[Vision2020] Story abut Obama Care in Chicago Tribune Oct.15, 2012

[Ron Force]

Few Drs, hospitals, insurers = no competition= higher prices. Just another expense for "livin' in the country".

http://www.nytimes.com/2013/10/24/business/health-law-fails-to-keep-prices-low-in-rural-areas.html?_r=0


...Some say the arrival of a co-op changed the landscape in Montana, where the insurers Blue Cross and PacificSource were joined by Montana Health CO-OP.
In neighboring Wyoming, two insurers are offering plans under the exchange: Blue Cross and WINHealth, a small health maintenance organization, or H.M.O. The cheapest silver plan available to a 50-year-old in Wyoming cost nearly as much as the most expensive Montana plan.
“Adding that third competitor really changes the landscape vastly,” said Jerry Dworak, chief executive of the Montana co-op. He said the other insurers had predicted that their rates would be 25 percent higher in the marketplace, but those increases did not materialize. “It was amazing how close the rates were,” he said...
...The Rural Problem
In rural regions, several factors combine to create a landscape that is inhospitable to newcomers. Developing relationships with doctors and hospitals can be costly where cities and towns are widely scattered and the pool of potential customers is small.
“I think the problem was that the Affordable Care Act was designed for where the majority of the people live, in the big cities where there’s a lot of competition among health care providers,” said Tom Hirsig, Wyoming’s insurance commissioner.
He said insurers simply did not find his state, with its population of fewer than 600,000, attractive.
“You’ve got to have some bargaining chips and we don’t have that much,” he said.
Often a single hospital dominates an area, giving insurers little leverage when negotiating reimbursement rates. Only one Wyoming county is served by more than one hospital, said Stephen K. Goldstone, the chief executive of WINHealth.
“What it costs to be treated here is more expensive than other places because there’s no competition among providers,” Mr. Goldstone said.
In southwest Georgia, another rural region, Blue Cross and Blue Shield of Georgia is the dominant carrier, and it is the only insurer operating in 54 of the state’s 159 counties.
“This has been what Georgia’s issues have been, that rural areas don’t have the best access to care,” said Amanda Ptashkin of Georgians for a Healthy Future, a consumer advocacy group.
Bert Kelly, a spokesman for Blue Cross and Blue Shield of Georgia, which is owned by WellPoint, said the higher premiums reflected the area’s higher medical costs and not a lack of competition...
...It is also difficult to attract new insurers to areas where the population has health problems. Only one carrier, Highmark Blue Cross, is offering coverage in West Virginia, which has high rates of obesity and chronic diseases like diabetes...

 
Ron Force
Moscow Idaho USA



On Friday, October 25, 2013 1:35 PM, Scott Dredge <scooterd408 at hotmail.com> wrote:
 
Obamacare fails to lower prices in rural areas.  Fortunately for Obama and the Dems, those are regions that vote Republican anyway, so it will have zero effect on future elections.
>http://www.cnbc.com/id/101140469
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>________________________________
>Date: Fri, 25 Oct 2013 10:49:29 -0700
>To: ngier006 at gmail.com; ngier at uidaho.edu
>From: lfalen at turbonet.com
>CC: vision2020 at moscow.com
>Subject: Re: [Vision2020] Story abut Obama Care in Chicago Tribune Oct.15,	2012
>
>
>Nick
>Again you are twisting my words. I did not say  that heath care was like a religion. What I said was that the beliefs about it were, in that both sides are going to stick to their ideology regardless of any facts. There are a lot of comments like yours in support of it. Likewise there is considerable data put out by the right that points up the deficiencies. I do not believe that either side is 100% percent correct. I have read a lot of articles that point out the deficiencies. Going back and finding those articles would require a lot of time. I did a search on Bing looking for data showing what is wrong with it. I found a long list of websites. I waited about 15 minuets for one to come up, which it never did. At that point I said "to hell with it" Some one with a better computer than mine, needs to take up the debate.
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>Roger
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>>________________________________
>>-----Original Message-----
>>From: "Gier, Nicholas" <ngier at uidaho.edu>
>>To: lfalen <lfalen at turbonet.com>, "Nicholas Gier" <ngier006 at gmail.com>
>>Cc: "vision 2020" <vision2020 at moscow.com>
>>Date: 10/24/13 11:29
>>Subject: RE: [Vision2020] Story abut Obama Care in Chicago Tribune Oct.15, 2012
>>
>>   
>Hi Roger,
>
>Just catching up on this thread.  I'm sorry, but health care is not like religion; it is not a matter of faith-except for the 46 million uninsured Americans, many of whom pray to God that they don't get sick.
>
>The two stories in the Chicago Tribune do not conflict. Obama has said that some premiums will go up, but current analysis,as the second story demonstrates, is that on average premiums will be lower.
>
>One does not have fall back on faith to know that single-payer universal systems have worked for decades, providing better health results in most instances and for less than half the cost in many countries.
>
>With regard to Canada, you again are mixing the anecdotal with the general record.  Some elective procedures are rationed in Canada, so if you don't want to wait, you can choose to cross the border for care.  Many Americans cross the border for much cheaper drugs, and many people here in Bellingham cross the border for good and cheaper dental care.
>
>My daughter, who lives in Edmonton, forgot to bring enough MS shots with her when she visited this summer.  They are listed $50 per dose in Canada, but she pays nothing.  When we called around in Moscow, the cost was $2,000!  She and her husband packed up and left for home one week earlier.  We of course were sad to see them leave for such an outrageous reason.
>
>MS treatments are not rationed in Canada. One month after diagnosis, my daughter had a neurologist, an MS nurse, and an MS counselor, and access to the current research at a clinic at the University of Alberta.  She also had her drugs immediately and without cost, and she has never received a bill.
>
>In stark contrast is a Moscow friend of mine, who had to wait three years to qualify for Medicaid and to receive care and drugs.  He is now wheel chair bound and has 24-hour care at a cost to society much more than if he had been treated when he should have been.
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>According to a Harvard study, there are 40,000 Americans who suffer preventable deaths each year.  We rank 19th in the world for preventable deaths.
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>I'll take reason, not faith, for health care any day, and I hope you will change your mind on this.
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>Nick
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>________________________________
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> From: vision2020-bounces at moscow.com <vision2020-bounces at moscow.com> on behalf of lfalen <lfalen at turbonet.com>
>Sent: Friday, October 18, 2013 10:37 AM
>To: Nicholas Gier
>Cc: vision 2020
>Subject: Re: [Vision2020] Story in Chicago Tribune Oct.15, 2012
>  
> Very foggy here this morning. My wife just got back from putting on the State Soils Contest at Burley. She said that there was a major wreak just south of Genesee.
> 
>On your post. These are two different stories in the same paper. Who is to say which is right. Maybe both to some extent. There are a lot of opposing arguments out there. We will have to wait and see who is right. Maybe neither. It is like religion. Everyone has their version of the gospel. Kind of like the Canadian system. Some swear by it, but a lot of those with money come to the states for treatment.
>Roger
>Incidentally I am mostly in agreement with Saundra's last two posts. For your information I also supported Otter's Heath Insurance Exchanges.
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>>________________________________
>>-----Original Message-----
>>From: "Nicholas Gier" <ngier006 at gmail.com>
>>To: lfalen <lfalen at turbonet.com>
>>Cc: "Sunil Ramalingam" <sunilramalingam at hotmail.com>, "vision 2020" <vision2020 at moscow.com>
>>Date: 10/17/13 10:53
>>Subject: Re: [Vision2020] Story in Chicago Tribune Oct.15, 2012
>>
>>
>> 
>>Hi Roger,
>>
>>
>>With your example of the one nurse I believe that you have committed the fallacy of generalizing from a very small sample. See the story from the Chicago Tribune appended below. Premiums in Illinois under Obamacare will be lower than the national average.
>>
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>>You speak of employers who will cut their workers hours but do not condemn them. There will be only one whammy, and it won't be Obamaspan>'s fault. If they had a union they would be protected from such arbitrary actions. And your second whammy would be avoided by subsidies, which could be avoided if employers didn't cut their hours in the first place.
>>
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>>You forgot to mention that many poor single people will not be eligible for Medicaid in those states where the GOP has refused to take fed's offer of extended Medicaid for three years paid at 90%. The result will be that the Red States will fall further and further behind in general health, eventually to Third World levels. We are already below Cuba in infant mortality rates. 
>>
>>
>>Yours for better facts and better arguments,
>>
>>
>>Nick
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>>
>>Illinois insurance exchange rates lower than U.S. average
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>>Plans under health care law expected to provide 'fairly competitive prices'
>>September 25, 2013|By Peter Frost, Chicago Tribune reporter
>>Illinois residents will pay slightly less than the national average for health insurance offered under President Barack Obamaspan>'s health care law, according to rates released Tuesday by state and federal officials.
>>The snapshot provides an early yet incomplete look at how much consumers might pay in premiums and comes a week before the launch of new insurance exchanges, the online marketplaces in which individuals, families and small businesses can compare and buy coverage, often with the help of federal tax credits.
>>While state and federal officials released broad details on how much those plans might cost in certain areas, they did not release exact figures for each of the 165 health plans being sold in Illinois, explaining that rates will not be final until Tuesday. They also did not reveal the specific copays and deductibles that most consumers will face when they see a doctor, visit an emergency room or undergo surgery.
>>Despite that missing information, the new data provide an important overview of the kind of options consumers will have. The report also demonstrates that many consumers will likely find an affordable option, though some may face higher premiums, as critics are quick to point out.
>>"We are seeing, across the board, fairly competitive prices," said Caroline Pearson, vice president of Avalere Health, a consulting firm closely following the rollout of the marketplaces. "The health plans are convinced that people will buy based on price, and they are working very hard to put low-cost products in the markets."
>>The federal analysis also includes specific data only from the 36 states that have elected to have the federal government run their marketplaces, including Illinois, which is operating in a federal partnership. (Premium information from the 14 states operating their own insurance marketplaces, including California, Maryland and Connecticut, in most cases is available through state websites.)
>>In Illinois, the average consumer will be able to choose from 58 health plans offered by as many as five insurance companies. In all, eight insurers will offer plans in the state, though not all will sell coverage in each region.
>>State officials were hesitant to release even a broad overview of rates until now because federal regulators were working with insurance companies to tweak plans and rates as late as last week, said Andrew Boron, director of the Illinois Department of Insurance.
>>"We decided to take a conservative approach," Boron said. "But today, what we're all really excited to announce is that consumers in Illinois are going to have robust options and affordable options."
>>According to state and federal data:
>>•A single 30-year-old who lives in Cook County and has annual income of $23,000 will be able to buy coverage for as little as $69 a month next year with the help of $67 in federal tax credits.
>>•A Cook County couple, both age 55 and with household income of $40,000, can buyhealth insurance for $70 a month after a $463 tax credit. If that same couple lived in Peoria, their monthly premium would be free.
>>•A family of four in Illinois with household income of $50,000 will be able to buy coverage for $84 a month after a $400 tax credit.
>>The health care law established four broad categories of coverage - platinum, gold, silver and bronze - where premiums vary based on the amount of out-of-pocket health care expenses consumers are required to pay.
>>
>>The above rates are based on a bronze plan, the least expensive, which requires policyholders to cover 40 percent of the cost of their health care. A platinum plan has much higher monthly premiums, but the patient share is only 10 percent.
>>Illinois insurance officials expect most consumers to choose plans in either the silver or bronze category.
>>All plans offered on the exchanges require insurers to cover 10 basic services called essential health benefits, including maternity care, prescription drugs, emergency services, mental health, laboratory services and hospitalization. Insurers also must offer plans to all applicants, even if they have a pre-existing medical condition like cancer, diabetes or hypertension.
>>"There have been a lot of products on the market where people would find out that they thought they had health insurance, but then they would find out that it wouldn't cover hospital visits, for example," said Gary Cohen, who oversees the online marketplaces for the federal Department of Health and Human Services. "It's important to understand that, because of the Affordable Care Act, the health insurance that people will be buying will actually cover them in the case of them getting sick."
>>Premiums also vary by family size, income, where people live and whether they smoke.
>>Some plans offered in Chicago, for example, are less expensive than identical coverage in Peoria and other parts of Illinois, largely because Cook County has more so-called narrow-network plans, which limit the number of doctors and hospitals available to consumers and tend to be less expensive, state officials said.
>>A 40-year-old tobacco user in Cook County would pay $196 for the lowest level of coverage, versus $152 for a nonsmoker.
>>Illinoisans who make between 138 and 400 percent of the federal poverty level - up to $94,200 for a family of four - and aren't offered qualified insurance through their employer are eligible for federal tax credits to help offset the cost of insurance premiums.
>>To receive those subsidies, which vary on a sliding scale based on income and age, they must buy a plan offered on the exchange.
>>Those whose income falls below that range will be newly eligible for Medicaid, the state-federal health insurance program for the poor and disabled.
>>The marketplace, or exchange, is scheduled to open Oct. 1; coverage begins Jan. 1 for those who buy plans before Dec. 15. Open enrollment lasts until March 31. Consumers who do not have health insurance in 2014 will pay an income tax penalty next year, starting at $95 or 1 percent of household income, whichever is greater.
>>Of nearly 1 million in the state eligible for federal tax subsidies to help offset the cost of buying insurance, state officials expect only about 337,000 to purchase subsidized coverage in 2014.
>>While both reports lay out the broad strokes of how much coverage will cost, the data do not include the size of an insurer's network of providers like doctors, specialists, health centers and hospitals.
>>"Everyone wants to do the political thing and talk about rates, but no one knows what you're buying yet," said Rich Fahn, president of Excell Benefit Group in Northbrook. "Just providing the premium is giving an incomplete picture."
>>Fahn and Jim Smith, a senior vice president at the health care consulting firm The Camden Group, said the lower premiums on the exchange-based insurance products likely indicate consumers will have more limited access to certain physicians and hospitals than those covered under more expensive, employer-based plans.
>>"Carriers are putting together smaller networks to squeeze bigger discounts out of providers," Smith said.
>>While state and federal officials acknowledge those concerns and said some of the plans offered on the exchanges will have narrow networks, they say all plans were subject to state and federal requirements that ensure an adequate selection of providers.
>>"We feel comfortable, as do the feds, that the networks are sufficient," Boron said.
>>Tribune Newspapers reporters Ameet Sachdev and Noam Levey contributed.
>>pfrost at tribune.com
>>Twitter @peterfrost
>>  
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>>On Thu, Oct 17, 2013 at 10:24 AM, lfalen <lfalen at turbonet.com> wrote:
>>
>> Sunil
>>>I think you are right. All government employees(Federal, State and local) have employer sponsored health insurance. So do most of those who work for larger companies. Obamacare would cover those who cannot afford insurance and those in the low income brackets. The potential problems are that some companies will convert some employees to part time. They will be hit with a double whammy. Getting insurance on their own will is most cases cost them more and they will have a reduced income to pay for it because they are now part time. Older folks and the disabled can get Medicare. the Indigent get Medicaid. Some of the money to pay for Obamacare is to come out of Medicare. Just how or where, I do not know.I pay a little over $100.00 per month for Medicare and $66.33 to the University for Part D and Dental, which Medicare does not cover. My doctor and has just quit taking Medicare. I assume this means I will have to change doctors.
>>> 
>>>Roger
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>>>>________________________________
>>>>-----Original Message-----
>>>>From: "Sunil Ramalingam" <sunilramalingam at hotmail.com>
>>>>Cc: "vision 2020" <vision2020 at moscow.com>
>>>>Date: 10/15/13 17:27
>>>>Subject: Re: [Vision2020] Story in Chicago Tribune Oct.15, 2012
>>>>
>>>>
>>>>Wayne,
>>>>
>>>>If they are not covered under the Act, isn't it because their insurance is covered as an employment benefit? Isn't the same true for University of Idaho employees?
>>>>
>>>>Or am I wrong about this?
>>>>
>>>>Sunil
>>>>
>>>>
>>>>
>>>>________________________________
>>>>From: bear at moscow.com
>>>>Date: Tue, 15 Oct 2013 17:15:59 -0700
>>>>To: lfalen at turbonet.com
>>>>CC: vision2020 at moscow.com
>>>>Subject: Re: [Vision2020] Story in Chicago Tribune Oct.15, 2012
>>>>
>>>>
>>>>Roger,And this is a surprise ?
>>>>Why do you seriously think that neither the White House nor Congress is part of "Affordable Health Care"?
>>>>
>>>>
>>>>Wayne
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>>>>On Oct 15, 2013, at 5:08 PM, lfalen wrote:
>>>>
>>>> 
>>>>>
>>>>>Adam Weldzius, A Nurse Practitioner is privately insured. His monthly insurance premium of $233(deductible of $3,500) will more than double. For the same coverage his deductible will be $12,500.
>>>>>A Tribune analysis shows that 21 pf the 22 lowest plans on the Illinois health exchange for Cook County would have annual deductibles of over $4,000 for individuals and $8,000 for family coverage.
>>>>>People who have health insurance threw their employer have an average deductible of $1,100 according to The Kaiser Family Foundation.
>>>>> 
>>>>>This is from a story in the Chicago Tribune. They are not my figures.
>>>>>Roger =======================================================
>>>>>List services made available by First Step Internet,
>>>>>serving the communities of the Palouse since 1994.
>>>>>http://www.fsr.net
>>>>>mailto:Vision2020 at moscow.com
>>>>>=======================================================  
>>>>  
>>>>======================================================= List services made available by First Step Internet, serving the communities of the Palouse since 1994. http://www.fsr.net mailto:Vision2020 at moscow.com ======================================================= 
>>>>________________________________
>>>>=======================================================
>>>>List services made available by First Step Internet,
>>>>serving the communities of the Palouse since 1994.
>>>>http://www.fsr.net
>>>>mailto:Vision2020 at moscow.com
>>>>======================================================= 
>>>=======================================================
>>>List services made available by First Step Internet,
>>>serving the communities of the Palouse since 1994.
>>>http://www.fsr.net
>>>mailto:Vision2020 at moscow.com
>>>=======================================================
>>> 
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>=======================================================
 List services made available by First Step Internet,
 serving the communities of the Palouse since 1994.
               http://www.fsr.net
          mailto:Vision2020 at moscow.com
======================================================= 
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>=======================================================
>List services made available by First Step Internet,
>serving the communities of the Palouse since 1994.
>              http://www.fsr.net
>          mailto:Vision2020 at moscow.com
>=======================================================
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