Aa
Obamacare = Quality care
http://www.msnbc.com/msnbc/how-obamacare-quality-care
The score-keeping over Obamacare tends to rely on two metrics: the number of people enrolling in health plans, and the prices they’re paying for coverage.
Both are key measures of success, but we often overlook a third measure that’s just as important.
Obamacare is not just an expansion plan. It also aims to boost the value of the care we purchase as consumers, employers and taxpayers. The traditional U.S. system costs more and accomplishes less than any other in the developed world. The ultimate goal of health-care reform is to improve our return on investment—to buy more health for our money.
The government has just published some early findings on that quest, and the news is encouraging. On Thursday, even as the Kaiser Family Foundation was reporting further erosion in public support for the health care law, Medicare officials released data showing that health care providers who embraced a new reimbursement scheme saved themselves and taxpayers about $400 million in 2012.
That’s a tiny fraction of the nation’s total health care costs, but the savings came from a handful of experimental initiatives that were still ramping up. The findings suggest that as more doctors and hospitals embrace the new payment model, it could transform the whole system and save billions.
The challenge is to build a health care system that rewards providers for quality and efficiency rather than sheer volume of services.
Under the traditional fee-for-service reimbursement system, the doctors and hospitals that rack up the biggest bills earn the most money. There’s no reward for preventing costly health crises, but treating them can generate huge profits. Every provider involved in a patient’s care has an incentive to intervene, and little reason to avoid waste or duplication.
To break the cycle of rising costs and diminishing returns, the federal Center for Medicare & Medicaid Services has launched a flurry of initiatives to seed so-called accountable care organizations (ACOs), and reward them for quality rather than sheer volume. To discourage unnecessary treatment, Medicare negotiates so-called “bundled payments” for different “episodes of care,” such as a hip replacement or the treatment of a heart attack. Instead of billing Medicare for every test or procedure performed during the course of a patient’s treatment, the ACO works to achieve the best possible result within a fixed budget that covers the whole episode.
These bundled payments reflect the known costs of meeting people’s needs in particular regions and circumstances, but they’re only part of the new payment model. If an ACO can achieve good outcomes more efficiently than expected—by coordinating care, eliminating waste or preventing costly complications—the organization gets to keep a share of the savings.
The transition isn’t easy. Medical practices built on the old reimbursement model still lack the tools, knowledge and personnel to devise patient-centered treatment plans and track the costs and benefits.
To operate efficiently, an ACO must be able to digitize and analyze patient records, and it needs physicians who can lead and participate in teams rather than working as soloists. The Affordable Care Act has helped participating medical organizations cover those investments, and the new findings show that those that make the leap can succeed.
The government’s new analysis focuses mainly on 114 ACOs taking part in the Medicare Shared Savings Program, one of several related initiatives. During their first 12 months of the program, 54 of the 114 groups came in below their projected costs, and 29 of them achieved significant savings. In that program alone, the ACOs earned $126 million in shared savings, and the Medicare Trust Funds earned $128 million. A smaller group of innovators, known as Pioneer ACOs, racked up total savings of $147 million, while acing every measure of patient satisfaction.
“This is a long-term strategy,” Dr. Patrick Conway of the Centers for Medicare & Medicaid Services said during a Thursday press briefing, “but the early results hold an obvious lesson. When health care providers are accountable for quality, we get better results.”
The score-keeping over Obamacare tends to rely on two metrics: the number of people enrolling in health plans, and the prices they’re paying for coverage.
Both are key measures of success, but we often overlook a third measure that’s just as important.
Obamacare is not just an expansion plan. It also aims to boost the value of the care we purchase as consumers, employers and taxpayers. The traditional U.S. system costs more and accomplishes less than any other in the developed world. The ultimate goal of health-care reform is to improve our return on investment—to buy more health for our money.
The government has just published some early findings on that quest, and the news is encouraging. On Thursday, even as the Kaiser Family Foundation was reporting further erosion in public support for the health care law, Medicare officials released data showing that health care providers who embraced a new reimbursement scheme saved themselves and taxpayers about $400 million in 2012.
That’s a tiny fraction of the nation’s total health care costs, but the savings came from a handful of experimental initiatives that were still ramping up. The findings suggest that as more doctors and hospitals embrace the new payment model, it could transform the whole system and save billions.
The challenge is to build a health care system that rewards providers for quality and efficiency rather than sheer volume of services.
Under the traditional fee-for-service reimbursement system, the doctors and hospitals that rack up the biggest bills earn the most money. There’s no reward for preventing costly health crises, but treating them can generate huge profits. Every provider involved in a patient’s care has an incentive to intervene, and little reason to avoid waste or duplication.
To break the cycle of rising costs and diminishing returns, the federal Center for Medicare & Medicaid Services has launched a flurry of initiatives to seed so-called accountable care organizations (ACOs), and reward them for quality rather than sheer volume. To discourage unnecessary treatment, Medicare negotiates so-called “bundled payments” for different “episodes of care,” such as a hip replacement or the treatment of a heart attack. Instead of billing Medicare for every test or procedure performed during the course of a patient’s treatment, the ACO works to achieve the best possible result within a fixed budget that covers the whole episode.
These bundled payments reflect the known costs of meeting people’s needs in particular regions and circumstances, but they’re only part of the new payment model. If an ACO can achieve good outcomes more efficiently than expected—by coordinating care, eliminating waste or preventing costly complications—the organization gets to keep a share of the savings.
The transition isn’t easy. Medical practices built on the old reimbursement model still lack the tools, knowledge and personnel to devise patient-centered treatment plans and track the costs and benefits.
To operate efficiently, an ACO must be able to digitize and analyze patient records, and it needs physicians who can lead and participate in teams rather than working as soloists. The Affordable Care Act has helped participating medical organizations cover those investments, and the new findings show that those that make the leap can succeed.
The government’s new analysis focuses mainly on 114 ACOs taking part in the Medicare Shared Savings Program, one of several related initiatives. During their first 12 months of the program, 54 of the 114 groups came in below their projected costs, and 29 of them achieved significant savings. In that program alone, the ACOs earned $126 million in shared savings, and the Medicare Trust Funds earned $128 million. A smaller group of innovators, known as Pioneer ACOs, racked up total savings of $147 million, while acing every measure of patient satisfaction.
“This is a long-term strategy,” Dr. Patrick Conway of the Centers for Medicare & Medicaid Services said during a Thursday press briefing, “but the early results hold an obvious lesson. When health care providers are accountable for quality, we get better results.”
posted to the wrong thread, sorry teko.
(as an aside, I will be taking any taxable capital gains on investments that may be subject to VT's possible 10% additional tax to fund single payer over the next few years. Get it off the table so to speak)
(as an aside, I will be taking any taxable capital gains on investments that may be subject to VT's possible 10% additional tax to fund single payer over the next few years. Get it off the table so to speak)
Not even out of the gate and already in the hole
"Also not part of the estimate is an $89 million shortfall in the state’s Medicaid fund spread out over the next three years, which Klein said the state will need to address regardless of the transition to Green Mountain Care."
I believe eventually Vermonters will wise up once they truly understand their out of pocket costs involved vs the benefits over the current ACA.
"Also not part of the estimate is an $89 million shortfall in the state’s Medicaid fund spread out over the next three years, which Klein said the state will need to address regardless of the transition to Green Mountain Care."
I believe eventually Vermonters will wise up once they truly understand their out of pocket costs involved vs the benefits over the current ACA.
Just the beginnings of obstacles
The move to a publicly financed universal health care system could cost the state from $1.76 billion to $2.17 billion, state officials said Thursday.
Lawmakers received a revised estimate of the cost of Green Mountain Care from a combined team representing the Legislature’s Joint Fiscal Office and the Shumlin administration.The group cautioned that the range could vary “dramatically” based on unresolved policy questions.
“A range is hard to legislate around, and you guys are going to eventually need hard numbers,” Steve Klein, chief financial analyst with the Joint Fiscal Office told lawmakers. “We view this as a step in that process.”
The new range is based on a state-commissioned study of the program’s cost by the University of Massachusetts and the actuarial firm Wakely Consulting Group.
It lands between the hard number given in that study and a higher estimate from the consulting firm Avalere in a study commissioned by providers and business groups.
The new estimate did not revise the UMass study’s total cost of $5.9 billion. Instead, it drilled down into the study’s estimated $1.6 billion in state costs, adjusting it to reflect higher expected implementation costs, lower federal matching and other anticipated revenue changes and costs not included in that study.
Also not part of the estimate is an $89 million shortfall in the state’s Medicaid fund spread out over the next three years, which Klein said the state will need to address regardless of the transition to Green Mountain Care.
“Probably the area where we have the most uncertainty is the implementation startup and transition,” Klein said.
The estimate offers a range of $50 million to $150 million for implementation and transition costs that were not in the UMass study.
Federal medical assistance has dropped since that study as well, adding between $21 million and $36 million, and ongoing technology, consulting and staffing needs could add from $33 million to $45 million, according to the revised estimate.
“There are some ways in which we fund the state Medicaid program that may not make sense in the future,” said Michael Costa, deputy director of health care reform.
It’s not clear how a provider tax would work in a universal publicly financed health care system, he said.
Costa said it’s possible the feds would agree to replace that money, but it’s also possible lawmakers could eliminate the tax, leading them to build a range of zero to $157 million — what that tax generates in a year — into their estimate.
The claims assessment and employer assessment, which currently fill the state’s health care fund, might also be eliminated in the new system.
“If every employer is paying in, having a special employer assessment probably doesn’t make sense,” he said. “If most private insurance claims go away, there’s likely not going to be a claims assessment.”
That builds another $51 million of uncertainty into the equation.
Other sources of revenue would have to be identified in a financing plan to recoup the loss from eliminating those taxes.
There is also the question of whether there needs to be cash reserves for a transition to Green Mountain Care, how much, and where the reserves will come from.
The estimate builds in zero to $125 million, or 5 percent of the state’s overall cost, for a reserve fund.
If the state contracts with a private administrator to operate Green Mountain Care, and it’s decided the system needs reserves, those could be built into the request for bids, Klein said.
There is also the question of what happens to the reserves of insurers in the current system after the transition happens.
“Can you transfer those reserves or somehow make use of them?” Klein said, suggesting that the state could somehow appropriate the reserves of private insurers.
Private insurers couldn’t just spend those down, because their reserve levels are set by the Green Mountain Care Board.
The administration doesn’t have a position on the need for reserves, Costa said.
“In the governor’s view, the more that we can use private administrator services the better,” Administration Secretary Jeb Spaulding said. “The governor does not want to build a whole inside administrative superstructure in state government.”
If the state should need reserves, its largest private insurer Blue Cross Blue Shield of Vermont happens to have roughly $130 million in reserves, for example.
The timing for when revenue needs to be available is also a question mark for legislators.
“People are paying insurance premiums now, individuals and businesses, there’d be a transition to Green Mountain Care, and you wouldn’t want people to pay twice if you can help it,” Costa said. “It’s not yet clear how we would manage that transition,” he added.
When policymakers start to map out the transition to the new system, there may be a need for revenue to increase as the go-live date of January 2017 approaches.
The Joint Fiscal Office and the administration identified several other policy choices they were unable to account for, which will alter the range they gave.
“As you change policy levers the range will change dramatically,” Klein said.
The benefit package that lawmakers settle on, what portion of medical expenses the plans cover, reimbursement rates for providers if certain populations are exempted, and changes in subsidies could all slide the range up or down the cost spectrum.
“This range is not static, we should expect it to change and, hopefully, get narrower,” Spaulding said.
The Joint Fiscal Office and the administration will continue their collaboration to refine these numbers and update them as policy decisions are finalized.
“The more we can work together without, you know, looking like we’re one branch of government … we’d be more than happy to do that,” Spaulding said.
Mike Fisher, D-Lincoln, agreed, saying there will be a “healthy tension” between the Legislature and the administration as the numbers solidify and policy choices become new laws.
http://vtdigger.org/2014/02/06/states-share-universal-health-care-2-billion-give-take/
The move to a publicly financed universal health care system could cost the state from $1.76 billion to $2.17 billion, state officials said Thursday.
Lawmakers received a revised estimate of the cost of Green Mountain Care from a combined team representing the Legislature’s Joint Fiscal Office and the Shumlin administration.The group cautioned that the range could vary “dramatically” based on unresolved policy questions.
“A range is hard to legislate around, and you guys are going to eventually need hard numbers,” Steve Klein, chief financial analyst with the Joint Fiscal Office told lawmakers. “We view this as a step in that process.”
The new range is based on a state-commissioned study of the program’s cost by the University of Massachusetts and the actuarial firm Wakely Consulting Group.
It lands between the hard number given in that study and a higher estimate from the consulting firm Avalere in a study commissioned by providers and business groups.
The new estimate did not revise the UMass study’s total cost of $5.9 billion. Instead, it drilled down into the study’s estimated $1.6 billion in state costs, adjusting it to reflect higher expected implementation costs, lower federal matching and other anticipated revenue changes and costs not included in that study.
Also not part of the estimate is an $89 million shortfall in the state’s Medicaid fund spread out over the next three years, which Klein said the state will need to address regardless of the transition to Green Mountain Care.
“Probably the area where we have the most uncertainty is the implementation startup and transition,” Klein said.
The estimate offers a range of $50 million to $150 million for implementation and transition costs that were not in the UMass study.
Federal medical assistance has dropped since that study as well, adding between $21 million and $36 million, and ongoing technology, consulting and staffing needs could add from $33 million to $45 million, according to the revised estimate.
“There are some ways in which we fund the state Medicaid program that may not make sense in the future,” said Michael Costa, deputy director of health care reform.
It’s not clear how a provider tax would work in a universal publicly financed health care system, he said.
Costa said it’s possible the feds would agree to replace that money, but it’s also possible lawmakers could eliminate the tax, leading them to build a range of zero to $157 million — what that tax generates in a year — into their estimate.
The claims assessment and employer assessment, which currently fill the state’s health care fund, might also be eliminated in the new system.
“If every employer is paying in, having a special employer assessment probably doesn’t make sense,” he said. “If most private insurance claims go away, there’s likely not going to be a claims assessment.”
That builds another $51 million of uncertainty into the equation.
Other sources of revenue would have to be identified in a financing plan to recoup the loss from eliminating those taxes.
There is also the question of whether there needs to be cash reserves for a transition to Green Mountain Care, how much, and where the reserves will come from.
The estimate builds in zero to $125 million, or 5 percent of the state’s overall cost, for a reserve fund.
If the state contracts with a private administrator to operate Green Mountain Care, and it’s decided the system needs reserves, those could be built into the request for bids, Klein said.
There is also the question of what happens to the reserves of insurers in the current system after the transition happens.
“Can you transfer those reserves or somehow make use of them?” Klein said, suggesting that the state could somehow appropriate the reserves of private insurers.
Private insurers couldn’t just spend those down, because their reserve levels are set by the Green Mountain Care Board.
The administration doesn’t have a position on the need for reserves, Costa said.
“In the governor’s view, the more that we can use private administrator services the better,” Administration Secretary Jeb Spaulding said. “The governor does not want to build a whole inside administrative superstructure in state government.”
If the state should need reserves, its largest private insurer Blue Cross Blue Shield of Vermont happens to have roughly $130 million in reserves, for example.
The timing for when revenue needs to be available is also a question mark for legislators.
“People are paying insurance premiums now, individuals and businesses, there’d be a transition to Green Mountain Care, and you wouldn’t want people to pay twice if you can help it,” Costa said. “It’s not yet clear how we would manage that transition,” he added.
When policymakers start to map out the transition to the new system, there may be a need for revenue to increase as the go-live date of January 2017 approaches.
The Joint Fiscal Office and the administration identified several other policy choices they were unable to account for, which will alter the range they gave.
“As you change policy levers the range will change dramatically,” Klein said.
The benefit package that lawmakers settle on, what portion of medical expenses the plans cover, reimbursement rates for providers if certain populations are exempted, and changes in subsidies could all slide the range up or down the cost spectrum.
“This range is not static, we should expect it to change and, hopefully, get narrower,” Spaulding said.
The Joint Fiscal Office and the administration will continue their collaboration to refine these numbers and update them as policy decisions are finalized.
“The more we can work together without, you know, looking like we’re one branch of government … we’d be more than happy to do that,” Spaulding said.
Mike Fisher, D-Lincoln, agreed, saying there will be a “healthy tension” between the Legislature and the administration as the numbers solidify and policy choices become new laws.
http://vtdigger.org/2014/02/06/states-share-universal-health-care-2-billion-give-take/
I appreciate your help. I really do.... but talking to these people is a major challenge. Most of the people I have talked to regarding my mothers situation (with medicare) don't know the difference between bull **** and applesauce.
Honestly, you can feel them making answers up on the other end, just to try to appease you. It is miserable. I spent a considerable amount of time talking to these people and got nowhere. The one solid answer I got was, "well, she needs a supplementary plan as well." When I provided with with her RECOMMENDED supplementary plan, you could hear a pin drop. I thought they hung up on me.
Apparently she does not qualify for medicaid because of her pension (which is rapidly getting chewed up). "She makes too much money" they consistently tell me. It's a junk show, and in the end I will have a better understanding of it all. But I have to tell you.... getting lied to is getting old. People not having any answers is getting older.
Honestly, you can feel them making answers up on the other end, just to try to appease you. It is miserable. I spent a considerable amount of time talking to these people and got nowhere. The one solid answer I got was, "well, she needs a supplementary plan as well." When I provided with with her RECOMMENDED supplementary plan, you could hear a pin drop. I thought they hung up on me.
Apparently she does not qualify for medicaid because of her pension (which is rapidly getting chewed up). "She makes too much money" they consistently tell me. It's a junk show, and in the end I will have a better understanding of it all. But I have to tell you.... getting lied to is getting old. People not having any answers is getting older.
Honestly brice, Im trying to understand what happened in your moms case, because I have never heard of something like this before and I have siblings on it and actually had a son on it years ago when he was terminal.. In his case because of his income he was also on medicaid which picked up the difference from medicare and he even got the home meals on wheels. When he died I didnt have a balance thank god. I would urge you to contact medicare and try to find out what resolution is available if any and check out her ability for medicaid as well....Im seriously confused and trying to point you where help might be available, or at least some answers. This is sad.
All of the crap we are going through with my mother right now was supposed to be the fears with Obamacare.... heck, we never made it that far to realize all of the fear.
(Long standing government program, so why wouldn't it work?)
Look at how the government operates and the answer is clear.
(Long standing government program, so why wouldn't it work?)
Look at how the government operates and the answer is clear.
This is all so confusing to me. Im lost. I know medicare only covers like 80 percent and is why we need a supplemental policy but I have never heard of the likes of something like this. I also realize that not all doctors honor medicare as well and I also realize there is lots of fraud within the program as well as our own lil gov realized and made a small fortune off of it himself.
Another reason for single payor imo.
Another reason for single payor imo.
Home health care is covered, to an extent up to 100%. And the amount of crap they pawn off on my mother is ridiculous! She has 3 walkers, a damned motorized scooter, a cane...... and she suffers from an arthritic shoulder and COPD!
The supplemental program my mother was steered into doesn't equate to much either. I think it is a stretch to say that it even benefits her.
No, my mom is on medicare. She was a school teacher and didn't have to pay SS or medicare because she was part of a health trust. The trust was mismanaged and everyones benefits ran out at the age of 65. So now, mom gets to pay handily for medicare.... and there are certain doctors she can and cannot see.
The supplemental program my mother was steered into doesn't equate to much either. I think it is a stretch to say that it even benefits her.
No, my mom is on medicare. She was a school teacher and didn't have to pay SS or medicare because she was part of a health trust. The trust was mismanaged and everyones benefits ran out at the age of 65. So now, mom gets to pay handily for medicare.... and there are certain doctors she can and cannot see.
Medicare IS the hospitalization portion of senior care. Additionally, Medicare covers a certain portion of home health care... Is your mother on actual Medicare or something else?
I dealt with a lot of this when I was caring for my Auntie and my husband just went on Medicare in Jan. Medicare doesn't cover 100%, nor does it cover drugs, doctor visits, etc. That's what supplemental plans take care of - or at least a portion of - or are supposed to.
I'll be going on Medicare in June... I'll get a supplemental policy, which has drug coverage, but unfortunately, the particular drugs I take won't be covered, because they aren't "preferred".
I understand that your mother lost the policy that she'd been paying for.
I dealt with a lot of this when I was caring for my Auntie and my husband just went on Medicare in Jan. Medicare doesn't cover 100%, nor does it cover drugs, doctor visits, etc. That's what supplemental plans take care of - or at least a portion of - or are supposed to.
I'll be going on Medicare in June... I'll get a supplemental policy, which has drug coverage, but unfortunately, the particular drugs I take won't be covered, because they aren't "preferred".
I understand that your mother lost the policy that she'd been paying for.
No drug plans on my mother's medicare. No hospitalization either. Between medicare and home health care professionals (not covered by medicare), my mom's pension barely covers her bills now.... Medicare is horrible.
If you make sense of it let me know. Im not too far away myself.
I'll check out your link, but please note - I'm not yet on Medicare but have done enough research to know that my meds aren't covered under most supplemental drug policies because they aren't "preferred" drugs and even though they are the drugs that work for me, I'll have to pay full price out of pocket for them...
This isn't what I signed up for and paid into for the past 40+ yrs... :-(
This isn't what I signed up for and paid into for the past 40+ yrs... :-(
oops, so sorry! I cannot believe I didnt post the link. Duh! lol
http://obamacarefacts.com/obamacare-medicare.php
The other one was an ongoing investigation into medicare fraud by pharma, I will have to see if I can find that one again! I had read that the med list for medicare was the same as for the VA program as well. That *****!
http://obamacarefacts.com/obamacare-medicare.php
The other one was an ongoing investigation into medicare fraud by pharma, I will have to see if I can find that one again! I had read that the med list for medicare was the same as for the VA program as well. That *****!
I think you forgot to post the link.
That particular med didn't just go up; that's the price I'd have to pay for it, because it's not a preferred drug and there is no generic; someone on Medicaid could get the same drug for free.
The price of my thyroid med doubled a few months ago and I've found out via friends and fellow forum members that all brands of thyroid meds have doubled in price, as have some other meds. That's pharma...
That particular med didn't just go up; that's the price I'd have to pay for it, because it's not a preferred drug and there is no generic; someone on Medicaid could get the same drug for free.
The price of my thyroid med doubled a few months ago and I've found out via friends and fellow forum members that all brands of thyroid meds have doubled in price, as have some other meds. That's pharma...
I don't know if your answer will be in this but here is a link describing the ways medicare is effected by the aca. I don't know enuff about medicare to make sense of it all frankly. But as I understand it, medicare, Medicaid, like other insurance plans have networks and allowed drug plans as well.
So the question would be why your particular medication is going up. Hopefully that link will help find the answer.
I also found this. Evidently a big issue with medicare drug fraud?
Anyway, its interesting reading.
So the question would be why your particular medication is going up. Hopefully that link will help find the answer.
I also found this. Evidently a big issue with medicare drug fraud?
Anyway, its interesting reading.
I never asked for anything free. I only ever asked that CARE be made affordable, so I could pay for it myself. From what I can see and am experiencing myself (or will soon) benefits are being cut in order to pay for it.
Why should I be forced to pay $529/mo (or do without) for a medication that someone who is subsidized can get for free? Since I can't afford $529/mo on top of paying for insurance premiums, I do without.
Why should I be forced to pay $529/mo (or do without) for a medication that someone who is subsidized can get for free? Since I can't afford $529/mo on top of paying for insurance premiums, I do without.
The ACA is the same coverage that we have always had, with the main difference of making it to where more can get the coverage, and subsidy's that help with the premium. You still have the out of pocket and deductibles. (so much for it being free right?) Co pays and deductibles are the norm from what I recall, but now there is an out of pocket maximum where there wasn't before, and they have to cover pre existing and have more in the way of preventable care. As one who had no access, I am grateful. No its not free, it never was, but at least now I can get coverage and will not be bankrupt over medical expenses. Insurers could always change or drop your coverage before the ACA and the ones that are dropping or changing is mostly because they do not meet the standards set down in the ACA of the 10 points of coverage.
Since its based on income, some will get subsidys and others may pay more if not thru their employer.
I really dont understand what people are complaining about, as it was never meant to be free in the first place.
But hey, I would still opt for single payor!
Since its based on income, some will get subsidys and others may pay more if not thru their employer.
I really dont understand what people are complaining about, as it was never meant to be free in the first place.
But hey, I would still opt for single payor!
"Although this plan does benefit some, I think mostly it benefits the insurance industry.
I support the idea of all people in our country having adequate health care however this one is a mess."
Couldn't agree more.
I support the idea of all people in our country having adequate health care however this one is a mess."
Couldn't agree more.
I do know of some young people working in the service industry who will be getting health care for the first time. Although this plan does benefit some, I think mostly it benefits the insurance industry.
I support the idea of all people in our country having adequate health care however this one is a mess.
I support the idea of all people in our country having adequate health care however this one is a mess.
I see a lot of people being denied care and/or necessary medications, unless they can afford to pay privately. Looks like I'm going to be one of them, come June.
http://www.weeklystandard.com/blogs/sick-kids-denied-specialty-care-due-obamacare-washington_776030.html
Obamacare=bad care
Obamacare=bad care
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