By the way, the more I read about the law and how it is going to be implemented, the more I think this is a monster.

I mean, yes, I preferred single payer to the individual mandate from the start. But as I read the ACA's descriptions of the health insurance exchanges, the bronze, silver, gold and platinum levels, certifications, what happens when this is true or when that is false or when the barometric pressure gets too low or when a ghost haunts your toaster (yes, this is an exaggeration), it became quite clear that we are going to pay some serious managing costs to keep all of these things straight.

Health care providers are already complaining that keeping straight the rules of dozens of insurance companies is costing serious money. I can't see it getting any better under the new system.

lemur wrote:By the way, the more I read about the law and how it is going to be implemented, the more I think this is a monster.

I mean, yes, I preferred single payer to the individual mandate from the start. But as I read the ACA's descriptions of the health insurance exchanges, the bronze, silver, gold and platinum levels, certifications, what happens when this is true or when that is false or when the barometric pressure gets too low or when a ghost haunts your toaster (yes, this is an exaggeration), it became quite clear that we are going to pay some serious managing costs to keep all of these things straight.

Health care providers are already complaining that keeping straight the rules of dozens of insurance companies is costing serious money. I can't see it getting any better under the new system.

well we should have gone with universal from the start, contrary to what the nay sayers say, it does work or else the rest of the industrialized world wouldn't have it.

Orange, has it, yellow, trying to get it.

lemur wrote:By the way, the more I read about the law and how it is going to be implemented, the more I think this is a monster.

I mean, yes, I preferred single payer to the individual mandate from the start. But as I read the ACA's descriptions of the health insurance exchanges, the bronze, silver, gold and platinum levels, certifications, what happens when this is true or when that is false or when the barometric pressure gets too low or when a ghost haunts your toaster (yes, this is an exaggeration), it became quite clear that we are going to pay some serious managing costs to keep all of these things straight.

Health care providers are already complaining that keeping straight the rules of dozens of insurance companies is costing serious money. I can't see it getting any better under the new system.

20% limit on administrative spending for insurance companies.

How do I manage now? I don't receive health care. That's how. I hope I don't have to go to an ER, that's how. I haven't had a single non-emergency (Edit: or worker's comp) visit since I was 16. That's how. The pain that my job/life has left me in, well as far as I can tell, it's just permanent. The elbow is probably operable, but I'll likely never know. I simply cannot afford anything medical without insurance, and even with a $500/yr credit, can't afford insurance. If I develop cancer, or some other ailment, I just have to hope it kills me... Quickly.

Unless something changes dramatically in my life, or we get single payer, I don't see this changing.

<$500/yr? So just under 1/6 of the lower number. That's just insulting.

The only reason costs are so bloated now is because we are having to support this GIANT for-profit leech that is the 3rd party insurance industry. Why the fuck are we propping this shit up... By FEDERAL LAW no less?

Fukshot wrote: 20% limit on administrative spending for insurance companies.

Are there also limits on administrative spending for doctors, hospitals, the government, people's accountants, etc?

What I was talking about is not how much it costs the insurance companies themselves to manage their plans but what it costs health care providers to manage billing under dozens of different plans.

gendoikari87 wrote:

AmirMortal wrote:Nice, but non-sequitur. Even if I didn't smoke, that's still 300 bucks I don't have every month.

Also, easier said than done.

actually how much a month do you smoke? you could quit, and put that money to insurance.

I'd like to point out to everyone that has an opinion about Amir's smoking, that if they haven't walked that road then they should politely STFU.

Smoking can be wicked hard to kick. There is a reason that the smoking cessation business has gotten robust enough that the only method of supplying you with non-cigarette nicotine that is NOT on the market is rectal insertion. Seriously, EVERY other method of putting nicotine in the body is currently out there, on store shelves and in pharmacies. Why? Because it's SO FUCKING HARD! It was damn near two years before I could say two weeks went by without a single craving, and that was situational because it was another two years before I could have a drink without the intrusion of the desire to have a smoke in my other hand, and ANOTHER year after that before driving while tired wouldn't give me the desire for the siren song of the wind whistling past the cracked window - cracked just a bit open so that the ashes could be flicked outside. Count that, five mother fucking years before the craving had been pulled out root and branch.

So, with much love in my heart for the way people want to be helpful, those of you who have nothing more substantial than 'Dude Quit' to offer, I really think you should STFU.

JayFromPA wrote:

gendoikari87 wrote:

AmirMortal wrote:Nice, but non-sequitur. Even if I didn't smoke, that's still 300 bucks I don't have every month.

Also, easier said than done.

actually how much a month do you smoke? you could quit, and put that money to insurance.

I'd like to point out to everyone that has an opinion about Amir's smoking, that if they haven't walked that road then they should politely STFU.

Smoking can be wicked hard to kick. There is a reason that the smoking cessation business has gotten robust enough that the only method of supplying you with non-cigarette nicotine that is NOT on the market is rectal insertion. Seriously, EVERY other method of putting nicotine in the body is currently out there, on store shelves and in pharmacies. Why? Because it's SO FUCKING HARD! It was damn near two years before I could say two weeks went by without a single craving, and that was situational because it was another two years before I could have a drink without the intrusion of the desire to have a smoke in my other hand, and ANOTHER year after that before driving while tired wouldn't give me the desire for the siren song of the wind whistling past the cracked window - cracked just a bit open so that the ashes could be flicked outside. Count that, five mother fucking years before the craving had been pulled out root and branch.

So, with much love in my heart for the way people want to be helpful, those of you who have nothing more substantial than 'Dude Quit' to offer, I really think you should STFU.

Well said. I'm quitting again in a week.

Never had a smoking habit. It's all negative and absolutely no positives. None. I have yet to meet anyone who enjoyed their first cigarette. Or their fourth for that matter. HTF do you actually get hooked?!

I'm always reminded of a good friend of mine and his story of how he quit. He's considerably older than me. He had been smoking since he was 10 years old. He had just graduated college when the surgeon general came on the radio and announced the health warning for cigarettes for the first time. At the time he had a 3 pack a day habit. He took the lit cig out of his mouth, put it out, and disposed of it. He then tossed his pack in the trash. Later when he went home, he took the carton he had and threw that in the trash. Never smoked so much as a single puff since.

You want to know something tough to do that takes willpower? Losing considerable weight. That takes willpower. At one point, I weighed over 260 pounds. I'm a short guy. I started to lift weights and got reading on weight lifting forums and whatnot. At one point, people on one of those forums talked about doing a bodybuilding competition. I decided I'd compete. This wasn't some small time competition either. This was a competition in NYC. At that time, I had already started learning how to eat right and I had lost 20 pounds. The competition was a year from then and I was morbidly obese still.

I posted pictures and even though they were very supportive folks, they told me not to do it because they didn't want me to feel embarrassed or get my hopes crushed. A year later, in NYC, in front of a packed crowd, competing natural against a pack of roidheads, I placed 3rd in the middleweights out of 13 middleweight competitors. I am DAMN proud of that achievement.

Willpower. That's all it takes. Just decide to do it and fucking do it. So tell me, what do you think is harder to do on your own?

1) Starting from a fat tub of crap addicted to junk food and beer. Removing any and all junk food and beer from your diet. Formulating a complex diet plan with precision macro nutrient ratios that involve eating 7 meticulously designed meals each day that taste horrible. Coming up with carefully designed workout schedules that involve lifting back breaking amounts of weight. Alternating appropriately between interval sprints and long distance training so as to optimize caloric burn without triggering catabolic processes. Doing this day in and day out and then getting up on stage in front of literally thousands of people and showing your results.

or

2) Not smoking.

I'm sorry, but I just can't sympathize. The first involves a great deal of effort. The second involves, quite literally, LESS effort than you currently engage in. Nicotine craving? HA! Try ravenous hunger every second of every day for a few years.

JayFromPA wrote:

gendoikari87 wrote:

AmirMortal wrote:Nice, but non-sequitur. Even if I didn't smoke, that's still 300 bucks I don't have every month.

Also, easier said than done.

actually how much a month do you smoke? you could quit, and put that money to insurance.

I'd like to point out to everyone that has an opinion about Amir's smoking, that if they haven't walked that road then they should politely STFU.

Smoking can be wicked hard to kick. There is a reason that the smoking cessation business has gotten robust enough that the only method of supplying you with non-cigarette nicotine that is NOT on the market is rectal insertion. Seriously, EVERY other method of putting nicotine in the body is currently out there, on store shelves and in pharmacies. Why? Because it's SO FUCKING HARD! It was damn near two years before I could say two weeks went by without a single craving, and that was situational because it was another two years before I could have a drink without the intrusion of the desire to have a smoke in my other hand, and ANOTHER year after that before driving while tired wouldn't give me the desire for the siren song of the wind whistling past the cracked window - cracked just a bit open so that the ashes could be flicked outside. Count that, five mother fucking years before the craving had been pulled out root and branch.

So, with much love in my heart for the way people want to be helpful, those of you who have nothing more substantial than 'Dude Quit' to offer, I really think you should STFU.

wasn't judging just saying you could cut that cost down a lot by cutting out smoking, and using the saved money to put toward the insurance.

AmirMortal wrote:Canada's too damned cold.


OK, so I just did some minor calculations. Last year I made more $$than I've made sine. '06: 32k. Going by the link posted, that puts me right about $300/mo before taking my smoking into account, which bumps it up to $450/mo. At this point in my life, that means no car payment or car insurance. It's not that I don't want to pay, it's just not in my budget, and that's before taking copays into the equation.

That means bankruptcy. It's very easy for these folks in Congress, who make what, in the neighborhood of $300k just from their part time job, to decide that 10% is "reasonable", but for those of us who work for a fucking living and actually have to live within our existing budgets (meaning we can't just vote ourselves a raise, or take bribes from lobbyists) it's not so easy. I can't just decide to make an extra few hundred thousand dollars. I can bust my ass and maybe make a couple extra grand, but it' not gonna be the extra cash to cover my new expense.

Even if the cost of all of this were completely offset by the tax credit, in theory I'd still have to cough up the fees throughout the year, then hopefully recover them at tax time. Either way, I'm out of luck, in that I lack the Capitol to cover the expense until that point. So we're right back where we started: I can't afford health care.

Amir, have you looked into Medicaid?

Quit smoking.

I mean this in the nicest possible way, and I appreciate the concern, but fuck you all.

The $1000/yr I spend on smoking won't come close to covering the fees.

AmirMortal wrote:

Quit smoking.

I mean this in the nicest possible way, and I appreciate the concern, but fuck you all.

The $1000/yr I spend on smoking won't come close to covering the fees.

actually I thought 10% was a bit of a high numer so I actually looked it up, the max you have to pay in for the first two years IIRC is only 1% of your income, and after that it gets raised to 2.5%. So unless you're making 100,000 it'd more than cover it.

3:20

AmirMortal wrote:

Quit smoking.

I mean this in the nicest possible way, and I appreciate the concern, but fuck you all.

The $1000/yr I spend on smoking won't come close to covering the fees.

If Amir didn't smoke how the hell would he deal with all the crap on this forum? LOL. Amir, I feel you pain my friend. But hang in there, the fine details of this are still fuzzy. I have a feeling it will work out for the better. If not, I will buy you a carton of cigs

I was on edge for the past month. I'm already subscribed/paying for an ACA healthcare program. & I can't afford it, btw. I'm borrowing (from family) all of the money I'm paying for healthcare these days.

I in the Pre-existing Condition Insurance Program. Have been covered since April Fools day. PCIP is for uninsured folks that can't get insurance anywhere else--and it's a bridge program until the main part of ACA, whatever that turns out to be, kicks in. I'm just 60, and anyone who's 60 and doesn't have some sort of disqualifying pre-existing condition is exceedingly rare or just plain lying.

I pay $334 premium each month, and have a fairly huge (for me deductible) and then a nominal co-pay. I've been sick this year and have been going to a primary care doctor, got an MRI, and about a dozen sessions with a physical therapy provider. I'm on the hook for a couple of grand (I guess) for the various services I've consumed. But my bulging disks are not bulging as much, the pain and weakness in my lower left back and left leg are better, still some pain--but I'm off the horrible pain meds and put my heating pads (2 of them!) away this week. What they don't tell you about healthcare insurance is that you get a better rate for services--even if you have to pay for them yourself. For example, my MRI was billed at almost $1400, but the carrier only allowed about $600, so that's what I owe.

I guess that my trouble with all the bullshit from the right is that they seem to act like this is a luxury. It's not. People have a right to live with pain that's reduced and treated as much as the medical arts can provide. And, if I hadn't gotten help from the overpriced/impersonal care system allowed through insurance, I would have been at the local university owned emergency room for whatever care I could get--and probably gone bankrupt--so that all those stupid, selfish people with employer provided healthcare would end up paying my freight through higher premiums.

On the smoking thing, I've never had the addiction, but both my parents were heavy smokers (which why I probably am not.) Both parents quit in their 50's, my Mom is now 85 and seems to be okay. My dad was dead of emphysema at 67. I can tell you, Amir, that lung cancer isn't the only (or worst) way the cigs can get you. My dad was sick, declining slowly for 17 years. Lung cancer is more painful, but it's relatively quick too.

Anyone who says "Just Quit" is naive. The shit is addictive beyond belief. And deadly. I've been comparing notes with some of the folks that I graduated from High School with. There's about 50 of us in the group--and of the ones that will discuss it, at least 15 of us have lost at least one parent to smoking related disease--and it's taken members of the class of 70 itself.

So don't "Just Quit" there are lots of ways & programs. Lots of 'crutches' to help you find a way. So don't give up--it can be done. You will crave--tho I hear that the craving is different for everyone who quits. But otoh, your senses of smell and taste will be more acute, you have better stamina and generally (eventually) feel better, and you won't smell like a stale ashtray and have nasty breath. And two packs a day, that's what? $10 or $12 per day? More money for guns, booze, and broads! (And a little vacation every year.)

?WTF? Gendo, could you please explainiate what you're talking about with the 1-2.5 percent thing?

gendoikari87 wrote:

AmirMortal wrote:

Quit smoking.

I mean this in the nicest possible way, and I appreciate the concern, but fuck you all.

The $1000/yr I spend on smoking won't come close to covering the fees.

actually I thought 10% was a bit of a high numer so I actually looked it up, the max you have to pay in for the first two years IIRC is only 1% of your income, and after that it gets raised to 2.5%. So unless you're making 100,000 it'd more than cover it.

3:20

as far as i've been able to find the most you are required to pay is 1% of your income, the government takes care of the rest IIRC, I don't have all the information on this, but I'm still looking for how exactly it works. It seemd a bit fishy that the government would require you to pay for something without making sure you could actually do it (which in your case, you'd be paying 10% which is a preposterous amount). Still looking for how it exactly works, I may have to actually wade through the bill itself, and that's gunna take a long time. .

This is what I can find now

Low income persons and families above the Medicaid level and up to 400% of the federal poverty level will receive federal subsidies[31] on a sliding scale if they choose to purchase insurance via an exchange (persons at 150% of the poverty level would be subsidized such that their premium cost would be of 2% of income or $50 a month for a family of 4).[32]

IIRC 400% of the poverty level is about 40k a year.

edit: oh here it is. I was wrong it's not the subsidy, it's the penalty that's capped at 1%

Impose an annual penalty of $95, or up to 1% of income, whichever is greater, on individuals who do not secure insurance; this will rise to $695, or 2.5% of income, by 2016.

also, until you make $44,100 (household?) the amount you have to pay out of pocket is capped at 4%

*this info is from wikipedia, take with huge grains of salt.