Wednesday, October 28, 2015

HMOphobia

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Frankly, Hope n' Change wasn't expecting anything really scary to arrive at our door until Halloween, but it turns out that Obamacare has jumped the gun by presenting us with a trick that is definitely no treat.

We already knew that "if you like your doctor, you can keep your doctor" was a lie. But it turns out "if you like your NEW doctor, you can keep your doctor" was also a lie. Because we, along with over 300,000 other folks in Texas, were just informed that Blue Cross Blue Shield has "discontinued" every individual PPO health insurance policy statewide because under the Affordable Care Act, "some affordable plans are no longer affordable for the company to sustain."

We're shocked. Shocked.

The letter we received cheerily pointed out that we don't need to do anything to have a brand new policy assigned to us. A policy under which our premiums will be raised to about $17,000 a year (for two healthy adults), our deductible is raised substantially, medical expenses which were covered 100% will only be 70% covered, we can't get prescriptions from the pharmacy we've used for years, and we can no longer see the physicians who were covered on our PPO plan. Instead, we're being downgraded into an HMO plan with a very limited pool of doctors, and we must choose one ("or we'll pick one for you!") who will become the gatekeeper of all our medical care.

Nothing will be covered unless it is specifically ordered by a second tier doctor (if we're lucky) who will be receiving bonuses for limiting care and denying referrals to other doctors.

Hilariously, the health insurance market doesn't even reopen until November 1st, meaning we've got 3 or 4 anxiety-filled days of vomiting blood before we can go online to compare plans from other insurance providers (if any) and sign up for something before the December deadline.

We're certainly not alone in this fiasco (not even counting the other 300,000 Texans whom Blue Cross just put out to pasture.) Nationwide, health care exchanges are going bankrupt, official estimated enrollment for 2016 Obamacare plans has been scaled way down, and premiums and medical costs are skyrocketing.

But at least wealth is getting redistributed and citizens are getting the fear of God (or at least of government) put into them. Which was, of course, the goal all along.

UPDATE: Here's a good piece by Michelle Malkin about the number of Americans losing access to their "new and improved" plans.

BONUS: FOUR TO ZERO

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And what a victory it is! No one in the State Department demoted or disciplined, and none of the
not-so-spontaneous terrorists "brought to justice" by the Obama administration.

BONUS TWO: NOTHING TO SNIFF AT

And speaking of Hillary...



24 comments:

George in Houtx said...

I thought "Dear Leader" PROMISED that he would bring whatever miscreants to justice for what they did to our ambassador (and the 3 brave men who defended him). are we to, now, believe that our presidents' word is just so much hot air? I am surprised!! okay, I thought I could pull this off. I guess I'm not as good at sarcasm as I once was. not to worry, tho'. the FBI is still investigating Hillary. I know it's a longshot chance, but it looks like the FBI is not QUITE as politicized as the DOJ. at least I can hope!

Cat Whisperer said...

Obama promised he would lower your premiums by $2,500.00 and instead they went up to $17,000.00? That is still well within the margin of error for an Obama promise.

My family had to sign up for Obamacare when my wife lost her health insurance through her work last December. She and my son were immediately enrolled, but I was denied because I the “Navigator” repeatedly assured me that I was not a U.S. citizen. I finally got signed up after faxing a tax return and birth certificate. I tried to use my health insurance for the first time yesterday to get a flu shot and was told by the pharmacy that there was a problem billing the insurance because I am listed as my wife’s child on the policy.

Anonymous said...

So far AARP has been wonderful! We'll see.

Fred Ciampi said...

Even the VA is better for those of us who have been lucky (?) enough to have served in the armed forces. Good 'ole Buck O'Fama is really doing the job on the citizens whom he vowed to be The Dear Ruler to. I do believe that he is punishing Texas for the high percentage of patriots there. I just wonder when he will go too far? 'Nuff said, now where did I put my moonshine?

Side note; Didn't Lenin say "first you control their health"?

Stilton Jarlsberg said...

@George in Houtx- Yeah, Barry promised he'd bring the killers to justice. However, based on his policies and his declaration (in response to the attack) that "the future must not belong to those who slander the prophet of Islam," I'm guessing he thought that justice was already done when Americans were murdered.

Regarding Hillary and the FBI, I think there's a good chance that they're doing a fair investigation - but I think there's no chance that any crimes they discover will be prosecuted.

@Cat Whisperer- I can't help but chuckle (sympathetically!) at your Obamacare story. Who knows what other errors have been introduced into our records - or when they'll be discovered? When you're rushed to an emergency room, it's not a great time to have treatment delayed because your "official" records don't match reality.

@Anonymous- AARP struck some sweetheart deals with the government when Obamacare was being rammed through. Specifically, their plans would be favored (giving them billions in profits) in return for lying to seniors about the benefits of Obamacare. Statistically, some people have got to be getting policies which they're happy with. I hope you continue to be one of them.

Stilton Jarlsberg said...

@Fred Ciampi- I'm not sure that Texas was singled out, I'm sure we'll be hearing a lot of stories in the coming days about widespread changes (none of them good) to insurance offerings around the country.

And yes, when you control people's health you control their lives. I despise the HMO "gatekeeper" model in which you have no say about your own healthcare. If that doctor says you'll get painkillers instead of a pacemaker (to quote B. Hussein), then that's what you'll get. And I'm just a little suspicious that vocal conservatives may be more likely than others to go on the "just painkillers" list.

CenTexTim said...

Had an obamacare moment at the ER a few days ago. I won't bore you with the details, but suffice it to say that next time I think I'll just bleed to death. It'll be quicker, less painful, and damn sure less expensive.

American Cowboy said...

I wonder how many vocal American patriots/conservatives will get "painkillers" for treatment with the disclaimer that, "We're sorry, evidently your pain tolerance threshold has suddenly and without explanation gotten very low. That must be why you are feeling every bit of pain as we operate on you with used instruments cleaned by third-world illegals."
The United States of America that I was born in has ceased to exist except in name only. What country is this?

JimLane said...

AARP's a**hole buddy, United (un)Healthcare gave many of us a "treat" last year when it suddenly dropped ALL the doctors in my neck of the woods from its "Medicare (dis)Advantage" plan. Things got LOTS more expensive overnight! Now I'm on "regular" Medicare, with the best supplement, and I'm anxiously waiting for the next Obama(don't)Care "feature" to rear its burka-covered head and stick a dull, rusty needle into THAT little balloon. It's not "if"; it's just "when"...

Juanita The Icon said...

This admin is criminal.

This admin lies.

This admin is "progressive."

And those that vote "progressive" are simply warm, animated Soylent Green.

They deserve the same ending as in Fargo - you know, the crazy "albino" guy and his buddy. Yeah, I know he wasn't albino. Whatever. Sadly, I do not believe there are sufficient wood chippers.

John the Econ said...

The single phrase that is scarier than anything that may show up at your door on Halloween: "Hi, we're the government and we're here to help you."

Mrs. Econ just alerted me that we have to dress up for a Halloween party Saturday, and asked what I was going to go as. I'm thinking of going as either ObamaCare or my health care bills. Can't imagine anything scarier.

If it makes you feel any better @Stilton, you know I feel your pain. The health insurance I liked used to cost less than $4,000-a-year. Post "Affordable Care Act", the same plan was over $14,000. And that was just the cost of staying healthy. It was "high deductible", but I was okay with that in that once the deductible was met, it paid 100%. Earlier this year, Mrs. Econ got a new job and we're now on her "more affordable" insurance. Although it includes a lot of "freebies" that were formerly out-of-pocket, it's not as good as our previous insurance in that after the deductible, it only pays 70% until we hit the 5-figure "superdeductible". And last week, we found that our share of the premium for our "new, improved, and Obama-compliant" insurance literally doubled! At least we still get to pick our doctors, but who knows how long that will last.

I wonder if out of the 165,000 new ICD-10 codes if there is one for vomiting blood between the time that one gets the dreaded "Good news, changes coming!" letter and the unpleasant surprise one gets when finding out what the new options and rates are going to cost you.

Meanwhile, ObamaCare is working exactly as planned by slowly destroying what was left of private insurance and care. Nearly a third of the innovative health insurance plans created under the Affordable Care Act will be out of business at the end of 2015, following announcements Friday that plans in Oregon and Colorado are folding. It's only a matter of time before the remaining free Americans are forced to cry uncle, and submit to what has been the Progressive goal all along, "single payer".

Then, we'll all be in @Stilton's new mega-HMO where all your choices will be made for you, just like they are at the VA, where Hillary sez everything is just fine.

John the Econ said...

@George in Houtx, I can't but imagine how well Obama and O.J. Simpson would get along if O.J. hadn't been sent back to prison; both tirelessly "looking for the real killers" as they hit the country's most exclusive links.

@Cat Whisperer, to hear Obama tell it, I should be at least $8,000-a-year richer. (the difference between what I now pay vs. what I paid pre-Obama, and the $2,500 I was supposed to be saving. Where's my money???

I would have thought seeking care as "non citizen" would be a plus. You just show up for care, and then leave.

In a "healthy" system, you'd be able to sue for such levels of incompetence. But since it's the government that is responsible, you have no such recourse. Remember that as the government continues to take over more of our lives.

Stilton Jarlsberg said...

@CenTexTim- I'm not quite sure what could be worse than a massive bureaucracy standing between a patient and potentially lifesaving medical care.

@American Cowboy- Given the example of the IRS seeking out conservatives for abuse and using/sharing their private data (and, most importantly, getting away with it) I have no confidence that government-run medicine won't be used to punish opponents. Or worse.

@Jim Lane- I used to be on United Healthcare, on a "grandfathered" plan, but once Obamacare hit they changed the terms to deny coverage in some critical areas AND raised the price. SO I had to go to an Obamacare Blue Cross plan, and now that has failed after a single year. And every bit of it was predicted.

@Juanita the Icon- I have long held that woodchippers should play a bigger part in politics.

@John the Econ- I'm sure that a lot of people are feeling the pain as their rates soar and coverage declines (when it's not eliminated completely), making me wonder if this will come up in tonight's debate. I wouldn't imagine that the debate moderators will ask, since they don't want to start a question "Given the ongoing collapse of the Obamacare system..."

When I hear about 165,000 new computer codes for illness and injury, my first thought is that there are now 165,000 new ways for someone at a keyboard to screw up my charts and perhaps kill me. Getting rid of annoying conservatives can be as easy as "accidentally" changing the official record of their blood type. One transfusion and you're dead - and if nobody is getting discliplined for Benghazi, they sure as hell won't be disciplined for an alleged typo.

I'm surprised (or, uh, not) that there isn't more news about the failing healthcare exchanges, failed policies, insurance companies leaving markets entirely and on and on.

As you say, the goal is to break the system so completely that "single payer" is all that's left. At which point the government literally owns us body and soul.

And I'm speechless about Hillary's declaration that the VA is already working well for our vets. And Barry, God knows, has done nothing helpful. Remember what happened when there was a firestorm of scandal about the VA and he had to do something? He made a prisoner swap to get back Bowe Bergdahl, to demonstrate his commitment to our armed forces.

Oh look! It's 10:30 am! Time for a drink...

Cookie said...

My niece's health exchange is also going belly up in Utah. It's happening everywhere. My husband's health insurance, which covers both of us, has been going up in cost and down in coverage for several years now thanks to the unaffordable lack of care act. It's getting frustratingly more difficult to meet the costs. American Cowboy said it right that the USA we were born into no longer exists but in name only. I fear greatly for my grandchildren.

Shelly said...

There is a special place in hell for John Roberts for the travesty of that Obamacare decision. And I thought I liked him when he was appointed and elevated to Chief Justice. It just proves there are absolutely no guarantees on SCOTUS appointments, which is doubly scary since they hold so much power over all of our lives. The only people helped by Obamacare are those who are getting subsidies on the backs of those, like Stilton, who are getting screwed. And a lot of them won't even use it and continue to go to the ER like they did before the thing was passed.

Sortahwitte said...

Stilton and Juanita.
There may not be enough wood chippers, but my area is just lousy with backhoes.
Did I mention that mine can reach down 14 feet?

Colby Muenster said...

@Stilton,

I know it doesn't alleviate the pain in your wallet, but you are one of what will be millions facing either bankruptcy or death at the hands of asswipes who get the best coverage in the world free.

But fear not; there is good news on the horizon! Sooner than we think, we will have that perfect, infallible, and cost effective single payer system, and our health care worries will be a distant fading memory (as we lie on that bed getting euthanized at the ripe old age of 65).

Don't even get me started on coding. A couple years ago, I had a colonoscopy that is "100% covered" by my plan, and due to some dimwit entering codes wrong, I'm still getting threatening letters from lawyers. And the doctor that did the procedure wants me to come back for another because he found a small polyp in there. I'm going to suggest that, this time, he try and find a more intelligent coding person up there. Shouldn't be too difficult; especially if I lie to them about taking the 47 gallons of laxative the day before.

Stilton Jarlsberg said...

@Cookie- I'll be double-dogged damned if I can find any big upswing in benefits that ANYone is getting under Obamacare. Yes, a lot of people are being added to Medicaid - which is more about encouraging sign-up that anything else. Some people are enjoying nice subsidies making their costs lower, but with the rest being paid by the suckers who are still dumb enough to go to work and pay taxes. There are still a lot of people who are uninsured (and still visiting emergency rooms), and the damage to our healthcare system and business productivity is incalculable.

@Sortahwitte- 14 feet, you say? On a completely unrelated topic, I don't think cadaver dogs can smell that deep...

@Colby Muenster- Your reference to euthanasia reminded me of this Johnny Optimism cartoon.

And I'm well aware of the colonoscopy nonsense. These days they're "100% covered" IF not a single polyp, pre-polyp, or goosebump is found and removed for analysis. If they DO find anything, your insurance tells you what to do with a rolling doughnut.

Your code may not have been entered "wrong" so much as it changed when your physician found (or pretended to find) a polyp - changing the procedure from a "diagnostic" code to a "treatment" code, and magically multiplying the payday of everyone in the room (including those who own the room) by about 4 or 5 times.

Tired of playing the game, I went to a website called ColonoscopyAssist.com. They set everything up with real doctors and real facilities for a set price of $1075 which was all-inclusive, including lab work on any polyps found. That was months ago, and I haven't received another bill from anyone - so I recommend the service. Bonus: if you have the procedure and nothing is found, then you can submit your bill to your insurance company and they'll probably reimburse you.

Boligat said...

@Shelly,

"It just proves there are absolutely no guarantees on SCOTUS appointments, which is doubly scary since they hold so much power over all of our lives. "

I beg to differ. The lefties ALWAYS get lefty justices. ALWAYS.

It's the Repubs that sometime get lucky and sometimes don't. I can't figure out how they manage to screw it up so badly when the Dems don't.

Paul said...

The bloody vomit doesn't last too long.

My insurance company gave me a personal call (a real person called!) in early September to tell me my policy was no longer offered in 2016.
I've been anxiously awaiting Nov 1 to 'shop'.
I tried shopping earlier, but for some strange reason no one was showing what is offered in 2016. They play their poker hand pretty damn close to the chest.
(I'm not on the 'exchange' -- as a retiree I make too much money - so I pay!)

Not looking forward to what I may find. I've had to suffer 25 - 30% annual rate increases the past 3 years. I take that back - last year it went up 29.96%. If it had gone up 18 cents per month more it would have been 30%.

Sortahwitte said...

Stilton. Don't be concerned about those cadaver type dogs. Just fence in the area and run about 20 hogs in there. In the folk stories of my part of Oklahoma, there is an interesting tall tale. Seems a certain fellow buried a whole car in a hole, covered it up and turned in the hogs. Of course, he was a professional and used a Cat track hoe. 27 feet deep.

Stilton Jarlsberg said...

@Boligat- You make a good point. Dems always appoint liberal justices, and Republicans tend to appoint justices who turn out to be liberal most of the time.

@Paul- I may be a little too free with using terms like the "exchange," as I pay for my health insurance too. But it's ALL Obamacare now - nothing else is legal. I'm counting on finding a new PPO plan on Nov 1 that will let my wife and I keep our doctors, but I'm now reading that there's no guarantee that there will be any PPO plans available in our area...and the likelihood is that there will be none nationally after 2016. (Insert obscenity of your choice here)

@Sortahwitte- I'm certainly not sanctioning what that guy did, but I have to admit an appreciation for professionalism.

Bruce Bleu said...

Stilton,
Rest assured that if lamont chooses your insurance it will be "Blue Crescent Panty Shield". Remember, the ONLY thing this "affirmative action" imbecile said was "above his pay grade" was ABORTION! (I still think he should arrange for Stanley Ann... well, we'll just leave that alone.)

Colby Muenster said...

Stilton,
I appreciate the tip on ColonoscopyAssist.com and will absolutely check that out for my next fun adventure.

And speaking of anal probing, how'd everyone like what the CNBC assholes got in return for their stupid-ass questions last night? I especially enjoyed the anti-media-bias responses from Cruz, Trump and Christie, but I think all of the candidates did well throwing some zingers towards the little leftie Hillary squad. Well, maybe not Kasich... Not entirely sure he was actually listening to anybody last night. Christie made Bush look like an idiot over the fantasy football thing. Not a big Christie fan, but that was hilarious.