G6W520090917 [reuters.com]
"Reuters) - Nearly 45,000 people die in the United States each year -- one every 12 minutes -- in large part because they lack health insurance and can not get good care, Harvard Medical School researchers found in an analysis released on Thursday."
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Govrnmnt says average cost is $516 / mnth / person (Score:3)
The government figures say a married couple with no children pay on average $11,381 in government healthcare premiums, and pay $3,414 for medication and other expenses.
Adding those two official numbers, that's $14,795 per year, or $1,232.94 per month for two people.
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Exactly, its a shitty handout to the insurance industry. Government mandated spending on for profit industry. A right wing corporatist bill through and through.
What we really needed is nationalized single payer healthcare. But right wing Obama and his conservative democrats bowed down before the crazy wing tea party leadership and their regressive republicans.
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Yup, it's a mess. Perhaps if you Americans would finally just introduce a proper universal health care system, instead of these constants half-measures, you could stop spending such an enormous portion of your GDP on health care.
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Universal health system = rationing = substandard care, waiting lists and corruption. I have lived under the NHS and under the US system and I will take the US system any day. for the 86% that have insurance in the US, the care they receive overall is superior to any major country (please don't start throwing in countries with 4 mil population and unlimited oil resources like Norway as a fair comparison to the US) with a single payer system .
Re:Is there really any point to this? (Score:4, Insightful)
You'd take the US system because you have enough money to participate in it. Healthcare is ALWAYS rationed. Currently we ration it based on who can pay the most. I'd rather it be rationed based on who needs care most urgently. Societies that choose this method always pay less as percentage of their GDP on healthcare, and get better healthcare outcomes than the US system.
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So if I'm unemployed under your system, how will I pay for, oh I dunno, treatment for melanoma?
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Let me explain something to you. Canada is a confederation of ten provinces with clear separation of powers. And yet we still have the Canada Health Act. And there's certainly no lack of Federal legislation that the States have agree to.
Re: Is there really any point to this? (Score:5, Informative)
Not their fault. They had to pass the legislation before they could know what was in it.
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The problem for Ted Cruz in 2016 is that on his present course he looks as if he will be so successful in dismantling the US government that its unclear if there will even be a presidency in 2016. However, I'm sure in that case, he will probably just appoint himself as the rest of the country just stand back helplessly in horror.
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. . . the same wonks that gave us so many failed DMV systems haven't found work in this sector too.
You're joking right? It's the exact same people.
SAIC is already in on the action. [seekingalpha.com]
That's the company that scammed New York out of all that money.
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Somehow it hasn't stopped people from driving. I suspect that the few glitches that do show up will get fixed and people will get health care.
Federal IT contracting also has the kickbacks (Score:3)
Federal IT contracting also has the kickbacks and other BS that put's lot's of PHB's in the way of getting work done.
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Yeah, totally, just like the entire progressive movement died after that total failure of government largesse, Social Security. People old enough to remember Social Security all agree on how terrible it was. Nobody liked it because it was a government takeover of medicine, just like the conservatives said when it was passed. Nobody ever again got to see the doctor of their choice, just like the conservatives said when it was passed. It was unaffordable and bankrupted the country, just like conservatives sai
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That's right. And what portion of the total federal budget is taken up by SS today?
Had that been known when it was being pushed through would it have passed?
No.
Your whole ideology thrives on ignorance, misinformation, and lies.
In the full light of day - you wither.
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Investigate (from reliable sources ) how health care works in countries that have it, and you really must learn the meaning of the word "socialist" or you'll wear it out. Before long it won't even be a boo-word for your troops. anymore.
Re:Let us opt out. (Score:4, Insightful)
And what portion of the total federal budget is taken up by SS today?
Negative 85.6 billion dollars. [ssa.gov]
Social Security has a net surplus right now. That will over the course of the next couple decades as the boomers retire, but that can be fixed by (for example) allowing the tax ceiling to be adjusted with inflation.
It's funny that you would claim our ideology thrives on misinformation and lies. Perhaps you're doing a bit of projecting?
Re:Let us opt out. (Score:4, Insightful)
You're lying. Or perhaps just regurgitating lies you heard on Fox or AM radio. Not a big difference, either way.
Here's an official Senate report [senate.gov] showing that removing the tax cap would ensure the solvency of Social Security for over 75 years (the maximum duration in their calculations).
Do you see how I keep citing numbers and figures? I'm able to do that because I'm telling the truth.
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Democrat stooge here with my "snarky" replies. Please enjoy.
Every trick in the book is on the table with this thing. By hook, crook, nail, and claw... this thing is going down or it will be so horribly scrambled that the democrats will wish it did die.
I can't really respond to this one. I will agree that the law isn't without issue. A lot of us on the progressive side believe in universal health so this was not the bill that we wanted. The good thing is that it does allow states to opt out of the implementa
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I have health insurance, idiot. My health insurance was deemed illegal by obamacare.
I don't know your situation so I'm only speculating, but it sounds like your policy didn't provide basic coverage. You may not think so, but the law is actually doing you a service in case you end up in a real mess. I would be interested to hear some details about the policy and the process it was deemed illegal.
Premiums around the country are doubling to tripling due to this legislation
The law may have contributed to increa