ObamaCare - exchanges ,report your states options!

[Night Strike]

I've never understood how medical costs could go down when taxes are being added to the actual tools being used in treatments.

Yo will have to back that up with data.

but overall, taxes have very little to do with real medical costs.

http://www.irs.gov/uac/Medical-Device-Excise-Tax:-Frequently-Asked-Questions

The government is directly adding 2.3% to the cost of medical devices, which is in addition to any inflation and other normal market forces. How will health care costs go down when the government is forcing suppliers to pay more?

Among the reasons for medical pricing, taxes are pretty low on the list.

So it's ok to add direct taxes because the amount they increase prices is less than the amount other factors add to the price? Is this really how the liberal mind "works"?

By the way, some of those "other factors" are themselves higher taxes on personal income, corporate income, property, capital gains, etc.

I can't believe this thread has gone 289 pages of the same shit. Either you are a socialist or you understand economics. All of you could have made enough money to buy your own insurance had you only channeled this energy into something more productive.

Hmm.. because according to you economics dictates that there is plenty of work out there, plenty of people willing to pay a decent wage... and oh, yeah, who cares if we are stealing our children's future to support a fictitious growth model..

But you're ok with stealing our children's future to fund our current big-government entitlement state?

[AndyDufresne]

What about today's current children?


--Andy

[thegreekdog]

What about today's current children?


--Andy

They all had access to medical care prior to the passing of the Affordable Care Act.

Night Strike's rhetoric notwithstanding, the correct way to do this was to go completely free market or completely socialist. The Affordable Care Act essentially requires people to pay for health insurance and the government pays if the people can't pay. So both a boondoggle for insurance companies and a boondoggle for those that cannot afford health insurance. It's the Republicans' plan from the 1990s.

[Lootifer]

What about today's current children?


--Andy

They all had access to medical care prior to the passing of the Affordable Care Act.

Night Strike's rhetoric notwithstanding, the correct way to do this was to go completely free market or completely socialist. The Affordable Care Act essentially requires people to pay for health insurance and the government pays if the people can't pay. So both a boondoggle for insurance companies and a boondoggle for those that cannot afford health insurance. It's the Republicans' plan from the 1990s.

Thats what I dont understand about the whole trainwreck.

"Hey we've got a broken system; we need to fix it"

"Okie dokie; how about since the system is already complex and unoptimised, lets tack on a whole lot more complexity and a whole lot of "greater good", but untested and under researched, ideas in the hope that the resulting trainwreck solves all of americas healthcare woes!!"

"Ok but it might cost a bit more; thus we need to invent some matching wtf-taxes to go along with our nice new shiney wtf-healthcare system!"

Seriously I blame the democrats/left almost more than I do the opposition. If you are going to increase government funding of healthcare at least do it in a remotely sensible way...

[thegreekdog]

What about today's current children?


--Andy

They all had access to medical care prior to the passing of the Affordable Care Act.

Night Strike's rhetoric notwithstanding, the correct way to do this was to go completely free market or completely socialist. The Affordable Care Act essentially requires people to pay for health insurance and the government pays if the people can't pay. So both a boondoggle for insurance companies and a boondoggle for those that cannot afford health insurance. It's the Republicans' plan from the 1990s.

Thats what I dont understand about the whole trainwreck.

"Hey we've got a broken system; we need to fix it"

"Okie dokie; how about since the system is already complex and unoptimised, lets tack on a whole lot more complexity and a whole lot of "greater good", but untested and under researched, ideas in the hope that the resulting trainwreck solves all of americas healthcare woes!!"

"Ok but it might cost a bit more; thus we need to invent some matching wtf-taxes to go along with our nice new shiney wtf-healthcare system!"

Seriously I blame the democrats/left almost more than I do the opposition. If you are going to increase government funding of healthcare at least do it in a remotely sensible way...

The easiest answer I can give you is that corporate lobbyists control the Democrats as much as the Republicans. It's just not widely accepted (in my opinion).

[Lootifer]

Yeh I can believe that. And thus I can see why some of the optics around big business repubs is far more convincing than big business democrats.

Sure both are trying to screw us, but at least the repubs are being somewhat honest about it lol.

Question: If you were faced with a choice between the new setup (which I dont fully understand, and cbf trying to) or a far more socialised/left setup (Norway/ NZ etc)? Those are your only two options.

[thegreekdog]

Yeh I can believe that. And thus I can see why some of the optics around big business repubs is far more convincing than big business democrats.

Sure both are trying to screw us, but at least the repubs are being somewhat honest about it lol.

Question: If you were faced with a choice between the new setup (which I dont fully understand, and cbf trying to) or a far more socialised/left setup (Norway/ NZ etc)? Those are your only two options.

If you're asking me, I would prefer fully socialized. I know a few doctors. They all would prefer either full socialization or the removal of all restrictions on medical care and the "ball cutting" (one of my friend's phrases) of the insurance industry. Basically, my friend's argument is that insurance companies control medical treatment, and not doctors (he says it's a product of government support of insurance companies). He said that 1930s medicine would be better than what is offered today.

[PLAYER57832]

I've never understood how medical costs could go down when taxes are being added to the actual tools being used in treatments.

Yo will have to back that up with data.

but overall, taxes have very little to do with real medical costs.

http://www.irs.gov/uac/Medical-Device-Excise-Tax:-Frequently-Asked-Questions

The government is directly adding 2.3% to the cost of medical devices, which is in addition to any inflation and other normal market forces. How will health care costs go down when the government is forcing suppliers to pay more?

Among the reasons for medical pricing, taxes are pretty low on the list.

So it's ok to add direct taxes because the amount they increase prices is less than the amount other factors add to the price? Is this really how the liberal mind "works"?
By the way, some of those "other factors" are themselves higher taxes on personal income, corporate income, property, capital gains, etc.

Uh, no. The primary reasons for rising cost is demand and need for profit. People will pay whatever they have to.. and so medical companies can charge what they wish, with few limits.

Also, a lot of those "excess taxes" you refer to support the research and development that ALLOW these companies to produce their products.. but it is done without recognition, by law. By law any patents, a lot of credit has to go to private corporations, though the research is done by the government.

On a related note, some pretty well known photographers took photos while on boats where I worked. They were contract, sometimes volunteers and got large sums, plus photo recognition for their published photos. Those working for the government got their basic pay, no mention. IF there was a mention, it was something like "ohoto courtesy of [government agency].

You have a LOT of distorted ideas about the government and how it works. Government SERVES us. Companies work for themselves.. solely. Government absolutely can be abusive, but abuse and claiming that any payment to and by the government is waste are two different things. Unless and until you actually pay attention to that difference, most of what you say will continue to be garbage.

You cannot make truth from garbage, no matter how much you try to repeat it.

I can't believe this thread has gone 289 pages of the same shit. Either you are a socialist or you understand economics. All of you could have made enough money to buy your own insurance had you only channeled this energy into something more productive.

Hmm.. because according to you economics dictates that there is plenty of work out there, plenty of people willing to pay a decent wage... and oh, yeah, who cares if we are stealing our children's future to support a fictitious growth model..

But you're ok with stealing our children's future to fund our current big-government entitlement state?[/quote]
No. I am not. Nor is that the question. Stop trying to pretend that anyone not wanting to utterly GUT the government and all it does is somehow wanting to just increase taxes and waste.

You know something, it was not so long ago that words like yours would have you investigated for treasonous activity.. you might just think about that. amongst all your whining about "liberal" takeovers.

[Night Strike]

You know something, it was not so long ago that words like yours would have you investigated for treasonous activity.. you might just think about that. amongst all your whining about "liberal" takeovers.

So now wanting a federal government that actually balances their budget and doesn't regulate every minutia of individuals and businesses is treasonous?

You have a LOT of distorted ideas about the government and how it works. Government SERVES us. Companies work for themselves.. solely. Government absolutely can be abusive, but abuse and claiming that any payment to and by the government is waste are two different things. Unless and until you actually pay attention to that difference, most of what you say will continue to be garbage.

It's impossible for any entity to survive, no matter what service they provide, if they continue to run billions and trillions of dollars of debt annually. And the federal government's job is to protect our individual rights and national security, not to serve our every individual need or want. It's not the government's job to publish 68 notices of potential regulations every day or to provide funds for every single "need" of people who don't want to work. If a person wants something in life, they work for it. They don't get to be so greedy as to demand that the government take it away from someone else in order to give it to them.

[tzor]

You have a LOT of distorted ideas about the government and how it works. Government SERVES us. Companies work for themselves.. solely. Government absolutely can be abusive, but abuse and claiming that any payment to and by the government is waste are two different things. Unless and until you actually pay attention to that difference, most of what you say will continue to be garbage.

I'm just skimming through this thread (as I see you have set up a red herring fish farm to throw so many distractions that's it not even possible to physically respond to them all without getting banned for spamming) but this one takes the cake.

Government doesn't serve us. It should, but it then again a lot of things should. It serves itself. Your local congressman doesn't serve you. Your local congressman only wants to be reelected in two years. The legions regulations aren't really there to serve you; these people are getting paid to write, enforce, and judge these regulations and they want to keep that job going forever.

This is the utopian fallicy that is as old as Plato's Philosopher Kings. Government, in the end, is no better, and no worse than Companies; they are both run by flawed humans. Government has a major disadvantage in that they are in fact a default monopoly and therefore does not have to worry about out performing the competition. (As people acquire mobility this changes as people can move to another government next door. Generally this works with states - unless people are trapped by underwater mortgages - but less so with Federal governments.)

[Phatscotty]

‘It’s a crisis for Quebec women’

MONTREAL — Surgery wait times for deadly ovarian, cervical and breast cancers in Quebec are three times longer than government benchmarks, leading some desperate patients to shop around for an operating room.

But that’s a waste of time, doctors say, since the problem is spread across Quebec hospitals. And doctors are refusing to accept new patients quickly because they can’t treat them, health advocates say.

A leading Montreal gynecologist said that these days, she cannot look her patients in the eye because the wait times are so shocking. Lack of resources, including nursing staff and budget compressions, are driving a backlog of surgeries while operating rooms stand empty. The latest figures from the provincial government show that over a span of nearly 11 months, 7,780 patients in the Montreal area waited six months or longer for day surgeries, while another 2,957 waited for six months or longer for operations that required hospitalization.

The worst cases are gynecological cancers, experts say, because usually such a cancer has already spread by the time it is detected. Instead of four weeks from diagnosis to surgery, patients are waiting as long as three months to have cancerous growths removed.

“It’s a crisis for Quebec women,” said Lucy Gilbert, director of gynecological oncology and the gynecologic cancer multi-disciplinary team at the McGill University Health Centre. Her team has had access to operating rooms only two days a week for the past year, with dozens of patients having surgeries postponed week after week.

Patients are prioritized according to need, Gilbert said, but surgical delays are still too long.

Gilbert says there are days she can’t face going into work at the Royal Victoria Hospital, a renowned cancer centre in gynecology, and dealing with crying patients. “Put yourself in their place. … I have difficulty making eye contact with patients. I am ashamed to be in such a situation.

“People are suffering. People are waiting too long,” Gilbert said. “This should not happen. No matter how good your surgery is, no matter how good your chemotherapy is, if you delay the surgery there could be a problem. The cancer grows. The cancer spreads.”

One worried patient, a mother of five children who waited three months for surgery for invasive breast cancer, said she is worried about the effects of such a long wait. After surgery, she paid $800 for a bone scan in a private clinic rather than wait five months for a scan at the Jewish General Hospital.

“They needed the scan to see what kind of treatment to give me,” said the woman, 40, who asked that her name not be published because she is starting chemotherapy this week. “The doctors are amazing but health system is not working.”

Montreal health advocates meeting in Toronto on Monday planned to discuss surgery delays in oncology, said Cathy Ammendolea of the Canadian Breast Cancer Network and a volunteer at the Hope and Cope Wellness Centre at the Jewish.

“We’re talking wait times of two to three months. Women are desperate and doctors are frustrated,” said Ammendolea, who encountered physicians at the hospital distraught they could not take on new patients because operating rooms are not available in a timely manner.

“To the point where they are not going to see patients that fast, because if they see the patient, they have to treat the patient, and to do that properly you need access to an OR. It’s crucial for ovarian cancer,” she said.

Officials at the Jewish were not available to comment Monday.

But according to advocates, women are shopping for available ORs in secondary hospitals not suited for complex cancer surgeries, Ammendolea said: “Once they are diagnosed, they are trying to get rid of it as quickly as possible.”

Dr. Robert Sabbah, president of the Association of Obstetricians and Gynecologists of Quebec, said some patients will seek care elsewhere to reduce wait times. But most are getting surgery within three months, he said. In 2007, Quebec announced it would reduce surgical wait times to less than four weeks for all types of cancer, but it’s a rare doctor who has wait-lists of less four weeks, Sabbah said.

Quebec’s promise to cut delays translated into improvements in eye, knee and hip surgeries, Sabbah said, but oncology remains a bottleneck because of budget deficits and staff and equipment shortages.

“Cancer patients are very vulnerable — no patient should wait, but especially cancer,” Sabbah said.

Two years ago, because of potentially devastating delays, oncologists at the Notre Dame Hospital of the Centre hospitalier de l’Université de Montréal sent women with gynecological cancer to other hospitals in Quebec City and Trois-Rivières.

Doctors had to alter treatment in women where the cancer had advanced, CHUM and Notre Dame oncologist Philippe Sauthier told The Gazette in an earlier interview. At the time, the wait-list there had about 120 women and 50 of them were waiting longer than four weeks. Sauthier then wrote an open letter accusing the Quebec government and his hospital of ignoring best practices in favour of balancing the books.

As of March, things began to improve, Sauthier noted in an email, once the CHUM added a sixth operating room dedicated to fast tracking gynecological cancer. By September, 61 per cent of the CHUM’s cancer gynecology operations were done within four weeks of diagnosis, said CHUM spokesperson Sylvie Robitaille.

In August, the McGill centre had at least 100 women waiting for gynecological cancer surgery; 78 of them waited longer than 28 days. As of September the wait-list shrunk to 46 women, 33 of whom were on a wait-list more than 28 days, said MUHC spokesperson Ian Popple.

Ariane Lareau, a press attaché to Health Minister Réjean Hébert, said budgets have little to do with OR congestion and it’s up to each hospital to determine its priorities.

Read more: http://www.montrealgazette.com/health/c ... z2CF4GUISz

Wisconsin legislators call for arrest of federal officials implementing Obamacare

Nine members of the Wisconsin state legislature say they plan to back a bill to arrest federal officials who try to implement Obamacare.

The state’s Republican Gov. Scott Walker must decide by Friday whether the state will draft a health care exchange plan under Obamacare or surrender the task to the federal government.

“Just because Obama was re-elected does not mean he’s above the Constitution,” Republican state Rep. Chris Kapenga told the Milwaukee Journal-Sentinel.

Of the nine Republicans who advocated arresting federal officials, eight have also said on record that they want to write a law that would permit prosecuting TSA agents who physically search passengers with sexual assault.

Additionally, all nine told a tea party-aligned group that they supported the passing of legislation that would allow people to carry guns without first acquiring a permit, allow people to buy raw or unpasteurized milk, allow people to carry guns without state permits and block state funding for federal Real ID laws that require states to develop more secure driver’s licenses.

Kapenga said that he doesn’t think “right-to-work” laws, which bar private-sector labor contracts from including provisions that require employees to join unions as conditions of employment, will be passed in the upcoming congressional session, even with Republican majorities in the state assembly and senate.

“I very much support right to work, but do I think it’s realistic? No. I don’t think we’ll have the political capital to do it,” Kapenga said.

Republicans were able to pass a bill in the last session allowing people to get permits from the state to carry concealed weapons, ending Wisconsin’s lengthy ban on the practice.

Read more: http://dailycaller.com/2012/11/14/wisco ... z2CF5IpOVo

[jj3044]

Just to play a little devil's advocate here, I have a hypothetical in regards to the Canadian story:

Say today in the current system we are at 90% capacity in the US from an operating room perspective, meaning there are some occasional openings, because we are catching and operating on about 90,000 cases of cancer (and total capacity is to operate on 100,000 cases within 4-weeks of discovery).

Now say that due to Obamacare, more people get preventive services, as the law is designed to do, and detect cancers in early stages. Say that it means that 120,000 cases are discovered after the law. The current capacity is 100,000 cases per year, and that is how many are serviced within 4 weeks. The other 20,000 will have to wait longer for surgery, but have at least had their cancer diagnosed and have started other treatments.

Is having the first scenario better, only discovering 90,000 cases and having a lot of cases going undiagnosed? Or, is the second scenario better, even though some have to wait longer than 4 weeks?

[Metsfanmax]

Is having the first scenario better, only discovering 90,000 cases and having a lot of cases going undiagnosed? Or, is the second scenario better, even though some have to wait longer than 4 weeks?

That is pretty much the conservative playbook. Let people die because of undetected and preventable illnesses, and claim the free market is working.

[GreecePwns]

More importantly, why are we talking about Canada, which along with the UK actually are by far the worst empirically performing government-run systems in the world? I thought we went over this 6789 times. Cherry-picking is bad form, Scotty.

[thegreekdog]

Is having the first scenario better, only discovering 90,000 cases and having a lot of cases going undiagnosed? Or, is the second scenario better, even though some have to wait longer than 4 weeks?

That is pretty much the conservative playbook. Let people die because of undetected and preventable illnesses, and claim the free market is working.

Yes, because this scenario is the conservative playbook.

/sarcasm

The free market does not let people die because of undetected and preventable illnesses. You guys are fucking idiots. Seriously. How someone can be so smart and so fucking stupid at the same time is beyond me.

[Metsfanmax]

Is having the first scenario better, only discovering 90,000 cases and having a lot of cases going undiagnosed? Or, is the second scenario better, even though some have to wait longer than 4 weeks?

That is pretty much the conservative playbook. Let people die because of undetected and preventable illnesses, and claim the free market is working.

Yes, because this scenario is the conservative playbook.

/sarcasm

The free market does not let people die because of undetected and preventable illnesses. You guys are fucking idiots. Seriously. How someone can be so smart and so fucking stupid at the same time is beyond me.

Your ad hominem arguments, while appropriate given the name of the forum, do nothing to advance the discussion.

It is certainly the case that many people die every year from illnesses that could have been prevented or treated, but were turned away because of insurance company polices precluding things like granting policies to those with pre-existing conditions. That is what happens when there is no government oversight on who can be insured. This is not an opinion. It is a fact, and has been well documented.

[Night Strike]

Just to play a little devil's advocate here, I have a hypothetical in regards to the Canadian story:

Say today in the current system we are at 90% capacity in the US from an operating room perspective, meaning there are some occasional openings, because we are catching and operating on about 90,000 cases of cancer (and total capacity is to operate on 100,000 cases within 4-weeks of discovery).

Now say that due to Obamacare, more people get preventive services, as the law is designed to do, and detect cancers in early stages. Say that it means that 120,000 cases are discovered after the law. The current capacity is 100,000 cases per year, and that is how many are serviced within 4 weeks. The other 20,000 will have to wait longer for surgery, but have at least had their cancer diagnosed and have started other treatments.

Is having the first scenario better, only discovering 90,000 cases and having a lot of cases going undiagnosed? Or, is the second scenario better, even though some have to wait longer than 4 weeks?

Let's assume that everything in your scenario is factual as to what will happen under Obamacare. Now, let's factor in the reality that because of the massive amount of payments to doctors that will be cut (the largest chunk of the cuts to Medicare that is supposed to be used to pay for Obamacare), enough doctors drop out of the practice to cause the total capacity of cancer operations to drop from 100,000 to 75,000 per month (a very plausible scenario given the number of doctors polled saying they will quit accepting new patients or will even quit such practices). So even though Obamacare might diagnose more people early, even fewer people than before will be able to receive treatments.

[GreecePwns]

I wouldn't say it is a part of the conservative playbook, but its certainly a part of someone's playbook:

President Nixon: Say that I—I—I'd tell him I have doubts about it, but I think that it's, uh, now let me ask you, now you give me your judgment. You know I'm not to keen on any of these damn medical programs.
Ehrlichman: This, uh, let me, let me tell you how I am—
President Nixon: [Unclear.]
Ehrlichman: This—this is a—
President Nixon: I don't [unclear]—
Ehrlichman: —private enterprise one.
President Nixon: Well, that appeals to me.
Ehrlichman: Edgar Kaiser is running his Permanente deal for profit. And the reason that he can—the reason he can do it—I had Edgar Kaiser come in—talk to me about this and I went into it in some depth. All the incentives are toward less medical care, because—
President Nixon: [Unclear.]
Ehrlichman: —the less care they give them, the more money they make.
President Nixon: Fine. [Unclear.]
Ehrlichman: [Unclear] and the incentives run the right way.
President Nixon: Not bad.

[Lootifer]

Is having the first scenario better, only discovering 90,000 cases and having a lot of cases going undiagnosed? Or, is the second scenario better, even though some have to wait longer than 4 weeks?

That is pretty much the conservative playbook. Let people die because of undetected and preventable illnesses, and claim the free market is working.

You're shooting at the wrong target there bucko. Did you see the bit where our resident fiscally conservative tax laywer said he'd prefer socialised HC over the incumberant?

This isnt a debate about left vs right; this is a debate around what makes sense and what is retarded.

[Metsfanmax]

Is having the first scenario better, only discovering 90,000 cases and having a lot of cases going undiagnosed? Or, is the second scenario better, even though some have to wait longer than 4 weeks?

That is pretty much the conservative playbook. Let people die because of undetected and preventable illnesses, and claim the free market is working.

You're shooting at the wrong target there bucko. Did you see the bit where our resident fiscally conservative tax laywer said he'd prefer socialised HC over the incumberant?

This isnt a debate about left vs right; this is a debate around what makes sense and what is retarded.

I'm not directly discussing Obamacare either. I believe that socialized healthcare ought to be the best system from an ethical perspective; whether it is the more efficient system in terms of generating the greatest good for the greatest number is not something I have the answer to.

Nevertheless, I wholly support a change from the status quo of 2009, where a large number of illnesses could be prevented by giving people access to health insurance. The fact that we couldn't achieve, for example, the single-payer system is not a reason to just abandon all hope of improving access to health care. Anyone who insists on either socialized healthcare or nothing may have a nice theoretical argument, but I can't see how it's morally justified to let people die from preventable illnesses because you didn't like the compromise we ended up getting.

[Lootifer]

My concern as a left leaning observer is that Obamas plans for HC while look like theyre heading in the right direction is going to have far too many of the unintended consequences BBS harps on about for it to be anything other than worse.

Having said that; I would probably suggest that Obamas plan is about as "left" as you could hope to pull off considering the political landscape in the US. (full socialisation is not possible; see NS/PS for proof - that is they would dig their heels in and [successfullly] block any kind of socialisation).

[Metsfanmax]

My concern as a left leaning observer is that Obamas plans for HC while look like theyre heading in the right direction is going to have far too many of the unintended consequences BBS harps on about for it to be anything other than worse.

I agree that the unintended consequences are probably incredibly hard to evaluate for a policy as large and sweeping as this. That being said, unintended consequences aren't necessarily bad, and I feel as though we are morally obliged to not sit and do nothing while the unregulated insurance market permits people to die of diseases that can be treated easily using modern medicine. It is possible that we will end up with a worse medical system as a result, but it is also possible that we will end up with a better one. Without some systematic evaluation of where such consequences might lie, I do not feel as though they are a reason for inaction. Not when we're talking about thousands of cases of where human life hangs in the balance.

[Lootifer]

Unfortunately I dant have the time nor the inclination to get into the details of Obamacare and its various supporting policies. So I cant comment.

[jj3044]

My concern as a left leaning observer is that Obamas plans for HC while look like theyre heading in the right direction is going to have far too many of the unintended consequences BBS harps on about for it to be anything other than worse.

I agree that the unintended consequences are probably incredibly hard to evaluate for a policy as large and sweeping as this. That being said, unintended consequences aren't necessarily bad, and I feel as though we are morally obliged to not sit and do nothing while the unregulated insurance market permits people to die of diseases that can be treated easily using modern medicine. It is possible that we will end up with a worse medical system as a result, but it is also possible that we will end up with a better one. Without some systematic evaluation of where such consequences might lie, I do not feel as though they are a reason for inaction. Not when we're talking about thousands of cases of where human life hangs in the balance.

Mets sums up my position nicely as well... while I am sure there will be some unintended negative consequences, I am hoping that the intended positive outcomes far outweigh the negative. Considering the old system is/was unsustainable, the only unacceptable course, in my opinion, was inaction.

[stahrgazer]

Illegally refusing coverage is perhaps rare, though you have to get technical there because Blue Cross (other than highmark, higher end Blue Cross plans) has a way of stone-walling and delaying approvals in such a manner that they are not technically denying coverage, but... they might as well be denying it.

These things all very much DID change. And far from what the Republicans are trying to claim, most doctors and hospitals are very happy about the healthcare reform act.

BUT.. it is far from perfect. We need true universal coverage.

Blue Cross isn't the only company who stonewalls and delays approvals. You're right, most doctors and hospitals are happy about the Affordable Care Act because when there was no one to pay, it was the doctors and hospitals who got shafted.

Personal experience: Auto accident. I had auto coverage, the guy who hit me had auto coverage as well.

The combined total coverage of both our plans did not cover my bills, plus the insurances were arguing about things. I had to hire a personal injury attorney to help figure out who would pay.

Fortunately, I also had medical coverage under a separate policy so was able to get treatment while things got ironed out.

Here's what the ironing did: The attorneys received a cut. My separate medical policy got reimbursed. Most of the doctors got 20% of what it cost to treat me (because the money was eaten up by the attorney cuts first, the reimbursement of the separate medical insurance policy second, the doctors last.) I got stuck with the bills, which I could not afford so had to bankrupt, so the doctors who got 20% were fortunate.

I understood the attorney cut from a business sense, although I detested that I had to go that route for a clear-cut claim. I did not understand why my other insurance got the second cut. The money from the auto insurances did not cover all the medical bills, but it was medical bills, so shouldn't my medical insurance have to pay the medical bills? If I'd fallen at home, they would have had to pay (anything over deductibles etc which I had already paid.) So why did they get reimbursed next?

I think it should have been: treatment paid by auto companies without having to hire attorneys to force it; leftover bills that were covered under my medical insurance paid for by the insurance. Not, "everyone gets paid but the docs who did the work."

The Affordable Care Act tries to ensure that the docs who do the work get paid some reasonable-and-customary amount for the work they did. That's fair.