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Nick Janes wrote:Man’s Back Surgery On Hold As Doctors Deny Covered California Coverage
SONORA (CBS13) — A Sonora mechanic is in so much pain that he can barely walk, but he can’t seem to find a doctor to fix his ailing back after he and his wife switched their insurance coverage through Covered California.
Chris Dunn reached out to CBS13 hoping we could get answers.
He needs his surgery yesterday. But instead of scheduling his date, he and his wife are navigating a confusing maze of doctors and insurance plans.
“Then it goes down, my feet are numb, like I can do this, and I can’t feel it at all,” he said.
His ailing back has him in almost constant agonizing pain. He walks with a limp and hasn’t had a good night’s sleep in months.
“I can’t sleep on my back,” he said. “I roll around all night, because I can’t lay flat. I can’t lay anywhere for more than five, 10 minutes.”
He’s still working, despite the pain. But finding a surgeon to fix his back has turned into a full-time job of its own.
“We get this coverage and go to the best doctor to fix Chris, and they tell us we’re out of network,” said his wife Tammy.
In January, they transitioned from an Anthem Blue Cross Plan over to Blue Cross Covered California. She says they had to switch to avoid the premium skyrocketing, but didn’t realize their provider network would be smaller.
We took their concerns to Covered California’s Dana Howard to get answers.
“A lot of people, this is the first time they’re purchasing insurance,” he said.
For privacy reasons, he couldn’t comment on the specific case, but said in general that consumers should do their research before purchasing plans.
“I would suggest they contact the plan to make sure what doctors are available to them,” he said.
Tammy says she finally found an in-network doctor, but the problems don’t end there. We looked him up using the couple’s plan info, and the Blue Cross website shows him as in-network.
But that same doctor’s officer told Tammy he won’t see patients with insurance from Covered California.
“It’s like we’re a second-class citizen,” she said. “We can’t get the coverage we need.”
For Chris, it’s another stop in a long road to the surgery he needs.
“To this point where it feels like I’m going to be in pain,” he said. “I can’t find nobody to do it.”
CBS13 wasn’t able to reach the doctor tonight, and a late-hour contact with Blue Cross didn’t get to the bottom of it, so we’re still pushing for answers.
This message was edited 1 time. Last update was at 2014/02/20 05:41:57
How 'bout that for "the law of the land"? Another satisfied Obamacare customer. This story is almost a carbon of a friend of mine that sheet rocked all his life. His back went out on him and he can't get any help with Obamacare either.
"True, plenty of the reports come from mainstream media. Thanks for the clarification"
"yeah, that adjective shouldn't have been there"
"My use of 'conservative' was wrong. Completely wrong. Zippidy doo dah wrong a wrong wrong wrong. Wrong."
And you still go on about it. fething pathetic. I mean, I didn't expect anyone to actually, you know, spend any time thinking about my comments on an echo chamber... but to be so transparently dishonest about it... wow.
“We may observe that the government in a civilized country is much more expensive than in a barbarous one; and when we say that one government is more expensive than another, it is the same as if we said that that one country is farther advanced in improvement than another. To say that the government is expensive and the people not oppressed is to say that the people are rich.”
Adam Smith, who must have been some kind of leftie or something.
Or you could just accept the fact that after such a blatantly erroneous statement that people are going to rip on you for a bit. I just took Breotan's post to be tongue in cheek.
Why not try engaging with the article that was posted instead of more "echo chamber" accusations?
Dreadclaw69 wrote: Or you could just accept the fact that after such a blatantly erroneous statement that people are going to rip on you for a bit.
'Blatantly erroneous'... because I used one adjective that I shouldn't have. The entire rest of my post, including all of it's meaningful content, was not addressed in any meaningful way. Instead you just try and ignore it by picking up on one poorly chosen adjective.
And of course you're going to try and rip in to me for a bit, because I'm the only one of a couple of people who can still be bothered talking with you guys about this. So you pick one single poorly chosen adjective and keep fething going on about it over and over again.
I mean, is there no thought just in the back of your mind, just quietly suggesting 'ah, I think we're being a bit ignorant here'? Nothing? Not even a hint?
Why not try engaging with the article that was posted instead of more "echo chamber" accusations?
Engage with what? A man has insurance, and is finding it difficult to find a doctor for his surgery, and while an in-network doctor has been found he isn't covering this guy's specific plan for reasons we aren't told. What's the story? Other than continuing a fuzzy brain idea of 'oh that ACA it's just like I always thought it would be'... where's the content here?
This message was edited 1 time. Last update was at 2014/02/20 09:06:27
“We may observe that the government in a civilized country is much more expensive than in a barbarous one; and when we say that one government is more expensive than another, it is the same as if we said that that one country is farther advanced in improvement than another. To say that the government is expensive and the people not oppressed is to say that the people are rich.”
Adam Smith, who must have been some kind of leftie or something.
Seriously Seb, if you think we're picking on you then you need to grow a thicker skin. As I said before, I just took it as tongue in cheek ripping on you. You took it as further proof of an echo chamber.
Engage with the story showing the mess that the ACA has made in some instances with insurances being cancelled, people being pushed onto other plans, providers not knowing what they can accept, no one being able to find out the correct information, etc. This isn't the first one of these stories posted in this thread. Sadly I don't think it'll be the last either.
This message was edited 1 time. Last update was at 2014/02/20 16:52:29
MICHAEL GRAHAM: Barack Obama, in his sixth year, are there any other presidents who were in similar positions where they had a key policy that was collapsing beneath their feet and taking their party down with them. Has this happened in the past that you can think of?
MICHAEL BARONE: Well, I think a lot of Democrats would say, and I think they may very well be right, that this is George W. Bush in Iraq. An ambitious policy that was entered onto with great hopes, that was not attended to with sufficient care and willingness to change tactics, and at this point in 2006, things looked pretty bad there for the president, and -- though Karl Rove and I were late to pick up on it -- for his party.
This Wednesday, my little sister, Julie, will be buried. She died because she delayed seeking health care for what turned out to be a catastrophic condition after her private health insurance policy was cancelled because of Obamacare. As she waited for a new Obamacare-approved policy to kick in, her condition deteriorated to the point that it was too late.
Julie, her husband, and four children were covered by a medical plan they liked, and had been promised they could keep by President Obama. But like so many others in this country, her family’s private health care policy was cancelled because of the Affordable Care Act. So my sister and her family struggled through the expensive and incompetently designed Obamacare website to find a new policy. Unfortunately, while they waited for their new Obama-approved healthcare plan to finally kick in, my little sister fell ill. She couldn’t keep down solid food. She should have gone to a doctor. But she toughed it out, as many people do, until her new coverage would kick in on February 2. She and her husband didn’t have a lot of money, so she didn’t want to incur what she thought were avoidable medical expenses.
But she didn’t make it. It turns out that, unbeknownst to her, she wasn’t suffering from an upset stomach or food poisoning, but a badly blocked gall bladder that had become highly infected. Her body went into septic shock just two days before her Obamacare policy would have kicked in. Her kidneys shut down. She went to the emergency room where, after heroic efforts, a marvelous medical team managed to stabilize her condition. I saw Julie that day for several hours. She could not move, or speak, but a tear trickled down her check when she saw the eldest daughter of her four children. After I left, hoping for the best, I learned the next day that her gentle heart stopped beating around 4:00 a.m.
So, while the White House sends out talking points to the talking heads who proclaim Americans will be better off because Obamacare forced them off of inadequate health care plans, my family knows better.
There are plenty of arguments against Obamacare. Sure, it was drafted behind back doors and passed in a crude, and utterly partisan, fashion. Yes, Nancy Pelosi famously said we had to pass it to see what was in it. And the bill was applied in a crony capitalist fashion, with corporate allies of the President receiving waivers. Then we had the series of backtracking and outright falsehoods—like the infamous “you can keep your plan if you like it” claim uttered by President Obama and repeated by his political and media allies.
Obamacare has also inflicted job losses, higher cost plans, and a shift from full-time to part time employment. Even when factoring in all this the economic damage and the harm it has done to working Americans, the most disturbing aspect of Obamacare is that this real world hardship is inflicted because it treats living breathing people as actuarial statistics in the service of giant insurance pools, rather than as the individuals they are. It is highly ironic that this Administration that talks so much about protecting “choice” in so many areas of American life, yet is harshly shutting down individual choice and initiative in such a personal matter of personal healthcare.
The public debate about Obamacare will continue for a long time. But for my family, the debate ended with the death of my sister.
dogma wrote: Actually I suspect that poverty and stupidity killed his sister.
...
Really?
Gallstones (what I assume she had) don't magically appear, and there are almost always symptoms which precede the really catastrophic ones: like constant nausea. She almost certainly should have been to a doctor long before the exchanges came on line.
This message was edited 2 times. Last update was at 2014/02/21 02:58:27
Life does not cease to be funny when people die any more than it ceases to be serious when people laugh.
dogma wrote: Actually I suspect that poverty and stupidity killed his sister.
...
Really?
Gallstones (what I assume she had) don't magically appear, and there are almost always symptoms which precede the really catastrophic ones: like constant nausea. She almost certainly should have been to a doctor long before the exchanges came on line.
Ok, so you insult the dead, based on an assumption? Classy dude.
Dreadclaw69 wrote: Seriously Seb, if you think we're picking on you then you need to grow a thicker skin. As I said before, I just took it as tongue in cheek ripping on you. You took it as further proof of an echo chamber.
I don't think you understand how jokes work. For instance, there's been a lot of cases of people being put in to the national spotlight when they claimed their premiums were skyrocketing, only for a journalist to do some legwork and find that if these people went and looked at what the market was offering they could get equivalent coverage for much less. On leftwing echo chambers you'll see these people mocked, even months after their story came out.
And those people will call those jokes, and if you were to challenge them on it they'd say 'it's just a joke' same as you're trying here. But it isn't actually a joke, it doesn't contain any of the things that an actual joke contains like surprise, a twist or anything like that. It's just a reference to a thing, ha ha ha.
Why those people in those left wing echo chambers actually like those 'jokes' isn't because they make them laugh, but just because they help them to confirm the self-satisfaction they feel with their own position, 'oh yes, that time when we showed the other side was wrong, ha ha ha.'
Engage with the story showing the mess that the ACA has made in some instances with insurances being cancelled, people being pushed onto other plans, providers not knowing what they can accept, no one being able to find out the correct information, etc. This isn't the first one of these stories posted in this thread. Sadly I don't think it'll be the last either.
How do you think reform works? What part of your brain made you think everything would stay the same? Obama's claim that people could keep their plans was terrible, both politically foolish and a just plain morally wrong lie. But the weird nonsense that's that has led to on the right wing, where people are now pretending to be outraged that a system wide reform actually led to change for individuals... well that's just fething silly.
And once we accept that, well fething duh people won't have everything exactly like they used to have it... then we actually have to start to think about a sensible means of measuring the impacts of ACA. Actually looking at how many people are covered that weren't covered before, and what the real changes in people's overall coverage are, and what is actually covered in those new plans compared to what was previously covered. That's how you build a framework for getting an actual understanding of the issue.
And one excellent starting point for that would have been to read the CBO report, but hardly anyone read it... instead one side deliberately misread a single component, and everyone argued about that, and no-one learned a damn thing about how ACA is actually changing things on the whole.
“We may observe that the government in a civilized country is much more expensive than in a barbarous one; and when we say that one government is more expensive than another, it is the same as if we said that that one country is farther advanced in improvement than another. To say that the government is expensive and the people not oppressed is to say that the people are rich.”
Adam Smith, who must have been some kind of leftie or something.
Sebster, for someone who didn't want a discussion you sure seem pretty invested in one.
Clearly you are setting out to be offended by a quip poking some harmless fun at your own terrible phrasing, while you were in a rush to discredit sources highlighting some of the many negative aspects of the ACA since it (sorta, almost, lots of kicking-into-post-election) came into force. So, rather than try to reason with you - because we've seen how that works - I'm just going to tell you to take as much offense as you want. It is free. Fill your boots. Go wild.
What made me think things would stay the same? I don't recall saying that they would. The problem is that the POTUS did. Many times. During an election. And his comments were about his signature legislation. As the person who owns it, and who's party alone supported it, that may give many who placed their hope in him a certain legitimate expectation that their plans would not be cancelled because of his legislation. If you cannot see why his supporters would be upset by that (and why many Democrats in less safe seats are distancing themselves from the ACA as best as they can) then I do not know what else I can say to you that will get past your ideological blinkers.
And for the rest of your post I would just say that it in no way changes anything that we have not touched on before. As I have already said, in the event that the ACA starts making more positive impact than negative I will reassess my position then. For now I am basing my opinions on the facts as they stand, not what they may be. When/if the facts and evidence change then I will revisit my position.
As for someone else's comments; simply beyond contempt. I do not ignore people lightly, but in this decision I feel absolutely vindicated.
This message was edited 2 times. Last update was at 2014/02/21 21:51:43
"True, plenty of the reports come from mainstream media. Thanks for the clarification"
"yeah, that adjective shouldn't have been there"
"My use of 'conservative' was wrong. Completely wrong. Zippidy doo dah wrong a wrong wrong wrong. Wrong."
And you still go on about it. fething pathetic. I mean, I didn't expect anyone to actually, you know, spend any time thinking about my comments on an echo chamber... but to be so transparently dishonest about it... wow.
I doubt that was about you. You're far from the only person who posts on this board to indicate that you believed all negative Obamacare news to be conservative propaganda. Hell, dogma's still going around insisting the president never said, "if you like your plan, you can keep it."
dogma wrote: Actually I suspect that poverty and stupidity killed his sister.
Julie, her husband, and four children were covered by a medical plan they liked, and had been promised they could keep by President Obama. But like so many others in this country, her family’s private health care policy was cancelled because of the Affordable Care Act. So my sister and her family struggled through the expensive and incompetently designed Obamacare website to find a new policy. Unfortunately, while they waited for their new Obama-approved healthcare plan to finally kick in, my little sister fell ill.
No mentioning however of WHEN her plan was cancelled and WHEN she had found a suitable replacement however.
"So, do please come along when we're promoting something new and need photos for the facebook page or to send to our regional manager, do please engage in our gaming when we're pushing something specific hard and need to get the little kiddies drifting past to want to come in an see what all the fuss is about. But otherwise, stay the feth out, you smelly, antisocial bastards, because we're scared you are going to say something that goes against our mantra of absolute devotion to the corporate motherland and we actually perceive any of you who've been gaming more than a year to be a hostile entity as you've been exposed to the internet and 'dangerous ideas'. " - MeanGreenStompa
"Then someone mentions Infinity and everyone ignores it because no one really plays it." - nkelsch
I doubt that was about you. You're far from the only person who posts on this board to indicate that you believed all negative Obamacare news to be conservative propaganda. Hell, dogma's still going around insisting the president never said, "if you like your plan, you can keep it."
I am?
I mean hell, that wasn't even the argument I was making. I was arguing that he made the statement, and that it wasn't a lie.
Did anyone who's deciphered this piece of burning stool notice any other way for the Admin to get their penalty funding besides just taking a tax refund. This whole thing seems propped up by the idea that fines will fund it, but if I'm technically owed a refund and know it will all go to ACA penalty then why would I file? If there's no recourse then we as Americans could theoretically defund it by just not filing taxes.
Study: Uninsured Patients Get Better Care Than Insured
WASHINGTON (CBSDC) – According to a recent study, severely injured patients are less likely to be transferred to a trauma center if they have health insurance.
Researchers from the Stanford University of Medicine found that patients with insurance are less likely to get the best care than those who do not have insurance. They found that insured patients taken to non-trauma hospitals were 13 to 15 percent less likely to be transferred to trauma centers than uninsured ones.
“Insured patients may, ironically, get worse outcomes because they are taken care of at a center where there’s a lower volume of resource for critically injured patients,” Dr. M. Kit Delgado, a former Stanford emergency medicine instructor, and the study’s lead author said in a press release obtained by HealthDay News.
Researchers analyzed data of more than 4,500 patients who were critically injured at 636 hospital emergency rooms across the country.
“We hypothesize that non-trauma center hospitals are more likely to want to admit insured patients presumably because they can get reimbursed for their services,” Delgado, who is now an emergency care research scholar at the University of Pennsylvania, added in the press release.
Shootings and traffic accidents are the most common causes of death in this county among people under 44-years-old. Previous research has shown that severely injured patients are 2 percent less likely to die if treated at a top-ranked trauma center than at a non-trauma center.
“Finding disparities in quality of trauma care based on insurance is very disturbing,” Dr. Nancy Wang, an associate professor of emergency medicine at Stanford, said in the press release. “It is important for researchers to identify and call attention to these disparities in access to care and outcomes so that all people can receive the appropriate, high-quality care, regardless of their insurance status,” Wang added.
The study was published online in the journal JAMA Surgery.
This message was edited 1 time. Last update was at 2014/02/22 18:07:20
Sheila Lawless is the office manager at a small rheumatology practice in Wichita Falls, Texas, about two hours outside of Dallas. She makes sure everything in the office runs smoothly — scheduling patients, collecting payments, keeping the lights on. Recently she added another duty — incorporating the trickle of patients with insurance plans purchased on the new Affordable Care Act exchanges.
. . . It’s presented a major challenge: verifying that these patients have insurance. Each exchange patient has required the practice to spend an hour or more on the phone with the insurance company. “We’ve been on hold for an hour, an hour and 20, an hour and 45, been disconnected, have to call back again and repeat the process,” she explains. Those sorts of hold times add up fast.
A big issue is whether the patients have actually paid their first month’s premium; the New York Times reported earlier this month that “one in five people who signed up for health insurance under the new health care law failed to pay their premiums on time and therefore did not receive coverage in January,” citing insurance companies and industry experts.
In Illinois, workers’ hours are dropping dramatically — almost as if a new law had given employers a major incentive to have employees working less than 30 hours a week!
In fact, average work hours increased slightly in two of these sectors between 2008 and 2010. But all three sectors (retail trade, food and beverage, and general merchandise) saw dramatic reductions in average work hours after ObamaCare was enacted.
Illinois is far from a unique example. This disturbing trend is becoming more apparent nationally, as well.
Retail employment, which makes up almost one-tenth of the nation’s total nonfarm employment, is seeing similar reductions. In 12 of the 14 states including Illinois where average weekly hours worked are available, non-supervisor workers in the retail trade showed average annual declines in hours worked between 2011 and 2013. In fact, six states saw average hours worked fall to 30 hours or below for that sector.
In Hawaii, the state has spent roughly $27,000 per enrollment.
Yet four months after enrollments began, the Hawaii Health Connector has allocated $120 million while signing up only about 4,300 people for health plans — fewer than any other state. Despite officials’ initial hopes of enrolling tens of thousands of Hawaiians, only 400 employers have applied for plans for their employees.
Maryland looks on in envy at a barely used state exchange that generally works:
Maryland has fired the contractor that built its expensive online health insurance marketplace, which has so many structural defects that officials say the state might have to abandon all or parts of the system.
The Maryland Health Benefit Exchange voted late Sunday to terminate its $193 million contract with Noridian Healthcare Solutions.
But perhaps Maryland’s mess looks good compared to Oregon, where the accusations of lying are piling up:
Carolyn Lawson, the IT expert who tried and failed to build Oregon’s online insurance exchange, complained to an Oregon Health Authority official that she was forced to leave under false pretenses in an email uncovered by the On Your Side Investigators.
Lawson emailed OHA chief operating officer Suzanne Hoffman in January to complain that a reporter had been given her personal cell phone number, and asked that the state “allow me to move on with privacy and grace,” after one of the worst health-care-exchange website launches in the nation left her career in tatters. “I have done everything I have been asked to do,” Lawson wrote. “I stuck to the talking points even though I protested . . . that they were not accurate. I walked away quietly when asked to resign. I wrote the resignation letter per the script I was given.”
KATU Investigators recently uncovered major accountability issues on Lawson’s watch, and former Republican state representative Patrick Sheehan told KATU earlier this month that he’d gone to the FBI with allegations Cover Oregon project managers initiated the design of dummy web pages to convince the federal government the project was further along than it actually was.
Sure, most Americans say the law hasn’t affected their lives yet. But among those who have, more say the impact is negative:
While most Americans (54 percent) continue to say they haven’t been impacted by the law one way or another, the share saying they’ve been negatively affected has inched up in recent months (29 percent in February, up from 23 percent last October) and continues to outpace the share saying they’ve personally benefited from the law (17 percent).
And evidence continues to mount that the uninsured have a remarkably resilient capacity to tune out news, information, and details of a massive, complicated piece of legislation that overhauled the entire health-care system in the name of helping them get insurance:
The vast majority of uninsured Americans do not know they must sign up for health insurance by March 31 or pay a fine, according to a new poll.
The Kaiser Family Foundation (KFF), in its monthly tracking survey, found that 76 percent of the uninsured are not aware of the looming sign-up deadline.
The vast majority of uninsured Americans do not know they must sign up for health insurance by March 31 or pay a fine, according to a new poll.
The Kaiser Family Foundation (KFF), in its monthly tracking survey, found that 76 percent of the uninsured are not aware of the looming sign-up deadline. Only 24 percent could name the date correctly.
The finding underscores the serious challenge facing the Obama administration as it seeks to sign up millions more patients for private plans by the end of next month.
The public has always had a weak grasp of ObamaCare’s provisions, but the administration’s tendency to shift deadlines has added to confusion about when patients must act to gain coverage.
Nearly two-thirds of the uninsured said they know only a little (37 percent) or nothing at all (26 percent) about the new marketplaces designed to make it easier to shop for health plans.
Perceptions of the Affordable Care Act have been trending negative among people without health insurance since February. Tuesday’s poll found that 56 percent now view the law unfavorably while 22 percent view it favorably.
The vast majority of uninsured Americans do not know they must sign up for health insurance by March 31 or pay a fine, according to a new poll.
The Kaiser Family Foundation (KFF), in its monthly tracking survey, found that 76 percent of the uninsured are not aware of the looming sign-up deadline. Only 24 percent could name the date correctly.
The finding underscores the serious challenge facing the Obama administration as it seeks to sign up millions more patients for private plans by the end of next month.
The public has always had a weak grasp of ObamaCare’s provisions, but the administration’s tendency to shift deadlines has added to confusion about when patients must act to gain coverage.
Nearly two-thirds of the uninsured said they know only a little (37 percent) or nothing at all (26 percent) about the new marketplaces designed to make it easier to shop for health plans.
Perceptions of the Affordable Care Act have been trending negative among people without health insurance since February. Tuesday’s poll found that 56 percent now view the law unfavorably while 22 percent view it favorably.
Hey, it's still better than congress' ! Isn't congress' approval rating at 5-10% or something?
Homosexuality is the #1 cause of gay marriage.
kronk wrote: Every pizza is a personal sized pizza if you try hard enough and believe in yourself.
sebster wrote: Yes, indeed. What a terrible piece of cultural imperialism it is for me to say that a country shouldn't murder its own citizens
BaronIveagh wrote: Basically they went from a carrot and stick to a smaller carrot and flanged mace.