SCOTUS Upholds Affordable Care Act!

edot

Well, actually if you want to build a new hospital, you have to show that the hospital is needed and that it meets certain requirements. For example, you have to have enough staff to work in the hospital.  It's been 5 years since I've worked in the US, so I'm a little hazy on the details. The requirements vary by state, but I used to live in Chapel Hill, NC (right down the road from Duke).

 Anyway, to build a new facility or add an operating room, or other big capital expense, in some states (like NC) you have to complete what is called a "certificate of need" or CON. I used to contribute to demographic analyses to justify new facilities in another life. Anyway, in North Carolina, for example, they look at demographic growth, how and where demographics are changing, and the sort of procedures people are having, procedures that facilities want to implement. The state says, ok, we will allow 3 new operating rooms in this area, another PET scanner here, etc etc. And health care systems submit a CON describing what they'll provide and how they'll fund it. When you want to add beds, the state gets involved because they do dictate the number of beds certified - and again, it's based on demographics, available staff, economics, etc. Usually in order to build this stuff, institutions have to be able to fund it, and if it's a public institution, a bond is issued. Sometimes though it gets to be a pissing match between behemoth systems. I believe that the state is involved also, because even though a facility might be private (Duke is a private university), there are public funds involved. And while you want to have enough beds to treat patients, you don't want too many empty beds either. 

Another problem in the US - because it is so diverse and large. There are populated areas where there are lots of facilites, universities, medical centers, and then there are less populated,  rural areas with either community hospitals, or no hospitals. There may be few primary care docs, and fewer specialists  because young physicians with young families want to be near culture and good schools - and those are in the population centers. Not sure how ACA will address this, but delivery of health care in these rural areas is a problem now, and will continue to be one. 

Momine

Edot, thanks for explaining. I can see why this sort of regulation might be warranted. I still don't see it as being necessarily problematic. The way it was presented, I thought government was scheming to leave people without hospitals. ON theother hand, It can obviously also create problems in some cases.

Wabbit

PatMom ... I was replying to the fact that you pointed straight at and even quoted lassie's comment and called it a "very dramatic , but inaccurate statement".  If you were intending to point elsewhere ... or meant to qualify it based on something else somebody else said ... then it seems we agree that lassie's statement is accurate afterall.

edot ... excellent explanation.   

alexandria58

I was going to defend my statement to Patmom, but the rest of you did it for me.

As for the anti-Christian remarks, I don't remember what exactly was said, but let me ask: what would Jesus think about universal health care?  Would Jesus, who said that it's easier for a camel to pass through the eye of a needle than a rich man to reach heaven,  who spent his ministry caring for the poor and the sick, have sided with those who don't want to have universal health care because they might have to pay something to help those less fortunate?   I am not a Christian, but I've read the Gospels, and I deeply respect the teachings.   I do think there is sometimes an incongruity between those who profess love and reverence for Jesus but do not follow his teaching or his example.  I root for the nuns, not Paul Ryan.   I think that may have been the gist of what ever post was said that reflected on Christianity - not on the religion, not on the teachings, but on those who claim to be Christian but fight against providing for the uninsured, the uninsurable, or the poor.

1Athena1

I am certain that Jesus would support the ACA - he would say it is far from enough, but better than what we have. I am also certain that he would defend access to health care as a universal human right. I am an atheist and do not believe in Jesus as the son of God, but I do believe in Jesus as a great man.

pupmom

Alexandria, it's the hypocrisy that gets to me. I feel that there is often a double standard for the haves and have nots among fundamentalists of every religion. They often preach one thing and behave in a totally different way, which suits THEIR interests. And yes, I believe Jesus would be 100% in favor of universal health care.

Momine

Alexandria, my husband is a Christian and life-long conservative. He is in favor of some sort of universal health coverage, in no small measure because of his faith.



As I am typing this, he is yelling at some big poo-bah in the church to do something for the Christians being slaughtered and persecuted in Syria.

bluedahlia

Exactly!!!!!!!!!!!!!!!  Anti abortion just to bring attention to themselves as being good Christians.  I don't for one minute fall for that act.  They have shown their true colours in their greed, bigotry and hatefulness.  I know athiests that are more Christian than so called Christians.  

alexandria58

Well, actually, I agree that hypocrisy exists in every religion, unfortunately, often the haves using it to deny the have-nots.  But not always. 

For the record, I was raised Jewish but am pretty much agnostic - or as Woody Allen would say, I'm Jewish with an explanation.

Momine

Blue, the Greeks have a wonderful concept called "divine economy." When my husband was trying to explain it, he gave an example. Medical services are limited in many of the islands, so typically women who needed an abortion would travel to Athens to have it done. Possibly also to keep the fellow villagers out of their business.



The church opposes abortion naturally, but, according to divine economy, that does not mean that the church should not extend help and succor to women who had abortions. As a result, the church operated (maybe It still does) hostels where women could stay and recuperate before returning home.

alexandria58

Momine: good for your husband.  I do admire people who actually follow the teaching of Jesus. And someone should stop what is happening in Syria.

gardengumby

Responding to something that's now back about three pages.... 

For the record - how quickly you get mammogram results - or for that matter any test results - how the surgery is performed in regards to clear margins, etc.  does not generally have anything at all to do with your insurance company - it has to do with the doctor and or medical team/hospital you choose.  What doctor and medical team you choose may be influenced by your insurance company (in plan or out).

I (for example) did not change insurance plans, but I did change medical providers.  I went from waiting for a week (or significantly more) for test/lab results, to getting the results the same day.  Both medical providers were in-plan for me - one of them just provided significantly better service.

pupmom

Alexandria, I love the "Jewish with an explanation" statement. Describes my agnostic, Jewish born husband, and his tolerance for his New Age Christian wife! 

kira1234

I would say in most ways I am right down the middle in my views, but will say this issue touches my life daily. My DD has no insurance at her job, and can't afford to pay for it herself, but she also doesn't qualify for medicaid. She had insurance before the economy went sour, but her boss just can't afford to pay for it now. She is one of the many that this insurance would cover.

bluedahlia

Well I'm Catholic with an explanation!  Love it!

QuinnCat

gardengumby - I went over 3 months between my first screening mammogram showing BC and my BMX.  First came doctor's vacations, delaying feedback on need for diagnostics tests and results (with no backup on my doctor's part), then Thanksgiving, BRCA positive test causing rescheduling, Xmas to New Year's (hardly anyone works), and then finally surgery in late January.

This being my first major illness, I hadn't given much thought to the "December January effect."   Deductibles and Catastrophhic limits rolling over, HSAs and FSAs, making it even more difficult to schedule something in December, or the other side, people waiting til January to get all of their expenses in the same year.  

1Athena1

I'm an atheist, shameless.

Anonymous

well, as long as we're quoting Woody Allen, it feels safe to post something - anybody remember reading his early books?

When he was supposedly being asked if he believed in an afterlife?  And he answered: "I'm not sure, but I'll bring along a change of underwear just in case."

On subject:  I LOVE that the WH is now referring to ObamaCares.  Love It.  Also all of Yorkiemom's posts... outa here b4 the fighting starts again...

Moderators

Hey Folks,

Let's stop it here. We see that the conversation has taken a turn toward the issues that are not reconcilable. Shall we close this topic?

The Mods

Moderators

Hey Folks,

Let's stop it here. We see that the conversation has taken a turn toward the issues that are not reconcilable. Shall we close this topic?

The Mods

gardengumby

Kam - I understand and agree with the total frustration over delays, I'm just saying that it isn't only or even necessarily due to insurance.  In the case of HMO's - yup - it's insurance.  But if you have a PPO plan (which I do after have a few disasters with an HMO) then usually the hold-up isn't insurance, it's the medical provider.

I'll also go on the record to say that probably "most" people in the United States do have insurance.  I just don't think "most" is nearly enough.  I also don't think insurance should be tied to your employer.  The part of the ACA I like the most is the fact that pre-existing conditions simply don't matter any more.  That's GREAT for the individual.  Now if you hate your job, you get to leave it.  If you've been laid-off you can get insurance.  That's really marvelous for so very many people.

The other problem with tying health insurance to employment is the fact that it is a huge expense for employers. If we want an increase in jobs in this country and want to be competitive with other nations, then we need to consider the whole package, and health care is part of that package.  That is one of the many reasons I so badly wanted the single payer option as part of the plan.

Moderators

Thanks Gardengumby for bringing this back on topic. We sincerely appreciate your post. 

QuinnCat

Agreed - delays, in my case, were not caused by insurance, but the medical system and holidays.  If I have one complaint, it is this calendar year stuff.  I know some people's start date for accumulating deductibles and out-of-pocket expenses are arbitrarily set, but mine has always been January 1, as well as the millions of other federal employees.  It does appear to create a bottleneck at the end of the year.  Why can't insurance companies let us set that date?   I can even see where this date might influence one to delay treatment.

Chickadee

Perry might just make Herbert Hoover look good. We have advised our son that when we are gone he needs to move from here. Without our insurance to protect him the services and care available for someone mentally disabled is pitiful even now and Perry has said repeatedly he will cut more.

gardengumby

Kam - I'm on a January 1 start date as well.  To be honest, I never really thought at all about the out of pocket expenses, or I probably would have delayed my MX another 2 weeks.  I had surgery on 12/22....  .  I had things other than money on my mind at the time....

I can see why insurance companies wouldn't want everyone having a different date, though.  It would get awfully confusing - and insurance companies REALLY don't do well when something is confusing....  which is why I'm fighting with them right now due to my DIEP stage II surgery....

Mardibra

"Exactly!!!!!!!!!!!!!!!  Anti abortion just to bring attention to themselves as being good Christians.  I don't for one minute fall for that act.  They have shown their true colours in their greed, bigotry and hatefulness.  I know athiests that are more Christian than so called Christians.".



So, the fact that I don't believe in abortion is an act? I'm not greedy, I'm not a bigot, and I don't have hate in my heart. You however, clearly have some harsh feelings for Christians. What we Jesus say about that?



Talk about a controversial thread. Politics and religion. Hmmm.

bluedahlia

I'm not getting into this with you.  You make no sense to me and that is MY opinion.  Hypocracy at its best!  BTW I don't believe in abortion either but I also care about the person that child becomes and that person does have a right to affordable healthcare.

OH and please direct me to the post where I referred to anyone specifically.  Oh Yeah, you can't.

ananda8

These are controversial times.  It started in the 1960's and will most likely last for another 20-30 years.  Dramatic change as we have had with controversial wars, boom bust economy, expansion of civil rights, to say nothing of almost doubling our population in less than 60 years always cause tremendous strife. Conflict in religion and politics is just a reflection of this dynamic change.

I don't believe we should be afraid of this conflict because through these discussions we actually move closer together.  I know that's odd to say but I agree with some Tea Party beliefs, some Libertarian opinions, and many liberal opinions.  I think most all of us have a mixture of political beliefs as well as spiritual beliefs and disbelief.  Just read the PEW Forum US Religious Landscape Survey that is a snapshot of religious and political beliefs of America in 2008. http://religions.pewforum.org/reports

Opinions on abortion, gay marriage and other issues have changed dramatically even in the short time since 2008 and today. IMHO, the internet has accelerated change and is being instramental in beginning to build a new consesus in America.  Right now things are in chaos, but even this will change.

Mardibra

Well Blue, you can't throw out insults and not expect to be confronted.

bluedahlia

Neither can you.