Patient Protection and Affordable Care Act PPACA aka Obamacare

[Disclaimer]

This thread reminds me why no one here is part of the 1% and never will be. It also reminds me why most other 1st world countries are outclassing us in most OCED metrics.

[alab32]

Why wont anyone on here be part of the 1%?

[alab32]

Here is a lot of good ideas if you ask me. Sure, it may not fix everything, however it is a GREAT start.

http://www.newt.org/solutions/healthcare

[cg2112]

Long before you NEED healthcare, you need water, food, and shelter. I guess we should receive free bottled water, fruits and vegetables, and shelter because its a basic human right. Why do those evil water companies, farmers, grocery stores, trucking companies, food manufacturer's, utility companies, roofers, window installer, contractors, clothing manufacturets, etc get to make a profit. Without water you die in days. Without food you die in a little over a week, and without the proper shelter you can die in days. I lived most of my childhood without health insurance so I would rate it a much lesser human right.

Maybe entertainment and alcohol should be human rights also since they help your sanity while dealing with life.

If you can't afford water or food, you can get that, as well.

It's not about making a profit. I don't know anyone who has a problem with insurance companies making a profit. It's about the current system making healthcare unreasonably expensive. We pay more for insurance per person in this country than any other nation on the planet. Yet, we don't have the best health care - in fact, we aren't even close to having the best health care. I find it odd that many people don't see this as a problem.

And you're right. Go days without water, and you can die. Go a week or so without food, and you can die.

At the same time, you can trip and fall, and without health care, be dead in an hour.

[justin0469]

Genuine question - not making a political point... We are already required to have car insurance and it is commonly accepted that those who do not have such insurance are an undue burden on the people as a whole - what is the difference between that and requiring us to have health insurance?

Just like car insruance, you should be able to file a certificate of self-insurance if you have the assets to pay for your own healthcare if needed. But if you cannot afford to pay for your health care then that's just like not being able to paty for damages you cause in a crash - hence why we are required to buy car insurance?

How much cheaper would *my* car insurance be if I wasn't also subsidizing the damages caused by the uninsured? Therefore, how much cheaper would my health insurance be if I wasn't subsidizing the health costs of the uninsured?

i have no political knowledge of whats going on here, or whats gonna happen or even what the health bill is all about. But this question is what i always had doubt myself. What i am about to say is just what i see and not my biased opinion.

Since we cover non insured patients coming into hospital everyday, i see in first person how much of money is going down the drain. Its not the fees and cost, its the defensive practice. non insured guy walks in fully drunk with no medical problems. He still gets admitted and gets at least the basic lab work done and a CT of head if he was found floored on the streets. By the end of the day 500-1000 dollars from tax payers is gone on this one guy in few hours coz he decided to just have a fiesta.

The only car insurance you are REQUIRED to have in Ohio is liability insurance in case you injure someone else or their property. (correct me if I'm wrong). That makes sense. Requiring someone to have health insurance is quite different, you don't run the risk of injuring someone else. Major contagious diseases exist now but are rare and there is no public widespread concern of it spreading from people who don't have treatments because they can't afford it.

[Scruit]

At the same time, you can trip and fall, and without health care, be dead in an hour.

If you are insured: You pay $500 out of pocket (if you met your deductible already. That's the 250 ER fee and then the balance after the either 70,80 or 90% coverage rate, excluding the doctor who bills differently than the radiologist who bills differently from the MRI who is different from the facility charge who is different from the pharmacy charge. Then you have to figure out if the hospital is in network, if the dcotor, radiologist, MRI tech etc are in or out of network, because then it is a seperate deductible of up to 8k then 70 coverage, maybe. Then it depends on if you precertified or got a referral, and just because it is an ER visit doesn't mean you won't get you benefits reduced by 50% for not pre-certifying the visit (ask me how I know). If you haven't paid you deductible this year then it is probably $2500 out of pocket. But also out-of-network are subject to reasonable-and-customary fee limits so you may find your benefits reduced again.) Now when the EOB arrives, how do you know they got it right? You have to check against coverages and make sure something wasn't coded wrong and you got a reduced benefit because of it.

If you are not insured: You pay $2500. Or you just don't pay - the rest of us will pick up the tab instead.

[alab32]

If you can't afford water or food, you can get that, as well.

It's not about making a profit. I don't know anyone who has a problem with insurance companies making a profit. It's about the current system making healthcare unreasonably expensive. We pay more for insurance per person in this country than any other nation on the planet. Yet, we don't have the best health care - in fact, we aren't even close to having the best health care. I find it odd that many people don't see this as a problem.

And you're right. Go days without water, and you can die. Go a week or so without food, and you can die.

At the same time, you can trip and fall, and without health care, be dead in an hour.

Which country's health care is so much better than ours that makes us no where near the top? And as for the trip and fall; even without insurance you can and WILL be seen in the ER. There are actually, in some cases, funds sites set up to help pay for the bill for people who do not have insurance. You will still ALWAYS get your medical care, but you will likely still have to pay for your bill.

[Disclaimer]

http://chronicle.northcoastnow.com/2011/11/10/emh-cuts-55-positions/

ELYRIA – A total of 55 positions are being eliminated by EMH – most

at the EMH Elyria Medical Center — as the hospital system continues to

grapple with rising costs of uncompensated care and shrinking

reimbursement for medical care.

Hmm.... TOTALLY didn't see that coming.

[Scruit]

If the above mentioned scenario is the norm for this nation' date=' then Americans are far dumber than I originally gave them credit for.[/quote']

Sorry to disappoint, but that is how insurance works in this country.

[alab32]

Sorry to disappoint, but that is how insurance works in this country.

That depends on the insurance and the hospital. Not every hospital and insurance company works the same way... That is a MAJOR generalization.

[Scruit]

That depends on the insurance and the hospital. Not every hospital and insurance company works the same way... That is a MAJOR generalization.

Do you have an EPO, PPO or HMO?

[Scruit]

$500 deductibles are for sissies.

500 isn't the deductible - that's the 250 ER fee plus 20% of the services (80% reimbursement rate).

My deductible is $4000.

[Scruit]

Are you on a HDHP?

That's my in-network family deductible. My out-of-network family deductible is $8000.

Best insurance I had was with my previous company. They had a 4k deductible then everything after was covered 100%. And the company paid into a free HRA that covered 3k of the deductible. My annual max out-of-pocket healthcare costs were $1k. Once that frist $1k was spent the rest of the year was just like being in the UK - go to doctor, get healthcare, never worry about the bill becuase my insurance covered everything. And that was a PPO - not HMO.

[Scruit]

Am I the only one who thinks the EOB should really be called a JNB?

It's not an Explanation of Benefits... It's a Justification of No Benefits.

[Scruit]

I once went to the emergency room with a cut on my index finger and middle fingers - cut down the bone while working on a car.,

Was at the ER for 4 hours. They talked about maybe suturing it, and finally decided to splint the fingers and use "sterile cyanoacrylate". I said; "You're gonna crazy glue my fingers back together?" "Yup!" (worked great, no scars even)

The bill was about $2500.

The first EOB came. Claim denied due to lack of information from the ER.

The insurance compnay had not received the "ER Face Sheet" and "ER Notes". I called the hospital and claimed to have sent them. The hospital refused to talk directly to the insurance, and the insurance refused to talk to the hosptial - not even on a 3-way call. I had to flip between calling the hospital and the insurance. Took a few weeks to figure out that the hospital had sent the ER Notes and ER Face Sheet to an old address for the insurance company - The old address was on my insurance card.

I had them resend the ER Face Sheet and ER Notes to the new address.

Next EOB came in. Only paid 50% becuase; "you did not pre-certify the visit or get a referral from your PCP". I argue that it was an ER visit after hours and I didn't need to precertify ER visits. They said they didn't kow it was an ER visit - despite spending weeks arguing about not getting the ER Face Sheet and ER Notes.

Had to go back between the hospital and insurance (wouldn't talk to each other) and figured out that the hospital billing department fat-fingered the billing code and made it look like a specialist consult.

Next EOB Came in. Benefits still not paid in full becuase the doctor and hospital were in network but the person who read my x-ray was not, so hi spart of the benefit was paid out at 70% not 90% but it was all assigned to my out-of-network deductible. I had met my in-network deductible already. Insurance said I was responsible for determining the network status of anyone who treats me. This is a huge problem with labwork. If your provider doesn't take you insurance network into account he may send the labwork to the 'wrong' lab and you wind up paying for them out-of-network.

This kind of thing continued through 3 more cycles.

After a year of fighting I let the last $100 go. Wasn't worth figting over.

My brother cut his finger down to the bone in the UK back in 1990. Went to the ER. Was there 4 hours. Got 7 stitches, was sent home. Total out of pocket - zero.

Edited November 11, 2011 by Scruit

[Uncle Punk]

As if the Justices or the Nation needed a reminder that the political world is still debating the law, the voters in Ohio — by majorities in every county — on Tuesday approved by a margin of 66 to 34 percent a new state constitutional amendment seeking to defy the main provision of the new federal law.

http://www.scotusblog.com/2011/11/health-care-now-the-courts-turn/#more-131544

It has begun. I wish I had more time right now to join in this discussion.

[Uncle Punk]

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NEW PETITION! Ask Congress to impeach Justice Elena Kagan if she refuses to recuse herself from hearing the Obamacare case NFIB v. Sebelius. Please select, sign, and WE WILL FAX your petition to all 535 members of Congress (saving you time!)

Justice Elena Kagan won't recuse herself from deciding Obamacare case. Take action!

Associate Supreme Court Justice Elena Kagan has declined to recuse herself from ruling on the upcoming Obamacare case NFIB v. Sebelius, to be decided next summer, joined by 26 states arguing that abortion-funding nationalized health insurance is unconstitutional.

A new poll shows 47% oppose Obamacare, 42% favor, and 11% are undecided. But Justice Elena Kagan recently declined to recuse herself from deciding this case.

Kagan personally strategized, and her office lobbied to pass the "Patient Protection and Affordable Care Act" (Obamacare) when she served as President Obama's Solicitor General, making Kagan highly biased today. How can a judge impartially decide whether a law she helped write and lobbied to pass is valid? She cannot.

Federal law requires judges recuse themselves in such cases, so KAGAN NOW VIOLATES THE LAW AND SHOULD BE IMPEACHED if she refuses to recuse.

Friends, we fought against the pro-abortion funding provisions of Obamacare by faxing over a million petitions to Congress. We fought against Kagan's appointment to the Supreme Court with nearly a quarter million petitions. We helped persuade 26 state attorneys general to join the lawsuit NFIB v. Sebelius to defeat Obamacare in court.

We're now joining the final battle at the Supreme Court of the United States, to defeat Obamacare permanently, but one biased Justice Elena Kagan could decide our fate.

We've created a BRAND-NEW PETITION to all 535 members of the House and Senate, first delivered by fax to both Judiciary Committees and to Justice Kagan herself. We're joining 40+ other organizations who co-signed a similar letter to House Judiciary Committee Chairman Lamar Smith (R-TX, 202-225-4236), demanding hearings. We're adding to this our own demand that Congress impeach and remove Kagan from office if she won't recuse herself, because she now violates the law she has sworn to uphold.

Let's take one final stand against Obamacare. Take action today...

SELECT HERE TO SIGN PETITION, and we will instantly fax all 535 Congressmen and Senators demanding impeachment hearings if Justice Elena Kagan does not recuse herself from the Obamacare case NFIB v. Sebelius. (Saving you much time and postage!)

Our petition reads: "Justice Kagan is biased and cannot fairly decide this case, because as President Obama's Solicitor General she was directly involved in promoting and defending the 'Patient Protection and Affordable Care Act' (Obamacare).

"Justice Kagan herself admitted during her Supreme Court Confirmation hearings before the U.S. Senate Judiciary Committee that she was present for 'at least one' meeting in which the PPACA litigation was discussed. Documents obtained through the Freedom of Information Act indicate Justice Kagan actively participated with her Obama Administration colleagues in formulating a defense of the PPACA.

"Her former deputy at OSG, Neal Katyal openly admits this, and should be subpoenaed and forced to turn over all records. Katyal's emails stated in January 2010 that: 'Elena would definitely like OSG to be involved in this set of issues.' Then after the first strategy meeting, Katyal emphasized his interest in getting her entire office 'heavily involved even in the dct' [District Court].</SPAN>

"Kagan personally appointed Katyal in early 2010 to meet and discuss strategy for defending the health care bill from anticipated legal challenges. Katyal's emails say 'Absolutely right on. Let's crush them. I'll speak to Elena and designate someone,' after which Kagan designated Katyal, confirming her own desire to 'crush' the opponents of Obamacare.

"U.S. Law, 28 U.S.C. § 455(b)(3) mandates that a judge or justice recuse themselves if the justice has 'served in governmental employment and in such capacity participated as counsel, advisor or material witness concerning the proceeding or expressed an opinion concerning the merits of the particular case in controversy.'

"Please hold HEARINGS, IMPEACH and REMOVE Justice Elena Kagan from her office if she declines to recuse herself from any Obamacare case, like NFIB v. Sebelius."

SELECT HERE TO SIGN PETITION, and we will instantly fax all 535 Congressmen and Senators demanding impeachment hearings if Justice Elena Kagan does not recuse herself from the Obamacare case NFIB v. Sebelius. (Saving you much time and postage!)

Friends, our Supreme Court will soon decide if Obamacare and it's pro-abortion tax-funding is Constitutional. Let's take a stand today, and demand Justice Kagan recuse herself, or face impeachment hearings.

God Bless you, in Jesus' name,

Chaplain Gordon James Klingenschmitt </SPAN>

For interviews, speaking invites, select here.</SPAN>

P.S. Time is urgent! Please sign our petition today. Prefer to donate by mail? Please mail paper check or money orders to: The Pray In Jesus Name Project, PO Box 77077, Colorado Springs, CO 80970.

SELECT HERE TO SIGN PETITION, and we will instantly fax all 535 Congressmen and Senators demanding impeachment hearings if Justice Elena Kagan does not recuse herself from the Obamacare case NFIB v. Sebelius. (Saving you much time and postage!)

Disclaimer: The views of Chaplain Klingenschmitt, who was vindicated by Congress after being honorably but involuntarily discharged from the Navy in 2007 after facing court-martial for praying "in Jesus name" in uniform, are his own personal views, not the views of any political party, government, or organization.

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[Scruit]

tl

dr

[Disclaimer]

Hmm, no mention in Punk's post that Clarence Thomas should recuse himself too.

http://abcnews.go.com/blogs/politics/2011/11/groups-suggest-elena-kagan-clarence-thomas-should-be-recused-from-health-law-decision/

[Uncle Punk]

That is in my first post. We try to go as slowly as we can for you remedial students, please try to keep up.

If we lose both justices the vote then becomes 4-3 in favor of the good guys.

[Disclaimer]

In that case, the Kagan thing is also mentioned in your first post too. So, I reiterated along with your reiteration

[Uncle Punk]

Redundancy much?

[Uncle Punk]

Having trouble viewing this message? Click here to view online | Forward this message to a friend

NEW PETITION! Ask Congress to impeach Justice Elena Kagan if she refuses to recuse herself from hearing the Obamacare case NFIB v. Sebelius. Please select, sign, and WE WILL FAX your petition to all 535 members of Congress (saving you time!)

Justice Elena Kagan won't recuse herself from deciding Obamacare case. Take action!

Associate Supreme Court Justice Elena Kagan has declined to recuse herself from ruling on the upcoming Obamacare case NFIB v. Sebelius, to be decided next summer, joined by 26 states arguing that abortion-funding nationalized health insurance is unconstitutional.

A new poll shows 47% oppose Obamacare, 42% favor, and 11% are undecided. But Justice Elena Kagan recently declined to recuse herself from deciding this case.

Kagan personally strategized, and her office lobbied to pass the "Patient Protection and Affordable Care Act" (Obamacare) when she served as President Obama's Solicitor General, making Kagan highly biased today. How can a judge impartially decide whether a law she helped write and lobbied to pass is valid? She cannot.

Federal law requires judges recuse themselves in such cases, so KAGAN NOW VIOLATES THE LAW AND SHOULD BE IMPEACHED if she refuses to recuse.

Friends, we fought against the pro-abortion funding provisions of Obamacare by faxing over a million petitions to Congress. We fought against Kagan's appointment to the Supreme Court with nearly a quarter million petitions. We helped persuade 26 state attorneys general to join the lawsuit NFIB v. Sebelius to defeat Obamacare in court.

We're now joining the final battle at the Supreme Court of the United States, to defeat Obamacare permanently, but one biased Justice Elena Kagan could decide our fate.

We've created a BRAND-NEW PETITION to all 535 members of the House and Senate, first delivered by fax to both Judiciary Committees and to Justice Kagan herself. We're joining 40+ other organizations who co-signed a similar letter to House Judiciary Committee Chairman Lamar Smith (R-TX, 202-225-4236), demanding hearings. We're adding to this our own demand that Congress impeach and remove Kagan from office if she won't recuse herself, because she now violates the law she has sworn to uphold.

Let's take one final stand against Obamacare. Take action today...

SELECT HERE TO SIGN PETITION, and we will instantly fax all 535 Congressmen and Senators demanding impeachment hearings if Justice Elena Kagan does not recuse herself from the Obamacare case NFIB v. Sebelius. (Saving you much time and postage!)

Our petition reads: "Justice Kagan is biased and cannot fairly decide this case, because as President Obama's Solicitor General she was directly involved in promoting and defending the 'Patient Protection and Affordable Care Act' (Obamacare).

"Justice Kagan herself admitted during her Supreme Court Confirmation hearings before the U.S. Senate Judiciary Committee that she was present for 'at least one' meeting in which the PPACA litigation was discussed. Documents obtained through the Freedom of Information Act indicate Justice Kagan actively participated with her Obama Administration colleagues in formulating a defense of the PPACA.

"Her former deputy at OSG, Neal Katyal openly admits this, and should be subpoenaed and forced to turn over all records. Katyal's emails stated in January 2010 that: 'Elena would definitely like OSG to be involved in this set of issues.' Then after the first strategy meeting, Katyal emphasized his interest in getting her entire office 'heavily involved even in the dct' [District Court].</SPAN>

"Kagan personally appointed Katyal in early 2010 to meet and discuss strategy for defending the health care bill from anticipated legal challenges. Katyal's emails say 'Absolutely right on. Let's crush them. I'll speak to Elena and designate someone,' after which Kagan designated Katyal, confirming her own desire to 'crush' the opponents of Obamacare.

"U.S. Law, 28 U.S.C. § 455(b)(3) mandates that a judge or justice recuse themselves if the justice has 'served in governmental employment and in such capacity participated as counsel, advisor or material witness concerning the proceeding or expressed an opinion concerning the merits of the particular case in controversy.'

"Please hold HEARINGS, IMPEACH and REMOVE Justice Elena Kagan from her office if she declines to recuse herself from any Obamacare case, like NFIB v. Sebelius."

SELECT HERE TO SIGN PETITION, and we will instantly fax all 535 Congressmen and Senators demanding impeachment hearings if Justice Elena Kagan does not recuse herself from the Obamacare case NFIB v. Sebelius. (Saving you much time and postage!)

Friends, our Supreme Court will soon decide if Obamacare and it's pro-abortion tax-funding is Constitutional. Let's take a stand today, and demand Justice Kagan recuse herself, or face impeachment hearings.

God Bless you, in Jesus' name,

Chaplain Gordon James Klingenschmitt </SPAN>

For interviews, speaking invites, select here.</SPAN>

P.S. Time is urgent! Please sign our petition today. Prefer to donate by mail? Please mail paper check or money orders to: The Pray In Jesus Name Project, PO Box 77077, Colorado Springs, CO 80970.

SELECT HERE TO SIGN PETITION, and we will instantly fax all 535 Congressmen and Senators demanding impeachment hearings if Justice Elena Kagan does not recuse herself from the Obamacare case NFIB v. Sebelius. (Saving you much time and postage!)

[Uncle Punk]

http://online.wsj.com/article/SB10001424052970204632204577133041141039110.html

health-care case, which the court has scheduled for argument in March. But for months, a chorus on the left has been calling for Justice Thomas to recuse himself, asserting that his wife's paid work for conservative groups opposed to the Patient Protection and Affordable Care Act has created a conflict of interest.

The right, meanwhile, has been clamoring for Justice Kagan to disqualify herself, asserting that her prior post in the Obama Justice Department ties her too closely to the administration's interests.

None of the actual litigants has formally asked any justice to withdraw from the case.

The case's central question is whether Congress can require Americans to carry health insurance or pay a penalty. The government asserts that it can, based on Congress's constitutional authority over interstate commerce, as well as its power to levy taxes and enact "necessary and proper" laws. Challengers, led by 26 Republican-controlled states, disagree and call the law an unprecedented extension of federal power.

Based on their past positions, Justice Thomas is expected to find the insurance mandate unconstitutional, while Justice Kagan is considered likely to hold that Congress may use such a mechanism to finance health care. Neither justice has responded to the recusal calls.

Ethics rules for federal district and appeals courts do not formally apply to the Supreme Court, but the chief justice said that the justices voluntarily hold themselves to the same standard. They call for withdrawal from "any case in which the judge's impartiality might reasonably be questioned," the chief justice wrote.

On the other hand, the ethics code "provides that a judge 'should not be swayed by partisan demands, public clamor or considerations of personal popularity or notoriety, nor be apprehensive of unjust criticism.' Such concerns have no role to play in deciding a question of recusal," Chief Justice Roberts wrote.

A judge decides for himself or herself whether to sit out a case, and those decisions can be appealed. But there is no court above the Supreme Court, the chief justice noted, so the recusal decision rests with each individual justice.

The chief justice wrote that Supreme Court justices should not recuse themselves unless absolutely necessary, because current law does not allow any other federal judges or even retired justices to substitute for them.

"A Justice … cannot withdraw from a case as a matter of convenience or simply to avoid controversy," he wrote.

Currently, there are three retired Supreme Court justices, two of whom regularly serve as substitute judges on the lower courts. One retired justice, John Paul Stevens, has suggested amending federal law to allow retired justices to sit when an active member must recuse. The Senate Judiciary Committee chairman, Sen. Patrick Leahy (D., Vt.) has introduced legislation to permit the practice, but current justices have been unenthusiastic.

Mr. Leahy said Saturday in a statement, "Given the recent public attention to the question of recusals on the Supreme Court, the New Year may provide another opportunity for us to consider this proposal."

In addition to releasing statistics regarding the federal court system, Chief Justice Roberts has used his annual reports to address issues involving the judiciary—in this year's case, judicial ethics.

In Saturday's report, the chief justice traced the codification of judicial ethics to the notorious Black Sox baseball scandal of 1919, when the Chicago team threw the World Series. The sport responded by hiring a federal judge to serve as the first baseball commissioner, prompting a discussion over whether he would have to resign from the bench and judicial ethics more broadly.

In 1922, the American Bar Association asked Chief Justice William Howard Taft to head a commission drafting a judicial code of conduct, and its report remains the basis of judicial ethics today, Chief Justice Roberts wrote.

In an appendix, the chief justice reported that federal district court filings grew 2% in 2011, to 368,000, while filings in bankruptcy court, which shot up 14% in 2010, declined 8% in the last year, to about 1.5 million petitions.

A surge in defaulted student loan cases and additional disputes over Social Security payments largely accounted for a 9% upswing in cases where the federal government is a litigant, the report said. Cases involving immigration offenses fell for the first time since 2006, dropping 3%.

[Uncle Punk]

"The comments of Chief Justice Roberts are an affront to the high ethical standards of our Founding Fathers and amount to a subversion of our laws," the brief said. "They are the result of someone who became Chief Justice by first ingratiating himself to the 'Washington establishment,' and now seeks to act as the Chief Justice not just of the Court, but of this same establishment - which for decades has pushed the nation to the brink of revolution by representing mostly its own interests, perpetuating and consolidating its power and selling out 'We the People.'"

http://www.huffingtonpost.com/2012/01/23/elena-kagan-recusal-supreme-court-obama-health-care-law_n_1223933.html