Anatomy of a Flame War

It's been a while, but this is my desolate, uninhabited bully pulpit, so I'm going to use it, damnit!

BarBri was fun - more fun than being a lawyer.  However, law has its perks too.

One of those perks is being able to join bar associations and their listservs.  One such bar association is the New York State Bar Association, and one such listserv is for "General Practice."  The emails are usually mundane, but last week things started to get absurd.

Below you will see the long ranging debate on the healthcare law.  Enjoy the people claiming to be experts based on anecdotal experience and the total disregard for the inboxes of the hundreds of others lurking in the background.

Everyone who has posted has shared their email addresses with the entire listserv, so I have no qualms about reposting their names here.  I will leave out their email addresses because they create enough spam and don't need more.  My comments are in Red Courier because I can.  Emails are posted in their entirety in the order I received them.  I left out the quoted stuff unless it was relevant and the vast majority of people's signatures.  

If you're studying for the bar, remember - follow the lead of these people and you too can do something besides the practice of law with your law degree.

Subject: OFF TOPIC - Health insurance

Thursday, November 14, 2013

1. It all begins fairly innocuously.  

4:47 PM, David Aronstam

Counselors:

I subscribe to the NYSBA health insurance plan.

I am a solo practitioner and my premium is a higher than those practicing in a group because the insurance lobby managed to have such a provision inserted into the law.

I was wondering if anyone has looked into what is available on the NYS health insurance exchange and how it compares to the NYSBA plan?

Thank you.

David J. Aronstam

2.  And then a genuine response, in an attempt to be helpful (but with the necessary side-track complaining about something or other that's totally irrelevant).

4:59 PM, Joanne Fanizza

David,

I was insured through NYSBA until the premiums skyrocketed.  I even wrote a letter to our attorney representative to tell them what happened, and I didn't even get a response.  That was sorely disappointing, so I went out in the market and found a policy with almost identical coverage for a little more than half the price.  I think the health exchanges are pretty close to what I'm paying, also.  It's worth a look. 

Joanne Fanizza, Attorney at Law

3.  The followup.

5:02 PM, David Aronstam

Thanks Joanne.

Can you share where you got your policy?

David J. Aronstam

4.  Ooooh - me too!  (Forgetting that everyone will reply to the entire listserv anyway).

5:42 PM, Esther Bryan

Joanne,

I would like to know where you got your policy, also.

Esther

5.  The first political comment.  Lacking substance and attempting to make an easy - and not very funny - joke.  Clearly an attempt to move the conversation forward.  I appreciate the automatic "Yours truly," included at the end.    

7:24 PM, Paul F. LaGattuta III

Isn't Obama saving us one at a time?  

Yours truly,

Paul F. LaGattuta III

6.  This email was started three hours earlier.  It is clearly off-topic, and veiled in an attempt to be "helpful" while admittedly being a "soap box."  That last line - who was being thanked?  Those who read the email?  Enjoy - now you're being thanked too.  And dear reader, maybe this is it - 9:19 at night, last one for the day.  Go to bed thinking that your email box won't be too full in the morning.

9:19 PM, Nancy Delain

David,

I can’t tell you how the Exchange compares to the NYSBA plan (since I don’t have the NYSBA plan), but I CAN tell you that the Exchange compares VERY unfavorably to the health insurance I now have in place and will lose, despite Mr. Obama’s speechifying today, on 1 January. I was paying $158/month for a health insurance plan that suits me excellently through my Chamber of Commerce (that $158/month is about $20/month higher than it would be if I had a partner or an employee; we’ve dealt with that inequity for years now), but will now have to pay $520/month for “better” insurance that also covers, by mandate, the expensive areas of pediatrics and obstetrics. Understand that I am pushing 60 and have no plans to conceive or adopt a child.

I am NOT happy. Unfortunately, for “individuals” (aka solo lawyers) there seems to be little alternative to the Exchange. Obamacare is upon us, and it will spread like a virus to larger employment groups next year. Verbum sapiente to all those who practice in groups: watch out; it’s comin’ at you, too!

“If you like your plan, you can keep your plan. Period.” Horsehockey. I just hope Mr. Obama’s line about keeping your doctor is more accurate, but that would surprise me.

Thanks for the soap box opportunity!

Nancy

Friday, November 15, 2013

7.  Another attempt at being helpful.  The early morning hour must of meant that the poster had no idea what he was getting into.

3:15 AM, Thomas Rothschild [Located in Brooklyn, NY according to the signature, so yes, this is in the middle of the night.]

Just remember that health insurance is rated county by county, so Joanne's experience may not be helpful to you if you are in a different part of the state.

Tom Rothschild

8.  Only woke up to one.  Phew.  This could have been bad.

10:57 AM, Joanna Fanizza

David,

I have a United Healthcare plan (Oxford).  My agent is JCD Planning Corp d/b/a Proactive Benefits of Setauket.  My contact there is [REDACTED - It's clearly not the contact's fault].

I've had trouble with United, too, but not as much as I did with MVP.

Joanne Fanizza, Attorney at Law

9.  Wait a minute ... there's more to be said here.  And I get to feign outrage too!!

11:02 AM, Joanne Fanizza

Only those who want to be saved.  There is still a large number of fools out there who like buying illusory policies and throwing their money out the window.  And still others who are shocked -- shocked!  I tell you -- that we would dare regulate an insurance industry.  They're the ones bent over.

Joanne Fanizza, Attorney at Law

10.  Time to pick a fight.  And written quickly too. [Also when I stopped reading every word of every email.]

11:10 AM, Robert Larson, Esq.

I don't know about that.  Tell the person who purchased the insurance that he/she, not some other individual, selected and that he/she, not some other individual, felt meet his/her needs that the policy was faulty or inadequate.  High deductible policies are in existence because they meet a need and are not garbage.  People want them because they are a value to the consumer who purchase the product.  Now the person who purchased the high deductible policy is basically being told your choice was dumb/stupid/foolish/choose your word to indicate the imbecile here.  When did government get to be the one who told the voter/electorate that he/she is an idiot and not the other way around?  All this healthcare spin would be a lot easier to take if Congress/White House was in the same boat and receiving the same cancellation notices, but they receive healthcare that the term "premium" would not even adequately describe.  To condescend to their constituents that the policies, high deductibles or otherwise, they have been purchasing are now junk is just too much to stomach.  

Robert Larson, LPN, JD

11.  "I'm not going to read all the emails of a subject and then reply at the end.  I'm going to reply to each one individually, progressively, and get more outraged as I go."

11:11 AM, Joanne Fanizza

Nancy,

What in the world did you get for $158/month?  I haven't seen premiums like that in decades.  Was it simply for catastrophic hospital coverage?

Joanne Fanizza, Attorney at Law

12.  I think this email is supposed to be helpful, but I'm not sure what it means.  It was clearly hastily sent from a smart phone.

11:16, Florian Bruno, Esq.

For those of us who just recently started their firms - healthy New York. You cannot make more than - I think $26,000 per year as a couple. That is firm profits after all deductions. They look at the last 6 weeks or so. 

If you qualify you can get 50 - 60% off on existing plans - like Aetna or Oxford. 

13. Finally caught up.  More personal outrage and feigned ad hominem attacks.  And the ever-present "cars are the same as people" argument.  Just remember folks.  Guns don't kill people, cars shooting guns kill people.  

11:17 AM, Joanne Fanizza

Who used the word "imbecile"?  Not me.  The only reason why those illusory policies are purchased is because people who can't afford health insurance would at least like to have catastrophic coverage, which usually have incredible deductibles, like $10,000. 

Let's see, you drive a car, don't you?  And you're required to have minimum coverage, aren't you?  And the gov't tells you that, doesn't it? 

So what's the difference?  We want you to have a healthy body, like we want you to have a healthy car. 

Joanne Fanizza, Attorney at Law

14.  There is no good way to write this sound: "na-ah."

11:29 AM, Robert Larson, Esq.

I used the word.  It is analogous to the ones all the politicos are using, just more succinct.  And yes, the government does tell me to buy car insurance.  The only problem with that argument is that it is not the Federal government it is the State government who is regulating that market.  The State governments were the traditional regulators of insurance, but now the Fed feels it knows how to regulate health insurance.  We see how well that is going.  The other problem is that the auto deductibles are not set in stone.  The insured can set the amount of the deductible to match the specific comfort level of the individual.  If you don't want a $500 deductible then go for a $1,000 or $2,500.  

The high deductible policies are not illusory.  They are not out there for the poor, the policies are there for people who do not frequent the health care system often and chose to purchase the policies.  None of those individuals purchase them because they have been forced to purchase them.  Which is odd because now they are being forced to purchase policies they actually don't want.  People who know what they need and when they need it.  The individuals who purchase high deductible types of policies understand their risk tolerance and are comfortable with the level of the deductibles and the type of coverage the policy provides.  

Robert B. Larson, LPN, JD

15.  I miss the autumn of 2012.  Don't you?  Can't wait for 2016!  Rah Rah Rahmney.  And I think Massachusetts is a commonwealth, not a state.  Maybe we can start emailing about that?

11:34 AM, Joanne Fanizza

It's going exceptionally well in MASSACHUSETTS, the state after which Obamacare was patterned.

It was called Romneycare, and not a Republican dissed it.

Joanne Fanizza, Attorney at Law

16.  Alex, I'll take "Getting My Jeopardy References All Screwed Up" for $200.

11:40 AM, Robert Larson, Esq.

Correct, and it should have stayed state specific and not been done by the Federal system.  Perfect argument against it.  Last question...how many times were people told they could keep their insurance (Period.) before they were summarily canceled?  I'll take what is greater than 25!

Robert Larson, LPN, JD

17.  The one-sided Fact Check.  (First of many.)

11:48 AM, Joanne Fanizza

The full quote, which I saw on MSNBC, but which you will not see on Fox, was:

"You will be able to keep your insurance if you like it.  Except some people will lose their policies because they won't meet the new standards.  Those people will get better policies and help buying them."

We have become a nation of partial information, rush to judgment, and general overall stupidity.  As a former newspaper reporter, I'm flummoxed by the crap that passes for media today.

Joanne Fanizza, Attorney at Law

18.  The reasonable liberal steps in to try to concede a little and steady the boat.  Does it work?  [Hint: Never.]

11:50, Joel Gaffney

The state/federal argument is a legitimate argument, but it misses the point.  The point is that the healthcare system in the United States has been, and continues to be, a complete failure for the vast majority of Americans.

You are probably right that mandatory, regulated individual insurance policies were not the best way to address the systemic problems with the healthcare system.  But it is simply wrong to argue that high-deductible health insurance plans were not predatory.  They may not have preyed on the individuals who purchased them, but they preyed upon the public at large, by shifting most of the cost of their healthcare to taxpayers.

Requiring individuals and businesses to internalize the systemic costs of their healthcare decisions is a good thing, because it is individuals and their doctors who make the decisions that determine the costs of the healthcare system.  Requiring everyone to contribute to the nation's health and well-being is reasonable, too, because a nation's health is a public good, much like transportation infrastructure, law enforcement, and disaster relief.

Maybe it would have been better to simply implement a public payer system so that the government pays for what is a public good, like it does for other public goods, but that wasn't an option that could have passed in Congress.  So instead, you have mandatory health insurance for everyone, so the insurance companies can get their bite of the apple.

19.  The original poster realizes that this is no longer about him or his concerns and therefore must chime in.  Also I have no explanation for why the time of this is so much earlier, but came in after the other, later posts.  Stupid interwebs.

11:38 AM, David Aronstam

And when an individual who has a low cost limited coverage policy gets ill and it's not covered by the policy, who pays the bill?

David Aronstam

20.  But Fox News is Fair and is Balanced.  Just like a fat kid on a seesaw.  And the President is a liar.

12:01 PM, Robert Larson

And when did he say that?  Before or after the numerous promises? 

 And dare I say, I have been a nurse for over two decades and am quite sure I am not stupid of the many things I am.  I would make that charge of the politicians, regardless of party, who are supposed to represent our communal best interests.  I dread what our healthcare system is going to become in the next few years.  Wherever you sit, stand or lay down on the political spectrum this fiasco is going to affect you.  And the media, especially MSNBC, is not doing the job they should--ever.  P.S.--Yes, that quote was and has been on Fox numerous times.

Regardless, you don't fix a bad problem with a bad problem.  Why not require all employers to provide group insurance to all employees?  Pool the applicants, make small businesses join together (like unions did) and purchase together to attain an acceptable risk pool?  There are other ways to attain coverage without involving the government messing up the system and spending $636,000,000 on a website that can't handle any traffic and then saying OOPPS!

Robert Larson, LPN, JD

21. Selective use OF all-caps IS LOTS of fun When Coupled with capitalizing Certain adjectives.

12:03 PM, Joanne Fanizza

Thank you, Joel.  I always wanted us to adopt what every other First World country, and what many Second World countries, have adopted, which is UNIVERSAL HEALTH CARE.

I would love nothing more than to have Medicare for All.  NOW.

Joanne Fanizza, Attorney at Law

22. OK.  Even with new posters, I've stopped reading every word.  My comments are also going to get sporadic.  This poster might not have intended to fan the flames of the war.  But maybe he did.

12:14 PM, Jason Lowe

I am not so interested in a political discussion - I am more interested right now about how this affects my pocket book in the immediate term.  My plan was cancelled for next year so I have been shopping around.  Here is what I have found:

The NYSBA plan is still expensive.  The broker told me NYSBA may come up with another plan but don't count on it for 2014.

If you live in NYC then NYCLA has a plan.  It is a little less than $600 a month.  It is solid in that it has little (or possibly no) deductible.  The provider network is not robust though.  It is a pre-ACA plan that has been grandfathered in.  If you sign up before the year ends you will be grandfathered in too.  I don't know if that grandfather will apply if you sign up after the start of the new year.  The other disadvantage is you have to be an area covered by the plan (I think Long Island, NYC, and Westchester).  You can go on the NYCLA website for more info.  I can also say the broker here was nice and very helpful.

Health NYer - someone else suggested that.  You need to have very low income to qualify.  Also, I heard it may be canceled because of the ACA.

I still think as attorneys we can't qualify for the freelancers insurance (unless you do a lot of IP, entertainment law, or some other specific areas).  It is worth exploring though just in case you qualify.

The exchange:
I have poked around there a bit.  If you want a lower tier plan there are plans in the low to mid $300 a month range (at least that show up for me here in NYC).  Those plans obviously have higher deductibles (ie $3000 per person and $6000 per family).  They also have plans in the $530-$550 a month range with much lower deductibles (ie $600-$1000 per person and $1200-$2000 per family).  If you want even smaller deductibles and co-pays the exchange has plans in the $620 a month range with deductible in the $0-$200 per person and $0-$400 per family range.

One other note - I think if you are not solo there is a way to sign up your business for the exchange.  I do not know how this works because it doesn't apply to me, but there may be a way to get cheaper coverage on the exchange that way (as others have noted we are for some reason penalized for being solo).

Anyway, that is what my research has shown.  I am happy to hear if anyone else has any other ideas.

Jason

23. Let me insult America based on some absurd comment.  That should lead to a positive conversation.

1:20 PM, Florian Bruno, Esq.

We've stopped being a first world country a while ago. Have you recently driven a car on New York city's streets? 

24. Calling back to 11:35 AM (post 15) and last night (post 6):

1:28 PM, Meyer Y. Silber

Joanne, are you kidding?  Respond to Nancy’s email re the options she is required to pay for yet will NEVER use.

25. The bombshell!  I.e., that this flamer can be classified as part of a stereotypically liberal group.  Reminds of a "republican" on a stereotypically liberal television network.

1:35 PM, Robert Larson, Esq.

Government in it's infinite wisdom has deemed that a 60 year old woman and a gay man (like myself) need maternity coverage.  I also am not having children, period.  I wonder if I get GNY visits too (doubt I'll take advantage of that benefit)!

Robert Larson, LPN, JD

26.  See ¶ 3 (blaming Obama).  Now blaming the media too.  And it's Kool Aid.  And truly, he is still yours.  Or mine.  I'm not sure.

1:39 PM, Paul F. LaGattuta III

Media has ALWAYS been pushing crap and now they are awakening from the Obama Koolaide they drank

Yours truly,

Paul F. LaGattuta III

27. What you really want is something less like what you want, you just don't know it.

1:39 PM, Joel Gaffney

No Robert, that's incorrect.

"Government in its infinite wisdom" has determined that maternity coverage for all women is a public good to which everyone should contribute.  Because the method used to distribute the costs of healthcare that the majority of Congress found most palatable was the "privatization" of that distribution, that means that everyone has to have an insurance policy that covers maternity coverage, so that the costs of maternity coverage are spread evenly across the entire country.

If you're unhappy with the system because you can pull out individual case studies that seem unfair (and admittedly, when you look at them in isolation, they do seem unfair), then you should be supporting a single-payer system.

28. The ever informative response.  (Responding to 26).

1:40 PM, Paul F. LaGattuta III

Funny

Yours truly,

Paul F. LaGattuta III

29. Oooh.  Oooh.  I have some barely related personal anecdote that makes me anything but an expert (even under Daubert) so I must chime in.

1:48 PM, Marla Pilaroscia

Having performed external review for Medicare programs (Medicare Advantage and prescription drug plans) for 15 years, I am not sure that Medicare enrollees are satisfied with these products.

Marla Pilaroscia

30. Doesn't this man have any clients?

1:48 PM, Robert Larson, Esq.

Thank you Paul and Marla.  Doesn't Medicare take like 9-12 months to pay it's suppliers (both medical and DME)?

Robert Larson, LPN, JD

31. A new voice - who unfortunately doesn't add anything to the conversation.  But here's a spoon.  Go ahead, stir the pot.

1:58 PM, Rebecca Oliver

I agree that the Affordable Care Act is fatally flawed and Medicare isn't much better. It is corporate welfare for insurance companies

I am lucky to have employer based coverage, which covers my family for $150 a month, and it is the highest level of coverage and covers EVERYTHING. I am afraid that the costs will rise and eventually this will go away. All of the choices available on the exchange are inferior to what I currently have. The plans on the exchange offer a basic, minimal benefit, not what many of us may be used to.  Also, exchange plans will cost ten times as much.

The employer mandate had already been delayed a year. How do we know this will not become indefinite? Employers are also cutting hours and forcing people onto the exchange by dropping coverage all together. So they have escaped all responsibility, and all costs are being pushed onto middle class consumers and taxpayers.

What we really need is a real employer mandate, to cover everyone with a job regardless of the hours with no exceptions. And Medicaid or Medicaid buy in for everyone else, with basic and not comprehensive benefits. Then if you want more you can buy more (like dental, vision, etc). 

32. RWC (Replied Without Comprehension)

2:09 PM, Joanna Fanizza

Rebecca,

I want to know where you're getting health insurance for $150/month.  I will sign up RIGHT AWAY. 

Joanne Fanizza, Attorney at Law

33. Another new voice, this time with historical references and everything.  Also, you'd think with a mouse and keyboard and delete key, post-script messages wouldn't be necessary.  

2:12 PM, Richard I. Leff

If the democrats had balls and the republicans had brains we'd get together and have universal health care; I don't know, let's call it Medicare (and combine it with Medicaid), where everyone would have 100% coverage for all medical (and, yes, optical and dental and even prescription drug) treatment, with no deductibles and no co-pays and no coinsurance and the world would be good. It would be paid for by taxes on everyone, proportionate to income.  We could regulate the drug companies as to what their products were actually worth and regulate the medical device providers as to what their products were actually worth, (of course we can't/haven't regulated the military industrial complex as to what their products are worth [$1,000.00 toilet seats and $500.00 hammers anyone?]and cut out the insurance companies altogether (except as to maybe being administrators of the paper work involved) and maybe we'd have a system that fit and served everyone, since we already pay in taxes for treatment of the uninsured indirectly in any event.

But that would be labeled "socialist" or even "communist" by red-necks who can't even read.

The lobbyists for the drug, insurance and medical device people will never give up their stranglehold on the current system which should be canned in favor of universal healthcare.

No one should lack access to or treatment by our healthcare system.  And if that means that those of us who are able have to pay for those who are not (and in the long run we do anyhow) so be it.

P.S.:  Don't you love when some a-hole who carries minimum coverage totals a $60,000.00 car and can't pay because he has minimum insurance coverage and is otherwise judgment proof?  Who pays the difference in the end?  Obviously, we all do since the insurance companies are not in the business to post a loss.  They just increase everyone's policy for the next few years, ad infinitum.

P.P.S.:  And I agree that it sounds absurd to require 60 year old, single women to have pediatric or contraceptive coverage, but it pays for the medicaid patients' coverage in the long run, which would be paid by everyone in increased taxes or increased premiums in any event.

And yes, the poverty level people won't be paying anyhow.  They even get an EIC tax credit/refund for not earning enough.  So what's the difference?

Just saying.

I hereby affirm under penalty of perjury that I am not now, nor have I ever been, a member of the communist (or socialist) party. 

So there-Joe McCarthy.

Richard I. Leff

34. Dear RWC-er.  Please begin comprehending.

2:16 PM, Rebecca Oliver

My husband's employer provides it.

35. RTS (Responded Too Soon).  This is in response to number 25.

2:18 PM, Richard I. Leff

Why don't you try. You might even like it.  (Disclaimer: That's only meant as a joke-it's the Robin Williams in me that somehow just pushes itself out [double entrendre intended]).

Richard I. Leff

36. I wonder which Senate she worked for.  And, damnit people, persons be dying.

2:33 PM, Marla Pilaroscia

I am not sure it is that simple.  In the late 80s I worked for a US Senate that has jurisdiction over Medicare and Medicaid. We researched other models extensively and to our surprise, we ended up not being in favor of a single payor plan.  I don't have any answers,  but the other countries (Canada, Europe) we researched had significant flaws and gaps in access to care  resulting in mortality.

37. Again, I don't know why the time stamp ended up coming in after a later time.  I think it's Marx's fault.

2:32 PM, Phil Byler

Richard:

It is unaffordable socialism, with its defective world view, that you are advocating that ignores there are some real and terrible costs in terms of lost lives and poor health care that results from socialized medicine.  Such socialism has failed elsewhere; what makes you think that it can work in a large country with a complex economy such as the United States?

Phil 

38. I bet he was eating lunch, and not tending to clients, for the last hour and six minutes (well, maybe he spent six minutes writing this email).  

2:54 PM, Robert Larson, Esq.

I went to law school in St. Paul, MN.  When I took health law courses one of the interesting things we talked about was the fact that our local healthcare system dealt with Canadians who used the system and paid cash to access it for all types of procedures they could not get in Canada in a "timely" fashion.  It ranged from new knees to heart surgery.  I was astounded.  

I visited a cousin with cancer in Leichester, England at the hospital in 1995.  Being a nurse I was terrified by the conditions she was in.  I felt like I had stepped back 50-75 years.  I would not want to be in the hospital in any other country.  So for those that think we have it bad, or are second/third world I say try getting the type of care you get in this country anywhere (and I mean that literally).  Go to anywhere else in the world and think about IV antibiotics or dressing changes and not worry about nosocomial infections (hospital acquired).  You think we have a problem with our healthcare system?  Think about those that are coming to this country for treatment.

Robert Larson, LPN, JD

39. Wait -- I thought you were on the other side of this.  No matter.  Now this person's personal anecdotal experience makes her an expert.

3:03 PM, Rebecca Oliver

That is the propaganda. Does anyone have any data showing "poor health care", higher wait times, and lost lives from the European and/or Canadian systems?  

My understanding is that the outcomes are equal or better in other developed countries, at much less cost. Wait times are also the same or less. Has anyone tried getting an appointment with a specialist lately?

I have also lived in France, Spain, and The Netherlands; plus my husband is from Italy. In all of those countries, we had exceptional care and paid little or nothing. My husband walked into an emergency room in France for a minor problem, and was referred to a head and neck surgeon who operated the next day at no cost. I was also sick in France. The doctor made a house call, then he called an ambulance,  and I spent a day in the hospital. Excellent quality care, and it cost nothing out of pocket, except 5-10 euros for medications. Europeans all complain about their system, but they agree it is better than ours- and they do not worry about care and costs like we do.

There are many "mixed" systems, like in Germany and the Netherlands. Some basic benefits are provided for all and private insurance for co-pays and extra benefits. They also work well and cost less.

I am mostly happy with the insurance I have, and would like to keep my insurance situation the way it is for now. That being said, don't believe everything politicians say. I am still waiting to see data proving our system is superior and others inferior. 

40. You don't believe me?  My off-the-cuff remarks and personal anecdotes are proof, damnit.  Yours are imaginary and illustrative of my point, not yours.

3:20 PM, Robert Larson, Esq.

Rebecca:

Propaganda?  Did you read my email?  I gave specific instances.  Either you are saying I am lying, writing incorrectly or just posting wonderful fallacies to fulfill your claim of propaganda.  France, Spain and the Netherlands are all beautiful countries, but...the difference is that we are a nation that actually produces stuff and we have a higher standard of living, GDP, name it.  France won't allow you to speak freely or practice your religion freely.  Spain is bankrupt.  The Netherlands allows rampant drug use and I don't mean professionally prescribed drugs either.  All three will tax you to the grave.  Need I say more.  Your husband went to a doctor for a minor injury and then was seeing a surgeon?  Wouldn't that be a waste of economic resources?  Couldn't the doctors time have been used for someone who didn't have a "minor" issue.  Propaganda, I'll say.  

Robert Larson, LPN, JD

41.  In response to 34, which was in response to your 32.  And what does any of this have to do with the general practice of law?  (Oh, we'll get there my friends.  We'll get there.)

3:25 PM, Joanna Fanizza

Thanks a lot.  What does that have to do with Obamacare?

Joanne Fanizza, Attorney at Law

42. Touche.  

3:29 PM, Joel Gaffney

Way to completely ignore Germany there, Mr. Larson.

Also, it's worth noting that the Netherlands actually has a lower per capita consumption of drugs that are illegal in the U.S. than the U.S. has.

43. IRWT (In Robert We Trust) because really, his personal anecdotes support my political views so much better than everyone else's.  God bless Murrica.  

3:30 PM, Phil Byler

Robert, there are some of us here who know you are absolutely correct.

Phil 

44. I rate Antarctica's health care system the best.  Freeze it off!  Unless global warming is real, then oops.

3:31 PM, Joanna Fanizza

This is all old information.  I've had multiple Canadians and Brits inform me and all my friends that they have everything they need now.  They may have had to work out a few kinks, but they are covered. They are not in need of American health care.  In fact, theirs is rated better.  (And before the anti-universal health care people start yelling, "Then why do so many of them come here for treatment?" I will answer:  Most of the treatment they come here for is cosmetic or extremely experimental.)

It's tiring hearing old arguments that no longer apply. 

But of course, it sounds to me like some of you prefer having a country with millions completely uninsured, many millions more underinsured, and the rest of us picking up the tab through taxes paying for Medicaid or higher premiums due to bankruptcy filings (most of which are necessitated by medical bills), etc.

Nothing like going backward. 

Joanne Fanizza, Attorney at Law

45. I don't think Marla said that.

3:33 PM, Robert Larson, Esq.

Read the email.  Obamacare is going to affect all of our premiums regardless of group or individual plan eventually.  Marla was saying she is concerned what this is going to do to her costs.  Well I can tell her, sorry, but eventually it will be more expensive.

Robert Larson, LPN, JD

46. Two in a row.  If the last one didn't make anyone respond, this one might.

3:37 PM, Robert Larson, Esq.

I was in law school from 2006 to 2009 and was taking health law classes during that time.  Wow, the Canadians must have really pulled together since then.  Great for them.  I still would not want to be in the hospital in Canada, England, Spain, Italy, France, Germany, Uganda, Russia, Costa Rica, Mexico, Burma, (insert name of country here) if I had my druthers.  Thanks, but I'll take the United States of America's healthcare system anytime.

Robert Larson, LPN, JD

47. It's hard to take you seriously when you can't spell There, Their, or They're correctly.  I thought about starting that sentence with "Its," but I feared nobody would get my joke.

3:38 PM, Rebecca Oliver

Robert,

The examples you used were 1) something someone in a class claimed to observe (no data), and 2) one visit to a cousin in England many years ago. I shared my personal experience living in three countries and the health care experience myself and my family had. If you have never experienced it you cannot really know.  This isn't the data I was asking for anyway. Do you have any research proving your opinion? That is what I am requesting.

The economy of the Netherlands is doing great. It is a tiny country but it has one of the top 20 GDPs in the world. There GDP per capita is not significantly different than ours. They produce, produce, produce. Where do you think your flowers and tomatoes come from? Though a tiny country, they accounted for 1/3 of all tomatoes sold in the US (we can't even produce that). They also have a system with private insurance and an individual mandate, and government covers some costs for all like hospital care. The system works very well.

You'd be surprised how rich France is too, and what they produce. As for Spain and Italy, nobody is suggesting their economic problems are because of health care. Unlike us, that is not the major factor.

No need to insult other places you don't fully understand. Just what are we producing nowadays? Maybe you been to Upstate New York lately and seen all of the abandoned factories? My husband is a mechanical engineer, who has been through five factory closings already in his career.

If your opinion is fact and not propaganda, show us the proof.  

48. I'm beginning to think this lawyer doesn't have any clients either.  (And, I might have been lying about not introducing every post.  We'll see.)

3:39 PM, Joanne Fanizza

My premiums were sliced almost in half due to Obamacare.  Please.  Not everybody

Joanne Fanizza, Attorney at Law

49. At one point, I thought Florian was a spanish name.  I guess the last name should have told me I was wrong.  

3:42 PM, Florian Bruno, Esq.

What has cost lives and provided poor health care is the fact that many Americans had no health insurance . That the uninsured and underinsured would just walk into an emergency room for any ailment. And of course not pay. At great expense to the public as ER is the most expensive medicine.

In the country of my birth (Germany) there is a dual healthcare system - basic coverage is provided by large corporations that are government controlled - and the rates are set and anyone employed can join. You can opt and buy your own coverage with rates based on your age and health record. Better service, shorter waits etc.

My parents back then chose not to opt out though they would have qualified - because with 3 kids it was cheaper to stay in the government regulated system. One could say that a couple with no kids may have paid a bit more so that my parents could have coverage for 3 kids. 

Not the most conservative person in Europe would dispute the need for government regulated health care. What else is government there for if not for that, they would say. 

So, the point is that a 60 year old woman may have to pay a bit more so that a 25 year old woman can go see an obgyn - and a childless man may pay a bit more so that parents with kids can get covered.  It's the principle of solidarity. I am of the firm believe that that's what makes a country and a nation - and not waiving flags at gun shows etc.

50. For the 50th post, let's try something new.  Going inline!

3:52 PM, Robert Larson, Esq.

Sorry, just couldn't think how to adequatly respond so see my response below in bold.  Robert Larson

The examples you used were 1) something someone in a class claimed to observe (no data), and 2) one visit to a cousin in England many years ago. I shared my personal experience living in three countries and the health care experience myself and my family had. If you have never experienced it you cannot really know.  This isn't the data I was asking for anyway. Do you have any research proving your opinion? That is what I am requesting.  THis is what law school classes are based on, case law and surprisingly data (which law school and other academic classes are generally based on).  That is why the teacher who was a JD and had a PhD in public health administration presented the information.  Thank you.  As a nurse I seem to be highly trained to understand what is going on in a hospital.  How about you?  You present your own personal experience.  That is not data, that is subjective experience.  Thank you.

The economy of the Netherlands is doing great. It is a tiny country but it has one of the top 20 GDPs in the world. There GDP per capita is not significantly different than ours. They produce, produce, produce. Where do you think your flowers and tomatoes come from?  California and Florida.  At least that is where the little sticker on the fruit says when I pick it up at the Stop and Shop in New York.  The flowers come from South America usually. Though a tiny country, they accounted for 1/3 of all tomatoes sold in the US (we can't even produce that). They also have a system with private insurance and an individual mandate, and government covers some costs for all like hospital care. The system works very well.  Amazingly so did we until it was broken quite recently.

You'd be surprised how rich France is too, and what they produce.  That would explain the riots.   As for Spain and Italy, nobody is suggesting their economic problems are because of health care. Unlike us, that is not the major factor.  Spain and Italy are bad because they produce nothing and don't care to.  Wonderful countries but they lack the desire to do something.  

No need to insult other places you don't fully understand.  How about read my email.  I did not insult anything.  When you go back and read my email/s, don't read anything into them that I don't explicitly state.  Just what are we producing nowadays?  Umh, pharmaceutical for the rest of the world?  How about that for a start?  Maybe you been to Upstate New York lately and seen all of the abandoned factories? My husband is a mechanical engineer, who has been through five factory closings already in his career.

If your opinion is fact and not propaganda, show us the proof.  Read my posts.  I am a nurse aside from being an attorney.  I have seen and been in other countries health care system.  I have studies them as a student of the law.  Not everyone believes the government is the solution to the problem.  

51.  Now she's invested.  

3:52 PM, Rebecca Oliver

Robert,

I agree with you that the affordable care act will cause everyone's costs to rise, except the "poor". That is why I brought up my insurance. I am also afraid it will cause employers to stop offering coverage. It is already going in that direction as the employer mandate was already delayed a year and many people were made part time as a result of the law.

The law has many problems. But I think a German or Dutch style system would be the fix that would work.

Also, Joel is right. There are fewer illegal drug abusers in the Netherlands and those that exist are mostly non-Dutch. How you feel about marijuana is an entirely different debate. The crime rate is much, much lower as well, as a consequence.

52. This man's emails are too long.  Be more like the Obama hater.  See ¶ 5.  Not that this guy likes the President, see the end.

3:59 PM, Richard I. Leff

I'm not sure what you're saying. Certainly, Canada has problems with not enough providers to provide needed services (I think the doctors there went on strike because they weren't making enough money under the program; too bad). 

If everyone (and I mean everyone) had the same coverage for basically everything we wouldn't have the problems with health care coverage that we have now.  Without a comprehensive overhaul, we still pay higher and higher taxes to cover medicaid and uninsured people to get basic health care.

So why not just revamp the whole system, where everyone gets everything.  And, if doctors want to op out, like they did in Canada, they better have a big wealthy following, because they won't have patients if everyone waits for treatment by doctors who accept coverage available.

It's a vicious circle.  Doctors won't accept new patients because they don't get paid what they think the market should bear, so patients go under treated and doctors will lose money in order to make a point.

We should all have the same health care coverage, at least, if not better, than our congressmen and senators have voted in for themselves (and their staffs).

Maybe if congress had to go to an exchange and pay for coverage like everyone else we'd have a workable, affordable, comprehensive health care policy in the US.

I, for one, would love to have the President's health care coverage, where I could call in my personal doctor (is he an admiral or a general?) every time I had an ache or pain, without worrying about cost.

Richard I. Leff


53.  IDK, my BFF Jill?  JK.  BFF!

4:06 PM, Joanne Fanizza

Colleagues,

Before I dash off for the weekend, I just want to say that I've enjoyed this discussion! 

Have a good weekend, all.

Joanne Fanizza, Attorney at Law

54. I swear he started this email the second he finished his last one.  

4:15 PM, Richard I. Leff

I don't have and don't presume to quote statistics, I can't give you exact numbers, but I am pretty, pretty, pretty sure that the US ranks very low in world rankings as to providing health care for its population.

And Phil, it won't cost us more to revamp a failed system where most of the money goes to lining the pockets of insurance companies and drug makers and medical device providers and lobbyists for all of the above.  We're all still paying higher taxes to pay for medicaid and uninsured people who get below standard treatment but we all still pay for it.  So instead we have to buy insurance (all of us) to make sure everyone gets coverage-which should lower medicaid costs in the end.

And Robert, what's wrong with drugs in Holland?  But, I'm not going to expound on that issue right now.

Richard I. Leff


55.

4:22 PM, Florian Bruno, Esq.

The US rank very poorly. 

I can personally testify that the health system here is below par compared to most other developed countries. We are not speaking about the health care the top 1% can afford (private everything) but the average care for the average person. It sucks. And it is crazy expensive. Sorry to say that. 

56.  I thought you went home for the weekend?  Lies, damn lies, and statistics!

4:25 PM, Joanne Fanizza

We were # 37, and I believe we've fallen to #40.  The first 39 are First and Second World countries with UNIVERSAL health care.

Imagine!

Joanne Fanizza, Attorney at Law

57. P.S., there are times post scripts might make sense.

4:25 PM, Richard I. Leff

P.S.: Robert:  Could you please explain your statement, and I quote:  I "am quite sure I am not stupid of the many things I am".  It sounds like something Rob Ford, Toronto's mayor, might have said.  Just asking for clarification.

Richard I. Leff

58. "You don't know what you just said."  And folks, don't confuse Richard and Robert.  With Rebecca, they're the three Rs.  

4:28 PM, Rebecca Oliver

Richard,

I completely agree. Every article I have seen has shown other systems perform better at a much lower cost. 

59. 

4:31 PM, Joel Gaffney

The problem is that those other systems don't provide the same high-end care that the U.S. system does.  And since the consumers of the high-end care are the ones who pay for all the politicians, nothing ever gets fixed.

60. There's something fishy here.

4:32 PM, Robert Larson, Esq.

Richard:

Here is the best way to elucidate what I was trying to get at:  

I am not stupid, I am gay, I am independent (politically) I am Catholic (really I would put that one first), I am a proud American, I am a descendant of immigrants, I am the first to graduate from college in my family, I am troubled by the baggage return at Heathrow (for those of you who are Monty Python fans).  That is what I meant.  

Robert Larson, LPN, JD

61. Or worse.  But definitely one of these.

4:35 PM, Florian Bruno, Esq.

Sorry but that's compete nonsense. Level of care for the average person is much better outside the US in many countries. Or it is the same. 

62. I think he's calling you a chicken.

4:36 PM, Robert Larson, Esq.

Thank you Joel.  I know I don't complain when you put the chicken beak compress on my fractured femur to help it heal.

Robert Larson, LPN, JD

63.

4:41 PM, Joel Gaffney

Okay, now I'm confused.  Florian is saying that what I said is complete nonsense, and Robert is thanking me...did I stumble into bizarro world?

64. Who thought they were done for the weekend?  Pshaw.

5:40 PM, Phil Byler

According to the CBO’s projections, in 2023, ObamaCare will leave 30 million Americans uninsured.  So, we wreck the well functioning health care system we have in order to address the uninsureds and have roughly the same number of uninsureds.  Brilliant!

Phil 

65.

5:45 PM, Joel Gaffney

More recent information shows that the price of coverage under the new law will be substantially lower than what the CBO predicted back in May, when it made those projections.  I wouldn't be surprised if the next time the CBO updates its projections, that number is significantly decreased.

66. Ok.  Now that I've put in my thoughts, nobody else should, and we should get back to the original question.  (Let's start counting the number of people that think they're ending the question.)  (I don't know if I can count that high.)

5:48 PM, Anthony Emmi

Robert,

Your arguments are dead on. But let's get back to the initial question: What are the names of these insurance companies that are reasonably priced that Sole Practitioners can check out.  Anyone willing to share that info.

Anthony Emmi, Esq.

67. 

5:49 PM, Florian Bruno

What "well working" system are you taking about?

68. If you thought I stopped caring earlier, you had no idea.  And we're still on Friday folks.

5:50 PM, Phil Byler

We did not have a failed system.  You can cite all the flawed studies by left academics favoring socialism you want, but in the real world, we had the best functioning health care system in the world.  There were market based reforms that would have made it better, but adopting Government run health care will destroy that system and will show all of you what a bad system socialized medicine is.  Under any system of socialized medicine, health care costs skyrocket and health care rationing takes place.

Phil 

69. WFRL (Write First, Read Later).

5:53 PM, Phil Byler

Richard, did you ever take an economics course? 

Phil 

70. Daubert, Frye, Academic Regalia - just give me something to tell who is really an expert and who is spouting nonsense based on their own personal experiences.

6:07 PM, Florian Bruno, Esq.

I don't know anything about studies - "flawed" (in your opinion) or not - but from my very own personal experience I can tell you that the system here is a not good when compared to the health care system in other countries. In many ways. Plus it's too expensive for what you get. 

71.

6:07 PM, Joel Gaffney

My favorite part of this response is that it comes with the inevitable implication that the Affordable Care Act is not a "market-based reform."  I hate to break it to you, Phil, but it definitely is.  All the Affordable Care Act does is establish a minimum standard that health insurance policies must meet, and require everyone to purchase one in order to spread the costs of those minimum standards across the whole population.

There is still a market for health insurance policies, and there will still be haves and have-nots.  It's just that now the have-nots are a little better off than they were before.

Markets are not the panacaea they are made out to be by conservatives and libertarians.  They can be an efficient way of pricing goods and services, but they are a horribly inefficient way of policing external costs.  Healthcare is a prime example of a system with huge external costs.  The cost that uninsured people put on society is far more than just the tax money that is spent on their treatments when they do eventually get them (which treatments, as has been discussed already, end up being far more expensive than they would have been if the person had access to preventative care).  The cost also appears in decreased productivity as unhealthy citizens are less efficient workers (no matter their field).  The costs appear in so many seemingly-disconnected ways that individuals making decisions about their own personal health insurance cannot truly appreciate their effect.

Government regulation is really the only way those external costs can be adequately addressed.  The market is designed to ignore them whenever the actors involved in it think they can avoid being caught pushing their costs onto someone else. 

72. Now who's being overly simplistic?

6:17 PM, Robert Larson, Esq.

Market based cannot under any circumstance come from the government.   That would by definition make it not a market based solution but a socialist/ communist based solution
Robert B. Larson, LPN, JD

73. Let's make that something besides the wikipedia page you just edited.

6:20 PM, Joel Gaffney

Citation needed.

74. Responding to 50.

6:20 PM, Rebecca Oliver

MANY drug companies are based in France,  Germany, Belgium and Isreal.
Does research prove your point? Can you cite any studies? Or is it your second hand opinion?

I also took health law in law school in 2009. The consensus was that our system is broken. 

75. I started this email chain and I'll cite Mayor Mike if I want too.

6:26 PM, David Aronstam

Here is a link from Bloomberg showing ranking of healthcare systems:

http://www.bloomberg.com/visual-data/best-and-worst/most-efficient-health-care-countries

United States is ranked 46!

David J. Aronstam

76.

6:30 PM, Robert Larson, Esq.

If you are so bent on cites, give me yours.  Practice what you preach and give over.  Even if I listed cite after cite I doubt it would be adequate for individuals who adamantly want to make the government the decision maker and the provider for healthcare .  The studies would be faulty or deficient in one way or another.  Sorry, I had little to no faith in the government before this and it (Obamacare) and its implementation has not helped.
Robert B. Larson, LPN, JD

77. Translation: I have no support for this (see ¶ 73).

6:31 PM, Phil Byler

You mean like a case that discusses why the Federal Rules of Civil Procedure apply to civil cases in federal court?

Phil

78. See how he responds to two different emails in one?  If everyone else learned from this, we'd only be at number 72.  Which would be no better.  Never mind. 

6:32 PM, Joel Gaffney

Bloomberg?  Come on now, everyone knows that Bloomberg's obsession with facts and data gives him a clear liberal bias.

And Robert, all I want is a citation for the assertion that anything coming from the government is "by definition" socialist/communist.  I mean, if it's really a matter of definition, surely you have a dictionary to point me to to show that I'm mistaken?

79.

6:35 PM, Phil Byler

Joel, good grief, no, ObamaCare is NOT a market based reform.  ObamaCare, with its 1,992 grants of statutory authority to the Secretary of HHS to dictate what happens in the health care industry and over 20,000 pages of implementing regulations, is a form of socialized medicine.

Phil 

80. What would Judge Posner think?

6:36 PM, Joel Gaffney

Hey Phil, that's easy.  The Federal Rules of Civil Procedure apply to civil cases in federal court.  Fed. R. Civ. P. 1.  Look, it's even in Bluebook format.

81. Someone forgot Article I, § 7, cl. 3.

6:37 PM, Phil Byler

Just wait until you see what ObamaCare delivers, assuming Congress does not have the good sense to repeal it.

Phil 

82. This lawyer and nurse has been on this issue all day.  I really hope he was defending a deposition this whole time.

6:38 PM, Robert Larson, Esq.

If the "market" wanted a product a certain way it would be that way.  Ifvthe market does not want or demand it, the it is not created/ produced unless big brother gets involved. Efficient market theory
Robert B. Larson, LPN, JD

83. I bet this guy reads all the rules too.

6:40 PM, Joel Gaffney

Basically, my point is that Robert's answer makes it clear that he is using definitions of "market-based" and "socialist" and "communist" that I do not understand.  So in order to have a meaningful discussion, I'd like to know where his definitions are coming from, or at least what they are.

84. WBR.  Tsk tsk.

6:42 PM, Joel Gaffney

Okay, so if that's what the "market" means, how exactly is it possible to have any kind of "market-based" reform?  Wouldn't the market just act on its own automatically?  Efficient market theory is only correct to the extent that you ignore external costs.

85. Gotcha! (see ¶ 80).

6:50 PM, Phil Byler

My point.  I asked for a case.

Phil 

86. Does anyone else realize that it's almost 7 on a Friday night?

6:51 PM, Joel Gaffney

It sounds like, by your definition, any government regulation whatsoever would be a form of "socialized" whatever.  If that is true, then the meaning of "socialized" becomes useless as a demonizing phrase.  If you honestly believe that there is no place for government in addressing the points where markets transfer the costs of individual actions to uninvolved third parties, then there is certainly no point in continuing this discussion at all.

If, on the other hand, you do believe that is a legitimate role for government, then our argument is one of degree rather than of kind, and throwing around labels like "socialist" and "communist" are just distracting from the real issues.

87. All the straw man ever wanted was a brain.

6:52 PM, Joel Gaffney

Right, but all I asked for was a citation, so your rebuttal was an obvious straw man.  As such, I chose to ignore it.

88.

6:53 PM, Rebecca Oliver

Robert the cite David provided is perfect. I am open minded but nothing I have ever read has put the US in any top category for health care. We do rank highest in costs and among the worst in most health indicators.
I have mixed feelings about the Affordable Care Act. Some good has resulted as has some bad. Only time will tell.
My point is, there is no need to repeat mindless propaganda about every other developed country. Data, such as that cited by David,  and the experince of people who have actually lived in these countries and have been part of these other health systems, shows the your allegations are baseless.  

89. I had a long day saying things I think.  I need a rest.

7:05 PM, Robert Larson, Esq.

Rebecca,
Have a nice weekend.
Robert B. Larson, LPN, JD

Saturday November 16, 2013

90. In response to 46.  I think you missed a few emails, sir.

1:29 PM, Patrick Wang

Amen for that.

Patrick Wang, Esq.

91. And the weekend name calling starts.

3:18 PM, Ken Metnick (? - not entirely clear)

Some of the right wingers on this list serve have been listening to morons like Rush Limbaugh, Hannity, etc. The goal is to get people insured .It is simple as that . Because it is not perfect does not mean it is an unworthy goal. We are not talking about starting another war here. Do you anti Obama people also believe climate change is a hoax. Because if you do you should move to Northern Florida or some where else in the South. The right wing Republicans are anti intellectual and an embarrassment to this country. As attorneys you should have enough analytical abilities to realize the right wing Republican agenda is crazy and moronic.


92. That bait is delicious.  

4:33 PM, Phil Byler

Excuse me, Ken, but if anything is moronic, it is your post.  Your rhetoric does not cover for the lack of intelligent analysis. It is you who are anti-intellectual and an embarrassment.    

If your goal is to get people inured, then consider three points: (1) under the prior system, most people who wanted insurance, had it and liked their plan; (2) right now under ObamaCare, there are over 50 million uninsureds and counting because of the plan cancellations caused by ObamaCare; and (3) according to the CBO, under ObamaCare, there will be 30 million uninsureds.  So, we go to a system in which people have to pay much higher premiums and don’t get to choose their doctor and there is health care rationing, all in order to get people insured and we end up with the same number of insureds.  That is really smart of you Leftists!

What, Ken, do you mean by “climate change”? Do you use those words because the statistics don’t support “climate warming”?  You do understand, don’t you, that over time, the Earth’s climate has been continually changing?  From 1000 to 1200, there was the Medieval warm period, with the Earth warmer in 1000 than it is now.  From the 16th to the 19th centuries, we went through a mini Ice Age.  So why bring up “climate change” here unless you think that it clearly justifies Government regulation and control.  Sorry, it does not.

Ken, what marks the political Leftist is not intellectual ability, but belief.  David Horowitz, a one-time New Left figure back in the 1960’s who became a conservative by 1984 when he voted for Ronald Reagan, once talked to an old left wing friend about what he, David, was thinking.  David’s old friend told him, “David, you no longer believe.”  David Horowitz has written that it was not on the Left that he found true intellectual exchange and discussion, but on the conservative Right.  Horowitz is correct.  

Phil 

93. Please?  Stop it.  Please?  Pretty Please?

5:08 PM, Leonard Sienko

oKay….There is nothing in the guidelines which prevent political discussions, although over the years, no one has really engaged in any type of politics as there was an unspoken understanding that the list shouldn’t degenerate into name-calling etc.

Incivility is prohibited by the guidelines.

More importantly, you are expected to delete any materials not directly needed for the context of your reply.  I don’t care if you want to argue how many doctors can stand on the head of an insurance actuary; but please stop cluttering up the list with unedited responses that scroll on and on.

94. In the future, the enter button on the right side of your keyboard is your friend, btw.

5:09 PM, Rebecca Oliver

Resorting to personal insults is what shows a lack of intelligent thought. As educated professionals, we should be able to have a conservation based on facts and evidence,  not  propaganda. 
I saw some pretty outrageous claims, such as Canadians have longer wait times, masses of Canadians come here for treatment,  British hospitals are filthy, and other systems are much worse than ours. Since I have never encountered this in reality,  and every article I've ever read indicates otherwise, I asked what evidence these ideas were based on, if there is any other than a third hand biased opinion.
Insulting or dismissing a request for information shows you have no evidence to support such ridiculous claims. If there are masses of Canadians fleeing here, or if British hospitals infect the most patients with staph, there should be an article or research to support that, right? Instead some resort to name calling ("socialism!" Morons!) To cover.
It is also tired propaganda to claim almost "everyone" who wanted insurance had it and LOVED it before the affordable care act. I haven't met anyone who was crazy about their insurance.  Most people are lukewarm at best. And denying there was a problem before is basically  denying the existence of the middle class and the poor,  which I guess is normal for some people.
Many of the people without coverage will be undocumented immigrants,  btw. 

Sunday, November 17, 2013

95. "Dude, he totally started it."  And I don't think Leonard did anything to indicate that he was only responding to the righties.  I think Phil's being a little touchy.

7:05 AM, Phil Byler

Leonard, I only wrote it was “moronic” because Ken called postings reflecting conservative views “moronic.”  It was Ken’s word in what was a political broadside of a post by Ken.  I quote Ken: “As attorneys you should have enough analytical abilities to realize the right wing Republican agenda is crazy and moronic.”  If you want to cite incivility, don’t single out conservative push back and pretend you did not see the original instance of it because it was a liberal writing, or admit that you are citing incivility to silence conservatives.

Phil 

96.

7:29 AM, Phil Byler

Rebecca, other than responding to Ken’s political broadside of a post calling conservative views “moronic,” I was arguing facts; yet, it was to my pushback you objected.  In any event, are you are really denying that under the prior system, most people who wanted insurance, had it and liked their plan?  If you say you have not encountered such people, perhaps you are having conservations like the Manhattan resident right after the 1972 election who said she did not know anyone who voted for Nixon. even though Nixon had won a landslide victory with well over 60% of the vote.  Are you really denying that right now under ObamaCare, there are over 50 million uninsureds and counting because of the plan cancellations caused by ObamaCare?  Are you turning a blind eye to Obama’s pledge that people could keep their plan and their doctor?  Are you really denying that denying that according to the CBO, under ObamaCare, there will be 30 million uninsureds in 2023?  Are you really arguing that there are not serious problems afflicting the Brit national health insurance system don’t exist?  I know left wing members of the Brit Labor Party say that, but I was always thought that was the product of ideological belief trumping reality.  

Phil 

97. This is really good.  Nobody had offered a personal anecdote in a while now.

11:52 AM, Ken Metnick

By the way I have a lot of clients from Canada and they like their health care system

98. Here fishie fishie...

11:50 AM, Ken Metnick

 Do you also believe women who are raped should not be allowed to have abortions. You are not using your analytical abilities. You are making things up and resorting to Sarah Palin, Ted Cruz , and Michelle Bachman logic.

99.

1:28 PM, Rebecca Oliver

Phil

I totally agree with you on some things. The Affordable Care Act was poorly planned and implemented. It has many flaws.  I am not fond of government mandates and taxes, especially when the employer mandate was delayed and the individual one was not. Yes Obama was wrong about keeping your doctor and your non compliant plan.
Let's not pretend that everything was wonderful prior to the Affordable Care Act, however.  To do so is denying reality. 
A huge proportion of the working class and lower middle class could not access insurance.  Even those that had it went bankrupt from non covered medical bills. How many of us love our insurance and never had a problem? I like mine, but we still had to file 3 or 4 appeals this year.
And of course other systems have problems too. Cost is NOT a problem like it is here, however. These systems produce better outcomes by every measure ever thought up, and NOBODY dies from lack of care, like they did here.
I don't know the numbers on how many people had their polices canceled.  But let's wait a few months and see. My bet is that the vast majority of them will have better coverage at a lower price next year. 

100. Mmm.  Crimson.

2:49 PM, Phil Byler

Ken, no, I am not making anything up, and Ted Cruz is a fellow Harvard Law School alum.  But you are such a rabid ideologue that it is best to discontinue the exchanges.

Phil 

101. Wait for it.  "People really did not die under the prior system."  He actually wrote that.  

3:11 PM, Phil Byler

Rebecca:

I was not claiming perfection for the prior system.  There were certain reforms that were in order before Obama took us down the road of ObamaCare, such as allowing insurance companies to sell insurance cross state lines.  What I do argue is that the prior system was better than ObamaCare will ever be, and we would have been far, far better off staying with the prior system and implementing market based reforms.

It is not true that a huge portion of the “working class” and “lower middle class” could not afford insurance.  Most people in lower income levels had employer provided insurance.  There will be less of that under ObamaCare and there will be plenty of people who will be working 29 hours a week so that employers do not have to provide insurance to such employees. Also, according to the CBO, ObamaCare will in 10 years leave uninsured the same number of people some people claim were uninsured under the prior system.

It is also not true that cost is not a factor in other systems.  Cost is always a factor; we never escape the economic problem of scarcity. In Government run health care systems, cost may seem less a factor only because the Government is attempting to dictate results.  The problem is that the cost is still there and will manifest itself in poorer health care quality, wait times, and failure of coverage.  And people do die under socialized medicine, just as they will under ObamaCare, because of wait times for care or Government dictated denials of care.  People really did not die under the prior system.

Your faith in ObamaCare providing for better coverage at lower cost is just that -- faith in a system of socialized medicine that does not warrant that faith.  The early reports indicate that premiums under ObamaCare are doubling, which many families simply cannot afford. 

I believe that ObamaCare needs to be repealed and replaced for the sake of everyone in society.           

Phil 

102. Like this will stop before there are at least another 50 emails. Bwa ha ha.  And it was 101 emails, not 100.  But pretty close.

3:16 PM, Adam Kalish

Dear politicians  

99% of the people on this LS don't care for the 100 emails that you just sent.  

If you want to run for office on your platforms, please do everyone and favor and act on it.  Just stop sending these asinine emails berating each other.  Stick to trolling in the comment section of CNN or Fox News and leave the emails to important questions and responses that the legal community need.

Thanks

103. Is it okay to kill someone to show that killing is wrong?

3:27 PM, George Williams

It was my understanding that listserv is solely to help other practitioners and discuss legal issues. Not someone's ideological and political views.   Please respect others concerns and limit correspondence to items if legal interest.  Maybe your views are best suited for " politicalsez"

George Williams Esq., CPA

104.

3:10 PM, Edward Papa

Good Idea Phil.

I have been watching these "exchanges" and by last count we got a Ted Cruz, Sarah Palin, War on Women, Climate Change and pretty sure a tea bagger or two in there somewhere.

If you keep it up, Ken or Joanne will invoke either "It's Bush's Fault" or the race card.

It's all so predictable. Next time you feel like engaging in a "discussion" with a progressive ideologue - don't. It's a complete waste of your time and intelligence.

Edward Papa, Esq

105. I really hope he washed his hands before sending this.

5:28 PM, Paul F. LaGattuta III

Bathroom reading.

Yours truly,

Paul F. LaGattuta III

106. That bait tastes pretty good too.

6:46 PM, Ken Metnick

You guys have to be kidding. I wouldn't be proud I went to school with Ted Cruz. What does law school have to do with anything. I went to George Washington law school. Is that relevant? The facts are Obama has fixed the economy as Bill Clinton did.Obama has also not waged any more unnecessary wars like Iraq.  The Republicans have been ruining this country for years . I don't like paying taxes but that is not a reason to support a party of extremists run by rich white men who need to get laid.Obama care will work out eventually and remember Reagan called Medicare socialism before he embraced it. What exactly is the Republican party platform? Is it to make poor people have babies and then to abandon the babies by not providing health care, education and food? Is the platform to destroy the environment? Is the platform to try to push their right wing anti - intellectual religious beliefs on everybody even when they say they don't want government to interfere.? Is it to put in power people like Justice Scalia who believes in the wily devil? Is it to support people like Michelle Bachman who think the world is ending or Sarah Palin who talks in tongues? Lastly you think shutting down the government like Ted Cruz wanted to do is a great idea? Yes Bush did screw everything up and there are many Racists in the tea party and the Republican party..Do you think Obama was born in Kenya and is a Muslim?

107.

7:29 PM, James C. Locantro

Name-calling, distortion of facts, making villains out of those with whom you disagree with, is what's wrong with politics today. Obamacare, while its' goal was noble, the politicians forgot the main rule which is " the Devil is in the details"

Respectfully yours,

James C Locantro

108. All joking aside, let me tell you what you really believe.

7:36 PM, Ken Metnick

I think we all agree it is flawed but can be fixed as time goes on. It certainly is noble and the health care system that pre existed it was not working. I believe a single payer medicare like system is better but the Republicans would never have allowed that.My firm has 10 employees not including spouses and children

 My rates will go down in January.It is essential to have a good health insurance agent.

109.

8:02 PM, Meyer Y. Silber

Richard, neither balls nor brains will help.  We need to at least appreciate that a concept you describe just can’t work across our fruited plain.  There are too many people with too many variables.  It’s a nice idea.  That’s it.

110.

8:14 PM, Jason Racki

If the republicans want to continue to call themselves Republicans, they better settle on sturdy platform soon like getting a manufacturing base back, rocking China back on its heels, or maybe jobs, jobs, jobs. Something, anything other than don't tax the rich on the hope that they invest it in American jobs. Nobody has any money anymore, and jobs is the only solution outside of openly practiced Socialism. But, protecting a economic system that doesn't serve its people anymore is also stupid. I say, where the government can do where the corporation can't, then let the government do, even if it is at a loss. That is what government is there for. When the profit motive doesn't solve the problem, then the people have to expediently do something about it. Something resilient enough that only the government can provide. This is how Capitalism has always been provided for. But now that the corporations really run things with their unrestricted campaign contributions, nobody knows what is real or important anymore other than there's no money and the Democrats seem to be the only political party willing to do anything about it. If the 1% had to spend even a day in the 99 percent's shoes, there would be no such thing as the current Republican Party. So, that's my two cents. My armchair manifesto. Whatever. Doesn't mean a thing in a country where your job is so closely connected to your vote, unless of course you are hypnotized by the rhetoric coming from all directions: church, the supermarket, the dinner table, which is always in front of a TV endlessly blaring Fox News' nonsensical propaganda. 

Jason Racki 

111. Wasn't Hitler a socialist?

9:08 PM, Florian Bruno, Esq.

What I take offense at is when these people are called "conservatives." It's not what I understand conservatism means. When I lived in Europe I was a conservative. Here, the word has become synonymous to a rattle bag of weird ideas - some of them offensive to human reason (evolution is "lie as from the pits of hell") held together by Fox News and a completely insane interpretation of Christianity.   

112. Yeah, you too.

9:47 PM, George Williams

And Florian as well.  What/How does your post benefit the legal brethren?

George Williams Esq., CPA

113.

9:58 PM, Mark Dunford

"Obama has fixed the economy..." The current unemployment rate based upon the US Bureau of Labor Statistics is 7.3%.  When Obama took office the unemployment rate was 6.5% and it immediately jumped to 7.8% and steadily increased to 10%.  The US GDP was 12.68 trillion in 2000 and at the end of 2008 it was 14.57 trillion.  A nearly 2 trillion increase in eight years.  In six years the GDP has gone from 14.57 to 15.79 trillion, a little over a trillion dollars.  The US debt was approximately 5.7 trillion in 2000 and in 2008 it was 10 trillion, an increase of less than 5 trillion.  From 2008 to the current time the US debt is 17 trillion, an increase of 12 trillion.  So tell me again that Obama has fixed the economy.  It is not the evil republicans that have caused this problem it is our politicians as a whole.    

You are right in that Obama has not waged any more unnecessary wars.  What he has done is step up drone strikes and killed many, many, innocent lives.  What he has done is continue to operate Guantanamo Bay, which he vowed to shut down upon his election.  What he has done is vow to send air strikes into Syria against the wishes of most of the G20 nations.  In the end he is a politician just like George Bush and Bill Clinton were.  

The rhetoric I have read from both sides on this issue, is in a microcosm, the essence of what the problem is in this country today.  There is no compromise between either party.  It is an all or nothing scenario.  But as was posted earlier, if the Affordable Care Act is so great why did the Democrats conveniently exclude themselves, along with all of Congress, from having to comply with the law.  Why are they able to keep their "cadillac" health care coverage?  Why do the unions, that so heavily support the Democrats, get an exemption from the Affordable Care Act.  

True, the US health care system needed change to cover those that did not or could not afford coverage.  But I don't believe the answer was a methodology that completely overhauled a system that essentially worked however it did have flaws.  The answer was to determine a way to cover those that did not have coverage and allow those that did to remain unchanged.  I live on the border of Canada and have many friends that are Canadian and they like some aspects of their system and dislike others.  Yes, for prescriptions and routine healthcare visits, their system has proven exceptional. For transplants, hip, knee or other replacements, there are very long waiting lists.  So it is not perfect.  One friend brought his father to the US for heart surgery because he would have had to wait 7 or 8 months for the surgery to take place in Canada.  By that time his health may have deteriorated to the point it precluded him from being a surgical candidate.  

You see Ken, it is never simply black and white, nor republican or democrat.  By your statements, you have shown your hatred and biases for those that think differently from you.  So, is it your platform that we all have to drink the kool-aid and drop in step with your thinking or else we are guilty of being racists, anti-environment, anti-education, etc.  As an attorney you do yourself an injustice stating that "republicans are rich white men that need to get laid" thereby debasing your argument to sophomoric levels.  

Mark J. Dunford, Esq.

114.  But see ¶ 66.

9:37 PM, Anthony Emmi

Ken

I cannot believe the email exchanges are still going on. Nobody thinks your comments are as brilliant as you do so why don't you just send a post to yourself and quit cluttering up the list serve.

115.

10:08 PM, Ken Metnick

Did you forget about the stock market and real estate? I did not start this conversation . But I am finished debating with irrational people . Thankfully the Republican party will lose the house in 2014 and the presidency again in 2016.This is about party politics. 

116. I think people stopped listening.

10:17 PM, Ken Metnick

I did not start the Republican Rhetoric. It started last week. I don't think my comments are brilliant. I am merely discussing what should be common sense. What is shocking that there are so many brain washed tea party people living in New York.One always assumes that states like New York, California etc are populated by reasonable educated people who support the democratic party.This has been an eye opening experience. Did I join the Alabama bar association or is this West Virginia bar association?Hey whats next you guys want to talk about the greatness of the NRA and guns.

117. This guy also but see (saw?) 66.

10:21 PM, David Mejia

Well said Anthony.

118.

10:27 PM, George Williams

Awesome question Anthony !  One that NOBODY has an answer for.  All I know us my clients are being dropped by the carriers and they are desiring part time employees or contractual workers and looking for advice to to circumvent ACA requirements.

George Williams Esq., CPA

119.  "Maybe if I answer the original question, this will all stop."  Fingers crossed.

11:01 PM, Marla Pilaroscia

I'm getting it from my county bar association (Monroe).   Hi-deductible for a single for about $318, up about $20 from last year. 

Marla Pilaroscia

120. 11:11 - Make a wish!  Maybe this will all stop?

11:11 PM, David Mejia

Deductible or monthly premium?

Monday, November 18, 2013

121.

6:32 AM, Ken Metnick

Humana. You have to go with large companies.

122. Only the Republicans know what's best for themselves.  And for everyone else.

7:12 AM, Phil Byler

Jason, we Republicans will determine our future.  In my view, Reaganite conservatism is where we need to go.  Thanks for your advice, but no thanks. 

Phil

123. Going back inline.  And this actually looks like some evidence.

9:57 AM, Rebecca Oliver

Phil, I responded to you in red below.

Ken, I am a member of the West Virginia Bar Association as well. You would be surprised and impressed with many of the members and the State in general.

Rebecca:

I was not claiming perfection for the prior system.  There were certain reforms that were in order before Obama took us down the road of ObamaCare, such as allowing insurance companies to sell insurance cross state lines. I thought y’all would love state regulation instead of a federal system.  What about the 10^th amendment? Or do you just want no regulation whatsoever?  What I do argue is that the prior system was better than ObamaCare will ever be, and we would have been far, far better off staying with the prior system and implementing market based reforms. Time will tell.

It is not true that a huge portion of the “working class” and “lower middle class” could not afford insurance.  Most people in lower income levels had employer provided insurance.  Hmmm…Are you going with Romney’s version of middle class? $250,000 a year? Here is some research: More than one in six (18%) of the nonelderly was uninsured in 2012. 76% of them were at or below 250% of the poverty level. http://kff.org/uninsured/report/the-uninsured-a-primer-key-facts-about-health-insurance-on-the-eve-of-coverage-expansions/ Let’s remember, Wal Mart is the largest employer in America. Retail and Service are the fastest growing job sectors. The vast majority of these people do not have affordable employer provided coverage. If they have coverage at all, we foot the bill.  There will be less of that under ObamaCare and there will be plenty of people who will be working 29 hours a week so that employers do not have to provide insurance to such employees. Also, according to the CBO, ObamaCare will in 10 years leave uninsured the same number of people some people claim were uninsured under the prior system. I agree that this is a MAJOR problem. The solution is to mandate that employers offer coverage to ALL employees.

It is also not true that cost is not a factor in other systems.  Cost is always a factor; we never escape the economic problem of scarcity. In Government run health care systems, cost may seem less a factor only because the Government is attempting to dictate results. Actually no. Cost seems less of a factor because government doesn’t allow drug and medical device companies to overcharge, and what doctors can charge is limited as well. Guess what? They still produce drugs and still work and still profit, but everyone in society can also access care.   The problem is that the cost is still there and will manifest itself in poorer health care quality, wait times, and failure of coverage. Many studies demonstrate this to be TOTALLY untrue. WE have longer wait times, poorer health care quality, and failure of coverage, much more so than any developed country, under the “perfect” system we had. See: http://www.bloomberg.com/visual-data/best-and-worst/most-efficient-health-care-countries,  http://www.theatlantic.com/health/archive/2013/01/new-health-rankings-of-17-nations-us-is-dead-last/267045/,  http://www.policymic.com/articles/46063/7-countries-that-show-us-how-health-care-should-be-done,  (“moving past the mythical tradeoff between time and cost, Germany is one of the few countries to have quick access to specialty services with very little out-of-pocket costs.”, “In 2010, 72% of Dutch adults saw their doctor the same or next day when they were sick, compared with only 57% of adults in America. And, whereas one third of U.S. adults did not see a doctor when sick, went without recommended care, or failed to fill prescriptions due to costs, only 6% of adults in the Netherlands faced these issues.”)  And people do die under socialized medicine, just as they will under ObamaCare, because of wait times for care or Government dictated denials of care. Can you provide one shred of evidence in support of this nonsense? http://www.drsforamerica.org/blog/the-waiting-times-myth (“Beyond anecdotes, there is actual data, such as the Commonwealth Fund study showing that "U.S. patients reported relatively longer waiting times for doctor appointments when they were sick, but relatively shorter waiting times to be seen at the ER, see a specialist, and have elective surgery.” )  Insurance companies, with a profit motive, ration all of the time, much more than a non-profit system. It is common knowledge that European countries will spare no expense when someone’s life is on the line, paying for treatments that our insurance companies never would. People really did not die under the prior system.  http://www.pnhp.org/excessdeaths/health-insurance-and-mortality-in-US-adults.pdf (“Given that an estimated 45,000 Americans are estimated to die every year due to lack of access to health care services, rationing in America is particularly troublesome, and oddly overlooked.”) Sadly I have a relative that worked at Wal Mart, was uninsured for ten years so did not see a doctor the entire time, and it turned out he had cancer at least ten years, and now it is terminal although it could have been cured completely ten years ago if he could have had treatment for the symptoms he was having. Oh and Medicaid has already spent MILLIONS on care that will do nothing, now that it is too late. It will probably be tens of millions by the end. He was only able to get Medicaid because he is terminally ill. And this is not the only person I know to have had a similar experience. I knew a man in his thirties who died from a heart attack. He was prescribed BP meds and could not afford them because he had a wife and children and did not make enough.

Your faith in ObamaCare providing for better coverage at lower cost is just that -- faith in a system of socialized medicine that does not warrant that faith.  I believe in what I see working. Take a look at the data again, or maybe apply for a passport. The early reports indicate that premiums under ObamaCare are doubling, which many families simply cannot afford.  My costs haven’t gone up.

I believe that ObamaCare needs to be repealed and replaced for the sake of everyone in society.       Too bad that your viewpoint is still the minority. I do agree that it must be improved.     

124. It's all flyover to me.

10:04 AM, Ken Metnick

I apologize . I used Alabama and West Virginia as examples of red states that have alot of right wing Republicans. Obviously there are democrats in those states and Republicans in New York.Have a great day.

125.

10:07 AM , Rebecca Oliver

Phil:

About the people who will remain uninsured:  Currently, accoriding to CBO, there are 53 million uninsured persons in the United States, including uninsured illegal aliens. The CBO estimates that in 2022--8 years after the Affordable Care Act has been fully implemented--30 million people will remain uninsured. - See more at: http://cnsnews.com/news/article/cbo-obamacare-will-leave-30-million-uninsured#sthash.jn41wyee.dpuf

How many undocumented immigrants do you think there are? Hint: Not 11 million, not even 15 million. It is at least 20 million and probably closer to 30. Plus remember that LEGAL immigrants face a five year bar to Medicaid. Many immigrants live in states like Texas and Florida where they will not expand Medicaid, and many more will also fall into the coverage gap where they cannot get Medicaid (by income or immigration status) but do not make enough for subsidies.

There are most of your 30 million uninsured. 

126. One piece of bad information and it's ALL WRONG.

10:35 AM, George Williams

Rebecca,  your last comment in your diatribe is without merit. a majority want it repealed 

Unless a minority in your book is  some other Mathematical computation. 

55% Favor Repeal of Obamacare

Most voters view the new national health care law as bad for the country and want to repeal it.
A new Rasmussen Reports national telephone survey finds that just 35% of Likely U.S. Voters now believe the trouble-plagued health care law is good for America. Fifty-five percent (55%) consider it bad for the country. Only two percent (2%) think it will have no impact. 

George Williams Esq., CPA

127. I didn't check, but if George just sent me porn, that would be HI-larious.

10:36 AM, George Williams

http://m.rasmussenreports.com/public_content/politics/general_politics/november_2013/55_favor_repeal_of_obamacare

George Williams Esq., CPA

128. "I don't disagree that we should be annoying most of the listserv members, but I do think we should have some integrity while doing it."

10:41 AM, Florian Bruno, Esq.

Now y r writing here despite having scolded others for contributing to this off topic thread

Sent from my iPhone 

129.

10:48 AM, Joel Gaffney

"Likely voters" are a deliberately distinct group from the general population.  Rasmussen's likely voter polls are traditionally skewed older, whiter, and more conservative than the general population.  And in recent elections, they've been older, whiter, and more conservative than the actual voting population, too.

Also, I wouldn't hang my hat on a 55% result from a question that didn't give respondents the option to say they don't care.

130. It's not the size of the post that matters.  It's what you do with it.

10:51 AM, Rebecca Oliver

George,

I was merely responding to a comment directed at me. My response was not any longer than the original comment I replied to.

If the majority of people supported a repeal, then there would be momentum to repeal it. A repeal has been brought up for a vote dozens of times and gotten nowhere. 

131. This is beginning to sound like Nixon's secret plan to end Vietnam.

10:53 AM, Phil Byler

Actually, Rebecca’s last comment was reflective of how all of her comments were mistaken.  People such as Rebecca sincerely but I believe erroneously believe what they do about Government run health care, insisting on its success that denies reality by citing various “studies” done to promulgate Government run health care and ignoring economic constraints. 

Phil 

132.

10:55 AM, James Quinn

with a nod to the tyranny of the majority, those with health care coverage, don't get to weigh in on whether those without health care coverage are entitled to it....

James F. Quinn, Esq.

133. This is why Lincoln wanted the 13th Amendment.

10:55 AM, Joyce Goldstein

Please everyone reply offline to this thread if it is of interest to you. You are flooding my inbox with a conversation that doesn't pertain to the purpose of the board. I do not wish to be a captive audience.

Joyce M. Goldstein

134.

10:58 AM, Florian Bruno

As we know many voters favor repealing "obamacare," that socialist monster. But they all LOVE the affordable care act...


135.

11:02 AM, Rebecca Oliver

Do you have any studies at all that support your point??? You are making some outrageous claims, but have not yet identified any source of relevant information.

Also, if you talk to people from different places or at different economic levels you may learn something. 

136. I'm not being pejorative.  Really.

11:09 AM, Phil Byler

With all of Obama’s changes to the law done by executive order (of dubious constitutionality), it is more accurate to refer to the law as ObamaCare.

Phil 

137. How long do you think he can hold out before he writes again?

11:10 AM, Phil Byler

OK.  I am done anyway.  I have paying client work I need to do.

Phil 

138. Responding to post 37.  Yes - 101 posts earlier.  Where have you been all this time?

11:12 AM, Charles Oliver Wolff, Esq.

The Nordic Model seems to be working quite well.

Chuck Wolff

139. Subject changed to be "OFF TOPIC - Health insurance PLEASE TAKE THIS CONVERSATION OFFLINE ALREADY."  This subject pops up a few more times, but as expected, most people ignore this.

11:13 AM, Joyce Goldstein

In my opinion this has become rude and inconsiderate of yoru fellow listserv members. This is not a listserv topic and many members, myself included, have requested that you take the conversation offline should you wish to pursue. We do not wish to be a captive audience so please stop this.

Joyce M. Goldstein

140. If you disagree with me - or ever support an untenable position - you're a bad lawyer.

11:14 AM, Rebecca Oliver

Phil

Do you go to trial, with no evidence whatsoever, and simply say something is true because you say it is? I gave some studies as well as what I have personally seen and experienced. I totally agree that no study is perfect and people's impressions differ greatly. But when you make outrageous claims about rationing and death and wait times and who can access health care, I truly wonder where this information comes from.

Also, many of the countries ranked higher than us on health care (like Hong Kong, Singapore, Australia, and Switzerland) are also more capitalist than us, even according to the Heritage Foundation http://www.heritage.org/index/ . Every advanced economy has a mixed system; you cannot ignore economic history either. 

141. Not a very long email to be responding to 132.

11:19 AM, George Williams

James, I see you want us not to chime in but you want us to pay for it.

George Williams Esq., CPA

142. Subject changed to: "Political Debate."  Only for that one post.

11:33 AM, Billie Gray

Only attorneys would call this a discussion of health insurance.

143. The answer was 22 minutes.  And only because he had to prove he was in fact a good lawyer.  But he still sounds like Nixon.

11:32 AM, Phil Byler

Rebecca:

One last comment: I won my last two trials decisively, one in state court and one in federal court, by a compelling presentation and handling of the evidence.  I can assure you that in a more structured situation than a List Serve, I would hammer your position with trustworthy evidence and undermine your “expert” evidence.

Now, I have to earn a living.

Phil

144. I'm sure this made sense in theory.

11:39 AM, James Quinn

George - there is always a price to pay, whether you have civil rights or you don't...

James F. Quinn, Esq.

145. Responding to post 102.  Maybe he was being ironic.

11:45 AM, Charles Oliver Wolff, Esq.

Amen.

146.

12:00 PM, Richard I. Leff

I have only one statement, really a question, to add regarding telephone polls:  What are, in this day and age, the demographics of those individuals with land line phones who are home in the middle of the afternoon (or for that matter, even at night, given that caller ID is pretty much the norm) who will  answer a telephone poll?  Therefore, as a corollary, how accurate are these polls?

Richard I. Leff

147. The posts start repeating!  Phew.

12:03 PM, David Mejia

And none of this comes close to answering the original question posed on Thursday, which was:

Counselors:

I subscribe to the NYSBA health insurance plan.

I am a solo practitioner and my premium is a higher than those practicing in a group because the insurance lobby managed to have such a provision inserted into the law.

I was wondering if anyone has looked into what is available on the NYS health insurance exchange and how it compares to the NYSBA plan?

Thank you.


148. Um.  This isn't a party line.  And don't you think the last 147 posts (or at least 140 of them) indicate that the answer is "no"?

12:04 PM, Tom Fazio

Is there a moderator for this listserv?

 

Thomas R. Fazio, Esq.

149. Hey look.  You're David.  I'm David.  We're both lawyers.  Oooh!!

12:10 PM, David Aronstam

Thank you, David Mejia.

In the several hundred responses, there were 3 that tried to address my post.  And I thank the respondents for that.

I contacted the NYSBA directly and I got a call back from the insurance carrier for their health plan.  I will call them back and share any useful information that I receive.

David J. Aronstam

150. You're welcome.  Congrats on hitting 150.

12:22 PM, Anthony Emmi

Thank you!!

151.

12:32 PM, Diane E. Ungar

Any answers to this one, Joanne or others out there - after the off-oFf-topic deluge of mails I'm afraid the answer to the original questions got lost. Still seeking comparison/alternative/better health insurance company actual names and/or agent names (since NYSBA rate hikes and coverage changes) for solos especially. Anyone able to share?

152.

12:59 PM, Patrick Wang

Joyce:

If  you are not interested in, just please delete it. you don’t have to read it. As long as it is civil way discussing back and forth I am interested in reading forum members’ opinion. And it says in its title, “OFF TOPIC”  .

Patrick Wang, Esq.

153.

1:37 PM, Forrest Strauss

I'm sorry Patrick but I must respectfully disagree with you. 

OFF-TOPIC in the subject line is fine for an occasional joke or a one-off observation, but when it becomes the subject of a vituperative non-law related thread with some 30+ posts, it's no longer a momentary thing and has, instead, taken over the domination of this list. 

However, this is not FaceBook - its a professional tool that most of us signed up for to use for professional purposes.  Would you post a request for Thanksgiving turkey stuffing recipes on this list?  I think not.  Why?  Because this list is not the Julia Child show.  It IS, however, for lawyers, asking for help with client based legal issues, as part of a collegial association of peers engaged in the service of the public.  This is why those of us, who want to continue using this list for its stated purpose, should not have to "just delete it."  The posters violating the listserve's posting guidelines should, instead, in my humble opinion, be the one's we "just delete" from the listserve itself.

If you want to hear member's opinions about political issues, I think that's great - more power to you.  I just don't think it belongs here.  If that's what you seek, there are dozens of political blogs and ostensibly, allegedly, arguably, "independent" news channels to seek out whatever your particular flavor is and/or debate with those who have other perspectives. 

But the "GENERAL PRACTICE" listserve is NOT one of them and it is NOT the place for a political free-for-all.  Quite frankly, the whole situation has become absurd.  If this doesn't stop, and right now, I'm going to ask the listserve administrator at NYSBA to get involved because I, for one, have certainly had enough detritus in my "inbox" for today. 

-Forrest

154.

1:56 PM, Joanne Fanizza

Diane,

I found my original response to this (at 10:15 a.m. Friday), as follows:

David,

I have a United Healthcare plan (Oxford).  My agent is JCD Planning Corp d/b/a Proactive Benefits of Setauket.  My contact there is Jill McKnight, 631-751-5401.

I've had trouble with United, too, but not as much as I did with MVP.

Joanne Fanizza, Attorney at Law

155. Not really that interesting.

1:56 PM, James C. Locantro

This off-topic thread has gone off topic regarding the OP question about comparative health plans for sole practitioners. 

I just don't want the OP question to be thrown out with the "bathwater. It is a question that is on a lot of minds both in and out of our profession at this time and deserves a response from those with knowledge without the poster/responder being drawn into an admittedly interesting, but way  off topic.

Thank you.

Respectfully your,

James C Locantro

156. It's a telephone that's connected by wire that ........ wait a minute ........ I don't think you really want to know.

1:40 PM, Paul F. LaGattuta III

What's a landline?  ;-)

I love how juvenile this has become...immaturity is not determined by age.

Yours truly,

Paul F. LaGattuta III

157.

3:54 PM, Diane E. Ungar

Many thanks, Joanne. I probably speak on behalf of others as well, as to how difficult to impossible it's become, finding half-way decent, half-way affordable coverage - especially for solos and out of network

Again, with gratitude,

158.

4:01 PM, Joanne Fanizza

And that's why I hope for Medicare for All before I go on Medicare at 65.  J

You're very welcome.  I hope the info helps.

Joanne Fanizza, Attorney at Law

159.

4:40 PM, Patrick Wang

Forrest:

Let's agree to disagree. I do not want to prolong this thread. So I will stop here.

Patrick Wang, Esq.

Tuesday, November 19, 2013

160. This is beginning to feel like the middle of the Cuban Missile Crisis.  

1:16 AM, Diane E. Ungar

I know that in researching the nycity bar assn, they - as of this year (their open enrollment was April 1) essentially got rid of their PPO (out of network provider) payments. It's still there, but eviscerated. Rather than them pay a low amount like 65% of reasonable and customary, they only pay an EVEN LOWER virtually sham amount - it's based upon what Medicare would pay the out of network PPO provider (extremely little) and then they pay us, the 'insured' a small percent of what Medicare would have paid that health care provider

I was encouraged by their agent (city bar) that if I do have out of network providers, and if I already have a plan that covers them (I do, NYSBA, lousy and uber-expensive as it is) I should keep it. Because my out of network will be barely compensated under their oxford-united health care plans.

Another listserv member did refer us to her insurance agent to use in lieu of NYSBA for cheaper better oxford/united care plans. I'm not sure if that agent deals with SOLO practitioners (such as myself and many of us) or if this plan seemed better because the listserv attorney has all in-network providers. Or maybe this plan from this agent does NOT do the medicare based PPO reimbursement system.

Enough said, it's late. -but interested still in others' research and coverages found in this terrible economy and terrible time for medical care costs and medical care insurance coverage.

Many thanks,

161. Now the crazy starts to set in.

6:04 AM, Florian Bruno, Esq.

All solos should start a gigantic law firm with 50,000 members or so and then buy cheap group coverage!!! 

162.

6:20 AM, John Castro

Or we should put some fire under the NYSBA to start a lobbying group or group to unite all attorneys for group health insurance, highly reduced insurance plans, fedex rates etc. retirement plans and the like. Did you know that most professions have vanity plates for their professions, but checking the DMV website, nothing exist for lawyers. While this is a minor point, it shows what very little power/influence we display when it comes to pushing for attorney discounts. 

NYSBA achieves some discounts, they barely equate to what any organized group buying in bulk would receive.

If other city agencies have unions that wield should great power, shouldn't the lawyers who draft policy and are vested in every aspect of policy making, drafters of policy and law wield the same amount of power to influence these things as the rest of our fellow workers.

JUST A THOUGHT!!!

John C. Castro, Esq.


163.

8:05 AM, Ken Metnick

I won my last three trials all seven figures for a total of 15 million approximately and you are wrong. You continue to spout out Republican propaganda after many people have asked you to stop. 

164. This flame war was years in the making.

8:54 AM, David Aronstam

A  few years ago  a group of listserve members got together to see what we could do about getting the NYSBA use its power to get a better deal on health insurance.  My main motivation was that solos pay a higher rate than groups of 2 or more.  The NYSBA did nothing.

David J. Aronstam

165.

12:34 PM, Joanne Fanizza

And let me tell you why I think NY lawyers are disadvantaged about ALL things legislative in this state.  It comes from my experience being a member of The Florida Bar.

We do not have a strong integrated bar that is recognized as the voice for all lawyers.  OCA takes care of regulating our admissions, but that's it; no specialty committees or anything like that that work with branches of gov't or outside groups.  NYSBA has a minimal amount of clout dealing with the legislature because it is a voluntary bar.

In Florida, The Florida Bar is an integrated bar:  It is the only entity that admits, regulates and disciplines lawyers in the state.  It has a very high profile in the state, and also has committees for a variety of specialties, which committees work closely with the state legislature to propose and pass changes to laws and keep them up-to-date.  (And because of that clout, the committees are very successful in this regard, avoiding the morass of overlapping, antiquated stuff you see in the NYS.)  You can belong to any number of specialty voluntary bars, but TFB is key.

They also have respect from the public because they take seriously their job of disciplining lawyers -- and disciplinary proceedings are made public.  Do people here even know where to file a complaint against a lawyer?  NYSBA probably gets most inquiries, but who -- other than us -- knows about OCA?  And really, who gets disciplined here, and do you ever hear about it?  Unless the public knows they are being protected, they will not have faith in this system.

You have to practice elsewhere and see how things are done in other ways to learn that things can be done more efficiently and effectively. 

Joanne Fanizza, Attorney at Law

166. There's no place like home.  There's no place like home.

12:45 PM, James Quinn

be careful what you wish for...

James F. Quinn, Esq.

167. Now I'm looking forward to 150 emails on whether George Bush was properly elected.

12:54 PM, Bruce J. Robbins

joanne

not intending to quarrel with your principal points, but only to with clarify a little your suggestion that the Florida Bar and not the Court (Florida Supreme Court) is the attorney disciplining entity, I think you will find that the rules/law may now be a little different.  it may also depend upon which entity the complaint is made to.

thankfully i am not an expert on that subject, but within the past week at a CLE at which the new Chief Judge of Florida Supreme (Hon Jorge Labarga, he was the FL circuit court judge in West Palm presiding in Bush v Gore that went to SCOTUS 2000) addressed that issue as did our local (Pinellas) committee chief and that distinction was one of those that was made.

BRUCE J. ROBBINS, ESQ.


168. You're not even in NY?  

1:01 PM, Ken Metnick

Ditto. I practice in Florida also after starting out in my home state New York.Besides the bar we also have the Florida justice association which supports plaintiff personal injury lawyers against tort reform efforts.As far as business litigation like life insurance disputes or probate litigation which my firm does I dont think there is much of a difference between the States. Florida is far from perfect though. Clients are encouraged to file bar complaints in the statement of clients rights which must be signed with a personal injury contract. This results is alot of bogus bar complaints and threats from clients if you dont reduce your contractual fee. We also have a conservative Governor and Congress. South Florida is mainly a bunch of liberal ex New Yorkers but the rest of the state is conservative. Also, who can forget the 2000 election ballot mistake and the hanging chads. Lastly what about some of our criminal cases like Casey Anthony and  George Zimmerman.The weather is great though but once a New Yorker always a New Yorker.

169. Totally relevant to the issue of where to buy the best affordable health care plan.

1:05 PM, Ken Metnick

The Florida bar investigates, files the lawsuit if necessary,and makes recommendations. A judge/ referee makes the ruling if necessary and the Supreme Court rubber stamps it or disagrees  and makes their own determination.

If I missed any, I apologize (or you're welcome).  If there are more, maybe I'll post them.


Updates:
1. 1:35 PM, 165-169