So how many more times will the right be wrong about the ACA?

[James D Hill]

That is about the size of it. Unless you qualify for a subsidy or a very generous employer, you are going to get stuck with a very expensive policy with a very high deductable.

They make enough money to pay it then.

 

[James D Hill]

We have elections every two years. Prohibition was repealed because the majority didn't like it. The ACA isn't even a constitutional amendment. If the majority don't like it, it will go away. If the majority of the people like it or don't care, it will remain forever. Your assertion that the majority doesn't like it isn't sufficient proof that the majority doesn't like it. Does that make sense?

The elections are won by the majority. The assertion of your own opinion and attaching it to the majority is not the way things are settled in this country. Someone could easily say, "The majority loves the ACA." How would that make it true just because someone said it? That doesn't make any sense.

Apples and oranges my friend. Booze is loved my many. Health care is loved by all. The main reason for many of those opposed are liberals who want socialized health care and do not want to go back to capitalist pigs running our health care. You know that.

 

[Conservative]

Why is it important in the first place? I swear you conservatives are the nit picking a bunch as I have ever seen. The man has one the battle over health care and not matter how much the right tries to question him as a legit president he has won the fight on health care, been re elected twice and swung this nation to the left. How can it get any better that that my friend?

Only in the liberal world do results not matter especially the debt. Please Mr. Compassion tell me where the compassion is in the 250 billion dollar debt service paid each and every year on the 17.3 trillion dollar debt we have, a debt that continues to grow. Tell me where the compassion is to have 5 million Americans get cancellation notices and then to find that their premiums and deductibles are going up? Liberal compassion always costs someone else money and never generates the promised results. Let me know when those 45 million that Whitehouse.gov say they were targeting for insurance get their insurance?

 

[James D Hill]

Only in the liberal world do results not matter especially the debt. Please Mr. Compassion tell me where the compassion is in the 250 billion dollar debt service paid each and every year on the 17.3 trillion dollar debt we have, a debt that continues to grow. Tell me where the compassion is to have 5 million Americans get cancellation notices and then to find that their premiums and deductibles are going up? Liberal compassion always costs someone else money and never generates the promised results. Let me know when those 45 million that Whitehouse.gov say they were targeting for insurance get their insurance?

Oh no. The great right wing Satan. The debt that they helped build. Get people to work and the debt will go down. It is that simple. Why do we subsidize Wal-Mart? They under pay their people and we have to give them food stamps to make up for their cheapness. Now that's an outrage. Pay you ****ing people.

 

[Conservative]

Oh no. The great right wing Satan. The debt that they helped build. Get people to work and the debt will go down. It is that simple. Why do we subsidize Wal-Mart? They under pay their people and we have to give them food stamps to make up for their cheapness. Now that's an outrage. Pay you ****ing people.

Since you don't understand the debt this is another subject you know nothing about but you spout your leftwing rhetoric. Getting people to work isn't something Obama cares about, just redistributing wealth which I am sure makes you happy

 

[James D Hill]

Since you don't understand the debt this is another subject you know nothing about but you spout your leftwing rhetoric. Getting people to work isn't something Obama cares about, just redistributing wealth which I am sure makes you happy

You talk like that is a bad thing. They sold our economy down the river for profit and gain. They deserve to have their wealth taken from them. They are capitalist pigs who deserve worse that losing their money.

 

[Conservative]

You talk like that is a bad thing. They sold our economy down the river for profit and gain. They deserve to have their wealth taken from them. They are capitalist pigs who deserve worse that losing their money.

LOL, this is a joke, isn't it? Your true colors come out

 

[Threegoofs]

They are to be found, in a way. I have run headlong into them myself. Have you read the law? Do you understand what's actually in it? I have. Over the last 5 days, I've had to read it. Because what's in it is trying to kill my wife.

Read the law. Talk to some doctors about how they are now restricted as to what treatments they are legally allowed to perform on patients that are prior to the age 50 versus after the age of 50, and then again at 70, and so on.

Do some research James. Not reading articles on web sites or listening to talking heads on TV or even articles in newspapers. None are to be trusted. The right and the left are both lying to great extent.

What the right claimed as death panels is incorrect, but the result via the actual law has the exact same effect on real people.

Read the law. Please. There are parts that are great, and I like them tremendously; however, there are parts that should scare the hell out of us all. Make us step back and evaluate our support of this law and what the government is doing to us in the name of cost savings.

Please, read the law.

Can't help but point out that's it's been a few days and we've heard crickets on this.

Because given everything I know about this law, which is considerable, I can't think of a single example of how older patients would be denied any care vs younger ones. Nothing.

 

[MAGAnificent]

Why is it important in the first place? I swear you conservatives are the nit picking a bunch as I have ever seen. The man has one the battle over health care and not matter how much the right tries to question him as a legit president he has won the fight on health care, been re elected twice and swung this nation to the left. How can it get any better that that my friend?

Our anti ACA stance is not personal. Obamcare is an unmitigated disaster that is affecting the majority of Americans negatively. Obama may have managed to get the ACA passed into law, however he is clearly losing the battle on public opinion of the ACA. That's why he is still spending millions in taxpayer money to try to sell it. And you can claim that Obama has swung the nation to the left until the cows come home, however in the long run he is having the opposite effect. Did you not learn anything from the shellacking that the democrats received in the 2010 midterms? Not just in the house of reps, but in the state governments across the nation. My own state legislature for instance had been democrat party controlled since Ulysess S Grant was president. Now it's republican controlled. The 2014 midterms will likely be another shellacking for the democrats.

 

[MAGAnificent]

They make enough money to pay it then.

You are kidding, right?

 

[vasuderatorrent]

Apples and oranges my friend. Booze is loved my many. Health care is loved by all. The main reason for many of those opposed are liberals who want socialized health care and do not want to go back to capitalist pigs running our health care. You know that.

My post had nothing to with prohibition or health care.

My post was about the people's ability to change laws that they don't like. When a law isn't changed over the course of 6 years the majority of people agree with the law or have little interest in the law.

If the ACA is unpopular it will disappear. If it is popular it will remain.

 

[MAGAnificent]

My post had nothing to with prohibition or health care.

My post was about the people's ability to change laws that they don't like. When a law isn't changed over the course of 6 years the majority of people agree with the law or have little interest in the law.

If the ACA is unpopular it will disappear. If it is popular it will remain.

\

Obamacare has been changed over 30 times by the Obama administration itself. In my opinion, the ACA will die...the only question is whether it will die quickly by repeal or whether it will die slowly by way of a 1000 cuts. I am betting the employer mandate will fall first....then the individual mandate. When the insurance companies figure out how badly they have been snookered...it's over.

 

[vasuderatorrent]

\

Obamacare has been changed over 30 times by the Obama administration itself. In my opinion, the ACA will die...the only question is whether it will die quickly by repeal or whether it will die slowly by way of a 1000 cuts. I am betting the employer mandate will fall first....then the individual mandate. When the insurance companies figure out how badly they have been snookered...it's over.

Jimmy Carter will forever be known as the honest president.
Ronald Reagan will be known for winning the cold war with Russia.
George H Bush will be known for his 'read my lips, no new taxes' comment.
Bill Clinton will be known for the Monica Lewinsky scandal.
George W Bush will be known for fighting the Iraq War.

What will Obama be remembered for if the ACA disappears? Killing Osama Bin Laden? What else? The first president to openly support gay marriage?

I am not sure how he will be remembered. I don't think he has time to do anything memorable unless he has a gay affair with a famous celebrity or something like that.

 

[MAGAnificent]

Jimmy Carter will forever be known as the honest president.
Ronald Reagan will be known for winning the cold war with Russia.
George H Bush will be known for his 'read my lips, no new taxes' comment.
Bill Clinton will be known for the Monica Lewinsky scandal.
George W Bush will be known for fighting the Iraq War.

What will Obama be remembered for if the ACA disappears? Killing Osama Bin Laden? What else? The first president to openly support gay marriage?

I am not sure how he will be remembered. I don't think he has time to do anything memorable unless he has a gay affair with a famous celebrity or something like that.

In my opinion....Obama will be known for destroying American healthcare.

 

[vasuderatorrent]

In my opinion....Obama will be known for destroying American healthcare.

That would require destruction of health care first. My local hospital is still open and accepting patients.

Do you mean health care or health insurance?

 

[MAGAnificent]

That would require destruction of health care first. My local hospital is still open and accepting patients.

Do you mean health care or health insurance?

Overall healthcare. America has the finest healthcare in the world. If we continue to allow the government to run more and more of it, the American standard of healthcare will disintegrate over time.

 

[vasuderatorrent]

Overall healthcare. America has the finest healthcare in the world. If we continue to allow the government to run more and more of it, the American standard of healthcare will disintegrate over time.

I don't think it will be destroyed fast enough for Obama to get credit for it. He needs to step it up into high gear if he wants to be remembered that way.

 

[Greenbeard]

Overall healthcare. America has the finest healthcare in the world. If we continue to allow the government to run more and more of it, the American standard of healthcare will disintegrate over time.

And yet quality indicators have been going up since the ACA's provisions kicked in.

The National Committee for Quality Assurance saw quality improvements in Medicare Advantage after the ACA's performance-based payments kicked in:

This year [2012] we saw significant improvement in measures included in the Medicare Star rating pay-for-performance program for health plans that participate in Medicare Advantage. Although Medicare Advantage plans have reported on quality and results have been reported to consumers for many years, the Affordable Care Act required the Medicare program to make higher payments to health plans with better quality performance, starting in 2012. In addition to this new program, the Department of Health and Human Services established a demonstration program to complement it, making even higher payments to plans with better performance.

New accountable payment and delivery models are showing the ability to improve quality of care:

Obamacare Shows Hospital Savings as Patients Make Gains - Bloomberg

Less than five months before the Affordable Care Act fully kicks in, hospitals are improving care and saving millions of dollars with one of the least touted but potentially most effective provisions of the law. . .

Under the program, hospitals and physician practices take responsibility for tracking and maintaining the health of elderly and disabled patients. If costs rise beyond an agreed upon level, hospitals may become responsible for reimbursing the government. If they cut the cost of care while maintaining quality, hospitals share in the savings. The government expects the savings may be as much as $1.9 billion from 2012 to 2015. Early indications suggest they are starting to add up. . .

Under the U.S. health reform law, Medicare’s accountable-care program requires hospitals and doctors to show they are improving or maintaining the quality of their care before they are paid any bonuses, Blum said. More powerful technology will also help. And unlike in the ’90s, today’s programs are backed by a new law, providing “some surety that the agency will have a commitment to the program,” Blum said.

Hospital quality in general is improving.

More hospitals improve quality of care | Healthcare Finance News

A larger number of hospitals are showing improvements in their quality of care said the Joint Commission in its annual report on quality and safety of hospitals.

Last week during a webcast detailing the results of its annual report, the Joint Commission said 1,099 Joint Commission-accredited hospitals were named in its report as Top Performer on Key Quality Measures hospitals, representing a 77 percent increase from last year.

Other ACA reforms are showing the ability to improve quality.

All Pioneer ACOs improved quality; only third lowered costs

The participants in the Obama administration's most aggressive experiment with accountable care had better success improving quality than lowering costs, according to first-year results revealed in a published report.

All 32 of the accountable care organizations in the program improved patient care and patient satisfaction against benchmarks, according to results shared with the Wall Street Journal in advance of their public release. Only 13 achieved enough savings that they qualified to share some of that money. Two ended up spending more on the assigned beneficiaries than traditional Medicare fee-for-service and will owe the government $4 million.

This isn't just true of Medicare-initiated reforms, it's true of similar models in the private sector (models that are now being supported by state-level/private sector partnerships in over half the states, thanks to the ACA) as well:

The Alternative Quality Contract, a global payment model put in place by Blue Cross Blue Shield of Massachusetts in 2009, has both curbed costs and improved the quality of care, according to a Harvard Medical School study published today in the journal Health Affairs. . .

Massachusetts enacted sweeping state health reforms in 2006 considered by many to be a prototype of the 2010 federal health law, and it is now experimenting with equally dramatic measures to rein in health care spending. The AQC is very similar to the Affordable Care Act’s Pioneer Accountable Care Organization contracts – a part of the Medicare shared-savings program.

The U.S. also saw the first first readmissions reductions in years as ACA payment reforms and care coordination programs kicked in:

New CMS figures show that the national rate of 30-day readmissions for Medicare patients dropped to 17.8% in November 2012 after spending years stuck at 19%—and White House officials say the Affordable Care Act deserves the credit.

Although the data released this week at a Senate Finance Committee hearing do not pinpoint a cause for the decline, Jonathan Blum of CMS argues that the drop "is largely the result" of the health law's provisions, such as penalties for high readmission rates and funding for new efforts to reduce readmission rates, the Washington Post reports.

For example, the ACA has funded an initiative that created 26 "hospital engagement networks," designed to work with more than 3,700 hospitals to better coordinate patient care. The largest of the HENs has reduced its average 30-day readmission rate among its 450 hospitals from 11.2% in 2010 to 10.2% in September 2012. Federal officials previously have touted what HENs already are doing to cut readmissions and infections.

Meanwhile, Medicare in October 2012 began penalizing 2,217 hospitals that had high readmission rates, and imposed the maximum fine of a 1% reduction in Medicare reimbursements on 300 of those hospitals through 2013.

Meanwhile, Medicare has begun adjusting reimbursements to hospitals based on quality performance (and is getting closer to doing the same for physicians). For the first time, the U.S. now has a National Quality Strategy and is amping up quality measurement and public reporting of results (on hospitals, physicians, insurance plans available in the exchanges, you name it).

In other words, it isn't just this or that isolated initiative. The focus on quality today--measuring it, reporting on it, paying for it--is unprecedented. And it's starting to show.

 

[MAGAnificent]

I don't think it will be destroyed fast enough for Obama to get credit for it. He needs to step it up into high gear if he wants to be remembered that way.

I think whatever goes wrong with healthcare for the next decade will go on the obamacare tab.

 

[mak2]

If Mrs. Jones in New Jersey cannot get an appointment on the Monday of her choice any given month it will be that damn Obama's fault. Being a leader sucks sometimes. If some poor guy in New Orleans can get antibiotics before he develops pneumonia, so what?

I think whatever goes wrong with healthcare for the next decade will go on the obamacare tab.

 

[MAGAnificent]

And yet quality indicators have been going up since the ACA's provisions kicked in.

The National Committee for Quality Assurance saw quality improvements in Medicare Advantage after the ACA's performance-based payments kicked in:


New accountable payment and delivery models are showing the ability to improve quality of care:

Obamacare Shows Hospital Savings as Patients Make Gains - Bloomberg


Hospital quality in general is improving.

More hospitals improve quality of care | Healthcare Finance News


Other ACA reforms are showing the ability to improve quality.

All Pioneer ACOs improved quality; only third lowered costs


This isn't just true of Medicare-initiated reforms, it's true of similar models in the private sector (models that are now being supported by state-level/private sector partnerships in over half the states, thanks to the ACA) as well:


The U.S. also saw the first first readmissions reductions in years as ACA payment reforms and care coordination programs kicked in:


Meanwhile, Medicare has begun adjusting reimbursements to hospitals based on quality performance (and is getting closer to doing the same for physicians). For the first time, the U.S. now has a National Quality Strategy and is amping up quality measurement and public reporting of results (on hospitals, physicians, insurance plans available in the exchanges, you name it).

In other words, it isn't just this or that isolated initiative. The focus on quality today--measuring it, reporting on it, paying for it--is unprecedented. And it's starting to show.

It is laughable to make those quality improvement claims based on 5 months. It is also laughable to suggest that medicare advantage plans have improved. Medicare advantage plans have been all but decimated by obamacare. You need to quote from sources that have not always been in the tank for obamacare.

 

[MAGAnificent]

If Mrs. Jones in New Jersey cannot get an appointment on the Monday of her choice any given month it will be that damn Obama's fault. Being a leader sucks sometimes. If some poor guy in New Orleans can get antibiotics before he develops pneumonia, so what?

It's not rocket science. Obamacare has everyone's attention and it has been an unmitigated disaster. And the worst is yet to come if the employer mandate is ever enforced. Unless Obamacare is outright repealed and soon.......everyone who has a problem with healthcare for quite some time is going to blame the moron president who shoved the ACA down our throats.

 

[Greenbeard]

It is laughable to make those quality improvement claims based on 5 months. It is also laughable to suggest that medicare advantage plans have improved. Medicare advantage plans have been all but decimated by obamacare. You need to quote from sources that have not always been in the tank for obamacare.

Five months? Most of this stuff launched in 2011 and 2012.

 

[mak2]

Oh stop it. Since the 1940's or 50's, maybe the 60's our healthcare system has sucked, big time. Obama has a couple of years to fix all the problems or it is an unmitigated disaster? where you been for the last 60 years?

It's not rocket science. Obamacare has everyone's attention and it has been an unmitigated disaster. And the worst is yet to come if the employer mandate is ever enforced. Unless Obamacare is outright repealed and soon.......everyone who has a problem with healthcare for quite some time is going to blame the moron president who shoved the ACA down our throats.

 

[MAGAnificent]

Five months? Most of this stuff launched in 2011 and 2012.

You really should google the obamacare implementation timelines. Most of the significant stuff did not start until 2013.