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Photograph of Health insurance policy.
I had my annual physical exam this week, and since I had to take time off work to do it, I figured I'd at least get a little bit of research done since I knew I wanted to do some kind of essay about it today, given the exchanges open for business in two days. So I queried my doctor about what he's hearing from patients when they talk to him about Obamacare. Do they have questions? Are they confused by any particular part of it?

He just sort of shook his head and sighed. Understand that this is Idaho, and he's a doctor. So he's pretty much a Republican. But he's a very frustrated Republican who keeps hearing his patients recite back to him Fox News talking points. They think government is going to dictate what kind of care they can get. They think they're losing their freedom. And don't get him started on death panels. Yes, death panels. Still. He talked to me about the real death panel experiences he's had. The ones with the insurance companies. Like last year when he had a patient in her sixties with early stage liver cancer. She was a fantastic candidate for a relatively new, very effective treatment in which the tumor is cauterized in a minimally invasive procedure. Nope, her insurance company said. It's not an approved procedure, so she didn't get it. And she didn't make it.

We all know those kinds of stories. Presumably, even the people who are duped in to believing that there really are death panels in Obamacare either have been or know someone who has been screwed over by their insurance company. And yet, this new law that will rein in some of the worst abuses of those insurance companies is scarier to them than the status quo. Because they just keep hearing the myths. So let's go through it one more time, those persistent myths that just won't go away. Because in just a few days the exchanges open, everybody's talking about it, so that makes now a really good time to inject some truth.

Let's head below the fold and talk it out.

Almost all of the big lies are aimed at, as usual, the people who are the "haves." That's why the people my doctor has been talking to are so scared. That's why they've been talking about losing "freedom." They've been listening to Fox News and hearing that Obamacare is going to take what they already have away from them.

Obamacare will take the insurance I have away.

Let's just get this straight: If you already have insurance, Obamacare is not taking it away. If you do lose it, it's because your employer has dropped your coverage. It's true that some employers might drop it, either to make a political point or because it would cost them less to pay the penalty for not providing coverage than to continue to carry it. But that's not something Obamacare is forcing them to do.

Obamacare won't let me see my doctor anymore.

Trust me, the government doesn't care what doctor you see. If you have insurance, and you have a primary doctor, that won't change unless your insurance company decides it will change. The power to force you to find a new doctor is something insurance companies have always had, and still do.

The IRS will control my health care.

That's a persistent and difficult one to shake. Everyone hates the IRS, so it's easy to believe the worst here. The IRS has a big role: It's going to be verifying how much of a subsidy you're going to be getting to help pay for insurance if you purchase it on the exchange. If you already have health insurance, the IRS will have nothing to do with it, with you, with your health care. They don't know who your doctor is. They won't see your medical records. They don't care about your medical records.

It's taking Medicare money away from me.

Scaring old people is the easiest and favorite thing for Republicans to do. Obamacare will not make you pay more for your Medicare, it will not take it away, and if you're on Medicare, you don't have to do anything at all on Oct. 1. But if you are on Medicare, you will see some additional benefits from Obamacare: more preventative care services and more savings on prescription drug coverage.

Obamacare is going to ration my health care (a corollary of death panels).

Your insurance company already rations your health care, but much of that's changed with Obamacare: you can now get preventive care services without having a copay; you don't face annual or lifetime caps on how much your insurance company will pay out for you if you get seriously, chronically ill; your insurance company can't deem a condition "pre-existing" and refuse to cover it.

The Independent Payment Advisory Board, the supposed death panel, is prohibited in the law from rationing health care. It's right there in black and white: It cannot make "any recommendation to ration health care ... or otherwise restrict benefits or modify eligibility criteria."

This is a government take-over of health care in America.

We should be so lucky. Your insurance company won't be going out of business, turning all your records over to the government. The insurance industry will continue to flourish, albeit with some new regulations that even the people propounding this one like, number one being no more pre-existing conditions.

There are a lot more, really crazy, chain-email type ones like "you won't get cancer treatment after age 76," or "government workers will force their way into your home to inspect it," or "this is the biggest tax increase in the history of the world," or "Obamacare creates a database of people's sex lives." Occasionally, PolitiFact is useful debunking lies. They do a good job with these and a handful of others.

But the lies directed toward the uninsured are the ones that really expose just how immoral Republicans are. They are trying to convince people, particularly young people, that it's better to go without the protection of health insurance to make a political statement. No one cuts through this better than, Brian Beutler, at Salon. A few weeks ago, he wrote about his own experience, being a victim of gun violence, and in a follow-up essay writes about the health care lesson he learned, because by luck and the nagging of his father, he had paid his first insurance premium six hours before getting shot.

One of the arguments I made in my first essay is that it makes no sense to respond to minor risks by taking drastic measures (in that case, I was responding to making sweeping racial judgments based on a lone incident). Nobody should respond to the threat of communicable illness by sheltering indoors like Howard Hughes. Nobody should mitigate the risk of accident by diminishing their quality of life. But buying insurance? That’s like taking a cab through a dangerous neighborhood. It’s a perfectly sensible hedge even if it’s somewhat costlier than the alternative. If it weren’t sensible, millions and millions of people insured by their employers — including, probably, the same people now encouraging young people to skip Obamacare — would be opting out in exchange for additional cash compensation.

Obviously people who have insurance already—including young people, who currently cross-subsidize their older colleagues in existing group markets—think it’s a pretty good deal. If you’re eligible for Obamacare, and people try to convince you otherwise, ask yourself if you think they’d be giving their own children the same advice. And your decision will be obvious.

This is simple, particularly for young people. Health insurance can save your life. Health insurance can secure your financial future. Bottom line, anything that makes it easier, more affordable to get health insurance is a good thing. Because, yes, you could be hit by a bus tomorrow. You could get in a car wreck. You could break your leg or develop diabetes or get cancer. It happens to people everywhere all the time, and rolling the dice that it's not going to happen to you doesn't have to be an option any more.

Rolling those dice to make a political point because the Koch Brothers, who can afford the very best of health insurance for their families, tell you to? Now that would just be stupid.

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Comment Preferences

  •  Is the $6,000 deductible ok with folks? What about (9+ / 0-)

    60% coverage? If you are poor, how are those amounts going to be filled in? Maybe they are myths, but just heard this on local news.

    “Well, when the president does it, that means it is not illegal.” Richard Nixon, 1977.

    by Kvetchnrelease on Sun Sep 29, 2013 at 09:34:16 AM PDT

    •  It is better than nothing. (21+ / 0-)

      Usually there is a doctor visit co-pay which prevents serious illnesses.

      Also preventive care is often low cost.

      If you get $6,000 sick it is better than $100,000 sick.

      The highest form of spiritual practice is self observation with compassion.

      by NCJim on Sun Sep 29, 2013 at 09:37:37 AM PDT

      [ Parent ]

    •  That's one choice of coverage (15+ / 0-)

      You have other options. Subsidized options.

      "The NSA’s capability at any time could be turned around on the American people, and no American would have any privacy left, such is the capability to monitor everything. [...] There would be no place to hide."--Frank Church

      by Joan McCarter on Sun Sep 29, 2013 at 09:47:14 AM PDT

      [ Parent ]

    •  Deductibles (23+ / 0-)

      Office care will be covered and only require a small co-pay.

      In the last few years I needed two surgeries.  Both were necessary.  One cost $15,000, the other about $20,000.

      Both surgeries were performed in the same year.  If I had a $6000 deductible, I would owe $6000.  That sounds a lot better than $35,000.  Would you agree?

      When the power of love overcomes the love of power, the world will know peace. Jimi Hendrix

      by Dave B on Sun Sep 29, 2013 at 09:52:15 AM PDT

      [ Parent ]

      •  I haven't seen this and would like to know the (0+ / 0-)

        answer to it.  How much will our doctor visits/lab fees/prescriptions cost up front and is it subject to these high deductibles?

        I don't care how low the premium is....I want to know if I can really use it for routine doctor visits for sick kids or when I have to see one because my job requires a doctor's note anytime I have to be out more than a day with an illness or any other time my family has to see a doctor.  How much will this cost me?  Full price until I meet deductible?

        I see no listed co pays anywhere for such things and that is important to me, if we end up on the exchange.

        •  This will depend on the plan you chose. But (3+ / 0-)
          Recommended by:
          micsimov, eru, VPofKarma

          go to Healthcare.gov and you will see examples. You will be buying a policy from an insurance company. They will pretty much run as the policy you have now or if tou bought one privately today.

          For Christina's America

          by DWKING on Sun Sep 29, 2013 at 12:19:27 PM PDT

          [ Parent ]

        •  Here's the California chart... (0+ / 0-)

          ...for cost-sharing under the Silver plan (the only plan for which there are cost-sharing subsidies): http://www.coveredca.com/...

          There are separate co-pays depending on the service rendered, such as lab test, doctor's visit and hospital stay.

          •  Thank you. We make more than the listed (1+ / 0-)
            Recommended by:
            Willa Rogers

            income levels but at the high end, I was hoping for much less co pays.

            Mine is currently 10 to 25 dollars for just about everything except an ER which I think is 50.  For someone who has a medical condition and requires multiple doctor visits all the time and yet only makes a low income...45 dollars to see a doctor is not good news.  It scares me.  I have a special needs child and frequent visits and labs etc are just a part of that.

            •  The cost-sharing will be difficult... (0+ / 0-)

              ...for lower- and middle-income people enrolled in the Exchanges. It might be worth paying for a higher-level plan, if financially feasible, for families with members who have chronic medical problems.

              As I've said in my other posts, Dems need to address the cost-sharing problem in the Exchanges sooner rather than later, or it will come back to bite them politically.

              •  I agree. The low premiums are great but if people (1+ / 0-)
                Recommended by:
                Kvetchnrelease

                find out they can't use it because they find out at their doctor's office payment counter that they still owe 50 to 100 dollars to just see a doctor, even with their new insurance, I think a lot of people are going to be sticker shocked.  

                •  That's why my 30 year old daughter isn't (1+ / 0-)
                  Recommended by:
                  Bailey2001

                  buying insurance.  She makes $10 an hour and can barely pay her bills.  She used to have employer provided insurance with a $1200 deductible which she couldn't use as she couldn't afford to pay the deductible.  She would basically self treat.  If one is cash poor then they can't pay up front to go to the doctor.

                  “It is the job of the artist to think outside the boundaries of permissible thought and dare say things that no one else will say."—Howard Zinn

                  by musiclady on Sun Sep 29, 2013 at 04:19:22 PM PDT

                  [ Parent ]

                  •  If they can't use it for doctor visit or anything (1+ / 0-)
                    Recommended by:
                    musiclady

                    people associate that new monthly bill with, how long before they figure that out?  Health insurance is not like car insurance in most people's minds.  They don't think of it for just a major accident or in this case a major illness.  They think of it as a ticket to be able to take their sick kid to a doctor or have their acne treated or have vaccinations done or have their corn removed or whatever.

                      I feel a lot of people who have no insurance for all this time, probably have tons of little things that they have left untreated and will get insurance expecting to go see a doctor for 10 bucks or whatever their neighbor told them they pay with their employer HMO.  I can honestly say that it was exactly what I had expected.  I really hoped it would be similar to an HMO...and with a low deductible and low co pays.  Something people could use when they wanted and so they could reap the benefits of having it and see how good it is to be able to get medical help when needed, even on a regular basis.  I never expected 12,000 deductible for a family.

                    •  That's the point. (0+ / 0-)

                      If you still can't go to a doctor, what's the point.  I understand that owing $12,000 (deductible) is preferable to owning possibly tens of thousands of dollars but if $12K bankrupts you, what's the difference?  Some doctors won't treat you unless you pay up front so a high deductible doesn't help anyone who simply doesn't have the money.

                      “It is the job of the artist to think outside the boundaries of permissible thought and dare say things that no one else will say."—Howard Zinn

                      by musiclady on Mon Sep 30, 2013 at 08:18:08 AM PDT

                      [ Parent ]

    •  A preview of plans in NM (1+ / 0-)
      Recommended by:
      daeros

      offered through a new nonprofit showed me that the coverage was actually worse than I thought it was going to be.  A fairly typical group plan PPO with a moderate deductible and 80/20 split is better than the "Gold" plan offered.

      However, low income folks will be getting subsidies for the deductibles and out of pocket expenses, as well as for the premiums.  The amount varies from two thirds to one third of the out of pocket expenses, depending on income level.

      http://www.benefitexpress.info/...

      Economic Left/Right: -7.38
      Social Libertarian/Authoritarian: -8.00
      Two steps to the right of Trotsky.

      by jvance on Sun Sep 29, 2013 at 10:07:30 AM PDT

      [ Parent ]

    •  local news (3+ / 0-)
      Recommended by:
      Texnance, Theston, JerryNA

      My local news talks about the high deductibles and lack of doctor choice.

      This is exactly what this is talking about.  That these problems are different from any other health insurance plan.  Perhaps the well off can go to any doctor they wants, and are not going to be stuck with deductibles and copay, but any plan I have ever had has not.  For instance my current plan expects me to pay $5,000 of my own costs, plus copays.

      This switching of perspective, comparing the best of one side to the worst of the other, is often used by intellectually dishonest people.  I see it a lot in the talk of being a vegetarian.  They say it is too expensive because they compare the costs of whole foods to the costs of wal mart.  They say it is hard because they compare eating frozen processed food to eating fresh food.  Or they say it makes them size because the think vegetarians eat lettuce and potato chips, and have never learn to cook for themselves.

      In the end, because ACA is not government healthcare on the level of the government gets, some people will still not have affordable health care.  But at least it will give many the option to take care of problems before the emergency room becomes the only solution.

    •  Republicans tout cheap catastrophic insurance... (0+ / 0-)

      ... for lower income folks, and I see little or no difference in the two -- except, I believe, everyone will get free/low cost annual check ups with ACA.

    •  The $6,000 deductible is a flat out lie... (3+ / 0-)
      Recommended by:
      CSPAN Junkie, CS11, JerryNA

      ...and I'm rather disgusted to see it here.

      Where it comes from is the cap on the amount of medical expenses that an individual receiving subsidized care can end up paying, which is around $6,000.

      However, that $6,000 is deductibles, copays, and "shared expenses" above the deductible.

      So, for example, that $6,000 could be met through a $2000 deductible, and a 70/30 split on expenses above $2000 until the $6,000 cap is hit.

      Yes, that's still a lot of money, but it's a lot better than what you're claiming to be the case.

      To put it in context, I have very comprehensive insurance through work, and it comes with a $300 deductible.  But my out of pocket maximum is $2,500.  I think that most people would agree that's a very different matter from having a $2,500 deductible.

      Political Compass: -6.75, -3.08

      by TexasTom on Sun Sep 29, 2013 at 01:16:40 PM PDT

      [ Parent ]

      •  Agree. the Out-of-pocket spending cap is confused (4+ / 0-)
        Recommended by:
        barkingcat, CS11, JerryNA, TexasTom

        with a high deductible, quite frequently these days.

        The annual OOP maximum is $6,350 for an individual and $12,700 for a family. But there are subsidies for this too, depending on how far above poverty level your income lies.

            100% - 200%: your max reduced by 2/3
            200% - 300%: your max reduced by 1/2
            300% - 400%: your max reduced by 1/3

        In addition, hospitals will always arrange a payment plans for what remainder you owe.

        Unfortunately, the OOP limits were delayed until 2015, but they are part of the complex solution to the problem of affordability.

        “It is useless to attempt to reason a man out of a thing
        he was never reasoned into” - Jonathan Swift

        by jjohnjj on Sun Sep 29, 2013 at 02:03:45 PM PDT

        [ Parent ]

      •  You still have to come up with $2000 up front (0+ / 0-)

        before you can get any care though.  Oh, and hospitals often do not set up payment plans anymore rather insisting that it be paid all at once, often up front.

        You have watched Faux News, now lose 2d10 SAN.

        by Throw The Bums Out on Sun Sep 29, 2013 at 06:25:16 PM PDT

        [ Parent ]

    •  A few things here: (1+ / 0-)
      Recommended by:
      Kvetchnrelease

      1. The "60% coverage" thing you sited is an actuarial value. It doesn't mean that the plans will only cover 60% of your medical expenses. Rather, actuarial values are a way of rating health insurance plans that use co-pays and deductibles as factors. The higher the co-pays and deductibles for a plan, the lower the actuarial value, as those are factors that get plugged into a formula used by actuaries. But, again, that number does not indicate the percentage of "coverage" you have. It's more of an overall rating of the quality of the plan.

      2. 60% is the lowest actuarial value a plan can have in the Exchange, but there are several tiers of plans that have actuarial values of 60%, 70%, 80%, and 90%. Generally, the higher the actuarial value, the lower the co-pays and deductibles, but also the higher the premiums will likely be.

      3. The "$6,000" figure you cited is actually a limit that plans can charge on out of pocket costs - both co-pays and deductibles. All plans are limited at $6,350 for total out of pocket expenses, co-pays and deductibles, regardless of their actuarial value.

      4. The $6,350 is a cap, not a requirement. Plans can choose to limit their out of pocket expenses to less than that amount. Many plans are likely to do so. However, today there are more than a few plans that do not have that limit on out of pocket expenses. Griping about the out of pocket expenses limit is like saying that we shouldn't have the minimum wage because the current minimum wage isn't enough for people to make ends meet.

      •  Actually, I'm somewhat wrong... (0+ / 0-)

        ...on point number 1: Actuarial values are sort of an average of total costs paid by the patient versus the insurance plan. So, on average, with a plan with a 60% actuarial value, your insurance will pay 60% of the costs while you pay 40%.

        I apologize for the confusion. The actuarial value thing has always confused me somewhat.

        I stand by my other points, though.

        •  So what then is the deductible? A broken thumb (0+ / 0-)

          Needing surgery happened to our family this month. First doctor visit and surgery came to $6500. We had yo pay deductible, $450, plus 10% $650 or almost $1100. How would someone getting in insurance for first time under exchange be charged?

          “Well, when the president does it, that means it is not illegal.” Richard Nixon, 1977.

          by Kvetchnrelease on Mon Sep 30, 2013 at 05:19:09 AM PDT

          [ Parent ]

  •  Before Obamacare Colonoscopy $1,200 (32+ / 0-)

    After Obamacare $75.

    This is a procedure I need or I will die (father had colon cancer twice and I have pre cancerous polyps every time I check which is every three years).

     

    The highest form of spiritual practice is self observation with compassion.

    by NCJim on Sun Sep 29, 2013 at 09:35:59 AM PDT

  •  But what about the "death panels"? (4+ / 0-)
    Recommended by:
    Faito, blue in NC, GAS, Loge

    And creepy Uncle Sam trying to rape our daughters and do involuntary proctology exams on our sons!?

    (hyperventilating, hyperventilating, hyperventilating...)

    ;-)

    -4.75, -5.33 Cheney 10/05/04: "I have not suggested there is a connection between Iraq and 9/11."

    by sunbro on Sun Sep 29, 2013 at 09:38:45 AM PDT

  •  Disconnect (3+ / 0-)
    Recommended by:
    jaf49, Halfton81, Subterranean

    What is really sad is the FAILURE of the President to effectively communicate all of the above.

    A cerebral and emotionally distant communication style is piss-poor politics.  I gave up a long time ago on expecting Obama to take the fight to the right-wingers who clearly have won the day in the propaganda battle over health care.

    Labor was the first price paid for all things. It was not by money, but by labour, that all wealth of the world was originally purchased. - Adam Smith

    by boatwright on Sun Sep 29, 2013 at 09:40:23 AM PDT

    •  I don't think that is it. (4+ / 0-)
      Recommended by:
      murrayewv, savannah43, eru, VPofKarma

      Watching the Sunday morning shows (until I threw up) I as the Republicans spout these pithy lies.

      There is no time or way to correct them.

      There is nothing you can say if one side lies and there is no way to correct it.  Pithy lies in return will not work.

      But the truth will eventually win.

      Is Obama blameless?  No.  His "11-D chess" gets in the way of his communicating to anyone but the base (i.e. the intelligent people who care about nuance and subtlety).

      He tends to bounce around too much.  He cares to govern and that is a problem in this messaging crap.    

      The highest form of spiritual practice is self observation with compassion.

      by NCJim on Sun Sep 29, 2013 at 09:53:15 AM PDT

      [ Parent ]

    •  It's not that simple. (19+ / 0-)

      He's an emotionally distant communicator.  True.  But we have a lazy, corporate, or cowed media that will not call out the GOP in any meaningful way about their lies and manipulations.  And the GOP knows that lies take hold in the minds of the base because their minds are fertile ground for nonsense.  These people cannot even nominate a person for president who will say, flat out, that the earth is not 6,000 years old, but is 4+ billion years old!  

      How about Repub. Tim Huelskamp repeatedly saying that ACA includes a $1 abortion surcharge that every American has to pay (lie).  Apparently  Kansan Huelskamp  isn't familiar enough with Kansas law to realize that Kansas does not have any abortion coverage.  Abortion is not covered by private plans; it's not covered on the exchanges; and it's not covered for the Spawn of Satan government employees.

      The death panel nonsense persists even though our existing health care system rations of medical services daily.  If you have no health insurance, your health care is rationed to whatever's in your bank account.

      The idea that this is "socialized" medicine persists as well, even though the whole scheme pushes privatized insurance (at what will likely be a huge boon to big insurance.)  And why don't the media point out that the cost of the uninsured is being 'socialized' every day.  Everybody is paying higher costs to make up for the uninsured who don't or won't or can't pay.

    •  I'd like to see Obama get fired up more often too. (21+ / 0-)

      But you can find hours worth of video of Obama explaining this shit. All the information is out there. The problem is that national and local media would rather feature some nut job ranting about death panels than lay out the facts.

    •  The only way the GOP wins anything is by lying. (1+ / 0-)
      Recommended by:
      Observerinvancouver

      Too bad so many people are too lazy to pay attention and do their own thinking.
      Anything BHO says is distorted by the right-wingers. Why should he bother taking it to them?

      •  I don't get this. (0+ / 0-)
        Anything BHO says is distorted by the right-wingers. Why should he bother taking it to them?
        This attitude absolutely mystifies me. And we sit around and wonder how we lose the message war.

        We were all there when this law was rolled out. We all know how the Dems ran away from this law as soon as it was passed to "pivot" to the deficit. They couldn't be bothered to talk about it at all. Meanwhile, the Republicans have never let up on it, ever.

        Banking on the American people to be able to sort all this out and declare the adult in the room the winner is a very big bet. -Digby

        by Boogalord on Sun Sep 29, 2013 at 11:23:12 AM PDT

        [ Parent ]

        •  Re Dems behaviour after the bill passed - that's (2+ / 0-)
          Recommended by:
          Loge, VPofKarma

          President Obama's fault?  

          Sometimes it really does seem as though Pres. Obama is the only adult in the room.  Everybody seems to think their pet issue is the only thing he should pay attention to.  And everyone seems content to sit back and wait until he's solved their problem.  Until he doesn't.  Then they start bitching.  I want to ask those people, What did you do to help?  

          Too many people appear not to understand how much he has to deal with.  Look at just this week.  The breakthroughs on Syria and Iran are awesome.  But I bet the behind-the-scenes activity has been hectic for months.  When opportunity does knock at your door you have to be prepared to answer it.  

          But difficult as all that was, keeping his mouth shut about Ted Cruz was probably the hardest part of the week.  I bet he's sympathizing with John Adams for his Alien and Sedition Acts.  

          We must, indeed, all hang together, or assuredly we shall all hang separately. B. Franklin

          by Observerinvancouver on Sun Sep 29, 2013 at 12:30:06 PM PDT

          [ Parent ]

          •  P.S. Re Pres. Obama talking to right wingers. (0+ / 0-)

            Hard to talk to someone who'd prefer consorting with a vampire than with you.  It takes two sides to have a conversation.  If you've listened to the utter garbage spouted by Republican Congresscritters ("lies" is far too generous) you have to admit it's hard to imagine any of them being willing to (let alone capable of) have a sane conversation with the President.  

            We must, indeed, all hang together, or assuredly we shall all hang separately. B. Franklin

            by Observerinvancouver on Sun Sep 29, 2013 at 12:41:02 PM PDT

            [ Parent ]

    •  What I find really sad is that people on (13+ / 0-)

      the left blame the President for the failures of corporate media, bought-and-paid for Congresspeople who have no problem with their constituents dying so long as they can make political hay out of opposition to the law, corrupt state governors and legislators who have enacted laws making it very difficult or even illegal to get information about the law to their citizens, the bottomless pockets of right wing billionaires who blanket the airwaves with false advertising against the law, "news"casters who allow lies to be told over and over on their shows without pushback, a Supreme Court who allowed states to opt out of Medicaid expansion thus compromising millions of Americans' health, a right wing news media which pushes falsehoods on tv and radio day in and day out, and ignorant racists who vote for leaders who take away their protections and services as long as they stick it to the black guy in the White House.

      Please read Jon Perr's exhaustive and brilliant article on today's fp, to further understand the orchestrated, concerted effort to undermine the health of Americans in order to sabotage the law.  I doubt you will come away with the simplistic view that this is all the President's fault.

      "It ain't right, Atticus," said Jem. "No, son, it ain't right." --Harper Lee, To Kill a Mockingbird

      by SottoVoce on Sun Sep 29, 2013 at 10:48:07 AM PDT

      [ Parent ]

      •  Great comment! (1+ / 0-)
        Recommended by:
        SottoVoce

        We must, indeed, all hang together, or assuredly we shall all hang separately. B. Franklin

        by Observerinvancouver on Sun Sep 29, 2013 at 12:43:03 PM PDT

        [ Parent ]

        •  If you think a comment is great, send it in (0+ / 0-)

          to Top Comments. Just click the link below.  We post the diary every night at 10pm Eastern. Help us recognize great comments.

          Top Comments recognizes the previous day's Top Mojo and strives to promote each day's outstanding comments through nominations made by Kossacks like you. Please send comments (before 9:30pm ET) by email to topcomments@gmail.com or by our KosMail message board. Just click on the Spinning Top™ to make a submission. Look for the Spinning Top™ to pop up in diaries posts around Daily Kos.

          I must end each day with a dose of Top Comments. A TC diary is a must for developing the calmness I need to get the required eight hours of sleep. - cohenzee

          by cohenzee on Sun Sep 29, 2013 at 02:53:38 PM PDT

          [ Parent ]

    •  I wouldn't blame the POTUS when (3+ / 0-)

      the average person in the US listens to any news at all for only 5 minutes per month.  So many people are more interested in Kim Kardashian than in what is happening in politics, health care, climate, etc.  We may lose our democracy due to people being too bored and disinterested to bother.

      I was wise enough to never grow up while fooling most people into believing I had. - Margaret Mead

      by fayea on Sun Sep 29, 2013 at 11:08:57 AM PDT

      [ Parent ]

    •  Disagree (1+ / 0-)
      Recommended by:
      Loge

      The problem is that the big benefits of the ACA took several years to kick in, and in the absence of tangible benefits it is a lot easier to demonize than it is to defend complex legislation.

      While I do think that the president could have done a better job on communications than he has, the fact is that there really was a limit in how much he could achieve until the benefits were imminent (as they now are).

      Perhaps the bigger mistake wasn't communications, but in having such a lengthy delay built in for the kick off of the exchanges.  Having it start in 2012 instead of 2014 would have given Republicans less time to demonize the law before real benefits kicked in.

      And, yes, I know that something this complex takes a long time to set up -- but I don't recall that the delay on Medicare Part D (prescription coverage) was anywhere near as long as for the ACA, and that was also a pretty complex (needlessly so!) program.

      Political Compass: -6.75, -3.08

      by TexasTom on Sun Sep 29, 2013 at 01:24:23 PM PDT

      [ Parent ]

    •  obama only has the pully pulpit when he's on it (0+ / 0-)

      the rest of the time the left gives it over to the 1200 coordinated radio stations they've been ignoring for 25 years.

      they will always win the messaging battles on any major issue until the left pulls its fingers out of its ears and stops giving the right a free speech free ride on the radio waves.

      blaming obama is useless

      This is a list of 76 universities for Rush Limbaugh that endorse global warming denial, racism, sexism, and GOP lies by broadcasting sports on over 170 Limbaugh radio stations.

      by certainot on Sun Sep 29, 2013 at 08:09:51 PM PDT

      [ Parent ]

  •  Rethugs Had No Problem With Romneycare, & (21+ / 0-)

    Ronmneycare is the exact thing as Obamacare, but Romney is a rich, white member of the Party of Stupid while Obama is a black member of the Democratic Party--- therein lies the problem with the Party of Stupid racists and their hatred of the conservative Heritage Foundation's health care plan.

    (If Obama was a rich, white member of the Party of Stupid, Obamacare would be embraced by right-wingers, but he's not so it's not.  It's that simple and contemptible.)

  •  Yes, the ACA is taking away my insurance. (17+ / 0-)

    It's an expensive, very high deductible plan for individuals with pre-existing conditions but under the ACA, since insurance companies can no longer deny for pre-ex, my insurance company (through the state of Colorado) is shutting down.  This has nothing to do with employer insurance.

    The plan is ending 12/31 although there is a provision allowing me to continue coverage through the end of March.

    In this limited circumstance the ACA does away existing policies.  

    Will I end up with better, less expensive coverage under the ACA?  

    I'm about to find out.

    When was the last time anyone in DC told America the f*cking truth?

    by jaf49 on Sun Sep 29, 2013 at 09:46:13 AM PDT

    •  Good point (6+ / 0-)

      I should have included that.

      "The NSA’s capability at any time could be turned around on the American people, and no American would have any privacy left, such is the capability to monitor everything. [...] There would be no place to hide."--Frank Church

      by Joan McCarter on Sun Sep 29, 2013 at 10:20:08 AM PDT

      [ Parent ]

    •  I'm from CO, go here to check rates (4+ / 0-)

      Here are the rates the insurance companies submitted to the state.  I think you'll be glad to get rid of the policy you have now.  There's also a good calculator to show how much you'll save with the subsidies.

      •  Thanks. I've been looking for the (0+ / 0-)

        Colorado rates.

        Sadly I don't qualify for any subsidy.  Due to my income my only option is Medicaid and there is no way I'm going in that direction.  Also with my assets I probably don't qualify for Medicaid anyway.  

        I'll be buying through a broker instead and hoping (and expecting) that my monthly premiums will be lower for a somewhat better plan.

        And then on June 1 I go on Medicare.  Too bad the ACA didn't think about people like me who will only need coverage for 1-12 months and allow a waiver.  They could have included a provision allowing people like me to stay on my current plan until starting Medicare.  

        Oh well, I am expecting to be better off.

        When was the last time anyone in DC told America the f*cking truth?

        by jaf49 on Sun Sep 29, 2013 at 12:34:23 PM PDT

        [ Parent ]

    •  I'm on the same plan.... (6+ / 0-)

      It's called "CoverColorado", and I'm looking forward to getting off of it!  My wife has separate insurance through United Healthcare that excludes her from coverage for anything to do with her head (she has pre-ex migraine headaches), so we will be able to finally go on the same plan through the exchange, and I gather this saves $$$$.  We will know for sure on Tuesday.  I can't wait!

    •  I am in the same situation in Indiana, losing my (3+ / 0-)
      Recommended by:
      tofumagoo, jaf49, Observerinvancouver

      current high-risk pool policy and may fall into the ACA coverage gap.

      It's not a myth. It's active Republican sabotage.

      "Let us not look back to the past with anger, nor towards the future with fear, but look around with awareness." James Thurber

      by annan on Sun Sep 29, 2013 at 11:14:15 AM PDT

      [ Parent ]

    •  I'm in the same situation in Maryland. (2+ / 0-)
      Recommended by:
      annan, jaf49

      The high risk pool ends Dec. 31 for those who receive subsidies under it, for the rest of us on the standard plan in the high risk pool it ends June 30, 2014.

      A society grows great when old men plant trees in whose shade they know they shall never sit. - Greek proverb

      by marleycat on Sun Sep 29, 2013 at 11:20:57 AM PDT

      [ Parent ]

    •  I'm self employed (14+ / 0-)

      and a I received a letter from United Healthcare a couple of months ago stating that starting Jan 1st I would not be insured by them anymore. They will no longer offer individual plans.   I wasn't upset because I didn't like them anyway. Crappy coverage and expensive. Over $600 per month, big deductable, and I would have to pay 35% of hospital expenses. Being self employed and poor, I wanted to have some sort of coverage in case of an emergency.

      I went on to Healthcare.gov, they told me to go to Covered California, I used the estimate calculator, and got estimates for around $120-$135 for enhanced silver plans which are much better coverage than what I currently have.

      That is HUGE for someone like me.

      •  great news! (1+ / 0-)
        Recommended by:
        corpsechorus

        we're probably going to hear a lot of stories like that from blue states and those fully cooperating (wonder how AZ is going to be since Brewer went with Medicaid expansion); hopefully the media (not holding my breath) and us can spread the word about the differences between those states fully implementing ACA and those that aren't; full implementation with Medicaid expansion means more people are covered, lower prices.

        The Democrats care about you after you're born. --Ed Schultz

        by micsimov on Sun Sep 29, 2013 at 01:01:31 PM PDT

        [ Parent ]

    •  Important to publicize this (0+ / 0-)

      Q: Will Obamacare eliminate some plans?
      A: Yes, probably. 1. Private insurance companies can do whatever they want to (just as they can now), and are not compelled to offer plans in your state, or to stay in business. 2. Companies selling very expensive plans, with crappy coverage, to individuals with pre-existing conditions are likely to find that those individuals can get much cheaper better insurance through the exchange. So those very expensive crappy plans are likely to disappear because no one in their right mind will want to buy them.

  •  Joan, I love hearing your voice on Kagro on Weds. (6+ / 0-)

    You are so logical. You are a nice person and your compassion comes through loud and clear.

    "For we, the people, understand that our country cannot succeed when a shrinking few do very well and a growing many barely make it." - President Barack Obama, Second Inaugural Address, January 21, 2013.

    by surfermom on Sun Sep 29, 2013 at 09:48:08 AM PDT

    •  Thanks (2+ / 0-)
      Recommended by:
      I love OCD, on the cusp

      I really love doing the show with Kagro. If it wasn't happening right as my work day is starting, I'd be there every day! I'm very jealous of Greg.

      "The NSA’s capability at any time could be turned around on the American people, and no American would have any privacy left, such is the capability to monitor everything. [...] There would be no place to hide."--Frank Church

      by Joan McCarter on Sun Sep 29, 2013 at 09:59:42 AM PDT

      [ Parent ]

  •  there was something better (4+ / 0-)
    Recommended by:
    tle, Willa Rogers, Boogalord, Nailbanger

    and not only was it ignored it was refused a place at the table:

    http://www.nytimes.com/...

    as for a "work in progress"

    http://www.nakedcapitalism.com/...

    "The ACA was passed in March 2010, incorporating many features designed to meet Republican objections to the Bill. Yet, in the end, Democrats never put Medicare for All on the table, abandoned the public option and many other features, and did not get a single Republican vote in either chamber....

    Is that better than nothing? Sure, but you also have to take into account the opportunity cost of what was done in 2009 to work towards and then pass the ACA in 2010. What if the Democrats had ignored the Republicans in 2009, and used reconciliation or elimination of the filibuster and their big majorities in both Houses to try to ram through HR 676?

    I think they would have succeeded because Nancy Pelosi had full control of the House, and with elimination of the filibuster and even reconciliation they would have needed only 50 votes + 1 (the VP) in the Senate to have passed that bill in the Spring of 2009, and implemented it by January 2010. Then there would have been no rise of the Tea Party, no sabotaging of the ACA, and full coverage for everyone with no co-pays...."

    Only more time will deliver the truth about ACA...

    everything else is noise.

    •  The problem was the Repub wing of the Democratic (2+ / 0-)
      Recommended by:
      tle, Observerinvancouver

      Party, the side that is on evil rich people's side.

      nosotros no somos estúpidos

      by a2nite on Sun Sep 29, 2013 at 09:55:57 AM PDT

      [ Parent ]

    •  All true (2+ / 0-)
      Recommended by:
      Faito, on the cusp

      what's also true, if if this doesn't work well, Dems will be too scared to try anything else for another generation. That's something else the GOP is counting on.

      But yeah, there was a reason so many of us were pounding on Reid to do take it out of Baucus's hands and do it by reconciliation from the moment it became clear that the GOP was going to obstruct and negotiate it down.

      "The NSA’s capability at any time could be turned around on the American people, and no American would have any privacy left, such is the capability to monitor everything. [...] There would be no place to hide."--Frank Church

      by Joan McCarter on Sun Sep 29, 2013 at 10:08:44 AM PDT

      [ Parent ]

      •  If this doesn't work well... (1+ / 0-)
        Recommended by:
        tofumagoo

        ...we need to start immediately promoting saner solutions than mandated expensive private insurance coverage with high out-of-pocket costs, and to remove the language of the law prohibiting state-based efforts for single-payer for the next several years.

        "Dems too scared to try anything else for another generation" are what got us to where we are today. If that's the case, then we need Better Dems, not more skeerdy-cats.

      •  But that still wouldn't have resulted... (0+ / 0-)

        ...in single payer.

        What it might have gotten us is a buy in option for at least some of the population for Medicare, or some sort of similar public option.

        Unlike single payer, there does seem to have been strong popular support for allowing the public to choose government-sponsored insurance as one of multiple choices.  And it is indeed a shame that we didn't get that...although I'll hope that we may see something of that sort appear at the state level in a few years.

        Political Compass: -6.75, -3.08

        by TexasTom on Sun Sep 29, 2013 at 01:32:43 PM PDT

        [ Parent ]

    •  Here we go again... (1+ / 0-)
      Recommended by:
      Loge

      Seriously, you need to get out of the progressive bubble if you really think that single payer ever had a snowballs chance of becoming law.

      Much as some people try to deny it, a large portion of Americans really are satisfied with the health coverage that they get through their employer -- and those people would scream bloody murder at any plan that would take that coverage away and replace it with a forced government program.  That's why Republicans are continually peddling the lie that the ACA would do exactly that.

      If Obama and the congressional Democrats had pushed for single payer, it would have been soundly rejected by the public at large, and would have ended up going nowhere.

      The idea that the mass public overwhelmingly wants single payer is every bit as much nonsense as the belief by conservatives that the public overwhelmingly hates the ACA and wants to see it repealed.

      Political Compass: -6.75, -3.08

      by TexasTom on Sun Sep 29, 2013 at 01:30:09 PM PDT

      [ Parent ]

      •  I just not see how that's relevant (0+ / 0-)

        to the question of what is or isn't true about the law that did pass. What-if history is a waste of time.

        And not for nothing, the ACA allows states to include public options and greatly expands the number of people on Medicaid, aka single payer. It also shores up Medicare by helping deliver unto it a healthier population and other cost savings.

        Difficult, difficult, lemon difficult.

        by Loge on Sun Sep 29, 2013 at 01:55:27 PM PDT

        [ Parent ]

        •  Expanded Medicaid or public option... (0+ / 0-)

          ...are not single payer.

          Single payer is where all coverage is through a single insurance option (presumably run by the government) -- hence the term single payer.

          Letting more people into Medicaid or offering a public option in competition with private insurance is not single payer.

          Political Compass: -6.75, -3.08

          by TexasTom on Sun Sep 29, 2013 at 08:04:44 PM PDT

          [ Parent ]

  •  We underestimate the RW propaganda machine (10+ / 0-)

    This is a planned combination of Talk Radio, a TV network, fake think tanks, websites, and columnists, all for the purpose of lying to the uninformed and irrational people of the country.  This is a powerful machine and until we figure out how to counter or discredit it, this country is at risk of becoming a 3rd world Oligarchy.

  •  I always like to look for broader and deeper (6+ / 0-)

    themes whenever I come across such stories, and I see this as a reflection and manifestation of the broader and deeper reality that a good portion of Americans basically think and act like pre-enlightenment bigots, morons and fools, i.e. non-rebellious serfs who superficially look like modern people but who basically believe everything they're told and want to be taken care of by their moral and social superiors. How else can one explain how they believe that insurance companies aren't "death panels" in the way that government agencies are, when making such decisions?

    A well-functioning republic (i.e. a country in which the people ultimately run things, however indirectly) doesn't require that all or even most of its citizens are knowledgeable about and engaged in affairs of state. But it does require that enough of them are, and that not too many are actively opposed to it. We don't have that these days. Even after all the shit we've been through over the past 15 years, not enough Americans are very knowledgeable about or engaged in the issues that most matter these days, and way too many are deeply ignorant about them, yet actively engaged in all the wrong ways.

    I don't know what has to happen or be done to change this for the better, but it's simply not sustainable. Another 10-20 years of this, perhaps much sooner, and the republic is dead (if it's not already and we just don't know it).

    More enlightened people who aren't just looking out for their perceived ethnic, racial and class privileges have to be more engaged in the running of the country, and less enlightened ones, who ARE looking out for their perceived ethnic, racial and class privileges, have to stop being so. I mean that racists have to stop being so racist, RW cultural warriors have to get over it and accept that it's the 21st century, rich people have to be less selfish, and the rest of us have to do more and not just stop at neverending outrage.

    "Reagan's dead, and he was a lousy president" -- Keith Olbermann 4/22/09

    by kovie on Sun Sep 29, 2013 at 10:00:37 AM PDT

    •  I think part of it (11+ / 0-)

      is that so much of the population is having to work so hard just to get by. I think they're overwhelmed and overworked and overburdened and so discouraged by not being able to move forward that they're willing to believe the worst of everything.

      Many of the people who have the luxury of being able to be engaged in affairs of state just see what's in it for them and use their engagement only for their own good.

      "The NSA’s capability at any time could be turned around on the American people, and no American would have any privacy left, such is the capability to monitor everything. [...] There would be no place to hide."--Frank Church

      by Joan McCarter on Sun Sep 29, 2013 at 10:11:19 AM PDT

      [ Parent ]

      •  I don't disagree with either point (0+ / 0-)

        It's just that I believe that endemic racial and cultural bigotry is also a huge part of the problem in addition to the fact that most less well off Americans are overburdened, and that many of those who are relatively well off are just out for themselves (and that some of them are self-styled liberals, sigh).

        Interestingly, the tea party speaks for all three groups, the overworked masses, bigots, and the selfish rich. They're good at ferreting out appealing to groups who are ripe for anti-government and anti-progressive messaging.

        Politics is never driven by just one set of issues, and the GOP is brilliant at knowing that and capitalizing on it in its very cynical and destructive way.

        "Reagan's dead, and he was a lousy president" -- Keith Olbermann 4/22/09

        by kovie on Sun Sep 29, 2013 at 11:55:18 AM PDT

        [ Parent ]

        •  It's not endemic. You may have meant frequent. nt (0+ / 0-)
          •  No, I meant endemic (0+ / 0-)

            Sorry if I violate PC rules by stereotyping, but certain groups have historically held and displayed and continue to hold and display bigoted views of other groups. I know some from personal experience. What they seem to have in common is a lack of liberal education, or respect for it.

            You're telling me that teabaggers aren't largely bigoted, and that their hatred of Obama isn't driven by his skin color? Nonsense.

            "Reagan's dead, and he was a lousy president" -- Keith Olbermann 4/22/09

            by kovie on Sun Sep 29, 2013 at 09:30:49 PM PDT

            [ Parent ]

      •  I worry about getting people (0+ / 0-)

        signed up to the exchanges who don't have regular Internet access.

        Difficult, difficult, lemon difficult.

        by Loge on Sun Sep 29, 2013 at 01:56:13 PM PDT

        [ Parent ]

  •  Just to show how venal insurers are, (12+ / 0-)

    I had an interesting experience today that shows where the insurance industry's head is and what it does to insure profits, minimize access and reduce claims.

    My wife and I recently came back to the US after 10 years overseas. My wife did not get a primary care physician yet as she was pretty busy. She got sick - nothing too bad; ear infection, sinus infection and bronchitis. Since she did not yet have a primary care physician no one at our GP's clinic would see her. So we did the next best thing and went to the very convenient urgent care center. Upon arriving we presented our very good insurance, PPO, minimal deductions and so forth, but were told that our insurance would not be good at this particular clinic.

    The reason why? The clinic was too convenient and too many people would use it! This and things like it are what is wrong with a health care industry in which profits are the only criteria. I.e. the insurer wants to minimize claims and costs by limiting usage at convenient locations in the hope that people will forego treatment in all but the most dire cases. It explains too why unless one lives near a major hospital the clinics are few and far between and why the urgent care centers (once godsends) are now excluded from many plans.

    “Never argue with someone whose livelihood depends on not being convinced.” ~ H.L. MENCKEN

    by shigeru on Sun Sep 29, 2013 at 10:04:36 AM PDT

    •  Great observation (4+ / 0-)
      Recommended by:
      on the cusp, myboo, tofumagoo, shigeru

      This part of the health care industry--the insurance side--hasn't been about health care in a really long time.

      "The NSA’s capability at any time could be turned around on the American people, and no American would have any privacy left, such is the capability to monitor everything. [...] There would be no place to hide."--Frank Church

      by Joan McCarter on Sun Sep 29, 2013 at 10:12:58 AM PDT

      [ Parent ]

      •  The urgent care centers were blessings when (0+ / 0-)

        they first arose in the 90's. As they were frequently aligned with existing clinics they were covered. However, the insurance companies figured out that people actually could use them, thus they decided to selectively reduce what clinics they covered.

        “Never argue with someone whose livelihood depends on not being convinced.” ~ H.L. MENCKEN

        by shigeru on Sun Sep 29, 2013 at 02:16:43 PM PDT

        [ Parent ]

    •  One other great thing about the ACA (1+ / 0-)
      Recommended by:
      shigeru

      massive investment in community health clinics for secondary care.

      Difficult, difficult, lemon difficult.

      by Loge on Sun Sep 29, 2013 at 01:57:02 PM PDT

      [ Parent ]

  •  I ran my wingnut brother's info through (10+ / 0-)

    the California healthcare market - his rates will go down considerably even if he goes with the platinum plan.

    http://www.coveredca.com/...

    Once in a while you get shown the light, in the strangest of places if you look at it right.

    by darthstar on Sun Sep 29, 2013 at 10:07:26 AM PDT

    •  Have you told him that yet? (3+ / 0-)

      "The NSA’s capability at any time could be turned around on the American people, and no American would have any privacy left, such is the capability to monitor everything. [...] There would be no place to hide."--Frank Church

      by Joan McCarter on Sun Sep 29, 2013 at 10:18:30 AM PDT

      [ Parent ]

    •  I did that with my RWNJ boss (2+ / 0-)
      Recommended by:
      darthstar, Calamity Jean

      He has a son with pre-existing mental illness issues.  I told him a BUNCH of times that ALL policies must have the 10 essentials which INCLUDES mental health.

      He then said that his premiums would be higher because his son had the pre-existing mental health issues to which I said NO.

      Then I used the calculator (estimating his income because I don't know at $200K), and a Silver plan would be $675/month for him and his son.

      He currently pays $1000 per month.

      Will he go to www.healthcare.gov and check it out for himself . . . probably not.

      You can't fix the stupid.

  •  Where's My "Summary of Benefits"? (1+ / 0-)
    Recommended by:
    on the cusp

    My family currently draws on parts of multiple insurance (medical, dental, prescription) from each of two very different employers. The ACA is very complex, and though most of it probably doesn't apply to my family (or to any other one family), we don't know what applies.

    Why haven't we received in the mail a "Summary of Benefits" for us that explains what the ACA changes? What our benefits are now, will be in a month, and over the years as ACA is implemented? I think I can go to a NY state website, but what if I moved to NJ? Or to FL? I should have to research the scenarios as if I were an insurance agent?

    The ACA would be a lot less spooky if each US household received a Summary of Benefits more or less applicable to that household. Something that could tell the household in under 30 minutes what its options are under the ACA.

    Or at least every insurance agent should know. I should be able to call my insurance agent and ask them what the ACA does, even though they're not the conduit for my employer-issued insurance.

    "When the going gets weird, the weird turn pro." - HST

    by DocGonzo on Sun Sep 29, 2013 at 10:09:28 AM PDT

    •  Your HR reps (2+ / 0-)
      Recommended by:
      I love OCD, on the cusp

      should be able to help.

      And yeah, your insurance company should have sent you something to inform you that you'd no longer have to make copays for preventive care, won't be subject to a cap if you or a family member gets an horrific, expensive illness, or if they don't spend 80 or 85 percent of your premium dollars on your care they'll have to send a rebate.

      Those changes are already in effect, and nothing else should change, unless your employer decides to stop providing coverage.

      "The NSA’s capability at any time could be turned around on the American people, and no American would have any privacy left, such is the capability to monitor everything. [...] There would be no place to hide."--Frank Church

      by Joan McCarter on Sun Sep 29, 2013 at 10:17:47 AM PDT

      [ Parent ]

      •  HaHaHaR Reps (4+ / 0-)

        My wife's employer is a very large multinational corp based in NY that "self insures" (it's the insurance company itself, though that's not at all its core business). All we've got from it is a glossy 20 page brochure telling us they've switched to a plan that sets fixed prices it'll pay for any procedures, beyond which we have to pay the difference. It gives us some websites on which we will have to comparison shop for the best prices.

        !!!!!!!!!!!!!!!!

        The HR reps at the corp never knew anything about even the previous "traditional" insurance plan. They might as well have been answering phones for how to change the cable TV subscription or what time the movie is playing. I am sure they don't even know what's in the new brochure for the new plan.

        I am also sure that all that ignorance and incompetence is by design.

        Then there's my employer, which is a small business in NYC that pays for the most minimal coverage possible to comply with the law, though its premiums are also very low because it pays some of its employees what amounts to welfare salaries in NYC. It hasn't announced any changes in the face of the impending ACA rollout, probably because it's generally incompetent at running a business and doesn't know/care about what's going on. There is nothing remotely like an "HR rep" at the company, and its insurer call center reps are even worse than my wife's company.

        My wife and I are smart and cherrypick between the plans to cover ourselves OK. But that's because we and our children are very healthy, with only minimal ordinary healthcare necessary to pay for. And we make enough money to pay for it.

        I want Medicare for All. I want a list of the baseline healthcare that everyone's Federal taxes pay for, plus another list of NY benefits beyond that paid by state taxes. The rest of this stupid system is far too complex, and therefore wasteful, while doing nothing to control costs or increase the provider capacity that are the real problems.

        "When the going gets weird, the weird turn pro." - HST

        by DocGonzo on Sun Sep 29, 2013 at 11:17:00 AM PDT

        [ Parent ]

    •  The cost of customized summaries of benefits (0+ / 0-)

      would be staggering.  Who would pay for that? The Republicans are refusing to give HHS funding to put out basic info.  I can't see them going along with a law telling insurance companies to do it.

      You all do really  have a simple solution to so many of your current problems:  Elect enough new Dems to take over the House.  

      We must, indeed, all hang together, or assuredly we shall all hang separately. B. Franklin

      by Observerinvancouver on Sun Sep 29, 2013 at 01:05:46 PM PDT

      [ Parent ]

    •  Well, the point is it doesn't change that much (0+ / 0-)

      so, look at the summary of benefits where you'd find them now.  I'lladmit I'd like more info on the different policies available on the exchanges, but note as well, these are state-run, so it can't all be on the federal govt.

      Difficult, difficult, lemon difficult.

      by Loge on Sun Sep 29, 2013 at 02:00:43 PM PDT

      [ Parent ]

  •  Very important - spread the word (9+ / 0-)

    Republicans will not repeal the law. Therefore, is very important you communicate the following via you social media - please help people to avoid scams regarding their health care insurance.

    To avoid fraud artists, only use this website: Healthcare.gov. In there, you can find links to the exchange offered in every state. In case of technical problems you can call 1-800-318-2596.

    This is very important - spread the word

    I stand by what I said, whatever it was

    by duende on Sun Sep 29, 2013 at 10:10:43 AM PDT

  •  Obamacare Forcing Employers (5+ / 0-)
    some employers might drop it, [...] because it would cost them less to pay the penalty for not providing coverage than to continue to carry it. But that's not something Obamacare is forcing them to do.

    No, if an employer saves money by dropping it though paying a penalty, then Obamacare is indeed forcing them to do that. Let's be honest.

    The previous insurance offered by that employer wasn't offered because the employer cared about the employees' health. It was because offering it saved the employer money, probably by giving a benefit worth more to the individual employee than it cost the employer, so the employer could pay less cash plus the benefit. When employers have the option to save money, especially when the other option is to be forced to spend more, they will take the savings option.

    It's business. That's the honest truth. It's why healthcare costs should not be an employee benefit, but rather a society cost paid without extracting profits or making people pay for baseline health. It's why we should have Medicare for All, not some insurer-written, Republican based healthcare finance plan.

    "When the going gets weird, the weird turn pro." - HST

    by DocGonzo on Sun Sep 29, 2013 at 10:15:37 AM PDT

    •  financially preferable *isn't* "forcing" (0+ / 0-)

      I agree that the way ACA was written makes it sensible (from a financial standpoint) for some businesses to drop insurance and pay the fine. But that is in no sense of the term "forcing" the business to do so.

      Labor is prior to, and independent of, capital. Capital is only the fruit of labor, and could never have existed if labor had not first existed. Labor is the superior of capital, and deserves much the higher consideration. -- K.Marx A.Lincoln

      by N in Seattle on Sun Sep 29, 2013 at 11:15:30 AM PDT

      [ Parent ]

      •  It's Forcing (0+ / 0-)

        In the business sense, giving a clearly cheaper is forcing. The business sense is the only sense that matters to businesses.

        "When the going gets weird, the weird turn pro." - HST

        by DocGonzo on Sun Sep 29, 2013 at 11:19:57 AM PDT

        [ Parent ]

        •  it would be "forcing" only if... (6+ / 0-)

          ...such businesses were required to drop insurance and pay the fine.

          Which they aren't.

          In fact, if the payment is called a "fine", it cannot conceivably be simultaneously a requirement.

          Are we quibbling over terminology? Well, no. Couching the situation as "forcing" implies a much more coercive, much more authoritarian, much more abhorrent government than is actually the case. It's particularly galling to make that implication when this particular "out" for businesses came about because of compromises between Max Baucus and Congressional Republicans; in a more rational ACA, the fines would be large enough to make maintaining coverage a more reasonable alternative for employers.

          Labor is prior to, and independent of, capital. Capital is only the fruit of labor, and could never have existed if labor had not first existed. Labor is the superior of capital, and deserves much the higher consideration. -- K.Marx A.Lincoln

          by N in Seattle on Sun Sep 29, 2013 at 11:37:14 AM PDT

          [ Parent ]

          •  Punitive Fines (0+ / 0-)

            Are you arguing that hundreds of dollars in fines for, say, speeding on roads doesn't force drivers to go below the speed limit?

            So what constitutes "forcing"? Only when the alternative is for police with guns to handcuff the executives? But in that case, the exec has the option of fleeing the country.

            There are degrees of force. When a publicly traded company has the option of offering some insurance policy, or paying a lower amount in fines instead, the law requires the company to pay the fines, because that is obligated under "fiduciary duty" to maximize equity value and profit returned as dividends to shareholders. If they don't pay the fine, or find some other legally accepted accounting principle on which to put dollar value on the books that makes the more costly option somehow accrue some higher net dollar value than just paying the fine, then they are forced by the law to pay the fine. Or be legally liable in court to the shareholders, at the cost of their jobs and the difference in dollars.

            "When the going gets weird, the weird turn pro." - HST

            by DocGonzo on Sun Sep 29, 2013 at 12:10:42 PM PDT

            [ Parent ]

        •  Not good business sense to piss off employees nt (0+ / 0-)
    •  last paragraph is a winner (1+ / 0-)
      Recommended by:
      Willa Rogers

      You are absolutely right in that insurance should not be a benefit tied to employers.  It's a hugely flawed part of the US model.  The ACA doubled down on this.  It didn't need to... but it did.  It's one of the tweaks that the mythical functioning congress could discuss.

    •  Yes, yes, Medicare for all (2+ / 0-)
      Recommended by:
      TexasTom, paradise50

      As soon as my magic wand comes, I'll get that done. In the meantime, those employers who are paying a tax to avoid insuring their employees are probably doing them a favor, and what they pay goes towards the subsidy pool. If you lose insurance, you can use the exchange to get some.

      As to it being too complicated: yes, it is. The only reason Medicare ISN'T is because it's been around for 50 years and all the bugs and kinks are out of it. It would be the same if we had single payer, there would be implementation issues for a while. And there would still have to be different plans; one payer doesn't necessarily mean single plan. Could we do what some countries do, cover everyone the same, with the government paying? Yes. Yes we could. But just imagine the political explosion if anyone even proposes such a socialist plan (government  pays and owns the system).

      •  ...welcome.... (0+ / 0-)
        Welcome from the DK Partners & Mentors Team. If you have any questions about how to participate here, you can learn more at the Knowledge Base or from the New Diarists Resources Diaries. Diaries labeled "Open Thread" are also great places to ask. We look forward to your contributions.

        Ignorance is bliss only for the ignorant. The rest of us must suffer the consequences. -7.38; -3.44

        by paradise50 on Sun Sep 29, 2013 at 07:13:44 PM PDT

        [ Parent ]

      •  New Around Here (0+ / 0-)

        You just keep waiting for your magic wand. While you're waiting, the rest of us will be working for Medicare for All, not pooh-poohing those of us who do like you are. BTW, it's been proposed, and more - learn something before you whine about doing something.

        Impressively, you admit that the present Medicare system didn't arrive by magic wand 50 years ago, but took that half century to work out to today's version. It could take another 50 years to make it universal. Especially if people like you just pooh-pooh all the way to that magic day, instead of pulling your weight, or at least get out of the way of those of us who do.

        "When the going gets weird, the weird turn pro." - HST

        by DocGonzo on Mon Sep 30, 2013 at 05:40:11 AM PDT

        [ Parent ]

    •  Interesting definition of force (1+ / 0-)
      Recommended by:
      AJ in Camden
      if an employer saves money by dropping it though paying a penalty, then Obamacare is indeed forcing them to do that.
      No, it isn't.  Employers still have the decision -- and choice -- of determining whether offering their own health plan makes sense from an employee retention and morale perspective.  

      Remember that under the pre-ACA status quo, those employers could have saved money by dropping health coverage and sending their employees into the individual policy market.  They chose not to do so because they were concerned about losing employees...and that same choice will still exist come January 1, 2014.

      Political Compass: -6.75, -3.08

      by TexasTom on Sun Sep 29, 2013 at 01:36:36 PM PDT

      [ Parent ]

    •  Part of it has to do with the quality (0+ / 0-)

      of insurance that is eligible for tax deductions for the employer.  If they offered real insurance, it wouldnt matter.  if they offer crap, take the employee contribution and go to the exchange, net win.  If the labor market were stronger, the whole issue would be moot, as employees would have to offer generous benefits.  But the only "forcing," is setting floors on benefits.  

      Difficult, difficult, lemon difficult.

      by Loge on Sun Sep 29, 2013 at 02:06:52 PM PDT

      [ Parent ]

  •  I wonder why these myths are so perisent. (0+ / 0-)

    Sure the media sucks and the Republicans continue to perpetuate them.  But Obama shares the blame, if not the most blame, since has failed miserably to educate people about the ACA, starting in the summer when the Tea Party took over the messaging (e.g., about death panels) when he was basically AWOL on it.  Imagine what a difference it would be from today if the the facts were given as much currency as the myths from the beginning.

    The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt. Bertrand Russell

    by accumbens on Sun Sep 29, 2013 at 10:24:32 AM PDT

    •  bc most of the myths have a foundation in truth (2+ / 0-)
      Recommended by:
      Willa Rogers, tofumagoo

      Let's take an easy one:

      Obamacare will take the insurance I have away.
      For some people this is going to be true.  The rebuttal to this in the diary is that the blame is on the company.  That could be true - UPS would be a good example of a company choosing to make a financial decision and then scapegoat the ACA.  But it could also be true that the government, by setting up a series of incentives and penalties, gives strong financial encouragement to companies to do something different.  In those cases it will be the ACA that is the reason for the changes.  Suppose for example a company offered a premium plan to their employees.  In the ACA era, that will result in an additional tax.  The company then has to make a financial decision (not necessarily an emotional or moral one).  Is it the fault of the company for doing what a company should do?  Or is it the fault of the change in policy?  Presumably the people changing the policy know that companies will act in a certain manner (or else they will be driven out of business by others that do).

      Right now everyone who supports the law has to be rah rah rah about it to present a united front.  But reality is, the law has some blemishes here and there.  There is room for improvement.  (For democrats to admit it would just give ammunition to political opponents.)

      •  Most individual insurance policies are ending... (0+ / 0-)

        ...too; mine is being phased out because it has a cap on lifetime limits.

        That's not necessarily bad; I'm one of those who will personally benefit by the Exchange subsidies, particularly because I'm old. But the diary is a bit disengenuous in calling the insurance industry's current shapeshifting a "myth."

        And the narrowed provider networks through the subsidized Exchange plans are not going to allow people to "keep the doctor you have."

    •  Yay, anti-O confirmation bias. Nt (0+ / 0-)

      Difficult, difficult, lemon difficult.

      by Loge on Sun Sep 29, 2013 at 02:07:42 PM PDT

      [ Parent ]

  •  Maybe insurance is the problem... (3+ / 0-)

    Your story about a patient
    “a fantastic candidate for a relatively new, very effective treatment in which the tumor is cauterized in a minimally invasive procedure”
    Sounds like radio-frequency ablation, which should be, in a rational world, an inexpensive procedure which a patient could simply purchase under a fee-for-service medical model. Before the insurance companies took over medical practice, fee-for-service worked pretty well.

    Reality is a good thing to know about, as long as you keep it separate from the Opera we live in

    by greatferm on Sun Sep 29, 2013 at 10:26:20 AM PDT

  •  My pre-existing condition kept me uninsured (1+ / 0-)
    Recommended by:
    annan

    for 30 years.  I then got on the ACA PCIP and have it until Jan. 1.  It is a basic 80/20 plan.
    I will qualify for subsidies, and will save at least $150 monthly on premiums, but the gold plan is 70/30.  
    Unless I am not reading it correctly, subsidies are not available for the Platinum Plan.
    I am in Tx, so I will use the federal exchange.
    I think to a small degree, I am getting screwed on what I will pay in deductibles and co-pays.

  •  So the insurance companies (1+ / 0-)
    Recommended by:
    annan

    are now going to approve the "relatively new, very effective treatment in which the tumor is cauterized in a minimally invasive procedure"? Or its equivalent in whatever situation comes up next.

    And when they don't, will that be the fault of the ACA?

  •  Yesterday during the Rules Com (0+ / 0-)

    meeting Louis Gohmert (I know) was relating stories about the doctors telling patients terrible things as his means of painting the ACA as evil - they just weren't true. The response was sort of funny - yes, Louis that's awful that those rumors are being spread by health professionals. It is our duty to inform our constituents about these lies and mis-characterizations so they get the best, honest information about their health care. Louis looked like one sad puppy. And then someone else in the room gave him the old oh, what a tangled web we weave quote.
    My 80 year old wife of a doctor (gone now, he can't set her straight) mom is being sucked in to the bullshit mania - for her, it's mostly fox news fed.

  •  Some positive news on the communications... (2+ / 0-)

    front - an entire section in today's Arizona republic. Generally, it is quite positive on the ACA. Even the section on the effect on small businesses is upbeat as it suggests the businessman profiled, who already provides health insurance for his employees, will be more competitive with those who don't provide employee coverage.

    There's a moving essay on a cancer patient and one on an early retiree in a situation not unlike mine.

    Just another faggity fag socialist fuckstick homosinner!

    by Ian S on Sun Sep 29, 2013 at 10:59:04 AM PDT

  •  Taking away my doctors may also not be a myth, (1+ / 0-)
    Recommended by:
    Willa Rogers

    if I do choose a new ACA policy (I may not qualify) the two providers offering policies in Indiana appear to be creating "narrow networks" that stick to a single hospital system.

    Here in Indiana my long term primary care physician is part of one hospital system but my cancer specialists are at the IU Med Center. In the past my insurance covered them both.

    However, it appears that the two narrow networks aren't going to overlap, so I may have to choose which network to join meaning that one or more of my doctors will be "out-of-network".

    We'll know more in a few days, but this may come back to bite us.

    "Let us not look back to the past with anger, nor towards the future with fear, but look around with awareness." James Thurber

    by annan on Sun Sep 29, 2013 at 11:21:33 AM PDT

    •  In some states Blue Cross is the sole insurer... (1+ / 0-)
      Recommended by:
      annan

      ...for the Exchange plans. The admin's official talking point is that most states will have the choice of an array of plans from only two insurance companies, lol.

      And yes, the provider networks for subsidized Exchange plans are laughably narrow in some areas, both in terms of doctors' groups and hospitals.

    •  Not really (0+ / 0-)

      What's true is, if you choose a new insurance plan through the exchange, some of the cheaper plans may only pay for physicians in their network. Insurance providers can also limit their plans like that right now.
      The plans for federal exchanges, like in Indiana, have not yet been announced, I believe.

      •  Plans have not been announced but the (0+ / 0-)

        providers have and they appear to be divvying up Central Indiana's major provider networks.

        Also this from one of the premier insurance agents in the area:

        Here is the reality of the future exchange policies. They are going to be HMO plans. These will be heavy-handed with managed care. You will have to choose a doctor in the network for all of your care, and this doctor will facilitate all medical services. For many people that are used to PPO plans, this may be a huge adjustment.
        Indiana Health Insurance Exchange

        "Let us not look back to the past with anger, nor towards the future with fear, but look around with awareness." James Thurber

        by annan on Sun Sep 29, 2013 at 12:06:40 PM PDT

        [ Parent ]

    •  Network exceptions (1+ / 0-)
      Recommended by:
      annan

      In my experience (pre-ACA), when you need specialized care that is only offered one or two places, they have to allow you to go to one of those at in-network rates. (I ran into this with genetic testing, for example. They wouldn't approve my first choice place -- a bit more convenient to get to -- but approved the second option that was really of equal quality.)

      And I suspect that the major cancer centers etc. etc. will have to join all the ACA networks, just as they have to accept Medicare. Otherwise their competitors will gain market share, which is contrary to their capitalist ethos.

  •  SHOULD HAVE GONE FOR SINGLE PAYOR (0+ / 0-)

    TODAYS NEW YORK TIMES OP-ED  
    THE ABOVE  ARTICLE SPEAKS OF THE DO'S AND DON'TS BUT DOESN'T ADDRESS THE MONEY ISSUES.
    THE OP-ED PIECE SOUNDS TERRIBLE.
    SEEMS TO ME OBAMA CARES SUCKS
    HAS ANYONE READ THE OP-ED PIECE AGAINST THE ACA IF THIS IS TRUE SOUNDS LIKE THE REPUGS WON'T HAVE TO SHUT THE GOVERNMENT DOWN THE LAW WILL FAIL ALL BY IT'S SELF.

  •  The scientologists have some myths of their (0+ / 0-)

    own on the ACA.  That there will be forced screenings and medication of children.

    I cant for the life of me figure out where they are coming from.  Is there a kernal of truth in this steaming pile?

    "Searches with nonspecific warrants were ‘the single immediate cause of the American Revolution.’” Justice Wm. Brennan, referring to the 4th Amendment

    by Nailbanger on Sun Sep 29, 2013 at 11:58:23 AM PDT

  •  Hmm.. (0+ / 0-)

    ....I thought there is actually going to be some medicare issues as because you won't be able to cheat the government anymore, more doctors/hospitals are going to just not take medicare patients at all.

  •  This is a very useful diary. I hope everyone (0+ / 0-)

    bookmarks it and sends it to friends and relatives who need accurate information.

    We must, indeed, all hang together, or assuredly we shall all hang separately. B. Franklin

    by Observerinvancouver on Sun Sep 29, 2013 at 01:23:15 PM PDT

  •  Obamacare will take the insurance I have away. (0+ / 0-)

    This one is true.  

    Look, no one forces a business to take a tax break when taxes are due, it just makes sense.  And it's the same thing here, they don't have to save money by cutting employee benefits but the will.

    •  Will it substitute something better? (0+ / 0-)

      Obamacare doesn't force anything on your employer, if that's what you're saying. It's your employer making that choice, if they do. And they may get penalized for their choice, depending on how big they are.

      You don't give any details. But I would be very skeptical of anyone (especially employers) claiming that their choices are forced by the ACA. It's being used as the excuse for everything up to why your burrito no longer has guacamole on it.

      •  interesting discussion on meaning of force above (0+ / 0-)

        Another way might be to say that absent the laws passed as part of the ACA, and absent any political games, would an employer change the benefits?  If the answer is no, then the ACA is the cause.

        The best example of this is employers who choose to offer "Cadillac" plans.  When the ACA kicks in and the cost of offering this benefit suddenly jumps, the employer cannot offer the same service within the same budget constraint.

        So suppose an employer decides to offer a less generous plan in order to keep overall benefit costs within the same budget, rather than to increase their benefits spending and maintain the same level of coverage.  You still want to point to the employer?  It's really not accurate.  The employer perhaps made a choice not to increase the value of benefits paid.  It's not quite the same as cutting them when it was the legislation that changed the price points.

        That is a real situation and a real concern for some people.

        •  this has been my point all along. (0+ / 0-)

          Look I am sure that for a lot of people the ACA will be great.  But if Obama was being truthful when he said we can get to keep our current plans, he was being a bit naive on how businesses work.  In the end sure we can pin it on the employer but not everyone is going to buy that line, especially if they are directly affected.

      •  that's not what Obama said. (0+ / 0-)

        He said 'if you like what you already have, you can keep it.'  Putting incentives or disincentives into the law that 'force' a company that wants to make money to do something that makes them money while not direct force, is still force nonetheless.  I'll let ya know in November ( when my company's health insurance changes usually come out ) whether or not I got a good deal from the ACA.

  •  I was pleasantly surprised (0+ / 0-)

    last week, one of the local TV station in Charleston, SC had a long segment about ACA, where to get help and information, explaining about navigators, etc.  They also had a telephone panel where people could ask questions.  It was very informative.  It was nice to see rather the usual cretins down here blasting Obamacare.

  •  Work At Home Special Report!$$$ (0+ / 0-)

    my co-worker's sister makes $89 every hour on the computer. She has been out of work for seven months but last month her pay was $15448 just working on the computer for a few hours. have a peek at this site....

    http://www.works25.com

  •  truth can't beat their talk radio advantage (0+ / 0-)

    the left has to fix the radio

    This is a list of 76 universities for Rush Limbaugh that endorse global warming denial, racism, sexism, and GOP lies by broadcasting sports on over 170 Limbaugh radio stations.

    by certainot on Sun Sep 29, 2013 at 08:04:34 PM PDT

  •  Joan (0+ / 0-)

    Great post. Thanks.

    Be involved! http://www.whereistheoutrage.net

    by ecthompson on Sun Sep 29, 2013 at 08:48:48 PM PDT

  •  Myth myths. (0+ / 0-)

    Why do I know I'm going to see spin when somebody writes about "exposing the myths"?

    It's good to correct falsehoods, but there is no need to add your own.

    Specifically:

    Obamacare will take the insurance I have away.

    It seems to be taking mine away.

    My current coverage does not meet the standards of a bronze plan.  Even if I could keep it, I would be subject to a penalty for doing so.  In 2014, it's not enough to matter, but it's much more noticeable starting in 2015.

    That doesn't, by the way, mean that I'll be worse off.  If I qualify for a subsidy, and that's looking pretty likely, I may be able to find better insurance for the price I'm paying now for a catastrophic plan.  

    Obamacare won't let me see my doctor anymore

    Glib cop-outs are not very useful.  If the insurance company's action is rooted to the ACA, it is still caused by ACA.  If not, not.  That said, I can't think of anything I know about in ACA -- and I am far from being knowledgeable that would cause an insurance company to drop a doctor.

    One thing I do know is that my current doctor is reducing his practice, setting up a membership relationship with patients, and blaming it on ACA. We're moving to Texas, so it doesn't mean much to me.  But I wonder if this is happening to others.

    Rationing?

    I hope you're wrong about that.  There is no way we improve on American health care without Death Panels.  We could certainly work to find a better nickname, but somebody's got to say no to doctors and companies pushing procedures, devices, and drugs that increase cost without improving health.

    LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

    by dinotrac on Mon Sep 30, 2013 at 12:31:53 PM PDT

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