Uncovering Covered California

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I suppose this is a sort of guest post. The following is the experience that a friend of mine had in wake of the “Affordable Care Act” implementation. He posted this to his FB and asked to share. Disclosure: My friend is more a classic liberal with a streak of libertarian in him. He’s a believer in liberty and the free market; but is far from being a social and foreign policy conservative. He’s also an agnostic atheist.

*UPDATED 2/23/16* PLEASE READ AND SHARE!!!

“Uncovering Covered California”

A brief recap of my last year and a half of bureaucratic nightmare. It’s a bit long but please read and share to get the word out.

Fall 2013: Skyrocketing insurance premiums in anticipation of the implementation of the Affordable Care Act force me to move from my Kaiser Permanente plan, that I had for about ten years with no problems, to a Covered CA plan with Kaiser which, even with a partial subsidy, is more expensive than my previous plan a year earlier.

August 2014: I receive a notice that Covered CA needed documents to prove my citizenship even though I had already provided them when I signed up 10 months prior. (I was born in California) I provide them with those documents.

September 2014: Covered CA sends me a letter saying they received the documents and that I did not need to worry further about the matter.

October 2014: Covered CA sends me a letter saying that our policy will be terminated on October 31st due to lack of documents proving my citizenship. This is very concerning as my wife is pregnant. I call them to provide them with the documents for the third time. They are unable to accept my documents in spite of my protests because they are in a “closed period” where they can’t make adjustments to files. I am told that they can’t make changes to my files until November 2nd.

November 2014: I call on November 2nd and am told they now can not make changes until November 11th. I call on November 11th and after 3 hours on the phone they were able to locate my documents. I was told that the changes would take “a month or two” to process.

December 2014: I receive notification that my policy has been terminated. I was not allowed to pay any premium payments. I start receiving bills for medical services rendered in November and December. I pay those out of pocket. I call to find out what is going on and Covered CA tells me that my status is still pending but it will soon be reinstated.

January 2015: I’m reinstated, and pay my premium. I soon find out that they accidentally put me into a deductible plan instead of the HMO plan I’m paying for. I get more bills for services rendered. I spend around 20 hours getting that straightened out but after a week or two I’m back on the HMO plan.

March 2015: I receive a premium bill that is more than three times the cost of my usual premium bills. I call, I spend about 30 hours on the phone between Covered CA and Kaiser and no one knows what’s going on. I pay my normal premium amount in the meantime.

April 2015: I’m told the reason the premium is so high is because my payments made from January thru April had all been pushed backwards two months to cover November and December of 2014 even though I had no coverage during that time. I inform them that they need to apply the payments correctly to the months I actually had coverage. I’m told that this problem will be fixed and that I need to continue making my normal premium payments in the meantime.

May 2015: I add my newborn son to my policy in a process that took several hours and involved me answering questions several times regarding his employment and marital status. He was nine days old.

May-October 2015: I repeatedly call to find out the status of my premiums spending over 100 hours on the phone being bounced around. I am repeatedly told that everything looks correct in their system and that the next bill should reflect that. It doesn’t. I keep making the monthly premium payment to make sure I’m doing everything correctly on my end.

October 2015: I’m unable to make my premium payment for November online. I call and am told that my policy has been terminated again because my payments were still being pushed back to the two months in the previous year when we were not covered. This left our most recent premiums as “unpaid” and caused them to terminate the policy. Even though I paid through the end of October, I had been terminated in August without being notified. It’s a good thing we had no medical emergencies during that time. I spend another 30-50 hours trying to get the reinstatement process initiated again.

December 2015: I’m told that I will be reinstated on January 1st of 2016. I make the premium payment (which now even with the subsidy is double the cost of our policy before being pushed to Covered CA). I make a payment on December 15th to cover the month of January. I am told that once I’m reinstated that I will need to pay for November and December of 2015 because we used the “believe me” policy to receive temporary coverage during that time.

January 2016: I receive a letter from Covered CA saying that my son will no longer be covered on Covered CA because he qualifies for Medi-Cal which is “free”. I do not receive any refund for the amount of his Covered CA coverage. I also haven’t received any confirmation on whether he’s actually covered or not. His employment and marital status has still not changed.

Early February 2016: I receive my premium bill which is now seven times higher than my monthly premium instead of the three times it should be (to cover November ’15, December ’15, and February ’16). I call to find out what’s going on. I’m told they accidentally generated two accounts for my policy and applied the ’16 payments to the wrong account. My payment made on December 15th is returned to me on January 31st. I now owe for four months of coverage. I am unable to pay online or via telephone because their computer system was tied to the wrong account. I’m told I will have to pay for four months via cash or check in order to maintain my good standing. I do not have this amount of money on hand in cash as the previous payment was returned to the credit card.

Mid February: They supposedly fix the problem with two accounts allowing us to make the back payments for November and December of 2015 as well as January and February of 2016. The premiums that I am paying include coverage for my son on Covered CA even though he is now supposedly on Medi-Cal. I have not received any refund for the difference nor does anyone at Covered CA seem to know how to initiate that on their end. We update my income on the Covered CA website as my hours were cut at work. The next week we receive a bill again for seven times the normal premium. We are told that it was a mistake and will be fixed “eventually”. We speak to Medi-Cal and are told that my son is activated in their system but they’re waiting for his account to be linked to the state. We are told there will be no interruption in coverage.

Late February: We take my son in for his 9 month checkup and are told he is not covered by Covered CA (which I paid for) or Medi-Cal. I call Medi-Cal and they tell us that because we changed the income on Covered CA, he has to be re-approved for coverage with Medi-Cal. I’m told I need to upload my new reduced pay stub to Covered CA to restart the approval process for Covered CA. I won’t receive my first reduced pay stub for another nine days so I can’t even begin the process of reinstating his coverage until then. He is currently not covered on either Covered CA or Medi-Cal in spite of the fact that I paid for his coverage in full with Covered CA.

As of today, February 23rd, my son has no health insurance even though his coverage is paid for. I do not know if I am covered or if my wife is covered. It depends on which department you speak to. I do not know how much I will end up owing and how much longer it will take before this is sorted out. I’m hoping that my son does not get sick or hurt while the bureaucracy tries to figure out if they allow us to receive what we paid for. I just hope it gets fixed before my son’s employment and marital status changes.

PLEASE SHARE SO WE CAN DO SOMETHING ABOUT THIS SYSTEM!!!

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I remember when it passed, another employee at work threw both fists in the air and screamed out, “Yeah! Free health care, baby!”
How can anybody smart enough to drive a modern truck with today’s DOT regulations be that freakin’ STUPID!!??

@Petercat:
They are called the modern day DEMOCRAT>

His problem seems to be having a job at all.
Looks like keeping covered via Covered California is a full-time job in itself.
Being unemployed also ends all that paperwork having to do with changes in income.

OK sarc/off

What a nightmare!
It has been bad for old neighbors of mine, too, but not THAT bad.
California should be ashamed.

And the leftists will continue to claim that the solution is to let these hacks completely take over medical care in this country.

Imagine such an insane system applied to buying your groceries.

Socialism always has, and always will, totally suck.

That’s an extreme and by no means representative anecdote. The uninsured rate in CA is down to 10% and falling. In MA,which had a head start and time to fix the bugs, it’s now down to less than 2% and falling. In Texas, it’s 25%.

In MA, Romneycare has 65% approval of voters and providers. In CA, Obamacare likewise has rising voter approval, and the experiences described in this blogpost are utterly non representative.

http://www.mercurynews.com/health/ci_28705381/obamacare-poll-shows-rising-support-throughout-california

@Pete: Imagine such an insane system applied to buying your groceries.

Socialism always has, and always will, totally suck.

But, to be fair, Bernie thinks we have far too many choices in food and in dry goods.
Why so many types and styles of shoes?
Just have a couple types of shoes.
And why so many options in foods?
Just have a hot cereal and a cold cereal and everyone gets an account to go to their closest store ONLY for their four or five varieties of lunches and dinners.
See:
http://www.demos.org/blog/5/27/15/bernie-sanders-deodorant-argument-one-most-substantive-campaign-so-far

@Petercat: Well said and Bernie and Hilldabeast have taken the same theme!! How in the world is healthcare or education free?? Do the teachers work for free, does the facility run for free, is there NO cost?? Oh right, the taxpayers pay the bill!! Wait until the true cost of Obolacare is flushed out!! America could have took the cost and insured everyone with this total fraud!!

@Larry Weisenthal:
Any idea why we saw no actual cost figures about what his increases were?
He kept track and told us of his many hours but never stated how much he had to pay
Whenever facts are omitted I become a bit skeptical

Wordsmith
Is he an Internet FB friend ?
Or someone you really know?
Could you ask him to give us a bit more info about the actual dollar amounts involved?

from FActCheck

‘Skyrocketing’ Premiums

Overall national health care spending is growing at historically low rates. President Obama has boasted that “health care costs overall are actually going up more slowly over the last three years than in the last 50,” which is true. From 2009 to 2012, the growth has been under 4 percent per year. Drew Altman, CEO of the Kaiser Family Foundation, wrote in September 2012 of the slow recent growth in both premiums and spending: “These are strikingly low numbers to those of us who have been studying health costs for a long time.”
This seems to not corroborate what your “friend” has experienced
Costs did go up 130% from 1999-2009

Obviously after his health care savings of $2500 a year, which Obama promised, he’ll only have to deal with the bureaucratic nightmare!

@John:

Wordsmith … And the FA blogmeister … Are two of the finest anonymous people I’ve ever met on my extensive sojourn through the Internet blogosphere. But I’m on a first name basis with neither.

Dealing with insurance companies is entertaining enough, add a layer of government workers it becomes so much better.

Once the remainder of the most egregiously burdensome aspects of obamacare come online, the pain will grow more intense.

Honestly, if obamacare was lowering the increases in healthcare, then why did the largest national insurer come out earlier this year saying they will have to get out of the obamacare market due to horrendous financial losses? Because the risk corridor payments from the government got cut to insurers secondary to inadequate obamacare enrollment revenue, IIRC by around $2 billion.

Hey guys. Gals. No … friends.

I’m a health care provider myself. I totally get it that you all don’t like Obama/Socialism/Democrats … whatever. That’s OK. My best friend forever … who was a (1) Germany occupying army vet (2) Vietnam War Vet (50 mm machine gunner) and (3) — truly — just because he wasn’t through serving his country after deployment in Germany and Vietnam infantry — a US Coast Guard vet — is a conservative, just like you all. But he actually likes me, in spite of the fact that I have honest differences of opinion with him regarding politics.

Here’s the thing. ObamaCare is the same thing as RomneyCare which is the same thing as the “sensible market alternative to socialist HillaryCare” designed by the Heritage Foundation and endorsed by Chuck Grassley and Newt Gingrich.

You all don’t like ObamaCare … because it’s OBAMAcare. I get it. That’s OK.

Here’s the deal:

ObamaCare accomplishes the following:

1. Gives everyone health care (eventually) … so we don’t have people “dying on the streets” (thank you Herr Trump … for gosh sakes … can we at least agree that we as a country have sufficient wealth to prevent people from dying on our streets? I mean … really.

2. Prevents the number one cause of personal bankruptcy … which are health care expenses — IN RESPONSIBLE HARD WORKING PEOPLE WHO ARE RESPONSIBLE ENOUGH TO ACTUALLY HAVE HEALTH INSURANCE!!!

3. Covers people with pre-existing illnesses.

4. Provides preventive health care … such as prenatal care, screening colonoscopies, and whatever.

5. Let’s young people stay on their family policy until they are 26.

Now, all of that are things which the large majority of American voters want. So how do you do it?

You don’t do it with “selling insurance across state lines”
You don’t do it with “health savings accounts.”

You do it with the “sensible market alternative to HillaryCare,” designed by the Heritage Foundation, supported by Chuck Grassly and Newt Gingrich, and instituted successfully by Mitt Romney.

OF COURSE THERE WILL BE GROWING PAINS. But this can and will work if Donald Trump (or Hillary Clinton) is elected President and we all roll up our sleeves and make it work.

As a personal note … I am 100% opposed to the true “socialist takeover of American health care” as proposed by Bernie Sanders, i.e. “Medicare for all.” I’ve never voted for a Republican for President in my life, but — as of today — I’d vote for Rubio or Trump (but not Cruz) before I voted for Sanders.

But Hillary Clinton is my candidate, as I write this (full disclosure).

– Larry Weisenthal/Huntington Beach CA

@Larry Weisenthal: I have been in the Health Care Industry for over 40 years both Nationally and Internationally and Obolacare is a loser. Answer me this, did Obola lie to over 6 million Americans when he ran for his first term and told America that you can keep your health insurance and/or doctor “period”!! Did Obola lie when he said it would not force insurance providers to pay for abortions?? Did he lie when he said it would cost America less?? Did Obola lie when he said it would not go to cover illegals, I know if you work in Orange County know the truth because I lived there for 22 years and in San Diego County for 26 years!! It’s not a matter of providing care because as you know you can visit an ER and care is provided with or without insurance thanks to the liberals in Sacramento!! Why would someone who is past child bearing age need maternity rider on insurance?? The elements of Obolacare that you identify as benefits to America has some value but to force on America what Democrats did was NOT necessary to achieve these values. I would NEVER vote for Bernie because he is a pure Socialist and I worked to hard and understand that free is a lie!! I would NOT vote for Hilldabeast because she is evil, a liar, and has committed treason!! I will choke if I have to vote for Trump but if that’s my choice versus the other two then there really is no choice. Thanks for your service and I am guessing we have more in common than not.

Hi Common Sense.

Thank you — truly — for your serious and non “ad hominem attack” comments. Let’s discuss/debate the issues seriously and objectively — realizing in advance that there will be no winner or loser in this debate — if it were that simple, then every intelligent person would arrive at a common agreement.

Here’s the thing. If your objective is to make Obama into some sort of a villain, then that’s where you’ll end up.

But here are some facts:

Firstly, I’m a self employed person (actually an MD — medical oncologist — self employed) who paid for individual health insurance plans through California Blue Shield for more than 20 years. Every year, my premiums were rising at rates vastly exceeding the inflation rate — throughout the GW Bush Presidency — long before ObamaCare was gleam in any liberal’s eyes. in 2006 and 2007, our premiums rose more than 20% per year. ObamaCare provided convenient cover for continued premium increases.

Now, ObamaCare is BETTER insurance than what previously existed. Coverage for pre-existing conditions. NO LIFETIME CAPS ON COVERAGE (which might not seem like a big deal unless you get a catastrophic illness — but which is the LEADING CAUSE OF PERSONAL BANKRUPTCIES in responsible people who actually had health insurance policies, pre ObamaCare. All of you fiscally responsible conservatives are only a cancer diagnosis away from financial ruin, absent ObamaCare (I write this as an informed cancer doctor). It wasn’t a bunch of socialist liberals who designed ObamaCare — it was the conservative Heritage Foundation, endorsed by none other than Chuck Grassley and Newt Gingrich.

Now, the fact is that pre-existing insurance plans and doctors made the decision that they could opt out of pre-existing insurance plans and keep enough patients to support their business model. And pre-existing insurance plans could use ObamaCare as an excuse to increase premiums — WHICH WERE INCREASING ANY WAY. But the cold hard facts remain that ObamaCare is succeeding and that this success will continue to increase. States which have embraced ObamaCare have seen a dramatic decrease in the uninsured. They’ve seen a decrease in the rate of inflation in overall health care costs. They’ve seen an increase in consumer satisfaction.

If the GOP would simply get on board and work to improve the things which need to be improved, it would be even better.

Which is why I would support either Hillary Clinton or Donald Trump. Actually, I’d even support Marco Rubio — because, once in office, they’d all face the reality that the conservative Heritage Foundation actually did get it right in designing the best national health care system on earth.

@Larry Weisenthal:

Larry, you are absolutely wrong in claiming those of us opposed to obamacare are opposed because of Obama. We are opposed because it cannot -and HAS not – work as proponents claimed it would. It is nothing more than a trojan horse to push for the socialist takeover of medicine which you wrote you oppose. We opposed the same government power grab back when Hillarycare was the mechanism. It is a strawman bogus argument to claim that opposition is due to the fact it was Obama’s project.

The entire foundation of obamacare is a collection of lies and deception:

1. You cannot keep your plan or your doctor.
2. The average annual cost of premiums for a family of 4 did not go down an average of $2500.
3. The projected enrollments have fallen far short of the ridiculous projections, and keep getting decreased since the law was crammed through by a party line “reconciliation” maneuver by the dems.
4. Obama stated repeatedly in the run up.to the vote that:
– it was not a tax (until arguing before SCOTUS it was constitutional.as a tax)
– abortions would not be covered. (They are)
– illegal aliens would not be covered. (The dems have been pushing for that)
5. Over 80% of people with obamacare policies have to be subsidized by taxpayers to pay their monthly premiums, yet are supposed to cough up deductibles 2-3x higher for individuals and up to 5x higherfor families.
6. Despite Gruber being captured on at least 2 videos stating clearly that federal dollars (from taxpayers) would be denied to states that refused to set up state obamacare exchanges – as was written into the law – SCOTUS ruled essentially that the clearly written words of the law did not mean what they said.
7. At last count, at least 11 of the state exchanges that were formed went under, and had to be taken over by the federal exchange.
8. As stated above, the nation’s largest insurer, Humana IIRC, stated at the beginning of the year they were losing around $535 million in the obamacare exchanges and were likely going to drop out of participation in the exchanges in 2017.
9. The federal government is shorting the risk corridor program roughly $2 billion due to severe revenue shortfall from inadequate obamacare premium payments that failed to cover woefully inaccurate medical expense estimates.
10. The obamacare website disaster.
11. Despite the rosy predictions of obamacare supporters that ER usage for primary care would decline after the law was passed, the exact opposite has happened.

The bureaucratic insanity of mandating the same coverage for every insurance plan automatically increases the cost of insurance. It makes no sense for a childless couple in their 50s, post-menopausal, to be required to have coverage for pediatric care, maternity care and birth control. Neither does it make any sense for a man to have mammography coverage, nor a woman to have prostate screening coverage. But a plan is not legal since obamacare was made law without such mandated coverage, regardless of the actual needs of the insured.

Bringing up romneycare is another red herring. Romney lost, in part, because he was the single GOP candidate who could not attack Obama’s plan precisely because of his own plan. What are the wait times now in MA to see a primary care physician?

The left pushed the sob stories of 30-45 million people supposedly unable to access the medical system because of a lack of insurance. We are 4 to 5 years into obamacare as the law of the land, with only 10 million obamacare insured, the vast majority who had insurance before obamacare, or who were eligible for medicare. How many billions have been spent, including the hundreds of millions wasted on the obamacare website and failed state exchanges to produce such a poor result?

And do not forget, Obama delayed the most painful aspects of his plan until.after he is out of office. What happens to all those who currently have employer-provided insurance – far more than the 10 million obamacare insured – when the employer mandate and the ‘cadilac tax’ kick in?

Obamacare is a complete disaster, based on nothing but lies and ‘feel-goodism’. The government that can’t care for our veterans in the VA healthcare system, and can’t even fire those responsible for that debacle, cannot be trusted with running the medical system for the rest of the country.

@Pete:

Pete, Many a beautiful theory has been ruined by an ugly fact. In the states that have actually tried to make the Heritage Foundation plan work — e.g. MA and CA — it’s working very well.

Less than 10% uninsured in CA and less than 2% in MA vs 25% in TX. 62% approval in CA, and growing. 65% approval in MA and growing. Slower growth in cost inflation.

This wasn’t Obama’s plan. It wasn’t Hillary’s plan. It was the plan of the conservative Heritage Foundation — endorsed by Chuck Grassley and Newt Gingrich. Put into place by Mitt Romney. And it’s working.

Personal bankruptcies among conservatives with catastrophic illness is going down. Don’t trust me. Trust the data.

As I said, many a beautiful theory is ruined by an ugly fact. [Wall Street Journal Link]

– Larry Weisenthal/Huntington Beach CAd

P.S. For whatever reason, my above link didn’t work. Here’s the quotation from the Wall Street Journal site:

Bankruptcy Beat

Jul 1, 2015
Bankruptcy Trends
The Future of Personal Bankruptcy in a Post-Obamacare World

The U.S. Supreme Court just put its stamp of approval on the Obama administration’s health-care reform, and a Boston law professor thinks he knows what will happen next.

In his 2014 study, Northeastern University law professor Daniel Austin dug into personal bankruptcy filings to figure out what happened after Massachusetts lawmakers made health insurance mandatory in 2005.

His findings? Massachusetts residents who file for bankruptcy protection these days have way less medical debt compared to the rest of the country. The typical Massachusetts person or couple who filed in 2013 had $3,041 in medical debt, while people everywhere else had an average of $8,594 in medical debt.

In fact, he found that Massachusetts is the only state where medical debt isn’t the leading cause of personal bankruptcy. (A loss of income is the No. 1 reason, he found.)

So what does Prof. Austin think will happen with mandatory health care in all 50 states? Could the system designed to give people access to affordable health insurance make families more financially stable and keep them out of bankruptcy?

“It absolutely should show a reduction in bankruptcies [filed] due to medical debt,” Prof. Austin said in an interview Tuesday.

Plenty of studies have pinpointed medical debt as the No. 1 reason why people turn to bankruptcy for a fresh start. In rallying for health-care reform in his 2009 State of the Union address, President Barack Obama said that 62.1% of consumer bankruptcies are medical bankruptcies, citing a study Sen. Elizabeth Warren (D., Mass.) co-wrote as a Harvard law professor.

Prof. Austin’s study found the percentage of medical bankruptcies to be far smaller. Overall, 18% to 25% of personal bankruptcies filed in the U.S. were prompted by medical debt.

That is, except in Massachusetts. There, he found that 3% to 9% of bankruptcy cases were filed because of medical debt.

Based on his study, Prof. Austin said it wouldn’t be a stretch to say that Massachusetts health-care reform is why the number of Massachusetts residents who file for bankruptcy is falling faster than the rest of the country. (The number of people who file for bankruptcy has been falling for a couple of years now, thanks to an improving U.S. economy and other ivory tower theories.)

For his study, Prof. Austin evaluated 5,400 of bankruptcy cases filed between 2005 and 2013 to determine what kind of debt people have at the time of the filing. Bankruptcy law requires people to list all of the debt they owe—including how much they owe and to whom—when they file. He also relied on roughly 380 survey responses from lawyer and bankrupt individuals.

Write to Katy Stech at katy.stech@wsj.com. Follow her on Twitter at @KatyStech

@Larry Weisenthal: Back to my initial response, I had a couple of questions regarding the passage of Obolacare. Did Obola lie about telling America that if you liked your current plan and/or doctor you could keep them “period”, did he lie when he said it would not cover abortion for those providers who had an issue with it, did he say it would NOT cover illegals, and did he say it would cost America less?? I would like your answer to these please. Also I question as did many Americans the constitutional foundation of such a law which FORCES Americans to an action such as this.

@Common Sense: C’mon Common Sense. Larry knows best and doesn’t want to respond to uncomfortable facts, as he accuses all the rest of us for ignoring his statistics. I trust and believe Larry as much as I do his choice for president, Hillary, and his savior of the healthcare system Obama. Don’t you? Hats off to Larry! (really terrible song from many years ago).

Hi you all.

Firstly, the plural of anecdote is not data.

Second, there is a difference between being “wrong” and “lying.” Did President Bush lie when he said that Iraq was developing biological and nuclear weapons, or was he merely wrong, based on bad intelligence? I give him the benefit of the doubt and say that he was merely “wrong.”

Now, to the best of my ability to distill the numbers that we are talking about, approximately 2.7 million Americans had their prior insurance policies cancelled under ObamaCare, because ObamaCare imposed higher standards (i.e. it was a better product, with no caps on coverage and so forth — these higher standards were not Obama’s personal idea, but were the recommendations of non-partisan National Institute of Medicine panels). This is 2.7 million people out of 262 million insured people, or about 1 in 100 who had to switch plans.

With regard to losing doctors, that was going on before ObamaCare and continuing on afterward. Health care costs were rising inexorably (the rate of rise has indeed slowed under ObamaCare). Private insurers want to maintain or increase profits, being capitalist entities. The whole game in private health insurance is putting together a provider network based on doctors and hospitals who negotiate fee schedules. If you as an insurance company want to have the best bottom line, you try to raise premiums and reduce costs. If ObamaCare forces you to provide a more expensive product (cover pre-existing conditions, provide preventive care services, remove coverage caps, cover kids on their parents policies until age 26, and so on) and you want to maintain and improve your bottom line you do so by raising premiums and squeezing doctors, until some begin to drop out of your network. But, again, this stuff was going on before ObamaCare and the data indicate that ObamaCare did what it was supposed to do, which is to increase the number of people with health insurance and slow the rate of health care inflation.

Of course there are growing pains, as there were for the more mature RomneyCare, but in states which have made an effort to make it work (e.g. California) there is majority voter support, which continues to grow. Look again at the numbers: 25% of Texans lack health insurance, compared to 10% of Californians and 2% of people who live in MA. And 62 – 65% of the voters in CA and MA like their states’ versions of ObamaCare/RomneyCare. And those numbers are growing, as the plans get their respective bugs worked out.

Regarding “illegals,” those people are prohibited from obtaining Federal subsidies.

ObamaCare and Immigrants

Regarding abortions, that’s a money shell game problem. Health insurers like paying for abortions, because it’s cheaper for them than paying for prenatal care, labor, delivery, and post birth pediatric care. Since they are capitalist, bottom line driven businesses, they do what they can to squeeze out more profits, just as in the case of their doctor provider networks. Federal dollars can’t be used to pay for abortions, but money is what’s called fungible — meaning that Federal dollars which go to subsidize premiums probably do end up paying for some abortions, despite efforts to set up firewalls between piles of money used to pay for different aspects of health care. But it’s not the fault of the government that private insurance companies figure out ways to make more money, in the same way that people figure out ways to lower their taxes. The fact of the matter was that — pre ObamaCare, virtually all private insurance plans covered abortions — famously including those which covered members of Congress. Excluding abortion coverage completely raises the costs of the plans. The intent of the ObamaCare law was to comply with the Hyde Amendment, but in reality that’s very difficult to guarantee, owing to the money fungibility problem.

I wrote in advance that I didn’t expect people to agree with me. I’m OK with that. We are all entitled to our own opinions. If I’m determined to believe that Bush was the worst President in history, I’ll go on believing that. Same for you all and Obama. If we all agreed, there would be no point in wasting time arguing about it.

@Larry Weisenthal: Your words reflect typical liberal drivel. According to you the Democrats were crafting a healthcare bill that actually is a Republican bill by the Heritage Foundation. A place where Democrats go for ideas all the time. Right? The ACA plan was SO Republican based Democrats barred Republicans from any of the negotiations on the bill during creation. Then for the actual vote all Republicans voted against this Democrat crafted Republican bill. Sorry not buying it.

I can tell you on a personal note I lost my doctor. I have a good friend who is a small businessman. He lost his plan, the one he was promised he would be able to keep, had to get a new one. So now his 59 year old wife has maternity coverage again. They were forced to buy coverage they won’t be using. Oh, the costs went up dramatically, not by the low ball numbers you like to use, and his deductible is much higher. I recall the Democrats kept telling us this was all about choice and competition. Actually it’s about crashing what we have a going to single payer. This is just the mechanism they are using to get us there.

We sure don’t want people ”dying on the streets.”
So, take Los Angeles County.

There are 150,000 single adults there who experienced homelessness during a 12-month period in 2014-2015.
More than 80% of L.A. County’s 44,000 homeless people are single adults.

The County spends close to $1 billion a year caring for and managing homeless people, with a majority of the money going to their health needs.
~~~~~~~~~~

Now, the poverty income level is over 4 times less than what the County spends on homeless people/year.

So, why is it that ObamaCare covers all these homeless types PLUS the County has to spend $68,000 each on them and it still doesn’t dent the homeless situation on the streets at all?
And, why is it that I must be covered for abortion, birth control, prostate tests, STD issues and mental health issues (all of which cost more money than an individualized plan, like the one I had before ObamaCare?)

Where does the subsidizing of poor people end?
$68,000/year each in Los Angeles County is OBVIOUSLY not enough.
Yet, if each homeless person got that money (instead of filtering it through a bunch of paper pushers) they would all be upper-middle class homeless people!

@Larry Weisenthal:

Quick points Larry as I am driving to my NICU this morning. Please pardon any spelling and grammatical errors, as the voice recognition software on my phone 10 sometimes make mistakes.

Relying on the pro Obamacare propaganda website Obamacarefacts.org should not be considered reliable data. These are the same jerks that told us we would be able to keep our plan and our doctor, that health care costs would decrease, that ER visits would also decrease, and that obamacare was not a tax (until the Obama admin argued before the courts it was a tax).

As an oncologist I am quite certain you are familiar with the concept of sampling error. Would love to see the actual poll question regarding Obamacare approval ratings, and the raw polling data/demographics, as opposed to simply taking the word of a pro Obamacare writer. There is nothing that this administration has done in the last 7 years with regard to Hillary’s unsecured email scandal, Fast and Furious, Benghazi, the IRS scandal, Obamacare, the insane Iranian nuclear deal, or the economy that would give them the benefit of the doubt regarding any claims they make.

Specifically regarding your statement that insurance companies prefer to play financial shell games to pay for abortion rather than maternity and pediatric care, I am calling you out for deflecting the issue. The point is that Obama LIED during the push to cram this evil plan down our throats in insisting abortions would NOT be covered. Or do you have no recollection of former Michigan Rep Bart Stupak?

If things are so horrible with healthcare in Texas and so great in California, why are so many people and companies leaving California and coming to Texas? (You remember Toyota is moving their US headquarters from CA to TX, right?)

You keep saying that its working in California, and its working in Massachusetts. Here is an anecdote for you. I have a daughter who lives in Los Angeles and who to my eternal chagrin is on an Obamacare plan. She has to contact me to ask that I call in her prescription renewals because the waitlist to get in to see her primary care nurse practitioner is 3-4 months long, and her plan doesn’t cover referrals to a dermatologist to get the acne meds her NP insists must be ordered by a dermatologist. Here in Texas, I regularly have to jump through hoops to coordinate outpatient continuity of care when trying to discharge NICU babies who are obamacare covered, because the majority of private physicians will not accept the coverage. This means having to send some patients 90 miles or more away to see the only specialist they need who is willing to accept obamacare insurance.

Larry, I appreciate that fact that you actually debate in a civil fashion, compared to far too many of the leftists who post here. But please understand that you aren’t going to get a pass on accusing opponents of ignoring your points, when you so blatantly avoid addressing key criticisms of your position. It is magical thinking “feelgoodism” to believe that something based on nothing but lies and deceptions as obamacare most certainly was can ever produce anything of actual positive value. It is an evil political scam by the left to take control of medical care in this country in the same effort to addict and enslave the less informed to the government political plantation that social security and all the idiotic “War on Poverty” garbage was.

Honestly, Larry, would you ask this pointed question? How on earth can an obviously intelligent person such as yourself (oncology ain’t for simpletons), after seeing the horrendous management and political coverups of the VA scandal, compounded by the disasterous rollout of obamacare and the threats by the largest national insurance groups to get out of the ACA exchanges next year, ever believe that the government should be given more control over medical care?

@Larry Weisenthal: Larry, President Bush and Democrats in Congress looked at the same intel that Bush did and they supported the findings. Turns out the intel was incorrect and of course Bush did NOT lie like so many many Democrats claim. With respect to Obola’s claims, first of all it was 5-6 million Americans, not 2 that lost their coverage directly associated with Obolacare. Secondly what intel did Obola provide to America to support his claim, oh right Pelosi and Democrats ONLY said you have to pass it first to find out what is in the plan. I contend based upon the evidence that Obola lied to America about his health care plan to get elected. He has ZERO evidence to support his claim so he lied or he would have produced evidence to support his claim.

@Larry Weisenthal: Larry, Pete is correct. Have you ever worked in government managed care?? I know you bill medicare and MUST be aware pf the fact that the fraud and abuse of government managed care is the worst. I worked at Balboa Naval Hospital, my wife works at Pendleton now, and I also worded for the VA when the scheduling fraud was exposed. Trust me, it’s much more widespread and worse that what you see now. I was a scheduler and what I saw and was told to do Vets is disgusting. I am a disabled Vet and it made me sick. I also worked for an Ophthalmologist in Orange County in a private practice and can tell you that the efficiencies created by private healthcare makes government managed care appear and is a fact as the worst possible way to go for America. In the government managed plan there is NO motivation to work more efficiently, faster, or effectively. In fact when you do you either burn yourself out or quit. You have employees who spend more time a day trying to get out of work than work and they are experts at it. NO Larry your wrong, sorry to tell you but I have seen it both ways and know for a fact that government managed care is the worst way to go.

@Larry Weisenthal:

Here is some data, Larry, that I think you will agree is not anecdotal:

http://www.merritthawkins.com/uploadedFiles/MerrittHawkings/Surveys/mha2014waitsurvPDF.pdf

This is a survey conducted in 2013, from June through November, well into both obamacare in the US, and romneycare in MA. Regarding wait times for physician appointments:

At 45.4 days, Boston has the highest cumulative average wait time for a physician appointment of the 15 metropolitan markets surveyed. Boston also had the highest average waits times when the survey was conducted in 2009 and 2004.

But wait, there’s MORE!

The average appointment wait time to see a family physician ranged from a high of 66 days in Boston to a low of 5 days in Dallas

The average appointment wait time to see an obstetrician/gynecologist ranged from a high of 46 days in Boston to a low of 10 days in Seattle.

The average appointment wait time to see a dermatologist ranged from a high of 72 days in Boston to a low of 16 days in Miami.

Hmmm…are we beginning to see a pattern here?

And even better, there is this:

At 10.2 days, Dallas has the lowest cumulative average wait time for a physician appointment of the 15 markets surveyed.

Simply put, Boston, with all the ‘goodintentionism’ of Obama/RomneyCare, has the highest average wait times to see a physician, while Dallas, with no state obamacare exchange, has the shortest average wait times to see a physician.

But wait…there’s even MORE!

The cumulative average rate of Medicaid acceptance by physicians in all 5 specialties and in all 15 markets surveyed was 45.7%, down from 55.4% in 2009 and 49.9% in 2004.

In other words, physician rate of medicaid acceptance was INCREASING before obamacare was forced down our throats, but since passage of ACA medicaid acceptance by physicians is going down by 10%.

Boston has the highest rate of Medicaid acceptance by physicians in the 15 markets surveyed (73%), while Dallas has the lowest (23%).

So to make it crystal clear, during 2013, a year when obamacare was in effect for just under 3 years, the city with the highest acceptance of medicaid by physicians had the longest average wait times to see a physician, while the city with the SHORTEST average wait times to see a physician had the LOWEST medicaid acceptance by physicians. Unless you believe that people in Dallas are richer and/or healthier than the folks in Boston, or you think that Dallas has a significantly better physician-to-patient ratio across multiple medical specialties than does Boston, how does one explain such a difference in wait times to see a physician? Before you answer that, note on page 15 of the survey, the authors very helpfully provided the physician-to-patient ratio for the metropolitan areas surveyed. Would it surprise you to note that Boston had 450.1 physicians per 100,000 population, while Dallas-Ft. Worth only had 197.2 physicians per 100,000 population? In fact, would it surprise you even more to note that Boston had the HIGHEST physician-to-patient ration of the 15 major metropolitan areas surveyed?

Process that…the city with the highest number of physicians per population, with the highest acceptance of medicaid insurance by physicians, had the longest average wait times to see a physician. Conversely, the city with the LOWEST medicaid acceptance rate by physicians had the SHORTEST wait time to see a physician in spite of having a 56% lower physician-to-population ratio. Boston has more than twice the number of physicians as Dallas., yet has an average wait time to see patients that is 35 days LONGER (or 4.5 times longer) than in Dallas.

And regarding your claims of California performing better than Texas, that doesn’t seem to hold out from the presented data either. LA had a physician-to-patient ratio of 253.9 per 100,000 (higher than DFW) but still had longer average wait times (12.2 days versus 10.2 days in DFW), and a medicaid acceptance rate of 36.4%. Even if you try to point to Houston’s results to compare against LA, the average wait time of 14 days in Houston has to take into consideration the lower physician-to-patient ratio of 235.2 per 100,000 patients, and the fact that Houston has a significantly higher medicaid acceptance rate (55.8%) than LA.

Happy to discuss data with you like this, Larry. Feel free to show me any discrepancies you can find in my analysis, the linked paper and its data, or perhaps any evidence-based refutation of the underlying point I am making that there is inherent severe gross declination in delivery of efficient medical care that directly correlates with the level of government involvement in medicine.

Gotta get back to my patients now. Have a great day.

@Pete: Pete, you just danced around the real problem.
Those who are pro-obamacare and those who oppose it are speaking past one another.
And I’ll tell you why.
This is a quote from Richard Fernadez:

In his book Private Truth, Public Lies, social scientist Timur Kuran argued that people, under pressure to conform by culture leaders often told public lies to get the pollsters and thought police off their backs, even as they nurtured a largely undetected private resentments inside them. Over time two divergent perceptions would emerge: the public lie would determine how the regime thought about itself while the private truth contained the real, but hidden data.

These two contradictory perceptions can coexist for as long as they don’t meet, living in a kind of superposition much like Schrodinger’s Cat. But eventually some event occurs which makes the public aware the private truth is really what everybody is thinking. That observation collapses the political wave function and causes all hell to break loose.

The Left, which created the positive ObamaCare narrative, have been sentenced by their own Narrative.
The most dangerous lie is the one which you tell others then wind up believing yourself. For many years the Western political elites not only espoused this “public lie”, but made certain that anyone who refused to repeat it was pilloried by the thought police.
They thought this solved the problem.
But it only ensured that the spring would be wound — and wound past the breaking point — precisely where they could not see it strain. (Richard F, again)

Nowadays, mostly because of the powerful forces pushing this narrative of ObamaCare ”working,” all we see on the other side is anecdotal.

Oh – almost forgot this link:

http://www.massmed.org/News-and-Publications/MMS-News-Releases/MMS-Study-Shows-Patient-Wait-Times-for-Primary-Care-Still-Long/#.VtMfdH0rKzc

Just a quick snippet, from this paper by the Massachusetts Medical Society:

The study also showed that only about half or less of primary care practices – 51% of family physicians and 45% of internists – are accepting new patients in 2013.

For pediatrics – primary care for youngsters up to age 18 – the average wait time was 25 days, two days longer than last year, with 70% of pediatric practices accepting new patients, a decrease of 2% from 2012.

Because, you know, when your child is sent home from daycare with a fever, you can wait 25 days to be seen by the pediatrician, right?

Medical Society officials say the trend data for access to primary care shows cause for concern in all three primary care specialties. While the numbers have fluctuated from year to year, the percentage of family physicians accepting new patients has dropped 19% over the last seven years; the percentage of internists accepting new patients has plunged 21% over the last nine years; and the percentage of pediatricians accepting new patients has fallen 10% over the last four years.

Mind you, this is not an insurance company, nor a right-wing group arguing against the idiocy of national socialist healthcare. I say that because Massachusetts has the highest rates of acceptance of medicaid – due to romneycare requirements and pressure from the leftwing state legislature.

MassHealth (Medicaid): Consistent with last year’s findings and in line with Medicare, primary care specialties are the least likely to accept MassHealth, with family medicine at 70% and internal medicine at 66%. However, physician participation in this program increased by 6% among family physicians and by 12% among internists in 2013. Pediatrics saw a decrease in acceptance, at 83% for 2013, down from 86% last year.

Acceptance of MassHealth by specialists saw increases in orthopedic surgery, to 85%, up from 78%; cardiology, to 85%, up from 83%; and OB/GYN, to 90%, up from 87%. Gastroenterology dropped to 90%, from 92%

.

Now, I would love to see data from 2014 and 2015 on medicaid and obamacare insurance acceptance rates by physicians – broken down by states with obamacare exchanges versus those that refused to set up state exchanges – given that the ACA was allegedly going to increase medicaid reimbursement rates to 100% of medicare reimbursement rates for primary care specialties. As a neonatologist, I am inpatient-based and don’t have to deal with the sort of reimbursement hassles that outpatient physicians deal with every day. But have been unable in my brief searches this morning to find published data beyond 2013.

@Nanny G:

Nanny, it is not that “both sides are talking past each other”.

When dealing with a leftist in a discussion, there are 2 basic types of leftists. The first are the ones who I classify as the “Don Quixote” type leftist. These are the ones with good intentions but who refuse to accept reality when it doesn’t align with the leftist’s preferred perception of reality. They may be good-hearted, but their desire to avoid feeling uncomfortable about the existence of unfairness of life (with the inherent resulting existence of pain, suffering and misery) makes them highly susceptible to the lies, deception and manipulation of the other, sinister type of leftist. These Don Quixotes are the folks who believe that their good intentions are what really the only thing that matters, and that the actual outcomes – no matter how predictably bad – should never EVER be considered because to do so would be ‘mean’ and/or ‘unfair’. There is a subset of these Don Quixote types who aren’t worried about unfairness or misery, but instead are fixated on refusing to accept the reality that their personal preferences or beliefs are considered by most others to be abnormal. As an example, these are the people who think it is the highest form of shameless bigotry to consider someone with a 46/XY set of chromosomes, functioning male genitalia, and who fathered multiple children with a woman – as being a male, when said individual decides against these obvious facts that he is somehow a female. These are the folks who think it evil for me not to want my young daughters exposed to a mentally ill male who is so starved for emotional attention he insists he is a female and wants to use the girl’s restroom. These are the people who think it is bigotry to decline to actively support an act that someone’s personal, Constitutionally protected religious beliefs consider to be sinful, while simultaneously insisting that even passive exposure with no requirement to do anything in support of religious symbols is a vicious, untenable violation of civil rights. Bottom line is these type of leftists can’t stand the thought that anyone anywhere has the ability to disapprove or disagree with the leftist’s acts or beliefs. I suppose you could call these the ‘Special Snowflake’ subset of Don Quixotes.

The second type of leftist is the corrupt political scumbag that claws it’s way to leadership positions within the collectivist party by blathering emotive talking points that the creature knows are completely false, but will push a narrative that allows the leftist to climb further up the stairway of power. Ethics are nothing but weapons for this type of narcissistic filth to use to to attack opponents, rather than rules to live by. These are the deceitful trolls which Orwell described so very clearly in “1984”, portrayed with a chillingly accurate demeanor by Richard Burton in the film. They don’t care about decency, accuracy, honesty, truth, or any long term impacts of their efforts other than the potential increase in their personal power and wealth. Alinsky outlined the playbook for these folks, notably dedicating his magnum opus to Lucifer.

You won’t like this, Nanny, but frankly I lump both Hillary and Trump into the latter category, though I consider Hillary to be far more directly corrupt and evil, and Trump merely egotistic with a danger for totalitarian traits. Neither of them – in my opinion – have exhibited anything in their respective careers other than self-promotion for personal gain.

As I ponder whether Cruz can somehow be successful against the unfortunate reality I see unfolding before me of Trump winning the GOP nomination, I am left hoping for the combination of events, first that Trump’s support will survive the inevitable media onslaught against him once it is Trump vs Hillary, and secondly that Trump will turn out to be simply self-obsessed but pro-American, and not evilly totalitarian leftist as every high-ranking member of the democrat party is.

Regardless, I do not see particularly bright nor hopeful prospects for the next few decades. The intellectual, economic and cultural decline so glaringly obvious in western societies that are failing to resist the frenetic, violent expansion from the third world does not bode well.

Hi Pete,

Your case boils down to two things: (1) Wait times to see physicians and (2) percentage participation of physicians in the RomneyCare/ObamaCare programs.

You are a neonatologist? Did I get that right? What is the bill for 10 days in your NICU? 30 days? How about the total bill between ages 0 and 25 for some of your patients with severe birth defects?

You, of course, know the above. For those who don’t, here’s a clear example ($73,000 for 10 days):

https://m.reddit.com/r/beyondthebump/comments/3idbzz/just_got_the_bill_from_our_nicu_stay_us/

Wonderful world of US healthcare

Now, it comes down to what, precisely, is the most important function of health insurance? Is it to pay for oil changes and tire rotations or is it to pay for a totaled car or a million dollar liability case?

Of course there will be longer waiting times if 98% of the people have health insurance than if only 75% of the people have health insurance. There is a nationwide shortage of primary care physicians.

A lot of the blame for this goes to the medical profession itself, which, in the 1970s, feared a doctor glut and cut back medical school enrollments. My class at the University of Michigan graduated 220 doctors in 1975. Today, Michigan only admits 170 students per year. It’s the same way at a great many other medical schools. But the State of Michigan recently started a number of new medical schools, as have other states — as the doctor glut has morphed into a doctor shortage. So it’s a problem on the way to being corrected.

Getting back to your point, here’s where we get into an honest difference of opinion over what I might call “values.” Is health care a commodity or a right? If you think it’s a good thing to have shorter waits for non-emergent care than to ensure that all people have health insurance, then you probably view health care as a commodity. But the people of Massachusetts have decided that it’s worth it to have some growing pains, including introducing more stress into the primary care system, in order to have universal health care coverage.

Getting back to the NICU bills and long term care for serious medical problems — this doesn’t simply apply to your specialty, but also to mine — medical oncology. Virtually all new cancer drugs are priced at upwards of $100,000 per year, not including professional fees, ongoing imaging studies (PET-CTs, etc.) to monitor disease response and a whole host of additional expenses. As I wrote earlier, the number one cause of personal bankruptcies used to be medical expenses in people who did have private health insurance.

Health insurance policies — all policies, not simply subsidized ObamaCare policies — are much better today. No lifetime caps on coverage — which will mean fewer personal bankruptcies. Payment for screening colonoscopies and other preventive services. Coverage for pre-existing conditions. Coverage until age 26 on family policies, and so forth.

Of course there are problems when you introduce anything big and new. One of the problems is that covering 98% of people instead of only 75% of people means that there are more patients per doctor. So the supply of doctors needs to go up. Which it will. More doctors, more facilities — that’s actually economic growth.

I don’t at all agree with Bernie Sanders that it would be good to have health care be only 9% of GDP, rather than 18%. There’s nothing inherently wrong with spending more on health care, anymore than it’s bad for our economy if Americans want to drive SUVs rather than European Fiats, even though both are transportation. …. hold that thought; I’m headed somewhere, but I’ve gotta run, for now.

– Larry Weisenthal/Huntington Beach CA

@Larry Weisenthal:

Larry, thank you for your civil response. Though you seem to be avoiding and deflecting in your response, I will be direct as possible.

Of course medical care is a commodity, which you admit in your post via your discussion of the supply shortage of doctors, and the fact that Michigan is opening up more medical schools. So is Texas, and I am sure many other states are planning on the same. This absolutely is in line with medical care as being a commodity. Doctors – especially good ones – do not grow on trees. Neither do new drugs for oncology or any other medical specialty. I am quite certain you are well aware of the long process required for any new drug to go through to gain FDA approval, at very high cost to the pharmaceutical company that develops it. I am also certain you are aware that the socialist medical systems in other countries impose government price controls on pharmaceutical companies which results in US citizens subsidizing these lower costs. How long do you think new cancer drugs would be developed if government fiat resulted in loss of any profit from development of new drugs?

You refer to a 98% rate of insurance coverage, which I cannot believe you are touting as the result of obamacare. The left pushed 30-45 million uninsured in their propaganda, and we have only 10 million who have enrolled in obamacare plans. Notwithstanding the arguments over how many of those 10 million previously had insurance which was cancelled under obamacare mandate coverage requirements, as well as those who were already eligible for medicare, obamacare has not, nor ever will, result in 98% of the US population having insurance coverage. And I am not sure if I am reading you correctly, but are you really supporting mandated coverage in cookie-cutter, one-size-fits-all design for all patients? Are you really arguing in favor of a childless, post-menopausal couple being forced to pay for insurance coverages they will not ever use, such as maternity, pediatric and birth control coverage?

I am not sure what the point of your ballpark estimates of the cost of a 10 day NICU admission was. If it is to shame me somehow, that didn’t work. I don’t set the prices, and in interacting between private insurers and medicaid, it is painfully obvious that private insurers are paying higher prices for their insured patients precisely to allow hospitals to cover the financial losses from medicaid patients. The larger insurance companies negotiate payment contracts with discounts for NICU care based on a number of things, to include estimates of numbers of patients, and have recently added in adjustments for failing to meet set outcomes performance measures. For example, if a hospital in Texas has more than 6% of infants in NICU or the normal nursery admitted with initial hypothermic body temperatures, the hospital has a cut in reimbursement for infant care by an agreed percentage. Yes, NICU care for critical patients is expensive. About 10-15% of all infants born in the US, roughly 3.8 to 4.4 million per year, spend time in the NICU. (between 380,000 and 660,000 infants per year nationally) Typically the worst outcomes (and most expensive cases) are due to lack of access to OB care, resulting in a pregnant woman walking into a local community hospital ER contracting at 24-28 weeks gestation and delivering where there are no resources nor personnel experienced in the immediately necessary interventions of what we refer to as ‘the golden hour’. These infants end up getting transferred to level 3 and 4 NICUs, sometimes hundreds of miles away, and statistically have roughly twice the morbidity and mortality of similar infants whose mothers deliver at hospitals with the appropriate resources and experience to immediately care for these infants.
In a magical world of unlimited resources, we would build level 3 NICUs every 100-150 miles, staffed with neonatologists and NNPs 24/7, ready to provide such care. But in the real world, such resources do not exist, and never will.

When I was a military neonatologist up in the Pacifc Northwest I would use my leave days from the military to moonlight in civilian NICUs. Every single time I worked in these civilian settings (about one week a month for about 18 months, as I had a lot of leave saved up after deployments to the sandbox) just south of the Canadian border, we would get transfers from British Columbia and Saskatchewan hospitals because they didn’t have enough NICU beds for their patients. Their government run system could not provide sufficient resources for their population, and had to rely on private US hospital systems to carry the load.

This is the bottom line. There are not enough resources to have everything we want, so choices have to be made. You want to make medical care a human right against the reality that it is a finite commodity, and to do so you don’t want to be bothered with the pesky aspects of scarcity of resources. I don’t know if you have in your medical practice had to engage in disaster/mass casualty triage. (And I don’t mean practice exercises, but actually had to do triage on mass casualties where you are having to decide which trauma patients are too injured to have a chance at survival without using up so much of your available medical supplies that others who are less injured would be negatively affected.) Would it be nice to have a magic wand and be able to heal everyone of every condition for a few pennies? Totally impossible, no matter how much politicians prim and smile and chant about ‘free’ medical care for all. Reality can only be ignored for so long before it makes you pay attention.

How can the over 80% of enrollees that need taxpayer subsidies to pay obamacare premiums come up with the deductibles of $5000/individual and $12,000/family per year?

With all of the lies that were pushed repeatedly to get obamacare passed, and the egregious flip-flop about “It is NOT a tax, until we have to defend it in court then it IS a tax”; the law’s clear wording that states refusing to set up state exchanges would not receive federal funding being ignored and overturned by SCOTUS; the humiliating failure of the 11 (so far) obamacare state exchanges going bankrupt and being taken over by the fed; the clear data I linked to showing the massive delays in appointment times associated with romney/obamacare; the disasterous obamacare website rollout; and the contemptible VA health care scandal – can you honestly tell me that those of us who do not believe the government has demonstrated any reliability or trustworthiness with regard to medical care are wrong?

Are you in favor of physicians being forced to accept obamacare covered patients?

Are you in favor of the government setting salaries for physicians, prices for medical supplies and hospital fees?

Are you in favor of the government being able to ration medical care?

The most important thing that our Founding Fathers tried to teach us is that government is NEVER EVER benign. It is a necessary social evil that must always be curtailed, limited and kept under control, or it will inevitably grow into tyranny.

@Larry Weisenthal: Larry, real story of my life and the NICU. We had twins and my wife had HELP syndrome and went into labor at 28 weeks. She spent two days on Mag Sulfate until the diagnosis was confirmed and then we had a C-Section immediately. We both worked here at Saddleback and knew all participants. When she went in she was placed next to an illegal who just came across the border to have her baby. The doctor said the issue is the mortality is higher because they come across and no idea of how far along they are, no pre natal care, and of course no ability to pay. Of course she got the same care as we did and we have health insurance and have for years. My daughters where 3 1/2 lbs each and spent 5 weeks in NICU. The bill was $250K!! Thanks goodness our health insurance paid it. Now tell me about cost to our country for illegals and health care!! Obola lied to America when he said his plan would not cover illegals and he knew it from the beginning. If he didn’t know he should be held even more liable because it was his and the Democrats bill only. A complete failure and fraud!! My girls are now 25, graduated, working in their majors, and all education paid for. I resent illegals getting the same and doing nothing for it!!

@Nanny G:

California should be ashamed.

From all I hear about Gayfornia, it’s all normal. Run by Dimocrats

@Larry Weisenthal: I just can’t see your side of the argument. Not one single person that I’ve read on the internet has lower premiums as a result of Obolocare. Not one. I’m on Medicare so it doesn’t affect me, but my daughters’ family went from full family coverage for a little less than 600 a month 3 years ago to a charge of 1900 a month this year. Both the Co-pay and deductable are now higher than under the older policy. Tell me again how successful their insurance coverage has been. Oh and now she’s in her mid 50’s and has maternity coverage. I’m not sure why anyone wants to ‘sell’ Obolocare as a good deal when they can’t provide one singe testimony as to personal experience that says that their family is now better covered for a lower or even equal cost as to previously.

@Larry Weisenthal:

Did President Bush lie when he said that Iraq was developing biological and nuclear weapons, or was he merely wrong, based on bad intelligence? I give him the benefit of the doubt and say that he was merely “wrong.”

He didn’t lie and he wasn’t wrong. Since you’re a believer of tripe from the NY Times, how about their stories documenting the many times the WMD’s have been used by ISIS? Where does ISIS get those weapons? From the stockpiles that were there when GWB said they were there.

@Pete: 32. excellent evaluation of the leftist side of the aisle. Not much to disagree with. I, too, share your disillusionment with the prospects for the future. I don’t see unemployment ever getting below a true 10% again. Average income will not increase, even with small or no inflation the standard of living will not increase. I’m of the age that I won’t see much of that, but unfortunately my children and grandchildren will have to live to those lowered standards.
I do believe that Trump will attempt to ‘make America great again’ something Obama has worked so hard to avoid. He is the first president, to my knowledge, that has actively worked to destroy the country. At least that time will end soon. I see nothing in the politicians that are presently running that seems to be better than the position Trump is offering to us.

@Redteam: Re “w” On 3/20/2013 he said “Iraq War was my biggest mistake.”
“a clear example of poor judgment.”
“unnecessary and too costly to justify.”
” I deeply apologize to the American people.”
For this I salute President Bush.
He also said re WMD’S “when we couldn’t find the evidence we fabricated it.” a little tougher to swallow.

Do you think egotists like Trump or Obama would ever be man enough to admit mistakes and ask forgiveness?

BTW rt I don’t think Pete shares your evaluation of Trump..

@Richard Wheeler:

He also said re WMD’S “when we couldn’t find the evidence we fabricated it.” a little tougher to swallow.

I don’t believe you can supply an actual quote of GWB making any such statement. Not from a ‘real’ source.
If there were no WMD’s, what is ISIS now using in their attacks in Iraq. The NY Times has documented repeatedly that ISIS is using WMD’s that were in stockpiles during the Iraqi war. That is the WMD’s that were claimed to be there. The only liars are the ones that maintain that there were no WMD’s.

Give me a link to an actual quote of GWB. Make sure you don’t quote THE DAILY CURRANT, you know that is a fake site.

BTW rt I don’t think Pete shares your evaluation of Trump..

BTW, I think you’re wrong. According to what I’ve read, we seem to be close.

@Richard Wheelerto save you the trouble, in 32 Pete said:

: I lump both Hillary and Trump into the latter category, though I consider Hillary to be far more directly corrupt and evil, and Trump merely egotistic with a danger for totalitarian traits. Neither of them – in my opinion – have exhibited anything in their respective careers other than self-promotion for personal gain.

and he said:

first that Trump’s support will survive the inevitable media onslaught against him once it is Trump vs Hillary, and secondly that Trump will turn out to be simply self-obsessed but pro-American, and not evilly totalitarian leftist as every high-ranking member of the democrat party is.

I’d say that opinion of Trump is ‘identical’ to mine. I also think the same of his assessment of the Dimocrat party.

@Redteam: Pete has said he much prefers Cruz to Trump–also said “God help us” if it’s Trump vs HRC.

@Larry Weisenthal:Would surely concur on your assessment of Word and Curt,

@Richard Wheeler:

also said “God help us” if it’s Trump vs HRC.

So? I would say the same thing myself. As I said, I think Pete and I are on same wavelength.
Both feel more likely that it will end up as Trump vs HRC as I quoted just above.

I notice you didn’t decide to provide a quote from GWB where he said he ‘fabricated evidence’. Let’s face it, it doesn’t exist. You tried to slip that one by.

I would expect you to support Larry Wiesenthal, he’s another lib that makes it up as he goes along.

@Redteam: Difference between you and Pete —pretty simple–he supports Cruz over Trump—you say Cruz isn’t eligible–or Rubio–or Obama—lol
BTW For months you assured us over and over HRC would not get the Dem. nom. What happened there?

Though Cruz has 3 votes in Texas from my house, and I believe he will win Texas, the polls seem to predict Trump is going to take all the other states tomorrow. Whether Rubio stays in after tomorrow will probably depend on whether or not he mames enough of a second.place showing in a majority of states tomorrow versus Cruz.

My growing fear is that either Trump or a GOPe-supported candidate goes.3rd party, which will almost certainly guarantee a Clinton victory in November. Even if that doesn’t develop.and it is just Trump vs Clinton, I believe that between the hostile media assault waiting for.Trump in the general election, coupled with those who will.stay home rather than vote for Trump, Clinton has a better than even chance of being elected. Though I am definitely NOT a Trump.supporter, the prospects of another corrupt Clinton administration makes me weep.for what will be facing our nation.

@Pete: Thanks for that confirmation–I concur.
Cruz and Rubio will stay in. Rubio obviously must win Fla in 2 weeks–longshot at this juncture.
If Kasich can win Ohio—down 6 he’ll stay in–loss he’s out
Carson should drop Wed
The fat lady is clearing her throat—not quite ready to sing

@Richard Wheeler:

BTW For months you assured us over and over HRC would not get the Dem. nom. What happened there?

Oh, has she been nominated? When?

you say Cruz isn’t eligible–or Rubio–or Obama

Actually it’s the Constitution that says that, it’s not original with me.