Health Care, Jenga Style

 

 

Jenga is the game of mental and physical skills in which players first build a solid tower of  equal sized wooden blocks. The goal of the game is to then remove a single block from anywhere  within the tower and place it upon the top of the tower. The goal is to not be the last person to remove a piece that causes the tower to topple and fall.

In many respects the Affordable Health Care Act, or Obama care as it is also known, reminds me a lot of the game Jenga.

You see when it was first conceived by President Obama and the Democrats, they simply put together all of their wishes, and liberal dreams of what the perfect liberal health care plan would consist of. And they built quite the tower of Babble.

However, since its passage, the President and his fellow travelers have had to suspend and delay any number of deadlines and requirements. In other words they have pulled pieces out of the tower and placed them on top, all the while denying that the tower was a failure and that it would ever fall.

The latest piece to be pulled, was pulled and placed on top of the tower by non other than one of the President’s shiny pennies, Supreme Court Justice, Sonia Sotomayor. It seems that Justice Sotomayor has delayed the timing of the mandated contraceptive clause of the AHCA. This is the clause that requires employers to provide health insurance that also pays for contraceptives. Even if the employer is a nonprofit organization whose beliefs condemn the use of contraceptives, such as the Catholic Church.

It seems as though The Little Sisters of the Poor, of Baltimore, have been granted a stay from the part of the AHCA that required them to supply health insurance to their employees that included paying for birth control and other medications designed to induce abortions.

The government has until Friday to respond to Justice Sotomayor’s ruling. Of course if this piece of the tower is lost, it may well be the piece that causes the tower to fall. After all, how can liberals support a health care act that does not fund one of their pet issues?  A woman’s right to choose.

Only time will tell how many pieces the President and his fellow travelers can pull from the bottom and move to the top before the whole thing comes crashing down.

 

 

 

128 Comments on "Health Care, Jenga Style"

  1. Mike Protack says:

    Health Care Reform has to include choice, competition and personal responsibility. Obama Care includes expanding Medicaid, more IRS agents, 2700 page bill which produced over 27,000 pages of regulations nation wide and over 1000 times the phrase ” the Secretary shall”.

    A very noble cause of health care reform was butchered by Obama and he will go down as the all time biggest Liar, worse than Nixon.

  2. delacrat says:

    I was particularly moved when Ted Cruz addressed the nation with the massive two foot Big Government monstrosity which was ObombaCare to his left, while to his right … was nothing.

  3. waterpirate says:

    I will leave all the financeing talk to those better qualified than myself. I will speak to what the ACA has and will do for middle America. The vast majority of middle America who chose to work in the private sector saw health care costs and deductibles sky rocket over the last few years. We saw forced plans, plans that allowed for a family to have the same plan based on the needs of one, not the group as a whole.

    The ACA has allowed for seperate policies for spouses and children. Seperate deductibles. Lower deductibles. Lower costs for the premiums.

    My wife and I recently left the employer offered plan for one we purchased in the free market, on our own, thanks to the ACA. We were able to get the same Higmark plan, for less premiums, and a lower deducble. Clearly advantage Waterpirate. It also allows middle America to purchase health care at the same rate or less than they can get from their employer. That means that a EE is no longer forced or held hostage to an employer for fear of losing health coverage for a loved on or themselves.

    I consider myself blessed that I do not qualify for any subsidy. Others in middle America who do qualify for subsidy should enjoy a new found freedom of savings.

    Is the ACA a house of cards doomed for collapse? I do not know. What I do know is that in the short term it is better than what we had. Tommorow will dawn a new day and we shall all wait and see what it brings together.

  4. Dave says:

    The principle of ACA is really unquestionable. The implementation leaves much to be desired. As they say the “The best laid schemes o’ mice an’ men / Gang aft agley.”

    To say that “A very noble cause of health care reform was butchered by Obama,” really does not even deserve comment. Especially in light of the fact that the GOP House spent their time on 40 some odd resolutions to revoke ACA instead of considering need improvements.

    The abject failure of the Congress, especially the House can be laid directly on the door step of the Tea Party whose mission was and is to burn down America. That’s unforgiveable and will never be. Ever.

    Affordable health care remains elusive to a great many. There were valiant attempts by some reach that goal. Unfortunately, there were even more attempts to pull down the ladder for that climb.

  5. Tuxamus Maximus V Part 1 says:

    I’ve edited this too many times and it’s still too long. That’s my problem in most comments I’ve ever made but I’m going to try to share something with anyone wishing to read this opus. It’s all true and something I’ve experienced first hand over the last few years…really over 10 but who’s counting.

    Hello to all. TMV is back to offer a comment on the ACA. I’ve read Frank’s post a number of times now and although I don’t agree with his sentiments I do see, sad to write, his viewpoint. Frank has his opinion and wants to read ours and that’s why he provides this venue. Frank will probably find some kind of major flaw in the facts that follow but that will only be because he needs to find fault with real world facts. No intended disrespect Frank just our difference in opinions.

    Let me start by writing that I agree with the last three (well there are only four comments at the time I started writing this rebuttal) comments in every way. From my rather short stint being back here (monitoring Frank’s blog) in the recent past the first commenter never really seems to have a positive thing to write about anything and that would most likely include sunny Chamber of Commerce type days. Mike Protack has the right to an opinion as does everyone else but isn’t there something right about the world.

    Frank I understand when looking at it from your apparent standpoint of losing a ‘liberty’ is how I’ve been told is your view from past discussions with HTM. What the TM’s wrote about the Spock statement holds true with me as well. I like to think I have at least some compassion towards others in making sure their world doesn’t fall apart because of a health care bill. If it does I loose as well.

    Frank there is also something that you may want to consider in that at least Mr. Obama tried, and did, something. Right or wrong he made an effort at fixing a problem that was (and most likely still is) out of control. Let’s go back 10 years in my real world hardcore facts. The first seven of those ten saw healthcare cost increases that were never less than 15% and the seventh year (2010) was a 24% increase. When ACA (Obamacare) became a real deal that year’s (2011) increase was just over 11% and when you consider that 2012’s increase was just over 9%, 2013’s just under 9% you have got to admit to a correlation to the ACA changing the insurance industry rate landscape. If you don’t I can’t help you understand why the sky is even blue (refraction). Add in the fact that we ADDED limited vision and dental in the 2012 package (a proud moment for me!) because of the ‘savings’ we were seeing in the overall picture due to ACA.

  6. Tuxamus Maximus V Part 2 says:

    When I go back and reflect on the years previous to 2011 and the crushing cost of being able to offer healthcare as a benefit I offer that I did because so few other small businesses do it to begin with in the first place. You want to keep good people that’s one of the ways you do it Frank. Give them something others won’t for whatever reason they have in not offering healthcare (greed?).

    That Delacrat could state in just a few lines what would take me two paragraphs. I agree with you Delacrat and usually do to some extent. The kids at HTM not so much.

    That ‘waterpirate’ not only likes the ACA but has benefited from it as well and apparently has appreciated it all along makes me happy for both he and the wife. Being able to stand up and state it openly as a GOP (apparently you’re headed back to being a real GOP’er?) guy gives me pause to think that I can reconsider my thought lines of him a bit. Even I can change my mind waterpirate!

    Dave! You are nothing less than spot on in your thinking (IMHO), although sad to read, is true at this very moment and probably will be for some time to come. What a mess. Obama tries and make a difference, and has to a great extent, but the rug just keeps being pulled from under his feet by the insurers. I’m not going to go into what the House of Reps can’t understand. When I was here on a regular basis recently I always hoped to see more of your comments.

    Some time ago I was quizzed (a number of times I might add) by the TM’s concerning the healthcare coverage’s provided by the three entities that make HTM happen. I could speak knowledgably about all three but of course most knowing about what I provide for TM’s F & W is what I could offer. Since that time things have definitely changed.

    I’ve been in business many years now and I’ve seen many changes take place over the years. Not only in healthcare, but in just about every facet of doing business, or dealing with various business interests that make up my life things change. Change isn’t fun and I think it’s safe to say that things change more rapidly now than ever before. But we have to deal with change or we become dinosaurs and fall by the wayside.

    When this ACA thing first became a reality many under the program we provided saw changes they loved such as being able to cover the college aged, or recent HS grads (kids up to 26 years of age I think) kids they have and the big one in that no one could be arbitrarily dropped for no real understandable reason. The whole thing about not providing coverage because of preexisting conditions is gone and although that’s cost an arm and two legs I’m all about it and love the ACA for those reasons and many more…and I’m the guy/company that pays the bulk of the cost.

  7. Tuxamus Maximus V Part 3 says:

    It’s a matter of wanting to be a kind, decent and fair employer. Just my opinion so deal with it…

    When the ACA first passed the HR lady did an analysis (as best she could because I don’t think anyone out in the day to day business world is smart enough to understand the entirety of it all) and the total SAVINGS was estimated to be enormous (I’m NOT going to proved a number) to the LLP’s involved. Once implemented with the phase in of different parts of the ACA it cost a bit more but not bad and easily absorbed.

    No real big changes to overall coverage’s until rather late 2013 when the 2014 policy was being negotiated with BC/BS (and we invited United Healthcare and others to bid as well per usual). We thought it was a done deal and although we still saw real cost reductions in the overall packages offered and stayed with BC/BS.

    Take a moment readers (if there are any) and consider that I used the words COST REDUCTIONS.

    In December we got the news that the whole thing was on hold and that until otherwise told we would remain covered by the old plan but there would be changes for the plan we thought we had negotiated for 2014. Find a barrel and bend over it but given the time to pull my pants down was my thinking.

    Went back to the other bidders and got the same story. It seems that the insurance providers had figured out a way of making a bit more money or at least being able to keep things on hold while they figured out what loopholes would be available to them when 2014 started up. That the insurers don’t collude with one another is something no one will ever convince me of…EVER.

    Really late 2013 we were told that co pays were GONE and deductibles were going up for 2014. More change to endure and not even a barrel was provided by the rep to bend over while we took with ‘smiles’ on our faces. The company is still going to save a lot of money (not the enormous amount we thought a few years back) and the coverage, even though changed quite a bit, is still actually better in some ways and CHEAPER than when we were paying after the first year of ACA going into effect. Imagine that!

    Bottom line is that the insurance companies have the gold and they make the rules in the end. ACA (Obamacare) changed the rules (for the good overall) of which the insurance companies have to play by which in the end run benefits the consumers (that’s all of us little people) but as usual the insurance companies still make the same amount of money just in different ways.

    They (the insurance companies) have people that are smarter than most of us will ever hope to be no matter how much education we have! They get some of the best and brightest legal eagles and actuaries that know numbers and statistics let alone find loopholes to out think Obama’s every move or at least it seems that way. Greed is NOT good.

    It’s all about change (and I’m not quoting the Obama campaign here). Everything changes in time and if we don’t adapt we get left behind. The healthcare industry was forced into change and they have adapted. The insurance industry sure has adapted to ACA and if you don’t accept and adapt you will get left behind and that is the worst outcome of all possible.

    Once again I want to thank Frank for allowing this venue to share thoughts and comments on and with great admiration for what he tries to do here. Throwing the finger to that other site took some guts. I don’t agree with Frank on much but I do have a great deal of respect for him and all his various efforts. He saw a light long before others and tried to give all a chance to see that light. One of the few things I’ve agreed with him about even now.

    Thank you Pandora. That was nice to read from HTM.

  8. Laffter says:

    Nicely done TMV, nicely done! 😉

  9. Frank Knotts says:

    TMV, since you are determined to talk about Spock and the needs of the many as opposed to the needs of the few, or one, I will attempt to address that in a moment.
    First of all, the post was about the failure that the ACA is becoming, due to the constant delays and exemptions that the administration is being forced to implement. Hence, the “Jenga” style reference.
    I cannot dispute either you or WP in your views that the ACA has seemed to be an improvement, let us not forget however, that the ACA is only in its first stages of being implemented.
    You may find that when the entirety of the ACA is in place that it is not the benefit you see it as now. Like any non-market driven enterprise it may grow fat and ponderous and collapse under its own wait, taking down even more lives with it.
    Also, many of the problems that myself and others have with the ACA is not simply the cost, or the benefits. It is the peripheral tack ons, such as the mandated participation, the fines and penalties for not participating, the forcing religious organizations to participate in things that go against their faiths. The forcing of young healthy Americans to spend money on unneeded health care levels, money they could be spending on new cars, homes and other items that would actually drive the economy.
    I will allow that you and others have found some benefit to the ACA, this does not mean that all have or will.
    Which I guest brings us to that “pointy eared devil”, to quote Bones McCoy.
    Let us look at the idea of the needs of the many outweighing the needs of the few, or the one.
    Have to say the first time I saw the movie, even I was move to emotion by Spock’s sacrifice.
    The idea behind it was that Spock’s life when weighed against the many aboard the Enterprise seemed insignificant, and so he sacrificed his for theirs.
    Now TMV, help me out, I may be forgetting something from the movie, or I may have seen an edited version, or maybe I had gone out for popcorn.
    At what point did Captain Kirk order Spock to go into that chamber and sacrifice his life, the one, for the many?
    You see Spock “CHOSE”, to make that sacrifice, and if like you, I wish to compare it to the health care needs of the many here in the real world, then I would have to say that Spock committed a charitable act.
    You try to liken the act of Spock to that of Pres. Obama. The two are completely different.
    Pres. Obama has taken the idea of the one, his, and forced it on the many, us, while Spock gave his one life freely for the many.
    Charity and goodwill cannot be mandated, it will only breed contempt for those we seek to help.
    Just because an idea is laudable, does not mean that is attainable.

  10. pandora says:

    I’m really trying to understand how health care in Frank’s world would work. Would we go back to not covering/dropping people with preexisting conditions? Would we, once again, allow rescission? Would we drop those over 18 from their parents’ coverage? Etc., etc., etc.

    Basically, I’m asking if people think these, and other things, were a problem in need of fixing? And, if so, how you would fix them? In my experience, people who believe health care didn’t need fixing were either people who never faced a serious and expensive health care situation (lucky) or people who have access to employer based health insurance (lucky, again).

    As someone who participated in the individual health care market in the 1990’s I can tell you how awful it was. (I even wrote a post on it, if anyone is interested.)

    So how would health care “freedom” work? And if we really want a market-based health care system then wouldn’t that be a pay to play system? Seriously, in order for that sort of system to function we’d need to stop treating people without medical insurance; we would start turning people away from emergency rooms and doctors’ offices. Get into a car accident or have a heart attack… well, you’ll get treatment provided you have insurance or can pay cash. And how, during an emergency, would we know who was insured? Would we need to create a data base? Tattoo people? How would that work?

    Before the ACA, people with insurance paid for the uninsured with higher premiums and higher costs of treatment. It’s no accident that Tylenol, etc. costs so much at a hospital. Things like that cost so much because the hospital is making up costs for the uninsured.

    Health care isn’t like buying a Happy Meal at McDonald’s. If you don’t have money… no Happy Meal for you. However, if you are uninsured and get in an accident or have a heart attack then you’ll be taken to a hospital and receive care. That’s the way it works.

    In order for a free market approach to work financially we would have to deny treatment for the uninsured. How would that work? Would we have people dying outside hospitals? What about children under 18 whose parents won’t (or can’t) buy health insurance? Should we deny treatment to a child because their parents don’t have insurance?

    I’m really trying to understand the Republican’s plan for fixing healthcare. Perhaps someone can explain the Republican plan? So far all I hear about is what’s wrong with the ACA. Plans to fix our health care/insurance system… not so much. So please, take the time to explain, in detail, what a market-based, freedom health care system would look like – who it would cover, who wouldn’t be covered, how it would be paid for, etc. Thanks. I really am curious.

  11. Frank Knotts says:

    Pandora, let me step over the dead bodies you envision. First of all, it is not a market based health “CARE”, system. It is a market based health “INSURANCE” system.
    You yourself stated that in America, unlike not being able to pay for your happy meal means no happy meal, but not being able to pay for your health care does not mean no health care.
    We already have safety nets for the poor and elderly, Medicaid and Medicare.
    So why the mandates? Because some people would choose to take the risk, and without those people paying in while not needing the insurance the Jengo stack falls over.
    As for preexisting? I’m good with that, but who gets to decide the rates in Pandora’s world? If I have a driving record loaded with speeding tickets and accidents, then I pay higher rates, do people with preexisting conditions pay higher rates in Pandora’s world? Or do I who am healthy and never use my insurance have to pay the higher rates as well?
    Keeping kids on their parents policies? I’m good with that, in fact I will take it one step further. I think any group of people who choose to, should be able to affiliate and negotiate with a private insurance company for lower rates. But by choice, not by mandate.
    You see Pandora, I believe that people are smart enough to make their own health insurance and health care decisions. And if they make mistakes, well that is the human animal, and then we as a society can step in and help. But this Minority Report mentality of trying to foresee the future and cure the imagined ills, well that just doesn’t work for me.

  12. TMV says:

    I expected nothing less Frank but thank you for sharing your thoughts on my long considered, greatly edited comments regarding my experience with the ACA.

    I’m not a good writer Frank. I thought the point was made, and I may have edited out what drove the point home that we never really got to negotiate, let alone affiliate (although it does seem I get the business end BC/BS barrel most years) with an insurance provider. They have no loyalty and would drop my interests on a moments notice. They did once but I have a rather good and large law firm and they changed their minds.

    With the help of my HR lady and the lead number cruncher every year we present an apples to apples renewal and bid it out. They all came back with a basket full of mixed bad fruit year after year until ACA came around for real. Magically they actually listened and offered rather than a here’s what you get attitude. It WAS an our ball, our field, our rules or go home kind of thing until ACA. THERE WAS NO CHOICE. There really isn’t much now only I bring the ball, we play on their field and ACA set the ‘rules’ in which the insurers find ways to interpret the rules to their advantage. We really don’t have, even now, the opportunity to make choices or decisions Frank. They are presented to us as ultimatums to choose from and I’m the buyer. It’s not like anything else I encounter in the business world. Ask your boss! Do you get a ‘choice’?

    My congressman (sorry but I’m not going to provide name but shouldn’t be hard to determine) is a right winger and he actually offered up legislation for health care reform. Never got out of committee but it did favor insurance, healthcare providers and HUGE corporations (look up ECC) and in no way benefited the smaller fish in the lake.

    As for Spock let’s agree to disagree. TM’s will give me brief grief but it’s a free exchange with them each week. I really do like trading, and hearing thoughts of the college educated younger current generation.

    Thank you for the kind words Laffter.

    Pandora I would greatly appreciate it if you would please provide a link (send to HTM if you want) to your post. Huge fan and I get a text every time you comment on Frank’s site. Happily married 32+ years I have a crush on your thinking and ability to express your thoughts.

    Well it’s late (Dave Letterman is on) and I’m up by 5:30 every weekday morning dealing with all ‘stuff’ in life and business. It never stops.

    I am glad that it’s just us making comments here. Respect for all.

  13. Frank Knotts says:

    TMV, that is the choice of a free market, there are many options out there, the question is what are you willing to pay? Yes I had options from my employer offered insurance. Four different levels of protection, or drop it and go it alone.
    I purchased that which suited my needs and my ability to pay. I did not choose the highest level of protection, even though I could have afforded it, that was my choice. Choice is not always about getting exactly what you want when you want it, sometimes it’s about getting as close to what you want and working hard to get more later.
    I understand that employers may see this differently than do employees, or people who were self insured and happy. I again point out that my views are not solely based on the numbers.

  14. pandora says:

    Let’s break this down…

    “You yourself stated that in America, unlike not being able to pay for your happy meal means no happy meal, but not being able to pay for your health care does not mean no health care.”

    So, in your plan, people without insurance would use the emergency room for their health care needs and those with insurance would pick up the tab? Because that is what’s been happening. We are paying over 1,000.00 a year in our insurance premiums to cover those without insurance. And I find it amazing that you’re okay with “responsible” people picking up the tab for those “risk” takers. So, freedom for the risk takers and no freedom for those of us picking up their tab?

    “We already have safety nets for the poor and elderly, Medicaid and Medicare.
    So why the mandates? Because some people would choose to take the risk, and without those people paying in while not needing the insurance the Jengo stack falls over.”

    While not needing the insurance? I must have missed the human evolution into psychic. No one knows whether they’ll need insurance. That’s the entire point of insurance. If you pay for insurance and don’t end up needing it that year you won the lottery. And the “risk” they’re taking is with the insured’s money.

    So this idea of why should people pay into something they don’t/won’t need is silly. No one knows when they’ll need health insurance, but when they do need it and they aren’t insured not only do they risk losing everything they pass on their medical expenses to the insured population. So much for personal responsibility.

    “As for preexisting? I’m good with that, but who gets to decide the rates in Pandora’s world? If I have a driving record loaded with speeding tickets and accidents, then I pay higher rates, do people with preexisting conditions pay higher rates in Pandora’s world? Or do I who am healthy and never use my insurance have to pay the higher rates as well?”

    You’re good with that? How do you plan on paying for it? Because the one way insurance companies made their profits (before the ACA) was through not covering preexisting conditions, cherry picking and rescission. So please explain to me how we’ll pay for a health care/insurance system that people only buy into once they’re sick. Seriously, how does that work?

    As far as the car insurance example… States require basic auto insurance, most require liability insurance. That means you can’t call anything auto insurance – it has a baseline of mandated coverage. And if you have a loan on your car your lender can dictate (mandate) how much insurance you carry. There’s a baseline with auto insurance – a mandated baseline. As far as the ACA, smokers pay more, so that preexisting condition is charged.

    And when you speak of charging more for preexisting conditions would you include genetic conditions? Should people carrying the gene for cystic fibrosis pay more? Should people with cancer in their families pay more? Should people or children who play sports pay more? How would you determine who was predisposed to these illnesses? How about the family that eats at McDonald’s? Would we install cameras to monitor people’s behavior, or would we simply ask them, “Hey, are you living a healthy lifestyle?” Seriously, Frank, flesh this out for me. I want to see how this would work.

    “Keeping kids on their parents policies? I’m good with that, in fact I will take it one step further. I think any group of people who choose to, should be able to affiliate and negotiate with a private insurance company for lower rates. But by choice, not by mandate.”

    I’m fine with keeping kids on their parents’ policies, too. Before the ACA 18 year olds with preexisting conditions were uninsurable, unless they could land a job with a big company. So, I guess there are parts of Obamacare that you like! 😉

    As far people forming their own groups… well… you do know how group insurance worked? You do realize, that before the ACA, if a person in this alternative group of people became ill everyone’s rates went up, and if some of the healthy people dropped out of this makeshift group (to find cheaper insurance, because, hey! they’re healthy!) the insurance company would drop everyone left because they no longer constituted a group. You do know that this is how insurance worked before the ACA, right?

    “You see Pandora, I believe that people are smart enough to make their own health insurance and health care decisions. And if they make mistakes, well that is the human animal, and then we as a society can step in and help. But this Minority Report mentality of trying to foresee the future and cure the imagined ills, well that just doesn’t work for me.”

    Unless they’re psychic they have no idea what their health insurance needs may be. Unless they can foresee that car slamming into them or that bit of ice on the sidewalk or that lump in their breast – which they can’t, which is the entire flippin’ point of insurance. We insure our homes for fire, but if we knew we’d never need it then why buy the insurance. Um… because we don’t know.

    And the “mistakes” you refer to can’t be rectified with a community bake sale. And society does step in under your plan – the insured pay for the uninsured. Again, so much for personal responsibility.

    Health insurance only works if it covers your health care needs and mine. It only works if the pool is big enough. It really isn’t a case of priorities, because, if it were, then that numbers game would result in orphan diseases (very rare diseases that only affect a few) not being covered. Health Insurance cannot be à la carte.

    TMV, here is the link. I hope it works this time. And it’s always nice to have a fan! :-)

    http://www.delawareliberal.net/2008/11/15/this-is-the-difference-between-healthcare-and-health-insurance/

  15. Tuxamus Maximus W says:

    Wonderful rebuttal Pandora! TMV is aware now. HTM will have your post up in kitchen for all to read and comment on as the day passes.

  16. pandora says:

    I’m really interested in the details of Frank’s plan – how it works. I need more than the ACA is wrong because… Freedom! I’ve given specifics, I’d like the same in return. Is that too much to ask?

    If you read the post I linked to, then you know that I handled health care/insurance benefits for a small business that lost their group plan. Honestly, people need to get up to speed. The majority of people who were okay with the old system didn’t understand how health insurance really worked. And that is their luxury.

  17. Frank Knotts says:

    Okay Pandora, this will take some time, but here we go.
    You say, “So, in your plan, people without insurance would use the emergency room for their health care needs and those with insurance would pick up the tab?”
    To which I say, how is that any different than ACA? You have only switched who pays. With ACA you will force young healthy people to pay for the sick and elderly, young people who are just starting out, you will force them to choose between saving for a home, and abiding by the mandate and buying health insurance that they may never use. That risk is theirs to take. You feel that because we can’t know what may happen, then we all must buy insurance. Why?
    Let us first look at the word, “INSURANCE”, the definition of which is,
    ” the act, system, or business of insuring property, life, one’s person, etc., against loss or harm arising in specified contingencies, as fire, accident, death, disablement, or the like, in consideration of a payment proportionate to the risk involved. ”
    Let us look specifically at the part that says, “in consideration of a payment proportionate to the risk involved.”
    “Proportionate” is the key word here. This means that the cost of the insurance should be based on the amount of risk that the insurer is taking on having to pay out to the insured.
    So why should a young healthy man or woman have to pay the same as an elderly, sick man or woman?
    In the ACA an arbitrary level of insurance has been chosen and mandated to all. Why? Because if the young healthy people are allowed to opt out, or choose lower levels of insurance, then the Jenga stack falls over.
    Why shouldn’t those most likely to receive a pay out pay more for the insurance?
    Let us talk about the preexisting issue. First of all, no, genetic traits should not be considered a preexisting condition. A preexisting condition in my view means that you already have a condition, you have been diagnosed, not that you may contract one based on your family history. After all, we may all get cancer, as you say, no one knows for sure. But many people carry the cancer gene and never contract it.
    So if you go into a situation already with a condition, then the risk to the insurance company is extremely high, they already know that they will be paying out large amounts of money, so why shouldn’t they be able to protect themselves and their investors, by charging, that’s right, “PROPORSIONATE” rates?
    It seems Pandora, that you seek to do away with insurance companies, or at the very least, make them no more than agents of the state.
    You also said, ” If you pay for insurance and don’t end up needing it that year you won the lottery.”
    Well Pandora I don’t know what lottery you play, but I don’t call that winning. If I pay for a year and don’t need it, then the insurance company won the lottery.
    However, using your lottery example, If I don’t pay for insurance for a year, and don’t get sick, then my friend, I have won the lottery, because I have saved thousands of dollars.
    You ask, ” How about the family that eats at McDonald’s? Would we install cameras to monitor people’s behavior, or would we simply ask them, “Hey, are you living a healthy lifestyle?”
    No. But you are more likely to see that happening under ACA, in my view.
    Next, “As far people forming their own groups… well… you do know how group insurance worked? You do realize, that before the ACA, if a person in this alternative group of people became ill everyone’s rates went up, and if some of the healthy people dropped out of this makeshift group (to find cheaper insurance, because, hey! they’re healthy!) the insurance company would drop everyone left because they no longer constituted a group. ”
    Okay. So what? It’s called a market based system. The insurance company has a product you want, they set the price. If the price becomes too high and people can no longer afford it, the market will correct itself. That is, unless government steps in and starts subsidizing the cost, which always will lead to higher cost of any product. That is what will happen with ACA, and then government will again step in and move to single payer, which will spell the end of the U.S. having the best health “CARE” in the world.
    Pandora would you travel to Cuba for heart surgery? Or New York?
    You get a little testy here but let me address this one as well, “Unless they’re psychic they have no idea what their health insurance needs may be. Unless they can foresee that car slamming into them or that bit of ice on the sidewalk or that lump in their breast – which they can’t, which is the entire flippin’ point of insurance.”
    Very true, insurance is bought in the hope of paying for the unforeseen.
    But once again, it should be done by choice and the cost should be “PROPORTIONATE”, to the risk. So if I want to buy insurance to cover myself again injury received as a result of being hit by and asteroid, then the cost should be very low since the risk is very low. However, if I want to buy insurance to guard against being shot in the city of Wilmington, well then that insurance should be very expensive, since the likelihood of being shot in Wilmington is very high.
    You go on with, ” We insure our homes for fire, but if we knew we’d never need it then why buy the insurance. Um… because we don’t know.”
    Again correct. But the question is, should we be forced to? Yes we are forced to by lenders, because until we pay off a loan we are living in the bank’s home and it is a condition of them loaning us the money to also insure that money by buying insurance. However, once the loan is paid off, we have no requirement to have insurance. Is that smart? No! But it is our right, at least for now.
    Maybe you misunderstand me. it is not that I think we should not buy insurance, it is that I think we should have the choice to buy it and at what level of protection.
    Your goals are laudable, yet unachievable. You seek to make the world safe from all risk. To metaphorically wrap us all in bubble wrap. And in so doing to make the cost fair and equal. Nice thoughts, but not realistic.
    The ACA is unsustainable. It will fail under it’s own weight. I see it expanding ever wider to cover more and more things until it con no longer meet the needs, then when government is forced to dial it back, and people have become reliant upon it, then what?

  18. TMV says:

    First of all I want to thank you both for your time on this issue. It may not have garnered many comments from others but that wasn’t my intent. It may well have gone right over a few heads. I just wanted to see what Frank thought of my travails. That Pandora saddled up and came along for the ride was an unseen perk to the work it took in typing and editing to tell my story.

    Pandora it’s easy to tell from reading the supplied link that you’ve got more than a clue about this healthcare/insurance debacle we’ve endured over the years.

    So many have lost so much due to health issues causing financial hardships with many losing everything they had in life including dignity.

    As ‘Wilma’ stated your rebuttal was an enjoyable read to Frank’s comments of yesterday. If you really thought you’d get a plan from Frank I hope you weren’t overly disappointed. Once I received word that you had responded I looked forward to reading what you wrote. Asking for a plan was just bonus.

    A lot of reading for me today. No plan offered Pandora. You didn’t think you’d get one did you? While reading Frank’s rebuttal to yours there really was nothing new offered other than…nope it’s not going to work.

    Frank, something has to change and the ACA is the only PLAN that has made it into legislation, passed and made a CHANGE. No one else has offered a real PLAN that actually makes a change. Pandora asked you to provide one but I didn’t see it. It’s not perfect by any means but it offers a CHANGE and a much needed CHANGE. I’m better off for it and so are many others now. You might not be but you pay for the choices you’re offered and I offer it as a PERK just to show up and work.

    Frank I understand your thinking to a point but I just don’t agree with it much at all. Unfortunately I can see Pandora trying to find the softest spot on a wall with her forehead but I could very well be alongside her doing the same thing. I’m sure I’ll get an earful tomorrow (almost is Friday now dang it) when I talk to HTM after they’ve read all of this but I can’t even see a middle ground with you conservatives let alone the far right can’s see for the trees wackos.

    One word to consider is compromise. You ‘see’ some of the ACA benefits but even then you only see just a small bit of the full deal and what it’s done for me and those with me.

    Once again I thank you both for your time and trouble. Naysayers will find fault but I find happy people with more money in their wallets. Not so much my wallet but I don’t really think I’m going to be the next Bill Gates either. I’ll still race and life goes on. I just won’t have as much in my pocket but I see more smiles!

    Highly unlikely I’ll be back to your site anytime soon Frank. Hope the TM’s behave to your liking!

  19. pandora says:

    I read Frank’s comment last night, tried to respond and ended up walking away. Even now I hesitate to respond, mainly because Frank’s response was short on details and long on freedom. I didn’t see any alternate plan.

    Frank, are you saying that Health care/insurance in this country was fine the way it was before the ACA? That nothing needed to change? When I read through your comments that isn’t what you’re saying. You said you’re fine with preexisting conditions being covered, but then say, “The insurance company has a product you want, they set the price. If the price becomes too high and people can no longer afford it, the market will correct itself.”

    I have never seen this happen with health care. Could you provide a link where the health insurance market corrected itself before the ACA?

    What I have seen happen, first hand since I actually handled benefits for a small business, is insurance companies raise rates to the point where people could no longer afford health care (30% increases) and then when people dropped out the insurance company said, “Hey, we offered them insurance.”

    I have watched as people lost their health insurance due to rescission. I have witnessed people looking for health insurance being told that they were uninsurable due to a preexisting condition. Call ended, meeting over as soon as they told the insurance rep they had a preexisting condition. No insurance for them!

    Basically, the health insurance system was rigged. If you were young, healthy and/or worked for a large organization then you could get insurance. If you had a preexisting condition (at any age), worked for a small business and/or an individual the rules were different – and always to the insurance companies advantage.

    So, I’m going to try this one more time. Frank, could you please answer the following questions:

    1. Do you think there were problems with our nation’s health care/health insurance before the ACA?

    2. If you do think there were problems, what were they? If you’ve listed problems please provide, in detail, how your plan would address them.

    3. You claim to be fine with covering preexisting conditions, but say that the insurance company should be able to charge people whatever they decide to cover them? Would you cap that amount, or should an insurance company be able to charge a person 3,000.00 a month, or more?

    4. And if we did let the insurance company charge people with preexisting conditions more and people were left uninsured due to the fact they couldn’t pay the premiums (which is what would happen) what would your plan do to address this problem? As of now, people with insurance pay for the uninsured. Are you okay with that?

    5. You speak a lot about the free market and insurance companies offering a product, but what about hospitals and physicians? Are they not entitled to be paid? It appears not, especially when you say, “You yourself stated that in America, unlike not being able to pay for your happy meal means no happy meal, but not being able to pay for your health care does not mean no health care.” So, in your scenario, doctors and hospitals should have to treat uninsured patients for free? Or are you saying that the insured population should have to pay for the uninsured?

    Seriously, Frank, what are you saying? You kid about stepping over dead bodies in Pandora’s world, but offer no plan to address these issues. Where I sit there appears to be three options.

    a. Hospitals/doctors refuse to treat people without insurance (and then what happens?)
    b. Hospitals/doctors treat uninsured patients and don’t get paid for services
    c. Hospitals/doctors treat uninsured patients and pass the costs onto the insured.

    Do you have another plan? If so, please explain. Thanks.

  20. Laffter says:

    1. I absolutely applaud as other have outside this blog the reasonable and intelligent discussion here regard healthcare – this is the way a blog should work and all here have done a tremendous job

    2. That said- I am lucky, I have been blessed most of my adult life with excellent healthcare, what I had in the 80’s from work, did go up in price so much, as the pool shrank, I did have to step downtown another plan but the coverage was and is still excellent.

    3. Even with that said tho, I have travelled overseas to have some procedure done and the cost out of pocket was half what it was here. The Dr who did the work TEACHES HIS PROCEDURE HERE IN THE US at a major university but sees American patients at his facility abroad,. I had his worked check out here in the US Upon my return and it was deemed excellent work.

    4. I have seen people go into serious debt over medical bills, people getting a divorce to retain property due to medical bills, and people loosing their homes over medical bills. This should Not ever happen. We HAD to do something and the ACA was a good long step into alleviating the issue. While it has glitches, at least is was a plan and is moving us forward
    I say give it a chance, it’s here, it’s the law and let’s see where it goes.

    Thanks again for a thoughtful discussion on the issue!

  21. Frank Knotts says:

    I hope all will forgive my delay in answering your comments, I was not ignoring you.
    First let me say thank you to Laffter for their complements about the discussion, I to appreciate the adult attitude.
    Pandora, this may be where you and I have to just agree to disagree. You see, you keep pushing me to deliver a plan for how the government can fix health insurance. But no, I don’t feel that government can fix health insurance. More government involvement can only further inhibit growth.
    Yes there are problems with health insurance, but having a mandate for all people to purchase it does not, in my view, fix the problems.
    The mandate does not make insurance more affordable for the so called poor. It forces people to pay for others, either through the mandated purchase with no real need for such a high level of coverage, or through government subsidies. Either way it is nothing more than wealth redistribution.
    So how do we lower the real cost of insurance? You won’t like this, competition and less regulation. We open up the markets to any and all companies to sell anywhere and to anybody that can pay.
    States don’t get to decide who can sell insurance within their borders, the customers decide. If I want to buy insurance from a company in Afghanistan, so what? As long as they pay up when the time comes, what do I care?
    Now with all due respect, please save the guilt trip, my father taught me never to pity myself, and never embarrass others by pitying them.
    You talk as if before ACA that there were no safety nets for those who could not afford gold ticket plans. Did I miss when Medicaid and Medicare were defunded and done away with?
    People who can show that they have no means to afford health insurance have always had these as backups. If they have the means and simply choose not to buy insurance, then that is their choice.
    Let us talk about short term unemployed. If you lose your job and also your insurance, then you should be granted short term healthcare through one of these programs. However, this should not simply become the new welfare.
    Not sure how anyone loses everything over health cost. I have had times when I could not pay health cost all at once. I made arrangements to pay what I could, and there was no interest added. Might you never pay it off? Sure, but as long as you are paying I don’t see anyone foreclosing on your home. And really, you are either going to be paying for the cost of health care or the cost of the insurance.
    On who sets the cost of insurance, well here again we may never agree. I see the companies as a business that have a product that you want, and so they get to set the cost. If the cost goes too high, the market will adjust, as I said above also, unless the government steps in and either subsidizes the cost, or fiddles with the market artificially.
    You asked me to show a time when the insurance market had ever self adjusted, well can you show me a time when government ever took a hands off approach on insurance? I know that seems like a sidestep, but if Frank’s world it is the way I see it. Sorry.
    Both of my parents at the end of their lives were receiving excellent health care and support, both through Medicare and other organizations, and they were denied nothing. They both passed away without the burden of concern over how to pay for it. They had worked hard in their lives to make this happen and yes relied on the promise of a government safety net at the end.
    I am concerned that we are moving further away from self reliance that my parents had lived, and had taught me, towards a more reliant society where everyone is looking for a “plan”.

  22. TMV says:

    Welcome back Frank. The delay is understandable. Just found out you’re back and somewhat amazed at how soon you’ve returned. It will be a few days until I can respond to your comment to Pandora but I’ve got a dog in this hunt and a few thoughts to share…AGAIN.

    Laffter I want to thank you for the kind words as this really is how things should go on a blog No wonder you’re a hero in the house! You and Pandora apparently get ‘toasted’ often if not nightly.

  23. pandora says:

    Here we go again…

    Pandora, this may be where you and I have to just agree to disagree. You see, you keep pushing me to deliver a plan for how the government can fix health insurance. But no, I don’t feel that government can fix health insurance. More government involvement can only further inhibit growth.
    Yes there are problems with health insurance, but having a mandate for all people to purchase it does not, in my view, fix the problems.
    The mandate does not make insurance more affordable for the so called poor. It forces people to pay for others, either through the mandated purchase with no real need for such a high level of coverage, or through government subsidies. Either way it is nothing more than wealth redistribution.

    Why do you keep ignoring that the insured/taxpayer are already paying for the freedom loving “risk” takers? Isn’t that wealth distribution? Seriously, why is it okay for risk takers to “mooch” off of the insured/tax payer? Why do you ignore the fact that someone has to pay the bill? That someone is paying the bill.

    You don’t like mandates? Fine, then offer up something else that holds the uninsured fiscally responsible. Or just come out and say if a person doesn’t have health insurance then they don’t get medical treatment. You can’t have it both ways.

    So how do we lower the real cost of insurance? You won’t like this, competition and less regulation. We open up the markets to any and all companies to sell anywhere and to anybody that can pay.
    States don’t get to decide who can sell insurance within their borders, the customers decide. If I want to buy insurance from a company in Afghanistan, so what? As long as they pay up when the time comes, what do I care?

    So… anyone can sell anything? Insurance companies can define health insurance and then charge what they want for these policies? Junk policies are once again okay? And what happens when people try to use them and find they don’t cover their illness? What happens when insurance companies go back to rescission? I take it you’re okay with rescission, since it was a major part of health insurance companies model before the ACA.

    Now with all due respect, please save the guilt trip, my father taught me never to pity myself, and never embarrass others by pitying them.

    You know, I haven’t appealed to your better angels. I haven’t guilt tripped you. I have asked you specific questions, most of which you have ignored. It appears you are a-okay with insurance companies selling a product (even a faulty one) they get paid for (Yea! Capitalism!), but could care less if doctors and hospitals get paid. Why is the insurance company business model more valid, and deserving of payment for services/products than hospitals and doctors?

    The reality is this: The uninsured are using health services they don’t pay for. So much for personal responsibility. And while neither of us is calling for people to be barred from hospitals if they don’t have insurance, I’m the only one of us concerned about the bill. Come on, Frank. Who picks up the tab for the uninsured? We know who’s been picking up. You really okay with that? If not, once again, what is your plan?

    You talk as if before ACA that there were no safety nets for those who could not afford gold ticket plans. Did I miss when Medicaid and Medicare were defunded and done away with?
    People who can show that they have no means to afford health insurance have always had these as backups.

    Nice try, but I’m not going to let you change the debate. We have not been discussing Medicare and Medicaid. Not one bit. But it is interesting that you cite government plans as part of your solution, no?

    If they have the means and simply choose not to buy insurance, then that is their choice.

    And the rest of us just pick up the tab!

    Let us talk about short term unemployed. If you lose your job and also your insurance, then you should be granted short term healthcare through one of these programs. However, this should not simply become the new welfare.

    Oh wow, I didn’t see that one coming. So, if a person loses their job and their health insurance then you’re okay with the government stepping in? Really? Suddenly government has a role? And if we go with this temporary plan of yours for the people who lose their job and health insurance… who pays for that?

    Not sure how anyone loses everything over health cost. I have had times when I could not pay health cost all at once. I made arrangements to pay what I could, and there was no interest added. Might you never pay it off? Sure, but as long as you are paying I don’t see anyone foreclosing on your home. And really, you are either going to be paying for the cost of health care or the cost of the insurance.

    Here’s a link for you: http://www.today.com/money/biggest-cause-personal-bankruptcy-medical-bills-6C10442408

    Here’s a synopsis:

    Rising medical bills are expected to push 1.7 million American households into bankruptcy this year—making health expenses the single biggest cause of such filings, outpacing bankruptcies due to credit-card bills or unpaid mortgages, according to new data. Even having health insurance doesn’t shield consumers against financial hardships.

    And I’m not claiming the ACA will solve all of this, but it is attempting to. At least it’s a step toward addressing these problems. Remind me again what the GOP plan is?

    On who sets the cost of insurance, well here again we may never agree. I see the companies as a business that have a product that you want, and so they get to set the cost. If the cost goes too high, the market will adjust, as I said above also, unless the government steps in and either subsidizes the cost, or fiddles with the market artificially.

    Which brings us full circle. Insurance companies get to define what health care includes and charge whatever they want, meanwhile hospitals and doctors will work for free? What avenue do hospitals/doctors have other than denial of service? But you don’t seem to want to do that, (no sick or dying people outside the hospital in Frank’s world, right?) so… come on, Frank, what should these businesses (hospitals/doctors) do to get paid for their product? Where does their free market come into play?

    You asked me to show a time when the insurance market had ever self adjusted, well can you show me a time when government ever took a hands off approach on insurance? I know that seems like a sidestep, but if Frank’s world it is the way I see it. Sorry.

    I hesitate to add another link and get caught in the spam filter, but you know that health care costs actually fell last May for the first time in almost 4 decades? Hmmm… how did that happen?

    As far as a showing you a “time when government ever took a hands off approach on insurance…” I’m confused. We aren’t, and have never been, discussing Medicaid and Medicare in this thread. Why you keep bringing up those programs baffles me. In answer to your question, yes I can show you a government hands off approach – it existed completely before the ACA. And the ACA is not government run health care. The ACA mandates coverage that a person buys through a private business (not government run) and defines what is allowed to be called health insurance. You know, we get this in other parts of our lives. Companies aren’t allowed to call ground beef filet mignon. So, if health insurance companies want to sell health insurance they have to, you know, sell actual health insurance.

    Both of my parents at the end of their lives were receiving excellent health care and support, both through Medicare and other organizations, and they were denied nothing. They both passed away without the burden of concern over how to pay for it. They had worked hard in their lives to make this happen and yes relied on the promise of a government safety net at the end.

    I am sorry for your loss. It’s a very hard time. However, thank goodness for government health care! Can you imagine what the insurance companies would charge people over 65? I mean, you’re all for insurance companies charging more for risk and preexisting conditions, right?

    I am concerned that we are moving further away from self reliance that my parents had lived, and had taught me, towards a more reliant society where everyone is looking for a “plan”.

    Self reliance? Where is that self reliance for those who choose not to have health insurance? Where is their personal responsibility? Right now they’re relying on others to pay their bills. Sheesh, for a party that goes on and on about the “makers” and “takers” you seem okay with these takers.

  24. Frank Knotts says:

    Pandora, first let me make it clear that many of my personal views do not reflect those of the GOP anymore than they do your own.
    You say, “Why do you keep ignoring that the insured/taxpayer are already paying for the freedom loving “risk” takers? ” Okay, why do you ignore that all ACA does is flip who pays. In the previous, and not perfect, system all tax payers paid into the Medicare and Medicaid safety nets. Now with the ACA model only those who are forced to actually pay for their insurance pay. All others either get 100% free coverage or subsidizes coverage.
    Pandora, let us find a compromise. I will go for preexisting, and even allow children to stay on their parents policy for life, will you remove the mandate? No you can’t, because without the mandate you can’t fund the subsidized and free coverage. So where is the compromise?
    How about you remove the mandated level of coverage? How about we mandate coverage, but allow the people to choose the coverage. No? Because again, the only way this works for you is that everyone is “EQUAL”. We can’t have anyone having better than someone else.
    Should hospitals and doctors be able to deny service? Maybe. If people knew that they might not get service without insurance, then maybe the mandate would be unneeded.

  25. Tuxamus Maximus V says:

    I’m just keeping up here so I can stay abreast of things. I wonder why Frank continues to bring up Medicaid and Medicare as neither has anything to do with this conversation.

    Nothing ‘flips’ here Frank. I don’t understand where you get that idea. No one is forced to pay. If they don’t they pay a fine of $95 (I think) and they still get to go to the emergency rooms all over the country that we all get to pay for but we got their $95 and that’s more than we ever got before.

    I’m not willing to compromise on a thing since the ACA is the law of the land and it’s allowed me to provide more at less of an increase than in previous years and that’s something you’ve yet to address Frank

    Pandora I can’t find a fault with even one remark you made. Real world things regarding real world people, that I hope that Frank at least reads when I comment with my thoughts of what he wrote on the 21st. When insurance ‘caps out’ and people go broke, or DIE, than something has to be fixed and that’s what the ACA attempts to do. You and I agree on a lot concerning this (and many other things it seems) and one of the things I can’t accept is not making any attempt at changing things from what it was before ACA.

    I’ll be back sometime Thursday and try to get a real comment up soon.

    I’ll part for now with this Frank. How insurance companies ‘insured’ wasn’t fair and there really never has been a ‘marketplace’…not even out of Afghanistan. Buying insurance could easily be compared to walking into a casino. You may win for a while but the odds are you’re going to lose in the end run.

    My supposed quick comment ends now. I’ll be BACK!!

  26. pandora says:

    This is exhausting, Frank, more so because you will not answer basic questions. You don’t like the mandate. Fine. Now please, spell out your plan, with costs and without the mandate. Or, just come out and say the old system was fine and we didn’t need to change a thing.

    You say, “Why do you keep ignoring that the insured/taxpayer are already paying for the freedom loving “risk” takers? ” Okay, why do you ignore that all ACA does is flip who pays. In the previous, and not perfect, system all tax payers paid into the Medicare and Medicaid safety nets. Now with the ACA model only those who are forced to actually pay for their insurance pay. All others either get 100% free coverage or subsidizes coverage.

    Wait… What? Wrong. Medicare and Medicaid are still funded by taxpayers. You know, the line on your paycheck labeled FICA. Are you claiming that that will no longer exist?

    And I noticed how, yet again, you didn’t answer my question. Who pays for the risk takers, Frank? Who pays for the person who gets rushed to the hospital and receives 100,000.00 worth of treatment? And your mantra that it’s somehow not fair that the healthy pay for the sick is silly because that is how all insurance works. That is the entire point of insurance.

    Pandora, let us find a compromise. I will go for preexisting, and even allow children to stay on their parents policy for life, will you remove the mandate? No you can’t, because without the mandate you can’t fund the subsidized and free coverage. So where is the compromise?

    The mandate exists because the insurance companies want it. They were the ones who wanted it in the law. It was their business model. If preexisting conditions are now covered and caps removed then insurance companies do not want people to buy insurance only after they get sick. It would be like being able to buy auto insurance after an accident. Bottom line: The mandate benefits the insurance company greatly. Without the mandates insurance companies would fold.

    You’ve stated several times that you’re okay with covering preexisting conditions, but haven’t explained how you would pay for this without the mandate. Go on. Tell me how you’d pay for covering preexisting conditions. Or simply say that when a child with an illness turns 18 it’s okay that the insurance companies won’t insure them. Because that was the reality before the ACA. It wasn’t that most people didn’t want insurance; it was that they couldn’t get insurance because the insurance company refused to insure them.

    How about you remove the mandated level of coverage? How about we mandate coverage, but allow the people to choose the coverage. No? Because again, the only way this works for you is that everyone is “EQUAL”. We can’t have anyone having better than someone else.

    You do know that people are still able to choose levels of coverage, right? You do know that the exchanges and business offer several different levels of coverage/different plans, right? I’m asking because I’m sadly reaching the conclusion that you do not understand how health insurance works/worked or how the ACA works and what it contains.

    One of the main things the ACA did was establish a baseline for what could be called health insurance. If you want more than the basics you can have more. So your line about everyone having to have the same coverage isn’t true. And I would bet your employer doesn’t offer you every plan on the free market, so aren’t they limiting your choice? They have chosen which plans and which company you’ll get to choose from. Have you complained to them about limiting your options?

    Should hospitals and doctors be able to deny service? Maybe. If people knew that they might not get service without insurance, then maybe the mandate would be unneeded.

    Maybe? Well, haven’t you come a long way from the Happy meal example. Looks like Frank’s world might consist of stepping over bodies outside the hospital, after all.

    The truth is you, and the GOP, don’t have a plan other than going back to the way insurance was before – but neither of you will say that because that would be political suicide. Repeal and Replace has turned into Repeal and Shrug. You remember the old plan, right? The one where the insurance business cherry-picked people, denied coverage for preexisting conditions and dropped people, with flippin’ insurance, once they became sick while sticking the bill for the uninsured to hospitals and doctors (a lesser business in your eyes?) and the taxpayers and the insured. With or without the ACA someone has to pay for these uninsured people, Frank. I just want you to tell me who that is.

  27. House Tuxamus Maximus says:

    OK Pandora here’s the deal/program regarding you and the members of the house TM. Last night we toasted you after doing a Conga line dance around the dinner table because doing a second ever Parade for Pandora around the house just isn’t going to happen (Love you but not that much!) due to conditions outside you’re going to get honored the same way again tonight!. You keep slapping Mr. Knotts across the face with facts and reasonable questions and he just seems to ignore them time and again.

    We did get a text from TMV stating “I’m aware and working on it” this morning so we know he hasn’t fallen off the earth.

  28. Tuxamus Maximus V says:

    Hello to Pandora, Frank and anyone else reading with any interest I’m ready to chime in again. I’ve gotten permission from the TM’s F&W to share a bit of their story as it pertains to the ACA and what it could have helped them avoid just a few short years ago.

    Frank and Pandora may “agree to disagree” but I’m not going to go down without a fight on this one Frank! The ACA has changed the rules of which the insurance industry has to play by. In the past they made up the rule and we all had to live by them. Now the rules have changed and they do their best to find the loop holes and make the rules favor them as best possible.

    By now I realize Frank isn’t going to offer Pandora a better plan to fix Healthcare insurance and to some extent healthcare itself in any way except complain about the ACA (Obamacare). I accept that and knew it wasn’t going to happen when Pandora first made the request (nice tries Pandora!). Aside from Obama coming up with a plan no one else has either. It’s the law and everyone including Frank is just going to have to live with it as is unless he changes his mind or in 3 years the government changes.

    Frank writes “But no, I don’t feel that government can fix health insurance. More government involvement can only further inhibit growth.”
    Oh come on Frank this is only the federal government forcing the insurance companies to play under a new set of rules that favor the common everyday person and small business owners that want to make healthcare available to guys like you and make you pay for it or guys like me that foot the premium bill. You’ve got a problem with small business being allowed to offer more for less? Let alone offer at all?

    Frank writes: “Yes there are problems with health insurance, but having a mandate for all people to purchase it does not, in my view, fix the problems.”
    My answer is: They don’t have to pay for it…they can be fined.

    Frank writes: “So how do we lower the real cost of insurance? You won’t like this, competition and less regulation. We open up the markets to any and all companies to sell anywhere and to anybody that can pay.”
    I’m going to borrow from Pandora and write REALLY? The market was being closed because of pre-existing and many other issues that insurers used to not cover people. REGULATION made it possible for people to buy insurance when they had previously been black listed because they had a pre-existing condition or any other little quirk that allowed the insurers to say NOOOOO.

    Frank writes: “Now with all due respect, please save the guilt trip, my father taught me never to pity myself, and never embarrass others by pitying them.”
    Well Frank maybe a little compassion for others wouldn’t hurt.

    Frank laments: ”Did I miss when Medicaid and Medicare were defunded and done away with?
    And I wonder, as does Pandora, when did this happen? Medicaid and Medicare are still there collecting FICA from your check…just like your employer is taking out for the plan you selected out of four I believe is what you wrote.

    Medicaid is still available and you’re just going to have to trust me on this one in that it just helps out. It doesn’t pay all the bills. It’s AID in paying some of the bills for those that are under 65. Same way with Medicare (over 65).

    Pandora really has covered most of this very well but I’m going to take it in another direction.

    Frank wrote: “Not sure how anyone loses everything over health cost.”
    Well it must be nice to live in Franks sheltered and naïve world. You’ve not met and spoken with enough people to know this really did USED to happen. Until the ACA (and portions of it came into effect over time) it did happen and happened to two people that post on your site on a regular basis. First hand straight up real deal in that “Fred and Wilma” lost EVERYTHING except an old minivan that ended up being their home for a while. That didn’t change until some guy made things better in life.

    Here’s the short of a long story for you Frank. Both had good jobs with health benefits with premiums paid by the companies they worked. Wilma was diagnosed with cancer.
    She used up the sick and vacation days she had to deal with the treatment protocols. She lost her job because she wasn’t coming to work (it’s a cruel world out there) and they paid the COBRA (not cheap) to continue the treatments. They went through every bit of savings, took out a second mortgage on the home they have owned for 12 years and sold off all their investments just to keep paying the COBRA insurance premiums from her former employer. Next thing you know she “capped out” for the excessive cost. At some point in time Medicaid kicked in and helped but they were going into the hole quickly now and the whole time Fred is doing his best to take Wilma to and from treatments because there is no way she’s able to take herself to and from these. Well Fred is using up sick and vacation days now and all of a sudden the recession hits hard (who was president when that happened?) and the next thing you know Fred gets laid off from his job (banking) and all of a sudden things go from really bad to impossible. Oh yeah…I forgot to mention that when they tried to put Wilma on Fred’s plan that was a big NO because she had….yes….a PRE-EXISTING condition!

    Well now you’ve got what I call an OH HOLIEST OF WHATEVER GOD YOU MAY ASCRIBE TO BAD SITUATION. Now everything is being taken from them except the good old minivan they end up living in and all they can afford is to keep a cell phone operating. They can’t even really afford to go through bankruptcy now. It didn’t take long for all this to happen and they were HOMELESS. BROKE. Done deal, Ship has sunk. People that one day were sailing along nicely and then it’s all over and done with for them. But they were lucky in that someone cared enough to give them a hand up and they are really the lucky that happened. Food stamps and all other kinds of government help were accessed along the way but try to get that when you don’t have an address.

    It really happened Frank and it could have happened to YOU or someone YOU know although apparently YOU don’t know enough people to have experienced this first hand yourself. You’re a busy man. Work every day, have a family, operate this site and go to GOP functions. Of all those people you used to see at those GOP meetings that you haven’t seen in a few years do you think it’s possible that Fred and Wilma may have been two of those people? You may well actually have known them but one day they just vanished. They may not have been big fans of yours and those that took over the Sussex GOP but at one time they actually were GOP’ers. Think about it Frank. How many of those people that you knew attended those meetings and functions in 2006-7-8 do you see there now? Do you think they were the only ones that had similar hardships? Do you think they were one off’s? I can go on and on about the people I’ve either known first hand or otherwise before the ACA started taking effect.

    Take a moment and give it some thought. Imagine if you will something like that having happened to YOU before the ACA took effect over time since it was passed.

    The ACA changed the rules and things like that, at least it’s my (and probably Pandora’s) hope that stories like that are a thing of the passed and that’s because THE RULES WERE CHANGED by the ACA (Obamacare).

    Maybe you just don’t have any compassion for people you may have ‘known’ in your past? Maybe because they fought you and the ‘others’ at the time things were changing in the Sussex GOP you really could’ve cared less? Do you feel that it’s part of the natural selection process in that only the lucky (like you) survive?

    Sit back for a moment and imagine yourself in ‘Fred’s’ shoes the day the eviction notice arrived. Go ahead and JUST DO IT. Still feel nothing? Let me know and I’ll turn off the “Show Frank respect rule” that’s in place because I’ll consider you the same kind of person they do but abide by my wishes. Go ahead Frank…this is one I want you to walk in his shoes for just the one day of his life. Not even the worst day but a landmark BAD DAY for them because it only got worse from that day on.

    Oh how I want to shower opus this with expletives.

    It can’t happen to you now Frank because of a law that was passed. Call it whatever you want but it’s the ACA (Obamacare) in the world in which we as Americans live today.

    I could move on the experience we had over years with my in-laws but you’d most likely have a hard time understanding because they were union people. Teamsters and Steelworkers union members for over 30 years each. Great benefit packages and ‘Daddy’ was a WWII vet. He drove a truck for General Patton was his proudest part of the war. Want to take a flying guess how hard it was and how long it took to for my wife to finally get what little benefits were available for him as a vet? They had six figure savings built up and by the time both had passed it was down to the mid five figures.

    Oh Holy God Frank you’ve got to realize that the ACA is more than just about you losing your rights/liberties/choice or whatever you refer to the ACA as infringing upon YOU.

    I’m all about every word Pandora offers in response to you and I’m trying to put a real world actually happened face on this problem that has been resolved by the ACA. Is it perfect? NO. It’s CHANGE and long overdue CHANGE.

    None of this could have happened to us because we’ve owned everything we have and it’s been this way for many years going back to 1997. We buy cars with cash. Make investments with cash we have on hand. Pay off the credit cards (love those points!) every month and have for many years. Not everyone is as fortunate and lucky as we are but we’ve worked hard. I’ve/we’ve paid it forward as best possible ever since but paying it forward isn’t part of your lexicon is it?

    Do you even understand the concept of “Pay it Forward”? Great movie by that title Frank. You should take the time to watch it one day…maybe even get invited to the House of Tuxamus Maximus for a viewing….yeah like that’s going to happen!

    Interested to read your response to this and anything Pandora offers as well.

    Oh yeah…’Wilma’ is and has been cancer free for some time now. Some guy came along and changed the course of their lives for the better and they are rebuilding with a roof over their heads and food on the table. Not real sympathetic to the GOP cause anymore. Go figure that one out!!

  29. Frank Knotts says:

    When I see words like “FAIR” used in reasoning for legislation, alarm bells go of for me. Life is not fair.
    Pandora and TMV, if you wish to donate to the needy, then you are free to do so, as am I and every other citizen.
    Yes Pandora I am aware that both Medicare and Medicaid are still in effect, so why must we double down with forced participation in ACA when safety net coverage is still available?
    If you tell me we would stop taxing people for these programs and only have to pay for ACA, that would be another compromise, is that what you are suggesting?
    TMV, the fine is only $95 or 1% of family income whichever is higher the first year of non-compliance, plus uninsured children are extra, after that it goes to 2% or $325, in 2016 it goes to 2.5% or $695 and continues to increase. Okay so you will now say that isn’t bad and people can still go to the emergency room and get treatment. Right?
    So you are defending a plan that is designed to give people a way to circumvent the “LAW OF THE LAND”?
    Let me get this straight, we mandate participation while including the loop hole to allow people to not participate, then we fine them on a ladder type fine, we continue to tax people for Medicare and Medicaid which are designed to be safety nets for those who cannot afford health insurance, and this is what you call “FAIR”?
    How about “FAIR” for all? Is it fair that I be fine for not wanting health insurance? No matter the cost of the fine.
    Pandora will now ask who pays for me with no insurance. Well I guess I have paid into Medicare and Medicaid over the years so why not utilize that?
    And before you again ask why I keep bringing them into this conversation, well in my view you can’t talk about this without considering why we are forced to continue to pay for them, if ACA will cover everybody, what will the need be for these two?

  30. Tuxamus Maximus V says:

    Frank wrote: “Not sure how anyone loses everything over health cost.”
    And I replied to Frank with a real world story of how it happened to REAL people.

    Is there a problem with Frank writing “I stand corrected”? I have a few other similar real life stories if that one didn’t make sense or work out for you.

    I’ll get to you on your above response soon enough but I’ve got three driveways to shovel out right now.

  31. Laffter says:

    This time I will toast House TM.

    I absolutely see that story, have seen it do see it. There is a thing as a medical lea in, and when one is 25 years old and have a serious medical condition and walk out of the hospital, alive but saddened with. 7 thousands debt,
    Trust me, there is very few places you can rent, your credit score drops and even if you are making payments, on your debt, it’s still impossible to get out from under that debt

    No one will allow you to buy a home with that debt to income ration, even is you work your but off.

    I also have folks I know that have suffered this horrible situation and while the ACA is not a magic pill, it’s a step in the right direction and does something positive.

    This will save lives, emotional lives and financial lives. I still say let’s leave the ACA alone, let it work or not. Then we can retrospectively look back and see if life is better or not.

    The proof of the pudding is in the eating……..let’s see.

  32. Tuxamus Maximus V says:

    Laffter I’m sure they will appreciate the gesture and most likley return the toast! They are just sitting on the sideline watching this play out for now. They (HTM), as do I, look forward to Frank’s response.

    I’m just looking forward to a nap in the next few minutes. I’ve been on the working end of large broom and snow shovel and feeling it now.

  33. pandora says:

    With all due respect, Frank, you do not understand the ACA, Medicare or Medicaid. They are different programs, designed for different needs.

    Medicaid is a government program designed to cover the poor and the disabled of any age. (Altho, poverty alone isn’t the only factor in eligibility and only certain disabilities are covered) States are not required to participate in the program.

    Medicare guarantees health insurance to people over 65 who have paid into the system. (It can also cover some younger people with specific conditions)

    Neither one of these programs is designed for a 30, 40, 50 or 60 year old who is middle class – this is where the ACA comes into play. Altho… if you’re under 65 and go bankrupt paying your medical bills you may then qualify for Medicaid. Is that your plan? Is that how your safety net would work?

    So, no… you cannot state, “Pandora will now ask who pays for me with no insurance. Well I guess I have paid into Medicare and Medicaid over the years so why not utilize that?” and be taken seriously. Sorry.

    And it hasn’t escaped my notice that you still haven’t offered a plan, or even said that we should go back to the old way.

  34. Tuxamus Maximus V says:

    Wonderful Pandora! How do we eat this elephant? One bite at a time!
    Heard today that the GOP is going to offer a plan Monday. Too little too late but willing to listen but color me happy with what we have NOW.

  35. Frank Knotts says:

    I did respond to that point with my own experiences. No interest is added to medical bills and you can make arrangements to pay what you can afford. While I have heard these stories, I have never experienced them, nor have I read in the papers about some mean old hospital foreclosing on someone’s home, maybe it happens, but maybe someone can lead me to a documented case rather than antidotal evidence.

  36. Laffter says:

    Frank -! With all the respect in the world, I think you can find cases of this easily if you google it

    I would start with the horror that is Arizona healthcare….

    If you don’t succeed in finding it yourself , I am sure Pandora and HTM can provide the stories.

    If that fails you know how to reach me, ……please feel free to do so.

  37. pandora says:

    You can start with this…

    http://www.nytimes.com/2009/11/25/health/policy/25bankruptcy.html?_r=0

    and then read this…

    http://www.nbcnews.com/id/20201807/ns/us_news-gut_check/t/when-staying-alive-means-going-bankrupt/#.UuWOwfZOm8o

    You know, I could post links like this for the rest of the night. Google is an amazing thing.

  38. pandora says:

    My links got caught in the spam filter, so I’ll post them separately.

    You can start with this…

    http://www.nytimes.com/2009/11/25/health/policy/25bankruptcy.html?_r=0

  39. pandora says:

    and then read this…

    http://www.nbcnews.com/id/20201807/ns/us_news-gut_check/t/when-staying-alive-means-going-bankrupt/#.UuWOwfZOm8o

    You know, I could post links like this for the rest of the night. Google is an amazing thing.

  40. Tuxamus Maximus V says:

    OK Frank I’m done here. Trees. Forrest. There is no light at the end of your tunnel. Why bother? It doesn’t get any more real than what I shared on behalf of TM’s F&W. Your viewpoint from deep inside the cave is why the ACA is being forced upon you and your kind.
    I’d be a fool to try anymore.

    Just as you stated “Life is not fair” and that is what you’re experiencing now. You feel the ACA isn’t fair to YOU and all I have to offer is take a moment and try to imagine just how little I care.

    As soon as I submit this comment I’ll be calling HTM and I’m sure they will gladly be more than happy to drop the one rule I’ve asked for all along regarding you…although I will ask that they refrain from comments until tempers cool a bit.

    Ultimately the brand of conservatism you and the others you fight with open and consistant basis is bound for failure if for no other reasons than the infighting and inability to understand the plight of others that walk among us. You are vastly outnumbered.

    To Pandora and Laffter: We can try but we can’t make some understand what they see before them in plain sight. They see only what they want to see. They hear only what they want to hear. From this experience I now truly understand why both are held in such high regard in the House of Tuxamus Maximus. That it comes from the young, and older, in the house is something that gives me hope for the future. Good night and good luck if you decide to persue this in the future as I have priorities that don’t include trying to teach stupid.

  41. Frank Knotts says:

    First of all TMV, you were the one who brought the discussion of fair into this conversation. Oh but I guess fair only matters to the things you see as important, if it works for you then it’s fair. This is the point I was making, that when we begin to pass legislation based on fairness, then we will without doubt be unfair to someone else. No way to run the candy store my friend.
    Pandora, I am getting ready to go to work so that I can keep my employer based insurance, so I can only respond to the NY Times article you linked to, I will try and get back to you on the other link later, so let me use that article to again show the gaping holes in your “LOSE EVERYTHING” argument.
    It talks of this family, “Wes and Katie Covington, from Smyrna, Tenn., were already in debt from a round of fertility treatments when complications with her pregnancy and surgery on his knee left them with unmanageable bills.”
    Notice it said they were already in debt, one reason being they made a “PERSONAL” choice to pay for fertility treatments. Who forced them to make these choices?
    The next example was, “For Christine L. Phillips of Nashville, it was a $10,000 trip to the emergency room after a car wreck, on the heels of costly operations to remove a cyst and repair a damaged nerve.”
    If ten thousand dollars puts you into bankruptcy, then you again most likely have already made some bad choices financially. I personally had to pay off more than ten thousand dollars in medical bills, it took me more than five years, with no interest and paying what I could every month, but I did it.
    Next we have, “Jodie and Charlie Mullins of Dickson, Tenn., were making ends meet on his patrolman’s salary until she developed debilitating back pain that required spinal surgery and forced her to quit nursing school. ”
    These people were not forced into bankruptcy due to medical bills, they were forced into bankruptcy due to her losing her job. Does the ACA guarantee lost wages? No matter what their level of insurance had been, she still would have lost her job, how would ACA have changed that?
    The article then goes on to say, “As with many medical bankruptcies, they had health insurance but their policy had a $3,000 deductible and, to their surprise, covered only 80 percent of their costs.”
    Really? So the majority of medical bankruptcies have insurance? I thought we were talking about people with no insurance being forced to choose between eating and medical care.
    Notice also that statement said, their policy only paid 80%, “TO THEIR SURPRISE”, if they don’t know what their policy covers, what chance do they have of balancing a checkbook? Also, a $3,000 deductible and 80% is a darn good policy.
    The article then makes this ground shaking statement, “Although statistics are elusive, there is a general sense among bankruptcy lawyers and court officials, in Nashville as elsewhere, that the share of personal bankruptcies caused by illness is growing. ”
    So there is no hard data to base these claims upon? Thanks Pandora for more anecdotal evidence, this time supplied by ambulance chasing lawyers.
    Pandora, did you read the article you linked to? Google may be wonderful but you should read the links, yours goes on to say about the ACA, “How many personal bankruptcies might be avoided is unpredictable, as it is not clear how often medical debt plays a back-breaking role.”
    So the article you linked to sates that no one knows how many bankruptcies are caused by medical bills, yet you and others are making a case for ACA based on the so called fact that people are forced into bankruptcy due to medical cost. OK.
    Like so many other things in life, many of these people’s troubles are due to poor choices made long before they had medical issues, they fail to plan or prepare for the unknown, and yes that means also buying insurance, yet your article states that many had insurance, so even that does not compensate for the other bad choices they may have made in living beyond their means.
    If I get a chance later I will look at you other link, but if it is more of the same I see no reason to respond. I asked for actual cases of medical bills being the cause, I see nothing in this piece of biased writing to lead me to believe that these people fit that description.

  42. pandora says:

    You know, Frank, I’m beginning to wonder why I answer your questions when you never answer mine. I should stop writing right here and demand you finally put into writing your health care/insurance plan. But my guess is that’s not going to happen. (Yep, I’m calling you out.)

    As far as the articles, you say:

    Pandora, I am getting ready to go to work so that I can keep my employer based insurance, so I can only respond to the NY Times article you linked to, I will try and get back to you on the other link later, so let me use that article to again show the gaping holes in your “LOSE EVERYTHING” argument.
    It talks of this family, “Wes and Katie Covington, from Smyrna, Tenn., were already in debt from a round of fertility treatments when complications with her pregnancy and surgery on his knee left them with unmanageable bills.”
    Notice it said they were already in debt, one reason being they made a “PERSONAL” choice to pay for fertility treatments. Who forced them to make these choices?

    Are you saying that people shouldn’t live their lives in case of a medical emergency? So, people shouldn’t send their kids to college, start a family, take out a loan for a car if they can’t pay cash? I’ll get into this more later.

    The next example was, “For Christine L. Phillips of Nashville, it was a $10,000 trip to the emergency room after a car wreck, on the heels of costly operations to remove a cyst and repair a damaged nerve.”
    If ten thousand dollars puts you into bankruptcy, then you again most likely have already made some bad choices financially. I personally had to pay off more than ten thousand dollars in medical bills, it took me more than five years, with no interest and paying what I could every month, but I did it.

    You know what goes hand in hand in medical bills and illness? Being unable to work. So bully for you, Frank. You were able to work and pay off a medical bill. But what if you weren’t? What if you couldn’t work due to your illness and still had to pay your mortgage, utility bills, feed yourself and pay the medical bill? What if getting back on your feet involved using your credit cards or emptying your retirement savings? Me? I’m not comfortable judging people, but you seem okay with it.

    Also, could you tell me why we should even consider your personal story about medical bills when you pretty much dismissed TMV’s?

    Next we have, “Jodie and Charlie Mullins of Dickson, Tenn., were making ends meet on his patrolman’s salary until she developed debilitating back pain that required spinal surgery and forced her to quit nursing school. ”
    These people were not forced into bankruptcy due to medical bills, they were forced into bankruptcy due to her losing her job. Does the ACA guarantee lost wages? No matter what their level of insurance had been, she still would have lost her job, how would ACA have changed that?

    The ACA allows individuals to purchase insurance at a large company’s rate. It allows a budding entrepreneur to leave their job and start a business without worrying about not having health insurance. You do know that health insurance is one of the reasons many people don’t leave their jobs and start up a business?

    But I’m rapidly reaching the conclusion that your plan involves people losing everything and then going on Medicaid. Looks like you’re okay with that government program. Up-thread you said, “Well I guess I have paid into Medicare and Medicaid over the years so why not utilize that?” You also said, in relation to Medicare/Medicaid, “If you lose your job and also your insurance, then you should be granted short term healthcare through one of these programs.” Those are quite telling remarks, Frank. Very close to liberals’ call for “Medicare for all!” Hmmm… Given your views on these government programs and how they should be utilized perhaps our views aren’t so far apart.

    The article then goes on to say, “As with many medical bankruptcies, they had health insurance but their policy had a $3,000 deductible and, to their surprise, covered only 80 percent of their costs.”
    Really? So the majority of medical bankruptcies have insurance? I thought we were talking about people with no insurance being forced to choose between eating and medical care.

    Did you miss the part up-thread where I discussed Junk Insurance, or where I stated that the ACA now defines what can be called health insurance? It was in our debate where you said insurance companies should be able to sell what they want for whatever price they want. And I said…

    So… anyone can sell anything? Insurance companies can define health insurance and then charge what they want for these policies? Junk policies are once again okay? And what happens when people try to use them and find they don’t cover their illness? What happens when insurance companies go back to rescission? I take it you’re okay with rescission, since it was a major part of health insurance companies model before the ACA.

    So stop pretending this wasn’t addressed. Junk policies were mentioned and rescission was mentioned, several times. You do know what rescission is and who it affected, right?

    Notice also that statement said, their policy only paid 80%, “TO THEIR SURPRISE”, if they don’t know what their policy covers, what chance do they have of balancing a checkbook? Also, a $3,000 deductible and 80% is a darn good policy.

    Given everything you’ve written on health insurance, I would bet good money you don’t know what your policy covered before the ACA. You write from the privilege of health and are unable to relate to, or show compassion and empathy for, anything that hasn’t effected you. You’re a “gotta see it with my own eyes” guy. That’s fine, but rather limiting wouldn’t you say?

    The article then makes this ground shaking statement, “Although statistics are elusive, there is a general sense among bankruptcy lawyers and court officials, in Nashville as elsewhere, that the share of personal bankruptcies caused by illness is growing. ”
    So there is no hard data to base these claims upon? Thanks Pandora for more anecdotal evidence, this time supplied by ambulance chasing lawyers.

    Oh look! We’ve found another free market business Frank doesn’t like. Insurance companies get paid – doctors, hospitals and now lawyers not so much? Your free market view has quite a few conditions. It sounds like… If you like the business then they deserve to paid? And if you don’t like the business…?

    Bankruptcies are cumulative. People are struggling, most trying to keep their heads above water, an additional bill sinks them. Are you saying that medical bills only count if they’re the last bill received? Are you saying that people need to save up for medical bills like a retirement account? How much should they save, Frank? 10,000.00? 30,000.00? 100,000.00? More? Go on, name your figure and then tell me what happens if the medical bill is significantly more than the amount you think they should have saved?

    Pandora, did you read the article you linked to? Google may be wonderful but you should read the links, yours goes on to say about the ACA, “How many personal bankruptcies might be avoided is unpredictable, as it is not clear how often medical debt plays a back-breaking role.”

    If Google is so wonderful why don’t you use it? Seriously, Frank, why do you always demand links from other people? Why must I always do your homework? Go back and read your responses and count the number of times you answered a question with a question. Nice way to dodge answering my questions – which is beyond frustrating and not what I’d call an honest debate.

    So the article you linked to sates that no one knows how many bankruptcies are caused by medical bills, yet you and others are making a case for ACA based on the so called fact that people are forced into bankruptcy due to medical cost. OK.

    Oh no, you don’t. You do not get to pretend that my case for the ACA is based on bankruptcy. Just like you don’t get to pretend that we’ve been discussing Medicare and Medicaid all along. Up-thread, I quite clearly stated in reference to medical bankruptcy: “And I’m not claiming the ACA will solve all of this, but it is attempting to. At least it’s a step toward addressing these problems.” I would really appreciate it if you stopped making up things I supposedly said or didn’t say.

    And “no one knows how many bankruptcies are caused by medical bills” does not mean that medical bankruptcies don’t exist. See how that works?

    Like so many other things in life, many of these people’s troubles are due to poor choices made long before they had medical issues, they fail to plan or prepare for the unknown, and yes that means also buying insurance, yet your article states that many had insurance, so even that does not compensate for the other bad choices they may have made in living beyond their means.

    Again, I have already spoken about junk policies. And do you have a list of things considered bad choices? You know, I doubt you’d be happy if I judged your life. Everyone has experienced times in their life where they added to existing bills. A car breaks down and while you’re buying another car your heater goes bust. Have you really never experienced such things?

    Here’s another link for you. Enjoy it because it’s the last one I’ll supply until you start carrying your Google weight. And please notice how I haven’t linked to any “liberal” blogs.

    http://blog.nj.com/njv_bob_braun/2011/11/braun_plight_of_stanhope_famil.html

    So I’ll end as I began – calling you out.

    You know, Frank, I’m beginning to wonder why I answer your questions, when you never answer mine. I should stop writing right here and demand you finally put into writing your health care/insurance plan. But, we both know, that’s not going to happen.

    Go on, put your plan in writing. I double-dog-dare you!

  43. delacrat says:

    Frank,

    You think Katie Covington’s “PERSONAL choice to pay for fertility treatments” was a “bad choice”.

    Then you must think infertility is a good choice.

    What a guy !

  44. Tuxamus Maximus V says:

    Have at him Pandora!

    Delacrat I think it’s safe to say Frank isn’t going to get nominated for any Humanitarian of the year awards…ever.

    Frank’s a real stand up guy as in he’d stand up over anyone that’s down and put his foot on their chest to keep them down due to “bad choices”.

  45. Laffter says:

    I like the folks in here all of them, well the regulars not the Trolls

    That said , and again with respect, I have a question

    So a woman chooses to have a baby, start a family, but she had junk insurance and the baby is born with a debilitating illness. Now her junk insurance won’t cover this because the baby has a pre- existing condition.

    So the mother is forced into backruptcy. The bills are incredibly high. Does she pull the plug on the baby, file for Mgdicais and have the state pay for a baby’s debilitating illness,

    That’s me and you

    Of- should she have had an abortion when it was discovered the baby had a dibilitaing illness that would not see them live past say age two.

    These are the MORAL, ETHICAL and HEART- BREAKING decisions that people have to face, every day.

    And a reason the we deserve decent affordable healthcare AND the ability to make medical decisions based on our own moral and ethical compass.
    And apart for providing affordable and regulated healthcare, stay the heck out of our decisions

    Because when it comes to termination a pregnancy, or pulling the plug on someone who is brain dead or euthanasia…….it’s going to be all about looking in the mirror for the rest of your life after you make the decision.and whether or not you like what you see there..

  46. Tuxamus Maximus V says:

    The more I read you Laffter the more I understand why HTM admires and toasts you! You’re common sense and subtle humor.

  47. waterpirate says:

    The biggest problem with the ACA is the campaign of dis-information and lack of understanding anything beyond the talking points of the oposition. To me, the ACA did not go far enough in the reform of policy and coverage reform. It is a step in the right direction but more needs to be done.

    As a side note. Is anyone else reading here gutting out the fiasco with the new castle chamber of commerce and highmark?

  48. pandora says:

    First, agree with everything in your first paragraph, waterpirate.

    Second, as far as Highmark… Steve Newton, of Delaware Libertarian, has been on the Highmark issue. Here’s a link (you’ll find additional links in the post):

    http://delawarelibertarian.blogspot.com/2014/01/delaware-is-currently-two-payer-health.html

    Third, Laffter poses interesting questions on real life situations. I’d love to see them addressed.

    Fourth, still waiting on Frank’s health care/insurance plan.

  49. Laffter says:

    Here is a tragic case of child abuse where the mother cannot work now

    I don’t know where she works or if she has paid leave or medical insurance

    But it is a real life situation with the possibility that the mother is now left unable to work with a horribly abused and sick child

    I hope Florida takes care of them

    Cody Marrone Burns Toddler’s Genitals With Hair Dryer: Cops
    http://www.huffingtonpost.com/2014/01/28/cody-marrone-burns-toddler_n_4679909.html

    Thanks Pandora for the Hat tip. Sorry about the bad grammar and spelling.

  50. Laffter says:

    Whoops. Forgot,

    Thanks TM. ;-).

  51. Tuxamus Maximus V says:

    You’re welcome Laffter! Been handing out snow passes last 24 hours. Need one? Understand you folks are in for the hit we’ve been taking all day. Got 6 inches now and still falling hard. Hope I don’t slip and bust my butt shoveling the same three drives I shoveled Sunday or I might need HEALTHCARE! This snow is NO FUN as a snowball can’t be made of this stuff.

  52. waterpirate says:

    Pandora,
    I am undecided if I should thank you for that link, or go get a sturdy plank and walk off the end into the briny deep…..
    Thank you for the info

  53. Laffter says:

    Just got in……in the south RT1 is covered , no Tarmac in sight

    And no snow plows in sight either….

    However, the private guys are out, lowes lot is cleared as is Home Depots at 5 pts

    Coming down fast and hard, thank God for the snow blower

    It’s 1:30 am and where is DelDot???????

    Sorry, off topic – but Frank, be safe driving in the AM

  54. Tuxamus Maximus V says:

    Ever since I last signed off on the 26th I’ve had a nagging feeling about what Frank on Jan. 26 wrote: “When I see words like “FAIR” used in reasoning for legislation, alarm bells go of for me. Life is not fair.”

    Press ctrl and F and type in any word and they come up in order.

    I use the word ‘fair’ in part 3 in describing myself as an employer. Nothing else.
    You use it next in your Jan 16 response to Pandora
    I use it next in my Jan 22 response to you in the context of it wasn’t fair how insurance offered policy packages to me (small business) in that there never really was a market place.
    Pandora used it next in her Jan 23 comment…ONCE.
    You used it again on Jan 26….FIVE TIMES
    I used it twice responding to you on Jan 26 and in your response you used it FOUR times along with an Unfair.
    I don’t get the logic you’re using. I’m small business. YOU are supposedly all about small business…right? If as a small business I want a fair and level playing ground which the ACA offers what’s the problem. You misconstrue the words to your liking and out of context. I keep good people because I try to offer perks others (competitors) won’t because of GREED.

    Having a hard time with the word ‘FAIR’ Frank? Quit using it more than we do and in context.

  55. waterpirate says:

    Frank appears to be MIA. I hope it is the propane shortage spurned on by the polar vortex thatis putting his cdl-w/hazmat endorsement to good use.

    I have talked to Frank about the ACA before, and as a recipent and provider of insurance benefits, I chose to ignore the talking points and focus on the meat and potatoes of the reform. Frank has some deep rooted feelings about it, thus the definition of opinion.

    In DE like some others states, they failed to plan ahead for the changes, because they believed that it would be killed and not implemented. The problems in DE I blaim directly on Highmark failing to make the changes or put a action plan in place. They being the single payer provider in DE they have fubar for a grade. I chose to go off my group plan and go throug an individual agent and purchase a cheaper plan with lower deductible that is the same as the coverage I have now. To no surprise, HIghmark who is going to be forced to charge less for small people now is bucking and bitching like a petulant pony. I wish someone in the Insurance commissioners office would take responsability for the fiasco that Highmark has brought in their failure to do their homework, and get us on a road to normal.

    Everyone who was wooed into the NCC chamber group with the lure of lower rates, is now suffering a supposed computer glitch that is sucking monies out of peoples pockets. This issue has been ongoing for 4 weeks…… Great job IT people, you suck!

  56. Tuxamus Maximus V says:

    Waterpirate I hope you don’t mind if I reply from the end of your post first but blaming the IT people may be misplaced in that they just use the data provided by the actuaries. The actuaries most likely worked using failed parameters the higher up mucky mucks that most likely make your assumption of ‘being wooed’ correct in that’s how they sell the plans! From the brief I was provided on the Highmark issue it seems to be a giant Chinese fire drill with fingers pointing in every direction.

    As for Frank I don’t want to defend him in any way but he’s got a lot on his plate being executor of his parents’ estate and that’s not an easy process. Then again he may well be trying to fill a lot of empty fuel tanks working long days. He may well be trying to consider his next comebacks blaming all of us for being wrong. For that he’s digging deep and he might know that when you find yourself in a hole you stop digging.

    Like you I’ve followed Frank’s diatribes against the ACA for some time now. Every time he’s gone on a rant I’ve been made aware. It’s usually the single biggest expense to any business interest that provides health benefits even if the employees partially pay.

    No doubt waterpirate has done a lot of work in making decisions! Impressive. I’ve followed Frank’s thinking because of the ultra conservatives anywhere that rail against the ACA his thoughts actually are more non Fox news induced and purely selfish in nature. If nothing else he does show the ability to think for himself to some extent. I agree about your definition of opinion. The Fox news thing is something I can’t stomach but I’m exposed to at every turn I make or at least it seems that way.

    Having watched the Sunday talking heads I was given to think that the GOP was going to present a plan of its own this week but I haven’t seen or heard diddly yet and was looking forward to reading about it. Oh well…I’m not surprised.

    For me this is all about CHANGE. Something had to change and the ACA made it happen. I love how Pandora asks Frank for a plan and calls him out on his thoughts and failures to address her questions. She’s got the Pandora whack a mole hammer out and he keeps coming back with nothing. Frank blames me for using the word fair and I’m not going to back off the small business issue regarding healthcare and insurance costs.

    Love the ‘fubar’ reference!

    By the time I finish and post this comment Frank may well have responded.

  57. pandora says:

    I completely understand what Frank has on his plate, and he has my sincere sympathies.

    All I want is an honest discussion – a back and forth where all questions get answered. Take your time, Frank, but please answer the questions. Thanks.

  58. pandora says:

    Oh look, one of those put-upon private insurance companies is pleasantly surprised.

    http://talkingpointsmemo.com/livewire/wellpoint-obamacare-sign-ups

    A major health insurance company reported Wednesday that its Obamacare sign-ups were higher than its projections, some of the first concrete evidence that the health care reform law is working from the industry’s perspective.

    Joseph Swedish, CEO of WellPoint, told investors that the company had received 500,000 applications through HealthCare.gov and its state-operated counterparts. He said the number was “ahead of our most recent projections.” He added that applications had spiked in December and the company expects another surge before the March 31 deadline to enroll in coverage for 2014.

    “We do feel good about what we’ve seen thus far on the exchanges,” Swedish said on the call. “While it is early, we are encouraged by the level of applications we’ve received”

    Well, what do you know? The free market is a-okay with the ACA. (Told ya so!)

  59. waterpirate says:

    TM-V

    Any chance you can share the details of ” the brief ” you recieved either publicly or send me an e-mail?

  60. Tuxamus Maximus V says:

    I stand corrected…Frank has yet to respond. My bad as I’ve had more faith in him in the past

    Well DANG Pandora call me Mr. Happy on that last newsflash! You ROCK!.

    As usual I agree with Pandora. All I ask is for Frank to offer us some answers that aren’t just throwing all we bring up back at us taking our words out of context to suit his needs. That Frank feels no empathy for those that were financially broken by the previous system is something we all just have to accept. No all people have the capability of empathy…not even those that profess to be good Christians.

    One premise I operate on in doing business and in life is that every problem has a solution. We had a problem with healthcare insurance and a solution was made into law.
    I’m only asking for one answer to one question and then we can move on to the next question. Call it the ‘KISS’ (Keep It Simple Stupid) system going into effect now with me being the ‘stupid’.

    My question to Frank: Why is it wrong for me as a small businessman to expect an insurer to negotiate a healthcare package that doesn’t have caps on benefits?

    I could go on to ask the same only involving accepting preexisting conditions but I don’t want to confuse the issue above.

  61. Tuxamus Maximus V says:

    Interesting request Waterepirate. The brief was done in-house (HTM) by TMJ at my request. Although nothing more than a compendium of all that is out there (and maybe some that isn’t…I didn’t ask) as I don’t have time for the research but became interested when you wrote of the debacle. Will discuss your request during weekly call Friday afternoon and give it some thought afterward. A HTM member may be in touch.

  62. waterpirate says:

    I understood it to be a written piece? If it was a weekly update by one of your appendages that is fine. I do however feel that if Highmark can not get un glitched, it bears all of our keeping tabs on the what and why for the debacle, and will the put upon(my household included) ever be reimbursed in a timely manner?

  63. Tuxamus Maximus V says:

    Now I understand the text “We’re appandeges!”. Not quite Laffter humor but you’re working on it!

  64. Laffter says:

    LOL, I heard someone call my name………

    :-). Kids gonna rock the plunge this year?

  65. Tuxamus Maximus F says:

    To do the plunge requires motivation Laffter! something that lacks around here right now. The poor snow for snowballs and building a knottman kind of slowed the silly around here.

  66. Laffter says:

    Yeah, wish the snow would go away

    And wish Frank would come back……but like Pandora said, he has a lot on his plate

    Hope all is well with everyone and stay safe and warm! Unless one is taking a dip on Sunday….. 😉

  67. Tuxamus Maximus W says:

    Thanks for the well wishes to all Laffter seems we’ve dropped the ball on that one of late. Don’t have a lot of love to pass around but know that you, Pandora and WP…and some others are appreciated as humanitarians.

    WP…something for you soon.

  68. waterpirate says:

    My days of plunging in the ocean in the winter in a speedo are loooong gone! I feel like the tin man most days as it is. The cold Atlantic would surely freeze my joints into non-compliance with my brain.
    TMW any info or direction would be greatly appreciated as this mess can not be explained under any classification, free market or otherwise. My greatest frustration is stemming from noboby taking any responsability for this mess. The broker said call NCCCC, NCCCC says call Highmark, Highmark says call NCCCC. Just 1 big circle. In defense of NCCCC they did provide a form to fill out and with reciepts the promise of re-imbursement. We are going to comply with the path provided but my skeptisism and bull$hit meter are in the red.

  69. Laffter says:

    ROTFLMAO, sweeties, my days of even BEING in a speedo are long gone! It would look like a plastic bag of leaves, tied in the middle……

    Id do better nude, because folks would act quickly to cover me up!

    However some would be scarred for life, screaming THE HORROR, THE HORROR for the rest of their lives…..

    Just thought I’d give you all a chuckle for the evening
    WP- good luck with bureaucracy, It’s always a paid

    ;-). Super Bowl party tonight into tomorrow! Who whoooohooooo. And I don’t care who wins…..

  70. Tuxamus Maximus V says:

    YO Frank! I can’t speak for that classy lady Pandora but we’ve both asked questions and have no answers, well comments from you, since the 27th of January. I ‘ve been told you were injured on the job and hope you’re on the road to recovery (and that the health care policy has you covered) but don’t forget about us over on this thread. Laffter and Waterpirate may want some attention as well but I can’t speak for them either!! Eagerly awaiting and signing up for the comments follow up emails now! Don’t leave us hanging by a ‘thread’.

    Get well soon! Pandora and I have questions and we’re sure you have some real answers by now! If not take your time because you haven’t answered any yet to our satisfaction.
    Sorry Pandora I didn’t mean to ‘speak’ for you…really! (insert a winky face here)

  71. Dunleve says:

    TM used the “I” word, what gives?

  72. Frank Knotts says:

    Sorry to all on this thread, I lost track of this thread, in my absence. Too much here for me to read and respond to now, I will attempt to catch up and answer Pandora’s questions soon.

  73. Tuxamus Maximus V says:

    Although I’m eagerly awaiting your response to Pandora’s last comment I’ll remind you that I for the moment have but one question. Once answered I will most likely have another.

    My question to Frank: Why is it wrong for me as a small businessman to expect an insurer to negotiate a healthcare package that doesn’t have caps on benefits?

  74. pandora says:

    Thank you, Frank. I’ll wait with bated breath. 😉

    BTW, where are the other conservatives in this debate? You’d think they’d be all over this thread – given how Obamacare is one of their main issues. There silence is speaking. Perhaps their thoughts on the ACA/health insurance only run as deep as what fits on a bumper sticker. Just sayin’

  75. Frank Knotts says:

    To all, sorry again for losing the thread of this thread. I hope some of you are still watching.
    Okay, so TMV asked, “Why is it wrong for me as a small businessman to expect an insurer to negotiate a healthcare package that doesn’t have caps on benefits?”
    So TMV, you would have insurers pay out with absolutely no caps on benefits? How long do you suppose they would be able to survive like that? So when the private insurers are out of business, who then pays for the benefits?
    Your views seem to have no anchor in reality. How could even a government run insurer manage to pay unlimited benefits? Answer? It couldn’t, it too would fail.
    You seem to also have a problem in defending the fact that you were the first to use the word “FAIR” to describe the ACA. But in my world fair means that all parties in the equation are happy with the outcome, so since that is highly unlikely in the case of health care, I merely am pointing out that seeking such “FAIRNESS” through legislation is futile at best or alarmingly naïve.
    You and others have argued that the ACA will cover the uncovered, but no one is uncovered because of Medicare and Medicaid, you then argue that it is good for employers, okay what if it is? Does that mean it is good for everyone? Is it fair to everyone? Your word, not mine.
    Okay enough of dealing with the children of HTM. They will only call me names and accuse me of no humanity, to that I will only say that I was raised to believe that you help a person more with a hand up, not a hand out. Creating more dependent citizens does nothing but create more dependent citizens.
    Which brings me to this as a response to my new friend Pandora. You have asked me for “MY” plan in defense of my criticism of the ACA. Why must I have a plan in order to see that the ACA is wrong and will be a detriment to the nation overall?
    Just because the ACA is a plan does not mean it is a good one. Just because I don’t have a plan doesn’t mean the ACA is a good one.
    Here is a link to a CBS (Didn’t want to use the FOX report and allow HTM to blow it off simply because of the messenger, something the house of Ayotte would do) report about a recent CBO report on the effects of the ACA.
    Will you tell me that this is good for the nation as a whole?
    http://www.cbsnews.com/news/obamacare-will-shrink-workforce-by-2-million-report-says/
    To be honest I don’t have all the answers, (I only think I do), but I do know that mandating that people buy that which they don’t want or feel they need goes against my personal principles and those of our Founders as I understand them. I have given my views and some suggestions for compromise, if you find them lacking there is little I can do to change your mind.

  76. Frank Knotts says:

    P.S. to Pandora
    Can’t speak for other conservatives, only myself.

  77. pandora says:

    So… if you don’t have a plan and you want to repeal the ACA then that means we go back to what we had before? Is that what you want? Because, without the ACA, we go back to the days of people with preexisting conditions not being covered, rescission, caps on treatments, junk policies that people pay for but don’t cover their illnesses, and kids no longer able to stay on their parents’ insurance. Seriously, is that what you want?

    No one claimed this is an easy fix and that the ACA is perfect. Most were saying that our health care/insurance system was broken and expensive and needed to change and that the ACA attempted to do this. Yes, it still needs work. I’ve never denied that. I just wish we could all work together to improve the ACA, rather then spend our efforts tearing it down – while offering no alternative.

    As far as the 2 million number… let’s look at exactly what the CBO said:

    The estimated reduction stems almost entirely from a net decline in the amount of labor that workers choose to supply, rather than from a net drop in businesses’ demand for labor, so it will appear almost entirely as a reduction in labor force participation and in hours worked relative to what would have occurred otherwise rather than as an increase in unemployment (that is, more workers seeking but not finding jobs) or underemployment (such as part-time workers who would prefer to work more hours per week).

    The CBO report is not saying that 2 million jobs will be lost. It’s saying that people will choose to work less hours. Why would people choose to do this?

    Well, because the ACA allows people to get insurance outside of a full-time job. Decoupling health insurance from employment is, imo, a feature not a bug. But who are those people that would be working less hours?

    “I think it’s important to distinguish between people choosing to work less and jobs being lost,” Larry Levitt, vice president at the non-partisan Kaiser Famiy Foundation, told TPM. “That is something important to keep an eye on, since you don’t want to discourage work. But, it’s not in all cases a bad thing.”

    “For example, some people in their late 50s and early 60s would like to retire because they have health issues but have kept working for the health benefits. Some of them can now retire because they can’t be discriminated against for having a pre-existing condition and may get help paying their premiums.”

    I’ve known plenty of people who wanted to retire, but kept working until 65 (when Medicare kicks in) because of health insurance. Before the ACA, if you retired at 60 and had a preexisting condition… no health insurance for you! I also know a lot of young families where a spouse would like to work less (or stay at home) once the children come along, but going part time/staying at home meant losing their employer-based health insurance.

    And employment based insurance isn’t conducive for entrepreneurship. Starting a new business is risky; starting it without health insurance…? The ACA allows for worker mobility. No longer will people have to stay in a job that doesn’t suit them simply because they need health insurance. I would think that giving people more choices (to retire when they want, to spend more time with their children, to leave the white collar/blue collar world and start their own business) would be a good thing?

    So yeah, if you actually read what the CBO report says, it looks like a good thing. Not perfect. Good.

  78. Dunleve says:

    1. we go back to the days of people with preexisting conditions not being covered, :

    You are then enrolled in Medicare. Liability limits on insurance are standard to the industry, and are chosen by the payee. When you get car insurance you are asked what coverage amounts you ELECT to choose. I choose higher so that it limits my personal exposure. If there were no limits in auto insurance premiums would explode.

    2. caps on treatments: Again, you are getting the plan you pay for.

    3. junk policies that people pay for but don’t cover their illnesses: One man’s trash… A self employed person may choose this for good reasons. Someone with money in the bank may choose to manage their healthcare needs and insure against catastrophic healthcare emergencies. This is especially true for the young. I had a high deductible plan when I worked for myself and was younger, just in case I got a tumor or something rare.

    4. and kids no longer able to stay on their parents’ insurance: In college maybe, but at what age are children going to start getting taught responsibility.

    So far the ACA has insure few that are actually paying. Most enrollees are getting subsidized healthcare. It is what it is, however, the plan that was promised has been proven to be a complete farce. Parents used to teach their children: go to school, get good grades, get a good job with healthcare, and save for retirement. Not sure what lesson society is teaching now.

  79. pandora says:

    I’ve covered a lot of this before, but we’ll break it down again. Dunleve says:

    1. we go back to the days of people with preexisting conditions not being covered, :

    You are then enrolled in Medicare. Liability limits on insurance are standard to the industry, and are chosen by the payee. When you get car insurance you are asked what coverage amounts you ELECT to choose. I choose higher so that it limits my personal exposure. If there were no limits in auto insurance premiums would explode.

    No, you’re not then enrolled in Medicare. (WTH is it with this talking point?) Medicare has specific eligibility requirements. You are eligible at age 65. You are eligible under 65 if:

    You have been entitled to Social Security disability benefits for at least 24 months (which need not be consecutive); or

    You receive a disability pension from the Railroad Retirement Board and meet certain conditions; or

    You have Lou Gehrig’s disease (amyotrophic lateral sclerosis), which qualifies you immediately; or

    You have permanent kidney failure requiring regular dialysis or a kidney transplant — and you or your spouse has paid Social Security taxes for a certain length of time, depending on your age.

    People (other than the exceptions listed above) do not qualify for Medicare because they have a preexisting condition.

    Second, the car insurance example, again. States require basic auto insurance, most require liability insurance. That means you can’t call anything auto insurance – it has a baseline of mandated coverage. So, you may elect to get more car insurance, but you cannot elect to get less than the mandated coverage.

    2. caps on treatments: Again, you are getting the plan you pay for.

    So, the solution is between losing everything to pay for unexpected (and 300,000.00+ medical bills are hardly budgeted items for most people), or you receive emergency care and pass your unpaid bill onto everyone else, or you don’t get treatment, because you can’t pay for the 10,000.00 per visit chemo treatment, and die? Those were the choices before the ACA. Which one do you prefer?

    3. junk policies that people pay for but don’t cover their illnesses: One man’s trash… A self employed person may choose this for good reasons. Someone with money in the bank may choose to manage their healthcare needs and insure against catastrophic healthcare emergencies. This is especially true for the young. I had a high deductible plan when I worked for myself and was younger, just in case I got a tumor or something rare.

    Lucky you. You didn’t get that tumor. But what if you did and then found out that your junk policy didn’t cover 90% of the treatment and, then, when you went to receive treatment you were denied unless you could write a check then and there? There are links above showing how this happened to people with insurance. Or… what if you got that tumor and the insurance company pulled the rescission card? That was one of their favorites. You okay with rescission?

    And again, this brings us back to who pays for the uninsured and under-insured? The old system placed that bill on the taxpayer and the insured. You were okay with that?

    4. and kids no longer able to stay on their parents’ insurance: In college maybe, but at what age are children going to start getting taught responsibility.

    Um… okay. You do know that an 18 year old with a preexisting condition was uninsurable before the ACA, right? You do know that, before the ACA, insurance companies were able to refuse coverage to people with preexisting conditions, right?

    So far the ACA has insure few that are actually paying. Most enrollees are getting subsidized healthcare. It is what it is, however, the plan that was promised has been proven to be a complete farce.

    Data/link, please.

    Parents used to teach their children: go to school, get good grades, get a good job with healthcare, and save for retirement. Not sure what lesson society is teaching now.

    I don’t really have much time for the “these kids today” argument. But let’s flesh this out. What if a child did these things and went to work for a company without health benefits and they had, or developed, a preexisting condition over this time? What if they weren’t covered in college and had/developed a preexisting condition during this time? What if they didn’t get a job with health benefits immediately after school/college and had/developed a preexisting condition during this time? I get it. It’s easier to paint “these kids today” as slackers rather than actually address these common situations.

    Here’s what I don’t get. Why, when discussing healthcare, do Republicans never consider these situations? Why is it always about kids/people being lazy and irresponsible. I’d understand it if they felt the same way about the person who elected not to get insurance (and then got into a car accident or had a heart attack) and then stuck everyone else with the bill, but they seem okay with that person “mooching” off everyone else. Seriously, explain this to me. Because, where I’m sitting, those “risk-taking, freedom lovers” are risking other people’s money – something I thought Republicans were against.

  80. Dunleve says:

    Pandora. Correct, Medicaid not medicare.

    Less than half enrolled are paying customers::

    MSNBC – 54% enrolled in medicaid. http://www.msnbc.com/msnbc/obamacare-whos-buying

    Businessweek – 79% with a subsidy – http://www.businessweek.com/articles/2014-01-13/whos-buying-obamacare-in-three-charts

    We won’t agree so there is no sense in arguing, time will tell. Since its the law best case scenario is I’m wrong.

  81. Tuxamus Maximus V says:

    Ok Frank on January 14, 2014 I first used the word ‘fair’. I owned up to it then, later and I’m doing it again now. Here is how it was being used: “It’s a matter of wanting to be a kind, decent and fair employer. Just my opinion so deal with it…”
    So you deal with it by twisting its intended use? I want to be a kind, decent and FAIR employer and YOU have to twist that into something other than its intent and still can’t deal with that? Do you have a problem with nice employers? Would you rather that all employers are like yours and let YOU pay the premiums?
    Don’t bother responding to it Frank as I’d rather you deal with the following.

    My 2014 BC/BS program/policy has NO CAPS ON MAJOR MEDICAL IN ANY WAY. There are caps on the non essential/elective procedures but they are all procedures that are choices my people make and have higher deductibles. All three healthcare insurers that bid had to deal with the NO CAPS proviso on MAJOR MEDICAL because ACA allowed it to happen. All three bid and offered packages. All three also offered cheaper policies that had caps but the differences weren’t that big so we recycled the paper.
    There are caps on vision wear and cosmetic dental. I don’t and won’t pay for vanity.

    You wrote: “So TMV, you would have insurers pay out with absolutely no caps on benefits?” and I reply that Well Yeah Frank I did make the insurers bid with NO MAJOR MEDICAL CAPS and I’m paying the premiums and they are taking the payments. Done deal for 2014 thanks to ACA.
    With that in mind feel free to try again because I’m pretty sure I just sunk your battleship.
    It IS reality Frank. Deal with it. Not my first rodeo and when my legal eagles sit in on the negotiations I have firepower and for the first time EVER we had the upper hand.

    Same question with just a minor twist: “Why is it wrong for me as a small businessman to expect an insurer to negotiate a healthcare package that doesn’t have caps on Major Medical benefits?”

    Going to be interesting to see how you twist the question around yet again.

    As for “dealing with the children of HTM”. Let me put it this way. You wrote: “If ten thousand dollars puts you into bankruptcy, then you again most likely have already made some bad choices financially. I personally had to pay off more than ten thousand dollars in medical bills, it took me more five years, with no interest and paying what I could every month, but I did it.” YOU really insulted not only ‘Fred’ and ‘Wilma’ and since the ‘kids’ look at them as surrogate parents YOU insulted them as well. Before I wrote of their adventure in healthcare they sat all of them down at a rotation change and told them the WHOLE story. Not the condensed version I wrote.

    BTW $10K isn’t in my pocket but is in my personal checking. No payments needed. Maybe YOU made some bad financial decisions in the past.

    The kids have my respect and I have theirs in return. I’m not asking them to back off.
    You went on to write: ”They will only call me names and accuse me of no humanity, to that I will only say that I was raised to believe that you help a person more with a hand up, not a hand out. Creating more dependent citizens does nothing but create more dependent citizens.”
    Well DUH… humanitarian awards will not be stacking up at your door Frank. I gave them a hand up by giving them a hand extended out. I learned that one on my own. The wife and I pay it forward. Known F & W as good people close to 40 years and never asked for a dime. When all totaled up between the hospitals, oncologists, therapies, rehabs and all the others that wanted money from them it was, and read this out loud, over FOUR HUNDRED and FIFTY THOUSAND DOLLARS ($450,000.00+) before being negotiated/arbitrated down, with almost all parties, to a ‘reasonable’ number. But I’m sure you could have paid that off just as easily…right?
    Real world Frank try to join us in it. If you need more info you know how to contact me.

    I’m hooked up to that email alert for new comments so I’ll do my best to respond in a timely manner.

    Dunleve: Pandora pretty well has your four points covered with the real world way of things. My hope is you can understand what she’s trying to explain without twisting it around like Frank. The Kids sent me some links to read your comments over in crazy world and I’ve got high hopes that you can understand facts as they’ve been placed in front of you. If you’ve got a better plan or even ideas on how to improve the ACA or something that would improve over the old system (pre ACA) bring it on as I’m sure Pandora, Laffter, Waterpirate and I would be willing to discuss it. Pandora smart lady we all know ACA isn’t perfect. From what I’ve read over in crazy world you’re smarter than the average bear so show some of that here. Like the Kids I welcome you to this conversation.

  82. Dunleve says:

    Pandora. Correct, Medicaid not medicare.

    Less than half enrolled are paying customers::
    MSNBC – 54% enrolled in medicaid. http://www.msnbc.com/msnbc/obamacare-whos-buying

    Businessweek – 79% with a subsidy – I removed link since it was sent to moderation.

    Real world is we won’t agree, time will tell. Pandora’s “facts” are her views and I have mine. Since its the law, best case scenario is I’m wrong.

  83. pandora says:

    So says the person who didn’t know the difference between Medicare and Medicaid. How embarrassing. However, I’m the only one with real life situations other than “kids these days.” Also, in order to qualify for Medicaid you need to be poor. Is that your plan, Dunleve? Go into bankruptcy in order to qualify? Great plan! If not, then spell out your plan. Go on, do it. Tell me how you’d fix it.

    As far as subsidies: ” Consumers earning less than 400% of the federal poverty level (about $46,000 for a single person or $94,000 for a family of four) may be eligible for a government subsidy to help them buy coverage in 2014.”

    If you have a problem with that, tell me why? Go on, explain why. And give me more than… freedom!

    Also explain why it’s okay that taxpayers/insured pay for the the uninsured. Go on, I’ll wait… again.

  84. Dunleve says:

    Yup, pretty embarrassed. And your wrong on who can qualify in the right conditions.

    I linked to 54% of ACA enrollments were Medicaid. How is the plan going to work? It’s as if just because we are compassionate, the money will be there. This Country is going broke, and its being done on the backs of our children. (yes I know, because of 2 wars) To think that this is not adding to the problem is naive. Like I said, not looking to convince you anyway. In our new utopia, I doubt your right, but hope you are.

    “Also explain why it’s okay that taxpayers/insured pay for the the uninsured. ”
    That’s what subsidies are. 79% of plans. You are the one defending them.

    “I’m the only one with real life situations other than “kids these days.” ”

    I haven’t seen much other than taking pot shots at opposing views. Real Life I’ve donated 6 hours on 3 calls since 2AM this morning in the healthcare field. I don’t have a podium or a plan, but I’m doing more with my time than just blogging about how uncompassionate the other Party is.

  85. pandora says:

    Really? I’m wrong about who qualifies for Medicare? Possibly. Can you link me to who qualifies for Medicare? Seriously, I’m interested.

    Here’s a link to how the ACA is funded.

    http://www.washingtonpost.com/blogs/wonkblog/wp/2012/08/30/how-congress-paid-for-obamacare-in-two-charts/

    Remind me again… what’s happened to the deficit under Obama?

    Um… okay. So you have a problem with subsidies, but, yet again, no problem with those freedom loving risk takers who stick everyone else with their medical bills. Pick a side. (Me? I’m fine with everyone receiving health care. You? Not so much. Consistency, please.)

    And your final point is nonsense. Really defensive, lose your argument, nonsense, but still nonsense. You have no idea what I do or what I’ve done, and I have no idea what you (anonymous internet person) have done. But I do understand that that’s all you got. Believe it or not, anecdote is not the plural of data.

    And I haven’t called out anyone’s compassion. I’ve presented problems and asked questions. And don’t think I didn’t notice how you avoided my questions, because I did.

  86. Dunleve says:

    Use current articles. You won’t find any showing its not a disaster.

  87. pandora says:

    Seriously? That’s it? That’s all you got? No ideas on preexisting conditions? Rescission? No plan on who pays the medical bills of the uninsured? Nothing?

    *sigh*
    (on the bright side, I accept your surrender!)

  88. Tuxamus Maximus V says:

    Dunleve I must say I admire your attempts and that you’ve been able to (not your words but) straight up say I stand corrected. Something another here isn’t capable of but at least you’re able to do it. Thanks.

    Satirical or not you’re at least able to type the words “(yes I know, because of 2 wars)” and that’s rather nice to see.

    I don’t disagree with Pandora (nothing new there) but will say I’ve kind of counted on her aspect and research to make her points and prove her thoughts in helping me make my case. At least you’re trying to make a case and be nice about it. Kudos to Dunleve.

    What does bother me in all of this is that my aspect doesn’t get considered. Small business interests combined to make healthcare insurance possible. Cover the costs of the employee’s premiums. Opportunity comes along and even better benefits offered. Good for all involved. Everybody is happy. Why is this a problem for those that oppose the ACA?

    Now there is another aspect that comes to mind. It’s all these statistics being thrown around. Using statistics it’s possible to make any case look reasonable and why I don’t trust people that use them for making a case but consider this aspect. Like the law classes I had in college I loved the Statistics and Probabilities class as well (made me a better poker player!) and learned that you prove anything using the right statistics!

    I don’t know if the spouses and dependents that I’m covering (half the premiums) are being counted and if they are how are they being counted? Especially the large number of younger people that have enrolled in our plan since the first of the year. I think it would help to know that you’ve got to be with the company(s) a year before we pick up the whole tab. Eligibility does count! These are the young people that are needed in ALL of healthcare insurance to make the ACA case work but are they being counted? I DON’T KNOW!!

    Granted that employers like me on a small business level are few and far between but we do exist. Many are like Frank’s employer and offer a plan, or plans, that the employees pay for entirely but some do foot the bill as a perk of being loyal and a productive worker.

    As for using ‘current articles’ I’ve got an issue there because any that I’ve read claiming doomsday seem somewhat biased to say the least. There seem to be many that are willing to see how it all works out a year from now. The sky hasn’t fallen and for me it’s brighter blue than ever before and I’m the one that so many say should be suffering from the ACA. Can’t figure that part out…

    Time to get all gussied up for the expensive meal that raises funds. That time of the year and the wife is not happy I’m sitting at this keyboard. Thanks for playing nice Dunleve and I’d be willing to bet that there is a bit of compassion for others unknown to you in you. Might be wrong….BUT I’m willing to lose that bet.

    What did you expect Pandora? At least he’s been nice about trying. GOT TO GO NOW

  89. Dunleve says:

    I have to assume you mean you are providing benefits for your employees thru the ACA. Not sure how that would work, maybe you could explain how you shopped on the marketplace for a group of employees. Nevertheless, I checked the same plan I have vs. buying it on the marketplace. Low and behold it is $250 cheaper per month on the marketplace, same Highmark BCBS. That’s $3,000 and that’s real money. The problem is how the marketplace premiums were figured.

    We have been in the same group for years. While our rates have risen, there is history that BCBS can base their rates off of. The ACA marketplace rates on the other hand are based off rates that the rules have changed for in the past 4 months. How many exemptions has Obama allowed since October. The actuarial tables are what they are, and changing the rules isn’t fair. Then you add in that Delaware has only enrolled 5,062 (Bloomberg) as of Jan 31 of an estimated 35,000 planned for. If the spread of 54% Medicaid I mentioned before is true for this area, there is a terrible gap in what was planned for in determining the rates and what reality is. I have to imagine, and took the gamble that the ACA plans are going to skyrocket next year when reality takes hold. There is already talk of a Federal bailout of insurance companies.

    Again, it would be great if the “believers” are right. If the ACA is proven a success, I can eat my own crow. I’m just a realist, the history of social programs and the numbers don’t add up.

  90. Frank Knotts says:

    Okay, if we throw out all of the bragging that TMV seems to have to do about how much he has, I think we can boil down his view of ACA as this.
    “It’s good for me, so the hell with the rest of you= fair”.
    I wonder TMV, does your new plan cover any genetic traits of insanity that may run in your family? Nasty is as nasty does.
    Pandora, you are just too smart to not be understanding what I and Dunleve have been saying about Medicare and Medicaid. Yes there are requirements for being accepted into either one. And those in the middle can buy there own insurance.
    You ignore the fact that you and I have already agreed that pre-existing and kids for life could be a compromise, if you would be willing to drop the mandate. But no again you can’t do that because you can’t pay for it without “FORCING” people into the plan.
    As for the loss of 2.5 million workers? Matters little “WHY” they leave the work force, the loss of those man hours will devastate the nation. Please explain in your view how the government will pay for this growing number of subsidized health care recipients, if at the same time 2.5 million fewer people will be paying payroll taxes?
    This will only continue to increase. Why should a young man find a job at the age of 19 0r 20? Why should I continue to work until I am of retirement age?
    It is called incentive. What is wrong with people working for what they want or need?
    And again, if they are unable to make it, we already have safety net programs for the poor and the elderly. You and TMV seem to believe that we now need safety nets for Bill Gates and Warren Buffett, which under your plan I will be helping to pay for their health care. Now there is some good thinking my friend.

  91. pandora says:

    Dunleve says: “There is already talk of a Federal bailout of insurance companies.”

    These are called “risk corridors” and they’ve always existed in the ACA – so this isn’t new talk; it isn’t breaking news if you actually read the bill. Here’s what the CBO says about them:

    “CBO now projects that, over the 2015–2024 period, risk corridor payments from the federal government to health insurers will total $8 billion and the corresponding collections from insurers will amount to $16 billion, yielding net savings for the federal government of $8 billion.”

    Are you suggesting taking this away? I know this has been Rubio’s issue for months, but I’m expecting him to drop it due to the fact that, if he gets his way, it will add 8 billion to the deficit.

    If you actually want to learn about it, may I suggest this article from Bloomberg Business Week. (I’ll stay with your source, because I’m thoughtful that way!)

    http://www.businessweek.com/articles/2014-02-04/obamacares-bailout-could-earn-billions-for-the-government

    As far as the number of sign-ups, the CBO hasn’t changed its overall projections:

    “Over time, more people are expected to respond to the new coverage options, so enrollment is projected to increase sharply in 2015 and 2016,” CBO analysts wrote. “Starting in 2017, between 24 million and 25 million people are expected to obtain coverage each year through exchanges, and roughly 80 percent of those enrollees are expected to receive subsidies for purchasing that insurance.”

    So while this year’s enrollment projections are down by 2 million, due to the website’s problems (and those glitches infuriate me), the CBO doesn’t score this as a lasting problem.

    Moving onto Frank. He says:

    “You ignore the fact that you and I have already agreed that pre-existing and kids for life could be a compromise, if you would be willing to drop the mandate. But no again you can’t do that because you can’t pay for it without “FORCING” people into the plan.”

    You keep using the word compromise, but that isn’t what you mean. You don’t like the mandate – I get that. But then you say you’ve already agreed that preexisting conditions and covering kids under their parent’s insurance (until the age of 26) is something you’d be willing to compromise on. HOW?

    Give me a plan that would cover people with preexisting conditions without the mandate. Seriously, I won’t fight you on this, since I’ve never been a fan of the mandate – but I do recognize why it exists.

    So just for fun…

    Okay, Frank, I’ll drop the mandate. Now what? Go on. I just compromised. Your turn.

    And if your response is simply, “Repeal the ACA because it won’t work,” then that isn’t a compromise, is it?

    Come on, guys. Show your work!

    * And it’s not 2.5 million workers. We’ve been over this, but feel free to provide a link to prove this claim.

  92. Tuxamus Maximus V says:

    Dunleve unfortunately you’ve made an incorrect assumption as I never mentioned Highmark as the BC/BS provider. I’ve only been addressing my experiences regarding how ACA changed the way I do business with my BC/BS provider and others that were brought in on the bidding.

    Now to Frank and his anger towards me! Apparently my being successful in life either through hard work, luck, being fortunate at times to be in the right place at the right time or just plain being smarter than the average bear at times as well. Maybe a combination of all of those in some cases seems to be an issue for Frank. Golly I thought that was the American Dream. I stand corrected now.

    My view of the ACA is that it allowed me to provide better benefits as a business owner. It has been since I first commented to this post on January 14th. The ACA gave me a level field to negotiate a better policy. Apparently there’s something wrong with that?

    It also seems that Frank questions the possibility of genetic traits of insanity in my family! Fair enough Frank considering that he knows a family member that’s off the charts flat out whack doddle. I’m not going to say its not impossible for the trait to be genetic but the guys in white coats aren’t waiting at my door and I’ve never been behind bars.

    Maybe Frank is upset with me because I asked if he could have paid a huge six figure debt off just as easily as he paid off his $10K debt.

    Maybe…JUST MAYBE Frank is upset with me because he can’t answer one simple question. He couldn’t answer it the first time around without a lot of hyperbole and twisting of what I’d stated had been my experience. Actually I never did read a real answer that wasn’t Frank’s selfish need of no mandate for me. Let’s try again!
    Simple question Frank and all it needs is a simple straight forward direct answer.

    Same question: “Why is it wrong for me as a small businessman to expect an insurer to negotiate a healthcare package that doesn’t have caps on Major Medical benefits?”

    Maybe Frank just has a problem dealing with the real world around him and blames me for putting it in front of him. Hard to be mean to a lady like Pandora so I get the backlash.

    That you don’t, or can’t, answer Pandora’s questions is just a running joke now.

  93. Dunleve says:

    Same question: “Why is it wrong for me as a small businessman to expect an insurer to negotiate a healthcare package that doesn’t have caps on Major Medical benefits?”

    Good question, why didn’t you?

    45% of employer plans in 2009 had no lifetime limits.

    http://www.hemophilia.org/docs/LifetimeLimitsReport.pdf

  94. Tuxamus Maximus V says:

    OOOOOK when I brought up the .pdf it looked kind of screwy so I went to the http://www.hemophilia.org/ site and did a search for lifetime limits reports. Nothing. And then looked for Price Waterhouse Coopers. Nothing. Did search for lifetime, limits and reports and got results but yours sure didn’t show up. Nonetheless I did read the pdf and when I brought it up in an actual Adobe file they didn’t seem to match up quite the same so I just stopped letting you waste my time….and won’t again. You’re not Frank anyhow and it’s a question to Frank. Not a sidekick of Frank’s.
    Be careful Dunleve…your credibility has taken a huge drop now. Didn’t take long to figure out that your supposed article proved nothing and you can’t comprehend what you most likely didn’t read.

  95. Dunleve says:

    Easy now TM. First thing, I asked valid questions earlier about you purchasing insurance for your employees, you seem to be silent on that.

    I even explained why I care. You say you purchased group but the SHOP website claims this: You apply for and enroll in SHOP coverage for employees of your small business directly through an agent, broker, or insurance company. How is that different from (pre-ACA)

    You are then touting the lifetime limits. In the past, removing lifetime limits did not add a huge expense.

    Second, unlike other blogs, I will cut and paste PDF’s. SO here it is.

    Prevalence of Lifetime Limits
     About 55 percent of individuals with employer provided health insurance are subject to lifetime
    limits, or 91 million people in 2009. The proportion of individuals with employer coverage, who
    have no lifetime limits increased substantially between 2000 and 2007.
     The most common lifetime limits are $1 million or $2 million. More than 20 percent of people
    covered by employer plans are subject to lifetime limits of $1 million; another 32 percent are
    subject to limits of $2 million or more.
     Employers that self-insure are more likely to have plans with lifetime limits.
     PwC estimates that in 2009 approximately 20,000 to 25,000 people are no longer covered by
    their employer-sponsored plans because of lifetime limits.
    Cost of Removing Lifetime Limits
     Increasing lifetime limits from $1 million to $5 million would increase premiums, on average, by
    0.6 percent to 0.8 percent (approximately $3 per month for typical single plan, $8 per month for
    family plan).
     Increasing lifetime limits from $2 million to $5 million would increase premiums, on average, by
    0.25 percent to 0.35 percent (less than $2 per month for typical single plan, $4 per month for
    family plan).
     Extending the limits from $5 million to $10 million would increase premiums on average by less
    than 0.1 percent.

  96. Tuxamus Maximus V says:

    You asked ONE question and if you had read and comprehended what I’ve written before you you know that I had a top of the line policy with NO CAPS. DUH.
    Your one question was : Good question, why didn’t you?
    My answer is : DUH I did. Go to the beginning and READ and COMPREHEND.
    You’re doing the word twisty thing and I’m going to debunk your PWC right now because of the qualifying words and lets remember that the dating of this is PRE ACA and only conjecture.
    At what point did I ever use the word ‘limits’. Limits and Caps are two entirely different terms in the industry. One is a time constraint the other a monetary constraint.
    For the increases very small percentages at best do you not think I’ve more than happily made those happen? At MY cost?!
    That you’re worth the time is straining my limits. But here goes. I’m going to eliminate all the non essential words and leave just the qualifiers of you copy/paste:
    Just for kicks and giggles I’ll leave the dates as well
    Prevalence of Lifetime Limits

    And please back this up with FACTS using CURRENT data.
     About (2009). substantially (2000 and 2007).

    I wish they could make up their minds here.
     most… are subject to limits of $2 million or more.

    OH yeah we’re proving stuff now with
     estimates (2009) approximately

    In this next one a key qualifying word is WOULD (means they think or it could) but I’m going to leave the whole thing because it’s such a small percentage increase what part of I’d have paid it anyhow confuses you? It’s peanuts!
     Increasing lifetime limits from $1 million to $5 million would increase premiums, on average, by
    0.6 percent to 0.8 percent (approximately $3 per month for typical single plan, $8 per month for family plan).

    If they are with me a year I pick up the family so your point is?

     Increasing lifetime limits from $2 million to $5 million would increase premiums, on average, by 0.25 percent to 0.35 percent (less than $2 per month for typical single plan, $4 per month for family plan).
     Extending the limits from $5 million to $10 million would increase premiums on average by less than 0.1 percent.

    Now, and this is a mighty big IF. your saying that I COULD have done this that’s not really the truth because you weren’t part of the program and I seriously doubt you understand that PRE ACA it wasn’t a level field for small business. Take it or leave it. Bids were opnly so good as the number of insurers in my state that could bid and they made the rules because they had the ‘gold’.

    Understand this Dunleve. A BC/BS rep, as well as other direct company reps come to my office and do the deal. ALWAYS been that way. Only this year I (well my HR lady was there every time) had the full power of the ACA and legal eagle that know how it can be used to benefit my interests in providing a better package/policy. THREE different insurers bid on this every year. Nothing to do with Highmark. Nothing to do with the government web site and nothing to do with any ‘shop’. This is always a BIDDING process. Not necessarily the lowest amount but the best package.

    Now…lets address the reason that .pdf didn’t match up and why it can’t be found on the site. Don’t bother…you have no credibility. You’re using a suspect article that uses only conjecture and statics and that…well reduces your credibility.

    Lastly you’re answering my question to Frank with a lame and questionable copy/paste. No words of your own like Frank can’t come up with. Just some questionable hyperbole.
    Move along old dog and let Frank write for himself.

  97. Tuxamus Maximus V says:

    In short Dunleve you are long on conjecture and have no facts. Just old BS.

  98. Dunleve says:

    “Dunleve unfortunately you’ve made an incorrect assumption as I never mentioned Highmark as the BC/BS provider. ”

    Since Highmark is the BC/BS provider for Delaware, and you claim you have BC/BS you are either buying insurance through the State, or are full of BS.

    You’ve certainly kept it classy.

  99. pandora says:

    Or… perhaps their business is located in Pennsylvania, Maryland, etc.? Just sayin’

    And I’m still waiting for you guys to show your work.

  100. Frank Knotts says:

    Pandora the CBO report suggest that ACA will shrink the workforce by 2.5 million that is the link.
    I have answered your question about “MY PLAN”, and again just because I don’t have one does not make ACA right or good. To do something just for the sake of doing something isn’t ever a good idea.
    I notice you failed also to answer my question, “Please explain in your view how the government will pay for this growing number of subsidized health care recipients, if at the same time 2.5 million fewer people will be paying payroll taxes?”
    I will even give you an out, and restate the question as, how will the government pay for the growing number of subsidized health care recipients considering the loss of revenue that the CBO project due to people working fewer hours now that they have been released from the burden of “HAVING” to work?
    Also how many workers will refuse to work more hours in order to not lose that government subsidy? This plan will do nothing but create another entitlement class of do nothings. Please explain how that benefits the many?
    TMV, I have no problem with anyone being successful, however someone who brags as much as you do seems only insecure and base.
    I have also answered your question, but like so many people, if it is not the answer you expect then you claim it is no answer. I stated that I feel that by limiting the insurer’s ability to cap claims, you will force the insurance companies out of business, which by the way many people believe is the end game goal of the ACA. I have to say you behave more and more like DA everyday, when the answer you are given does not allow you to counter the point, you simply attack the person. I have responded in kind, childish on my part? Yes. But if all you want to do here is to attack me personally, well I can act like I am in the third grade as well.
    Could I have paid off the medical bills that you and or your family incurred? Maybe not in my lifetime, but the question and the point was about being bankrupted. If I had made arrangements and paid according to my ability, then I do not believe that I would have been bankrupted. Now I answered a question and you took it personally as an attack on you, and your make-believe legion started calling me names on another thread. Again very Ayotte like.
    I must admit it was very creative how you created your sock puppets by making people think that you were this big organized group of people using some super computer in some hidden away mansion. Genius, but puppets are puppets, and now you will tell us all about the toasting and the dinner table. Please imagine wide open mouth yawn!!!!

  101. pandora says:

    You know, I posted a link on how the ACA was funded above. So, I did answer that question.

    In regards to the CBO… You are aware that they issued another statement yesterday? Here’s part of their response to the question: Will 2.5 Million People Lose Their Jobs in 2024 Because of the ACA?

    A: No, we would not describe our estimates in that way.

    We wrote in the report: “CBO estimates that the ACA will reduce the total number of hours worked, on net, by about 1.5 percent to 2.0 percent during the period from 2017 to 2024, almost entirely because workers will choose to supply less labor.” The reason for the reduction in the supply of labor is that the provisions of the ACA reduce the incentive to work for certain subsets of the population.

    For example, under the ACA, health insurance subsidies are provided to some people with low income and are phased out as their income rises; as a result, a portion of the added income from working more would be offset by a loss of some or all of the subsidies, which represents an implicit tax on earnings. Also, the ACA’s subsidies effectively boost the income of recipients, which will lead some of them to decide they can work less and still maintain or improve their standard of living. Therefore, some people will decide not to work or to work fewer hours than would otherwise be the case—including some people who will choose to retire earlier than they would have otherwise, and some people who will work less themselves and rely more on a spouse’s earnings. (Many other factors influence decisions about working, including, for example, income and payroll taxes and the cost of commuting and child care. Moreover, under current economic conditions, a substantial number of people who would like to work cannot find a job.)

    Because the longer-term reduction in work is expected to come almost entirely from a decline in the amount of labor that workers choose to supply in response to the changes in their incentives, we do not think it is accurate to say that the reduction stems from people “losing” their jobs.

    And I don’t understand why you wouldn’t think those labor hours would be picked up by others (the unemployed/under-employed). Do we have 0% unemployment? Nope. Also, I really don’t understand why you view people as lazy and why you’re okay with using a person’s health to tie them to a job? Do you really believe the only way to get people to work is if we hold them hostage with health insurance coverage? That’s really a sad commentary on our fellow man. But… Know what else was cut into business profits? The end of slavery, child labor laws, etc.

    And yes, you do need to put forth a plan to solve our health care/health insurance problem. If not, you need to go on the record in support of the old system which included not covering preexisting conditions, rescission, caps, the insured/taxpayer picking up the uninsured’s bills, etc. You need to pick a position.

    What you can’t do (especially if you write a post on it) is throw stones and offer no solutions. Well, you can, but you won’t win the argument. If you think there were problems with health care/insurance before the ACA then tell us how you would fix them and pay for them. If you can’t do that, then do you really want a discussion? Why not just post your thoughts and shut down the comment section? Because that’s sorta what you’re doing now.

    You know what would help this discussion? If you actually read the CBO reports. From the reports I’ve read, the CBO did not make any claim about the loss of payroll taxes in regards to the 2.5 million labor hours. Can you supply a credible link to this claim?

  102. Tuxamus Maximus V says:

    Give it up Dunleve as nothing is getting past Pandora. This lady is smarter than you’ll ever hope to be! Nothing and I really mean NOTHING gets past her. GOLD medal to Pandora!

    As an aside it would be wise to consider that some states accepted Fed money to implement the ACA and others didn’t and that effected how some guidelines were implemented to an extent.

    On you best day neither you nor Frank will ever come close to Pandora on her worst day ever. Just Saying…ROFLMAO

    So Frank chimes in! You’re CBO reference was rebuked by Pandora when she went on to bring up the rest of that report…the part you failed to understand if you even understood what you probably didn’t even read. She’s also answered all your questions as well for what I’ve read.
    As for your answer to me I offer this response. Insurance companies will go bankrupt….REALLY? Do you read what you wrote before you submit? Aside from AIG (still around and coming back after a bailout and that had nothing to do with health care) PLEASE tell me one major health care insurer that has gone belly up of recent history… REALLY?

    Name just one major that’s in financial trouble….PLEASE!

    That’s my response to your lame answer. Bankrupt Insurance providers. REALLY? Where do you come up with such silliness? They are the ones with the GOLD and people that can find the loopholes and make numbers work to their advantage. When it comes to working the numbers do you even have a clue as to how brilliant the actuaries they hire are when it comes to numbers? One long time friend has a son that has worked as an actuary for a major insurer and he isn’t from Sussex…that’s for sure!

    Make believe? Really? OK I will be signing payroll for direct deposits to a DE bank later today (so it all shows up by Thursday night). Looking at an unopened Visa statement that I know is going to pop my eyes open from DE expenditures. I only wish it was one super computer as well and they only wish it was a mansion. It’s not even 3500 square feet unless you count the garage. My need for a safe place when I have to be there was determined almost a year ago now and I have to leave it at that.

    If I didn’t have two other firms involved with the payroll funding it sure wouldn’t be happening as that’s out of my league.

    I pay invoices for excede and Huges internet and DTV home entertainment system with some Genie DVR I don’t even have in my own residence. That Netflix account is way cheaper than what that on demand billing was costing me (those expenses are mine). All in DE but that’s all make believe? Really? Feeding a home in DE that eats better then I do at times! REALLY? OK. You’re the Wizard of Sussex so it must be so!

    Poor F & W get a mere pittance when the loan payments are taken out but they have a roof overhead, food on table and fuel in tank. They’re happy and all involved are happy including the wife.

    As for the bragging…well see it as you want to…like everything else your blinders allow. Not even sticks and stones. Underestimation is a flaw for many in Sussex and it may well be because they can’t see past Sussex.

  103. Tuxamus Maximus V says:

    Frank one more thought regarding your answer. Are you aware that Insurance compainies are now (and have been for some time now) BANKING INSTITUTIONS as well. Just go to the State Farm website and click on finances if you need proof.
    DANG…what part of too big to fail confuses you?

    Investment houses are also in the banking business and that all came about when your former hero Bush let the economy fail.

  104. Tuxamus Maximus V says:

    Well Frank I’ve got to say THANKS for all the laughs you’ve provided me throughout the day. I think I’ve gotten texts of every possible ‘legion’ on this and other planets. American Legion, French legion, Legion of Doom, Super heroes and on and on. Then the mythological name of every god (some I did know of), half god, half human and creature that was every written about.
    The biggest laughs came from the check I signed for a leased vehicle and an email of a listing for a house in Rehoboth that must be on the south end of the boardwalk.
    Although the last part of my day was spent having my cell being on the car charger I’ve got to say THANKS for the laughs you’ve provided both here and there.
    Now I’ve got to read Pandora for another laugh at your expense!!

  105. Tuxamus Maximus V says:

    Well done Pandora. Great stuff. If he understood that he’s probably in the fetal position right now. If one reads the Mission Statement you would think that a rational mind was at work but it’s more along the lines of If I can’t see it than it doesn’t exist or if you don’t agree with me then I will make sure you know you’re wrong because I say so. It’s made clear that even non-like thinkers are welcome so what gives with the Mission Statement?

  106. Tuxamus Maximus V says:

    Can’t forget this one or I’ll get another barrage of texts.
    They really preferred ‘Borg’ for a number of reasons. It’s a make believe collective of bad humanoids and best of all it was bestowed upon them by Waterpirate!

  107. Tuxamus Maximus V says:

    There is apparently little activity on two new posts and no replies to either Pandora or I at this time regarding this post/thread. One has to assume that responses from Frank won’t be forthcoming and this thread is dead. That’s one way of avoiding coming up with answers! Dodge, ditch, hide or whatever word applies the one thing that’s for sure is that the ACA is here to stay.

    All things happen for a reason. It was an informative dialogue that went well for a while. If nothing else Pandora and I can rest assured that neither the GOP nor the Tea’s/ Conservatives (as they seem to be rebranded) have nothing to offer regarding health care reform other than fearing change from what was a lopsided system.

    One thing is for sure in that I’ve learned that what I wrote on the 11th stands loud and clear regarding Tea/Conservatives in that if they can’t see it than it doesn’t exist or if you don’t agree with me then I will make sure you know you’re wrong because I say so. Bullying seems to be the way of thought with the Tea’s or whatever they want to be now.

    My advice is to remove the blinders and take a look around for those that resist change. We won’t be bullied anymore because the play on fear is getting old.

    I was reminded earlier today that the Borg stated “resistance is futile” (don’t you just love young people!) and that change is inevitable because it’s been happening for eons.

  108. Frank Knotts says:

    Pandora please excuse the long periods of time it takes me to respond, unlike some of our guest my job puts me behind a steering wheel, not a computer screen, and since I am not independently wealthy I am forced to work for a living.
    Which brings me to my first response to your last comment, it seems that some choose to change the argument simply by changing the perception of certain things. You ask should people be tied to a job by their need of health care, well in the past employer offered health care was a “BENEFIT” which was used to entice the best to work for them.
    However those who would see us move closer and closer to single payer government run health care attempt to now paint it as some kind of chain to a job.
    I have already stated that I feel that there are way to make the old system better without the mandate, pre-existing conditions and allowing lifetime participation of children on parent’s policies among others.
    As for a link to the revenue question, okay here you go.
    This is from the CBO’s own web site in an answer to frequently asked questions, this is in the 7th paragraph in the answer to the first question,
    “There is a broader question as to whether the society and the economy will be better off as a result of those choices being made available. Even though the individuals making decisions to work less presumably feel that they will be happier as a result of those decisions, total employment, investment, output, and tax revenue will be smaller. (Those effects are included in CBO’s budget and economic projections under current law.) To be sure, the health insurance system in place prior to the ACA generated its own distortions to people’s work decisions, but many of the decisions to work less under the ACA will be made possible by government-funded subsidies, the burden of which will be borne largely by other people. Moreover, people’s decisions about work are also affected by taxes and benefit programs apart from those related to health insurance. Hence, whether voluntary reductions in hours worked owing to the ACA are good or bad for the country as a whole is a matter of judgment.”
    http://www.cbo.gov/publication/45096

  109. waterpirate says:

    Frank,
    Sorry but the second paragraph made me choke on my coffee. The state of DE is the largest employer in DE and they have chained otherwise private sector people to them through a form of slavery known as health benefits.
    Takeing away that form of slavery would stop state EE’s from bitching about low pay, and not being able to leave based on provided health care benefits.
    I have told you all before that the parts of the ACA that addressed reform of benefits helped me, and allowed me to escape employment slavery. If anyone should be afraid of the impact of the ACA, it should be DE largest employers fear of not being able to control the work force by weilding the big stick of healthcare.

    To all TM’s,
    I applied the term “borg” as a term of endearment for a collective of minds speaking as one. NOT because ” resistance is futile”.

    The majority of the populace needed health care reform, the fact that we are going to be able to provide for those less fortunate as a side benefit is just icing on the cake.

  110. pandora says:

    Which brings me to my first response to your last comment, it seems that some choose to change the argument simply by changing the perception of certain things.

    There are two sides to every argument, so I haven’t changed anything. I’ve merely presented the other side.

    You ask should people be tied to a job by their need of health care, well in the past employer offered health care was a “BENEFIT” which was used to entice the best to work for them.
    However those who would see us move closer and closer to single payer government run health care attempt to now paint it as some kind of chain to a job.

    First, a benefit should be a good thing. If I gave you a beautiful home, with everything you ever wanted inside, but then told you, you could never leave that home (and if you did walk outside you’d lose that home and wouldn’t be able to buy another one) how would you feel? Sure, you’d have a great house, but you’d lose that freedom you guys go on about. Not the greatest example, but my point is that what can start out as a good thing (a benefit) can become a prison.

    If you had a preexisting condition you were chained to a job that offered benefits. No entrepreneurship for you. No retiring a few years early for you. No staying home with the kids for you.

    Here’s what I don’t understand… you view Americans as a group of scammers, swindlers – people who always have some sort of nefarious plot. Look, there are people who will take advantage of any system (and that goes across every socioeconomic line), but we don’t legislate for that – if we did then cars, guns, alcohol, desserts, cough medicine, etc. would all be illegal, because, ya know, people will abuse those things. But most don’t.

    It’s like saying, if you give an employee a raise they’ll kick back and work less, or if a person wins $20,000 they’ll quit their job – and only come back once the money is gone. Human nature, for the most part, doesn’t work that way. We always seem to want more.

    But what about the people who don’t want more? Why is it wrong for them to decide to work less? Or retire early? If they can support themselves and don’t need/want the latest TV or a Lexus then why can’t they cut back on work? Isn’t that freedom of choice?

    Why can’t a person who has saved and saved for retirement retire when they have enough money to live on? Why is it a good thing that they can’t retire because of health insurance?

    You go on and on about freedom, but you seem to prefer an authoritarian system – a system that doesn’t consider an individual’s wants/needs and, instead, tells them that they’ll be punished (loss of health insurance) if they don’t play by someone else’s rules.

    But is this really about the importance of the work ethic for you? Do you apply this work ethic to those who inherit wealth? Should the rich have to work, too? And, if you think the rich don’t have to work, then how are they different from the person who has enough money to retire early or the person who has enough money to support their chosen lifestyle? If you truly believe that people who don’t work don’t have a strong work ethic, then, by all means, start calling out the rich. Go tell them to get a job!

    I have already stated that I feel that there are way to make the old system better without the mandate, pre-existing conditions and allowing lifetime participation of children on parent’s policies among others.

    But you haven’t said how you would pay for that, or spelled out how that plan would function. Go on… spell it out. How would your plan cover, and pay for, people with preexisting conditions? What incentive will you offer to insurance companies to cover these people? Details, please. You keep avoiding this topic. I’m asking that you think this through and lay out your plan. Who knows? I may like it. Right now, you seem to like, and want to keep, certain aspects of the ACA, but haven’t told us how that would work or be paid for. You really need to do this.

    As far as the CBO report, they don’t make a judgement call on the hours worked. (But, at least you’ve moved past calling it jobs lost!) Personally, I think giving Americans the choice to work at a job they want for the hours they want is freedom. You, Comrade, not so much. 😉

  111. Frank Knotts says:

    Well you waited till the very end to address the loss of revenue which was my response to your previous comment. The CBO clearly states that they believe that there will be a reduction in tax revenue, let’s stay on point here, what led us to this point was my question, as of yet unanswered, of, how will the government pay for the growing number of subsidized participants, if as the CBO has stated there is a reduction in tax revenues?
    It would seem as though both the ACA and the old plan in your view have the same problem, how to pay for it.
    Now let me address some of your more emotional points. You see insurance as a prison, since a person can’t possibly find a new job with better benefits. Maybe true, maybe not. But forcing others to pay for that which you want is not freedom in my view.
    Let’s take your great home scenario, if I have a beautiful home, with everything you ever wanted inside, why would I leave. I assume you are using the home to represent a job, and everything I ever wanted meaning health care, then why would I leave that job? You may be barking up the wrong tree here Pandora, I have worked for the same company for thirty three years. Why? Because I like the job and yes because it has offered me over the years, in varying forms, health care. In that time I have had good plans and bad plans. Some I paid more for and got less. But I paid my own share of the group plan along with my fellow employees.
    You then say, “It’s like saying, if you give an employee a raise they’ll kick back and work less, or if a person wins $20,000 they’ll quit their job – and only come back once the money is gone. Human nature, for the most part, doesn’t work that way. We always seem to want more.”
    You are correct, human nature is to want more, that is called incentive. That raise is incentive to work harder to earn another raise. As for winning $20,00.00 and quitting their job, well all too often that actually happens, but what makes them come back for their job is the incentive to earn a paycheck.
    If our society continues to remove incentives through social engineering with welfare, unlimited unemployment, and subsidized if not free healthcare, then what incentive will people have to work?
    Human nature is to want more, but if we can get more without working, what is the incentive to work?
    A society of users without enough producer cannot be sustained.
    You have asked me the same question and I have answered it though my true feelings seem to escape you. How do we pay for my view of health care? By paying for what we want with what we earned for working for it. And before you come back once again with the poor and the aged, we have safety nets for them already, we don’t need to create a new one and also create the people to fill that net.

  112. Tuxamus Maximus V says:

    Way to go Pandora! Frank is giving a better try this time around!

    Waterpirate. The text I got yesterday was: “pls pass regret to WP had change is inevitable and chgd to Borg resistance is futile just for WP laugh TM’s goof flop. TM’s like Borg & WP tho”. Even I understand that waterpirate.

    I will pose another question, or two, to Frank to see if he’s even paying attention to me. He may just care only to lampoon me again. As I’ve read it your employer of 33 years offers you various health care packages you purchase. What if you find another company offers the same job with the same pay, maybe even a nicer/newer truck but also pays for half of your health care premium on a plan that’s the best you’ve ever had? Isn’t that incentive to move on to the other company because that’s a lot more money in your pocket? We are not youngsters anymore and we cost a lot to insure because of age alone!

    In your reply to Pandora you mention the “safety nets” for the poor and elderly. Are you aware that one of these programs has “look back” policy for previous years of incomes? Although you probably don’t believe this actually happens to people in that they do go from making a good living one year to nothing in the next year or two it really does happen. The ‘look back’ sees what you earned, assets you had at the time and from those numbers the amount of help is determined.

    You seem so concerned about the social engineering and life of government free this and that and all I offer is that those people have always been among us in one way or another. The existence of the world’s oldest profession proves that point.

    It also seems that you and I have something in common. Many, many, many moons ago I was a long haul OTR (Over The Road) trucker. The company I worked for had a health care benefit policy of “don’t get sick and don’t get hurt if you need or want to work”. I started the summer of 79 and every break in school and summer thereafter. Even drove full time after graduation due to Reagan Recession making jobs hard to find. Truck stops, weigh stations, load/unload (by my own hands) and a log book throughout 37 of the 48 contiguous states was my life. I was gone for weeks at a time in those days. All totaled about four years of my life. Over time I promoted myself out of that life to where I am now because I could. Of the 60+ hours I put in every week now probably 30 are spent behind desks with computer screens and too many meetings. Lots of time spent in the field doing physical labor as much as possible because I like it better than being a desk jockey. I only do this late at night when I’ve been made aware you’ve come back or not as the case has been at times.

    If you want to lampoon a man’s life and success you better be sure he hasn’t been there and done that before you write “unlike some of our guest my job puts me behind a steering wheel, not a computer screen, and since I am not independently wealthy I am forced to work for a living”. Been there. Done that. Wanted to have what we think for us was, and is better. Still work hard just don’t make a living behind a steering wheel anymore. I stopped doing it for a job that had me at home every night for basically the same money and an opportunity to use the education I’d received. I’m glad you like your job and can’t understand why you can’t appreciate how I earn a living.

    Once again it’s past my bedtime and I’m writing on the blog. I wish I had time to do this during the day but that, and other reasons are why HTM exists. I’ll stay with this until I read something that makes sense regarding the ACA from a true conservative like Frank.

    One last thing. What happens if one day Frank is injured on the job and has to take disability or workers comp. How would one view Frank from Frank’s way of seeing things?

  113. This blog was… how do I say it? Relevant!! Finally I’ve found
    something which helped me. Thanks!

  114. TMV says:

    Well Dang Frank this new site makes finding this post rather tough so I just googled it. Looks nice and all that but you’re making old dogs learn new tricks.
    To the point at hand and it’s been mid February since this post had any real attention.
    The ACA (Obamacare) not only reached it’s goal of 7 million but apparently went over 8 million new paying subscribers. Even his the target ratio of young people so it’s now up to the money crunchers to determine, in time, whether it is a good or bad thing.
    What I know as a fact is that I looked a REFUND check from BC/BS for the first quarter of the year that arrived today. NEVER has that ever happened before. It wasn’t much just barely over 4 digits to the left of the decimal but it was like manna from heaven considering it’s NEVER happened before! The money people will just enter it into the healthcare account as a line item credit but dang it Frank I’ve got no other explanation to offer for a REFUND from them other than It must be the ACA cutting costs some way or some how. One thing is for sure we’re not going to call and ask why they sent us a REFUND for the first time ever. If another check comes for the second quarter, and a third check for the third quarter and they are about the same amount it would mean I make better benefits available at about the same cost as 2013. What else do I attribute this manna other than ACA (Obamacare)?
    Makes one want to go HUMMMMMMM.
    TMV not holding breathe and won’t be checking for reply until I’m in the slower lower soon enough.. Someone at HTM will copy and paste any responses in short order.
    Oh Yeah…Toasts to Pandora, Laffter, WP and the other usual subjects or I’ll hear all about not writing to the beloved ones!

  115. pandora says:

    The reason you received the refund is due to the ACA’s Medical Loss Ratio, also called the 80/20 rule which states:

    The percentage of your premium dollars that an insurance company spends on providing you with health care and improving the quality of your care (as opposed to what it spends on administrative, overhead, and marketing costs) is known as “Medical Loss Ratio” or MLR.

    The new law limits how much of your premium dollar your insurer can spend on things other than providing health care and improving its quality. If your insurance company exceeds that limit, it must provide a rebate of the portion of premium dollars that exceeded this limit.

    Basically, the law says that when you buy health insurance the company has to, you know, actually spend your money on the product you purchased. So yep, thank the ACA.

  116. TMV says:

    Pandora! I hope you know that sometimes you’re just TOO GOOD!! We knew yesterday what the answer was but had hope that I’d get Frank to take the bait. Won’t even get a nibble now but at least he knows that small business can, and actually does benefit from the ACA.
    Maybe Frank is against small businesses, that provide health benefits, getting a break. Never did figure that one out.
    It’s all a matter of how you want to look at things. In this case it’s the greater good vs. selfish needs but that might be quoting a movie line or something and we all know Frank would never do that….but apparently he does according to HTM. They’ve pointed a few out in the past months on what they sometimes call The Hypocrite Report on Friday.
    On a side note the check was hand delivered by the BC/BS rep who tried to make make it seem like BC/BS was doing something ‘special’ until my HR lady looked at it and made sure he knew he should have had this check in her hands two weeks earlier. He left after that happened.

  117. Dunleve says:

    So TMV, that was for 2013, correct. You recieved a refund based on your 2013 premiums and “pandoras” claim its the 80/20 rule for 2013. Lucky guy, you. Ours went up 12%. I bet MSNBC is knocking on your door. Probably to talk about your book though, cause everyones saving money with the ACA.

  118. Frank Knotts says:

    Well dang Taxi Maxi, it is great that you have benefited from the ACA, and I guess your employees as well.
    If you would go back with an honest eye, my concern has always been with the mandate to buy insurance, you know the one that makes it possible for the government to subsidizes all those people who would never have bought insurance.
    As for you statement about the ACA reaching goals? You said, “not only reached it’s goal of 7 million but apparently went over 8 million new paying subscribers.” Well the reports I have heard is yes 7 to 8 million people may have signed up, but a very low percentage have actually “PAID” anything, and then you must also again allow for those in that 7 to 8 million who will never pay anything but simply be subsidized buy the working middle class.
    I would like to again thank Pandora for pointing out that their was no need for the mandate (except to force people to subsidize other people) the part of the law she pointed out could have been implemented without the mandate and would have resulted in the same savings for your small business.
    As I have said in previous comments, there was need and room for reform and improvement of the health “INSURANCE” industry, I just don’t believe that mandating that people buy a product was the way to go.
    I am sure there are other individual stories such as your own, as there are also individual stories stating the negatives of the ACA. As you have said, time will tell. Only hope that when people realize the negatives outweigh the positives it’s not too late to reverse the damage.

  119. pandora says:

    Please, Frank, I’m begging you… Read the law.

    And when you say, “Well the reports I have heard is yes 7 to 8 million people may have signed up, but a very low percentage have actually “PAID” anything” I wince because you are so wrong and actually believed that bogus GOP “survey.” It is past time for you to start questioning your sources. This made up nonsense was put to bed over a month ago. Today, there’s even more data that puts to rest that GOP lie.

    “The new McKinsey report, authored by Amit Bhardwaj, Erica Coe, Jenny Cordina, and Ruchira Saha, indicates that the proportion of uninsured individuals paying for coverage has shot up, from 53 percent in February to 83 percent in April. For previously insured individuals, the percentage of payers increased from 86 to 89 percent.”

    You know, in real life, we understand how this works. When you apply for your new Mastercard and then use it the day it arrives, no one says, “Well, have you paid the bill?” Because, well, that would be silly since you haven’t received the bill yet.

    As far as thanking me for making your point… I did no such thing. Then again, I have no idea what your point is. So please explain how the 80/20 (MLR) insurance company rule makes the mandate unnecessary.

  120. Frank Knotts says:

    Pandora, my apologies, I have to admit I hadn’t checked in on the hard numbers in the last two months or so. It does seem as though there has been a rise in the % of people paying their first months premium to complete the sign up.
    This does not however change the fact that a large number of people are being subsidized.
    And I didn’t say that the 80/20 rule makes the mandate unnecessary. I said that there was no need for a mandate to have been able to implement the 80/20 rule. The mandate is unnecessary all on its own, except, to force the working middle class to subsidize others.

  121. pandora says:

    The ACA contains a lot of new requirements (MLR, Risk Corridors, children remaining on their parents’ plans, what treatment/services has/have to be included to call something health insurance, etc.) that addressed many problems with our health care/insurance. So while the MLR could have been implemented on its own it doesn’t help, or address, the uninsured, those with preexisting conditions, rescission, etc.. And I’m really not sure why you see the MLR as your “Ah ha!” moment. Maybe because you just learned about its existence?

    And if you keep insisting that the mandate is unnecessary then you’re going to have to explain how your plan would work without it. Go read this entire thread. You’ve said that preexisting conditions should be covered. Okay, now tell me how you pay for that. Not kidding, Frank. No more “freedom!” nonsense. Show your work; explain your plan. So far, you’re entire argument against the ACA is that it sucks. When asked why it sucks or how you’d fix it… crickets.

    And all insurance is subsidized by others – that’s how all insurance flippin’ works. Everyone pays into the pool and the lucky ones never have to use it. Unless, you know people who say, “I’m really lucky I got cancer and finally got to use all that money I paid in insurance premiums.”

  122. TMV says:

    Taxi Maxi here just off the weekly call with HTM and starting really soon that becomes a daily call until the actual time to visit happens in the relatively near future. I really do look forward to participating in an outdoor Pandora Parade (weather permitting) and the dinner toasts (I’ve been asked to provide a toast for both Pandora and Laffter). All at HTM pass along greetings to the usual suspects. Got to say I love hearing from the younger generation as they offer insights and thoughts elders should pay attention to at times.
    Apparently the phrase “Not Don Ayotte” has become a catch phrase of sorts around the house. Now that I’m here on this site I understand why. It is rather ‘catchy’.
    Thank you Pandora. Well done and before I offer my response I want to offer this giggle to you.
    Yes Frank. All that have paid in will benefit as I’m not going to pocket this, or any other similar refund. Not mine to do that with is it? It’s a redundant question so don’t bother.
    Imagine being a fly on the wall in the office of a company owned by some right wing Obama/Obamacare (ACA) hater that received a refund. That fly probably heard something along the lines of: “Well this just sucks. Now I have to take some of my precious time to go to the bank and deposit this check because Obama makes the insurance companies give me back my money they didn’t use last quarter. Why can’t they just keep my money as pure profit like they used to do?” I’m sure that has happened many times in the past few weeks. LMAO.
    Frank I’m just not sure where to start with this hatred you have for the mandates. Are you saying that insurance companies didn’t need to have this mandate to start ponying up this money? Are you saying that they would have gladly said “we’re more than happy to cover you and your precondition!”? Are you saying that insurance companies would have been more than happy to cover dependents up to age 26 all you had to do was ask us! Real world Frank…come on man…face the facts.
    What I’m reading from Frank’s statements is if that had they (big insurance) known they would have gladly made these things, and more, happen had we simply asked with no mandate necessary. Do you really think they would pass up the free profits Frank? REALLY? Without the mandates it would still be business as usual. Do you REALLY think they would have changed the previous business model without the mandates?
    Without mandates how was this going to happen Frank. Pandora and I still wonder when that gets answered in some relevant way.
    I could go into a long diatribe about how ACA has benefited my business interests and quite honestly I’ve tried in this very thread but all anyone is going to read is the violations of Frank’s ‘freedoms’. All I have for that is that many are benefiting from your freedom violation and they could all care less. They have better benefits and that’s the bottom line especially when you consider the cost impact is minimal compared to previous years.
    Lastly I wonder what confused Dunleve regarding which quarter the refund was issued. DUH. That check should’ve been the mail by the end of April 2014 at the latest but hey keeping our money for as long as possible makes them money. I wonder how this would confuse someone that claims to be involved in a business. Although you didn’t use the word ‘assume’ you most certainly inferred it by using ‘correct’. It’s kind of like using the word ‘never’…..

  123. Frank Knotts says:

    Pandora, all of the things you listed could have been imposed on the insurance companies, without the mandate that every citizen must buy insurance.
    We already regulated that industry, now we have given them a built in market.
    We may have to agree to disagree since no matter what I say, or what you say, we will continue to disagree.
    How about I make you happy and say, I work for what I get, I earn it, and I give charity where I see fit. I also believe that people will benefit far more from policies that encourage them to also work for what they receive, rather than simply “mandating” that those who do work, pay for them.
    You use the fact t that all insurance is subsidized by others.
    Yes, but I choose to participate, I choose to pay into that pool in an effort to offset the risk of catastrophic health issues.
    If I were to choose not to pay in, then the risk factor goes up, simple.
    I know, I know, don’t talk about freedom of choice, but that is what is at issue here. Not the money I am forced to pay to the government to support people I don’t know and have no choice in. What has been taken from me and others who do care, is our freedom of choice. And really I don’t care if it resulted in the cheapest insurance in history, because the loss of freedom would be the same. You don’t have to like my opinion, you don’t have to agree with it. However, you don’t get to decide my opinion, at least not yet.
    It’s great that TMV and the imaginary menagerie have seen a benefit, it’s great if you don’t mind government’s intrusion into you personal life and death decisions. I don’t have to agree with you, I don’t have to like it, but I don’t get to choose your opinion, and the difference is, I don’t want to.

  124. pandora says:

    Pandora, all of the things you listed could have been imposed on the insurance companies, without the mandate that every citizen must buy insurance.
    We already regulated that industry, now we have given them a built in market.

    You do understand why that is, don’t you? You do realize that if we imposed all these things without the mandate every health insurance company would go out of business? Think about what you’re saying. So… if we imposed all these things on the insurance companies without the mandate then why would any healthy person buy health insurance? Why not wait until you’re sick/injured and then purchase a plan, since, hey! insurance companies now have to sign up and cover people with preexisting conditions. That means they would have to cover the illness/injury you received prior to purchasing insurance.

    I’m sure you also realize that the mandate was imposed by the health insurance companies. It was what made them agree to stop cherry picking people, take preexisting conditions and halt the nasty practice of rescission. They would take everyone, but couldn’t afford to take only sick people.

    And this kills me. I’m not a fan of the mandate (I would have loved single-payer, but that’s me), but I understand why it exists and how it functions. I’m still waiting for you to explain your plan without the mandate.

    You say we could impose all these things without the mandate. Okay, show me how that works.

    We may have to agree to disagree since no matter what I say, or what you say, we will continue to disagree.

    And with that line I should just declare victory.

    How about I make you happy and say, I work for what I get, I earn it, and I give charity where I see fit. I also believe that people will benefit far more from policies that encourage them to also work for what they receive, rather than simply “mandating” that those who do work, pay for them.

    Um… people that don’t/can’t work or are extremely poor are on Medicaid (You remember Medicaid? It was the government program (along with Medicare) you proposed using up-thread for working people who couldn’t afford health insurance. I still haven’t gotten over that one!) So they aren’t even part of your mandate problem. People receiving subsidies do work. They too, earn it and even *gasp* give to charities and volunteer their time.

    You use the fact t that all insurance is subsidized by others.
    Yes, but I choose to participate, I choose to pay into that pool in an effort to offset the risk of catastrophic health issues.
    If I were to choose not to pay in, then the risk factor goes up, simple.

    If you choose not to participate it’s not only your risk factor increasing. Everyone who does participate ends up covering your, and your freedom lover moochers, irresponsible butt by paying higher premiums and higher medical bills. Deliberately choosing not to have health insurance isn’t freedom, it’s a way to make sure someone else ends up paying for you.

    I know, I know, don’t talk about freedom of choice, but that is what is at issue here. Not the money I am forced to pay to the government to support people I don’t know and have no choice in. What has been taken from me and others who do care, is our freedom of choice. And really I don’t care if it resulted in the cheapest insurance in history, because the loss of freedom would be the same. You don’t have to like my opinion, you don’t have to agree with it. However, you don’t get to decide my opinion, at least not yet.

    Freedom! Blah, blah, blah. And I haven’t tried to “decide” your opinion. WTF, Frank? I will point out that I haven’t been dealing in opinion (other than a few statements here and there), I’ve been dealing with the facts and flippin’ asking you specific questions that you seem incapable of answering. I’m not the one saying your arguments (not that you’ve really put forth any. Sorry.) are “anti-freedom” or that the ACA is “Freedom!” I’m not the person on this post doing that. But you obviously feel your “you don’t get to decide my opinion” line is a winner since you used it with TMV, as well.

    So, opinion aside… please explain how your plan works without the mandate. I’m begging you to answer this question.

  125. Frank Knotts says:

    Well, that was exactly the response I expected. Pandora you want me to spell out a plan that would solve everyone’s problems. That is not possible. No matter what plan is put forth someone will be hurt, and some may benefit, for a time.
    Personally I have not been affected by the ACA, yet. I have the same insurance that I had before. I was not forced to do anything differently. I personally have not lost anything as of yet.
    Yes I understand why the mandate was needed to make the ACA work, because that is the only way to pay the cost of subsidizing those who can’t afford it.
    People who could not afford insurance already had Medicare and Medicaid, so why was it needed to force others to buy that which they did not want?
    Young people who felt no need, wealthy people who can pay out of pocket?
    To pay their share in your view, right?
    Just be honest, the ACA is the progressive dream come true. All paying according to their ability, all receiving according to their need.
    And would it be so bad if insurance companies went out of business? Think about the trajectory of rising health care cost, do they not coincide with the advent of health insurance?
    Your response is, ” Freedom! Blah, blah, blah.” Okay! Poor people, blah, blah, blah!
    How about we work at putting people to work where they can afford to buy insurance if they choose to, either through their employers, or on their own?
    How about we allow more competition within the industry, rather than narrowing the field as ACA will do in the long run?
    How about we remove the redundancies within Medicare and Medicaid to make them more efficient?
    How about we encourage more personal responsibility, rather than educating people that if they choose to live off the state, then that is just fine.
    The problem isn’t the ACA itself, the problem is that some people do not see a problem with the ACA.
    Of course none of this will satisfy your definition of a plan, because your idea of a plan is to run the individual lives of every American through government regulations and mandates. The reason you see Freedom as blah, blah, blah, is because like me I am sure that ACA made little difference in your life, so you are free to state what a great idea it is. Oh, sorry about using the free word, I know it pains you so.

  126. pandora says:

    Thanks, Frank, for once again showing you don’t understand how insurance worked, what the ACA law says and what, and who, Medicaid and Medicare does and serves. Perhaps you’ll refrain from writing any more posts on this topic.

  127. Frank Knotts says:

    A declaration of being right does not make it so. You act as if you don’t understand what I am saying, you spin what I do say.
    You say I don’t understand Medicaid and Medicare. Are they not for the elderly who have no insurance, and the poor who can’t afford insurance, were they not instituted to provide health care for those groups?
    I don’t remember anyone suggesting that once the ACA was instituted that we would do away with Medicare or Medicaid. How come? If everyone who can pay does, and everyone who can’t is subsidized, what is the need for these programs? In a previous comment you said, “in order for that sort of system to function we’d need to stop treating people without medical insurance; we would start turning people away from emergency rooms and doctors’ offices.”
    Really? But isn’t it illegal to do so? And who didn’t have access to insurance? Since there was Medicare for the elderly, and Medicaid for the poor?
    You also said, “Before the ACA, people with insurance paid for the uninsured with higher premiums and higher costs of treatment.”
    And the ACA change that how? Since the people who can afford to pay for their insurance will now be paying for those who can’t
    What has changed Pandora? The progressive plan has simply moved the deck chairs around on the Titanic that health insurance has become.
    I would oppose the mandate no matter which party had instituted it, I am on record as criticizing Romney for his version of socialized health care.
    But I get the feeling you defend it simply because it was a democrat administration that was able to shove it down the people’s throats. Do you remember the percentage of people who were opposed to the ACA when the Democrats were ramming it through? Wasn’t it something like 70 to 75%?
    But of course what do the people know, right?
    So if it makes you feel superior to declare yourself to have won, feel free (oops! did it again).

  128. Juana Parkhurst says:

    Invaluable article . I am thankful for the facts , Does anyone know where my company could get ahold of a template FL DACS-13645 version to fill in ?

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