The Dems/Libs Throwing Obama Under Bus!

[70Gtx]

[video=youtube;HbRd49chSxQ]http://www.youtube.com/watch?v=HbRd49chSxQ&feature=youtu.be[/video]

 

[MarPar]

bout freakin time

 

[Meep-Meep]

Hope that bus is big enough for the rest of his cronies. If not I'll help buy the second one.

 

[Sonny Black]

UnitedHealth Group Inc., UNH +0.60% the nation's largest provider of privately managed Medicare Advantage plans, has dropped thousands of doctors from its networks in recent weeks—spurring protest from lawmakers and physician groups and leaving many elderly patients unsure about whether they need to switch plans to keep seeing their doctors.

Doctors in at least 10 states have received termination letters, some citing "significant changes and pressures in the health-care environment." The notices also tell doctors they can appeal within 30 days. That means many physicians and patients won't know for sure who is in or out of UnitedHealth's Medicare Advantage networks before the open-enrollment period to switch Medicare plans ends on Dec. 7.

UnitedHealth said its provider networks are always changing and that it expects its Medicare Advantage network "to be 85% to 90% of its current size by the end of 2014," although it declined to say how many doctors are being cut in individual states or what criteria it is using.

The company said it is managing its network, in part, to provide more value for members, particularly given Medicare's new five-star rating system that ties bonus payments for insurers to certain measures of cost and quality.

"That's what's driving our actions," said Austin Pittman, president of UnitedHealth's networks. He also said, "It's no secret that we are under substantial funding pressure from the federal government."

UnitedHealth Group reported a third-quarter profit of $1.57 billion last month, but Chief Executive Stephen J. Hemsley has issued cautious outlooks for 2014, citing expected cuts in Medicare payments tied to the Affordable Care Act.




Letters to Doctors
A Sample Letter Sent to a Doctor
A Letter to a Doctor Explaining How to Appeal the Decision

Medicare Advantage, an alternative to traditional Medicare, combines hospital and doctor coverage and often includes prescription drugs and perks like gym memberships. Enrollment has more than doubled since 2004 to 13 million in 2012, which represents about 27% of Americans on Medicare.

The federal government pays private insurers a per-capita fee to manage the benefits. The rate is currently about 12% more than the average Medicare patient spends annually. The Obama administration plans to cut those extra payments to insurers by about $150 billion over the next 10 years to help pay for the health law. Some experts expect enrollment in Medicare Advantage plans to decline sharply if that occurs.

Other Medicare Advantage providers, including Humana Inc., Aetna Inc. and WellPoint Inc., said they are always evaluating their provider networks, but doctor groups say none appear to be shrinking them to the extent of UnitedHealth.

UnitedHealth is the biggest player, with nearly three million members in Advantage plans, many of them sold under the AARP brand. The company says it had over 350,000 doctors in its Advantage provider networks.







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Among the practices UnitedHealth has dropped are Moffitt Cancer Center in Tampa, Fla., and the Yale Medical Group in New Haven, Conn., which includes 1,200 faculty physicians.

"Instead of a scalpel, United is using a chain saw," said Michael Saffir, a rehabilitation specialist and president of the Connecticut State Medical Society, which estimates the insurer has cut 2,200 doctors across the state.

Two Connecticut county medical groups filed suit against UnitedHealth in U.S. District Court, alleging that the terminations violated contract provisions.

Several state attorneys general are investigating. Congressional delegations have complained about the company's timing and tactics to Medicare administrator Marilyn Tavenner, as did 43 national medical associations and 40 state medical societies in a joint letter on Nov. 6.

A spokeswoman for the Centers for Medicare and Medicaid Services said CMS is reviewing UnitedHealth's and other provider's networks "to ensure that beneficiaries have full, transparent and timely information and access to needed care."

"We recognize that change is hard," said Mr. Pittman. "This is about meeting the needs of patients in specific geographic areas, improving the quality and sustainability of our networks and deepening our relationships with providers over the long term." The company said it had no comment about the investigations.

AARP issued a statement saying it "has heard from a small number of our members regarding this decision" and was encouraging anyone with concerns to contact UnitedHealth directly.

Some terminated physicians predicted that UnitedHealth's patient satisfaction, a factor in Medicare quality ratings, would suffer with fewer doctors in the network.

"Fewer practitioners mean longer waits, longer drives, less convenience," said ophthalmologist Steven Thornquist of Trumbull, Conn., who said he is the only specialist in adult strabismus—which causes double vision—in a 20-mile radius.

"Patients battling cancer should be focused on their treatment, not on finding another doctor," said gynecological oncologist Johnathan Lancaster, one of more than 200 doctors dropped from UnitedHealth's network at Moffitt, which is a nationally recognized cancer center.

Dr. Lancaster said the cuts mean that about 2,500 current Moffitt patients will have to switch plans or find other cancer doctors—and that thousands more who come for consultations and second opinions can no longer use their UnitedHealth Medicare Advantage plans there.

A UnitedHealth spokesman said plan members could receive appropriate cancer care at other Tampa-area hospitals that remain in its network.

At least one axed practice has successfully appealed. After the only two doctors on Block Island, 10 miles off the Rhode Island coast, both received termination notices, their clinic complained that the 25 affected elderly patients would have to take a plane or a ferry to find in-network care.

Barbara Baldwin, executive director of the Block Island Medical Center, said a UnitedHealth official told her by phone that the practice would be reinstated. "But I still haven't gotten anything in writing," she said.

Depending on their plan, UnitedHealth Medicare members may be able to see terminated doctors if they pay an out-of-network fee or pay 100% of the cost themselves. They can also switch to a rival Advantage plan or to regular fee-for-service Medicare—if they do so by Dec. 7.

But many are reluctant to do either. Louise Pannulla, of Seymour, Conn., said both her ophthalmologist and her primary-care doctor were dropped, so she may switch to another plan. "I just hope that one doesn't change, too," she says. "At 90 years old, you don't want to change anything."
WSJ.

 

[Bruzilla]

Just to offer some context, Medicare Part C, AKA Medicare Advantage plans, came into existence because the government found that private insurers could process claims faster and cheaper than they could (big surprise eh?) It cost the government about 30 cents on the dollar to process a claim, while private insurers could do it for about 17 cents. So how Medicare C works is instead of having doctors send claims to Medicare for processing, they send them direct to the insurer, and in return the insurers are paid a set amount, $800, per member/per month, or $9,600 a year, and they must use that money to pay for claims. That is supplemented by whatever premiums they charge, usually $200 or so a month, for a total of about $12,000.

This meant claims could be processed quicker and cheaper, but also shifted the risk element to the insurers since if a member runs up less than $12,000 in bills, the insurer has a surplus, but if they run over $12,000, as many do, the insurer has to either make up that money from surpluses from other members or take money out of their overflow account they must maintain for that purpose. To optimize the use of the funds, the insurers optimize the use of in-network doctors who charge the best rates, provide the best benefits for people who receive care on an out-patient vice in-patient basis, etc. This is why Democrats have been targeting Medicare Advantage plans since they were enacted. While senior love them because they cover 100% of their expenses, with no co-pays or co-insurance, the Democrats hate them because the government doesn't get to hold and control that money that gets paid out as stipends. It doesn't matter that more work is being done quicker and for less money, or member benefits are much better, or even that the government is faced with less financial risk... all that matters to the Dems is that money goes to the insurers and they have no say over how it is spent and that drives them insane.

So since Obamacare pulled $500 billion out of Medicare Advantage, out-of-network doctors, in-patient only doctors, and the highest-charging doctors are no longer supportable and are getting the axe.

 

[Dako]

And what did Nancy Pelosi say?, "We need to sign it, to see what's in it." Who actually votes for people who think like that?

 

[rocky61201]

I just read this and felt the need to post it. It's been awhile since I've been on a college campus, but I'm bettng that the overwhelming majority are Obama supporters. Now i know a few people here will complain its from "FAUX" news. But is it true or not? Prove it ain't true to prove FOX is FAUX please.

This is probably my favorite paragraph of this article - "Students were paying so little before because the coverage they received was so scant. The costs have gone up because under ObamaCare, plans must offer coverage for services like annual checkups and alcohol abuse treatments. Because they offer a wider range of services, the premiums also increase."

So now, John or Jane Doe college student has to pay for alhohol abuse treatments even if they don't need it because their parents taught them right from wrong. Congrats, you got what you voted for and didn't read the fine print or read between the lines. I guess that critical thinking class didn't work for you, lol. Can we change your grade to "F" now.

http://www.foxnews.com/politics/2013/11/18/students-suffer-sticker-shock-from-obamacare/

 

[Bruzilla]

It gets worse. The lowest annual deductible for a plan that I've heard of yet is $7,500. How many young people run up medical bills of over $7,500 every year? Not many! So every dime they pay in will be wasted because they won't see any benefits aside from minor physicals and wellness checks until they pay $7,500 out of their pockets. Any private insurer that did this would be run out of business.

 

[Budnicks]

And what did Nancy Pelosi say?, "We need to sign it, to see what's in it." Who actually votes for people who think like that?

not me, some of the more stupid or lack of common sense type Kool Aid drinken' SF & Bay Area Liberals usually do thou... Libiots

 

[Coronet66JJ]

where are you getting this information ? is it factual or just propaganda?

 

[eric383]

I am neither a Republican or Democrat but consider myself a conservative. I really hate the government telling me I have to purchase health insurance or face a penalty. Whatever happened to free choice? Anytime the government gets involved in anything it will cost more, well isn't this just dandy. I really dislike politicians because most of them have their own agenda but I have to vote for the lesser of 2 evils. Just look at the Dems. jumping off the Obamacare band wagon because they are facing elections next year. I guess over 50% of the americans would like the government to take care of them instead of rolling up their sleeves and doing some hard work. Just my 2 cents worth and I will get off my soapbox now.

 

[Roadcuda]

And what did Nancy Pelosi say?, "We need to sign it, to see what's in it." Who actually votes for people who think like that?

Apparently way too many gullible ones!

 

[snakeoil24]

I will be happy when i see the skid marks on his face!

 

[Lowhound]

I don't know why you all seem to get upset when someone mentions this but........ Obama won the election, TWICE. Don't worry though Hillary will be in to help about 3 more years. Just stirring the pot fellows. LOL

 

[Dako]

I don't know why you all seem to get upset when someone mentions this but........ Obama won the election, TWICE. Don't worry though Hillary will be in to help about 3 more years. Just stirring the pot fellows. LOL

I'm concerned...that your Hillary statement could become reality. Like Nancy P, who could elect someone like Hillary? She abandoned Americans! I for one, will not forget Benghazi! Bring back Condoleezza Rice. I would vote for her to be President over any name being thrown around at this time!

 

[Bruzilla]

There was a story CNN was reporting about how a woman out west had emailed the White House saying how grateful and thankful she was that as a single mom she was going to be able to afford insurance for the first time ever, and Obama read her email at his "everything's just ducky" press conference. Then the woman finds out the software her state uses to calculate her "subsidy" was way off and she was told her subsidy would be reduced, then she got a letter saying it had been eliminated, and now she was so upset because she can't afford the insurance without using a subsidy.

What's not being reported in this story is this woman is like millions of Americans who think this mythical "subsidy" is some sort of discounted premium and it isn't. It's a tax credit, not a discount. They're thinking if they have a $300/month premium, and a $250/month tax credit, that they will only pay $50/month, and that's not what's going to happen. They are going to pay $300/month starting in January. They can claim their tax credit on next year's tax return and reduce their taxes owed by $3,000, but they're going to be paying $300/month starting in January, not the $50 they expect. So if this woman couldn't afford to pay $300/month with no subsidies, she wouldn't be able to afford that premium with subsidies now because it would also be $300.

What's worse is the people who do qualify for subsidies are people who also don't pay a lot of income tax. A tax credit is only valuable if you pay more in taxes than the credit it for. If you owe $4,000 in taxes, and have a $3,000 tax credit, you lower the amount you pay the government to $1,000. But if you're poor and pay $400 - $600 or so in taxes, that tax credit only nets you $400 - $600, which isn't much subsidizing after paying $3,600 in premiums. These fools are thinking they're getting subsidized and they are in for a very rude shock in a few months.

 

[wahya]

It gets worse. The lowest annual deductible for a plan that I've heard of yet is $7,500. How many young people run up medical bills of over $7,500 every year? Not many! So every dime they pay in will be wasted because they won't see any benefits aside from minor physicals and wellness checks until they pay $7,500 out of their pockets. Any private insurer that did this would be run out of business.

Ok, I'm not here to defend Obama care, but I have to disagree. You live in Florida. Do you pay for hurricane insurance? Premiums go up by the hundreds of dollars every year, whether you have a claim or not. If you don't ever get hit, all those years of premiums go where? Car insurance premiums are expensive too. You may get a discount to be accident free, but your still paying. Insurance companies are not in business to be fair, they make money, the more taken in and the less out the better. btw that policy that was $7500, was that a private company. The only real winner in this mess is the insurance companies.

 

[Budnicks]

I don't know why you all seem to get upset when someone mentions this but........ Obama won the election, TWICE. Don't worry though Hillary will be in to help about 3 more years. Just stirring the pot fellows. LOL

yeah right

 

[cudaus1]

And what did Nancy Pelosi say?, "We need to sign it, to see what's in it." Who actually votes for people who think like that?

Obviously too many people!

 

[Budnicks]

a complete & utter failure

his base is turning on him now, finally see some of the many lies that have been perpetrated on the USA tax payers, the ones that actually "even pay any income taxes", not all the freeloaders that love the socialist healthcare system, it's just legal extortion, called insurance un-Affordable Care Act/Obamacare it's a TAX... Insurance isn't heathcare or a doctor, people don't seem to get that...