The "true" cost of healthcare?

[Athena]

Originally posted by: TheSkinsFan (as a deliberate misquoting of Athena's words to reflect his own views....)
I don't seem to understand what the Exchange is; it is a Federal Government listing of approved private insurers. Companies are "listed" using To-be-determined standards. The Insurance Exchange (singular) is completely relevant to what employers offer.

It is unethical to change someone else's words and present them as a quote.

To get to the point though, the Health Exchange is not a list of "approved" companies -- it is a selection of plans that conform to minimal standards. Carriers are not obligated to participate in the Exchange and participating does not restrict them from offering other plans for employers.

As noted in the article linked in my other post, there are all sorts of Insurance Exchanges, both government and non-government sponsored, already in operation.

 

[TheSkinsFan]

Originally posted by: Carmen813

Originally posted by: TheSkinsFan
I've already read all of sections 121, 122, 124, etc, that deal with the so-called "standards" and details. Sadly, the only dollar amount they list is the one pertaining to cost-sharing. Other than that, we don't know jackshit about the standards.

In fact, if you look at Sec 124, page 36, you'll find this gem:

(b) ADOPTION OF STANDARDS.?
(1) INITIAL STANDARDS.?Not later than 18 months after the date of the enactment of this Act, the Secretary shall, through the rulemaking process consistent with subsection (a), adopt an initial set of benefit standards.

So, they are giving "The Secretary" a year and a half to come up with the "initial" standards AFTER the bill is passed. Swell.

Standards = details. A simple list of titles for the type of services that might be covered in any plan (Section 122) doesn't quite cut it for me.

Have you ever managed anything in your life? Look up micromanagement. What dollar amounts are you looking for? The bill eliminates the "maximum lifetime limit" a lot of policies have.

That's a cop-out.

Why do we only get to see the "standards" a year and a half AFTER the bill is passed?

Such details are the very thing that will make/break these proposals.

How many years did healthcare reform supporters have to come up with "standards" again? Oh yeah...

 

[TheSkinsFan]

Originally posted by: Athena

Originally posted by: TheSkinsFan (as a deliberate misquoting of Athena's words to reflect his own views....)
I don't seem to understand what the Exchange is; it is a Federal Government listing of approved private insurers. Companies are "listed" using To-be-determined standards. The Insurance Exchange (singular) is completely relevant to what employers offer.

It is unethical to change someone else's words and present them as a quote.

Please untwist your feminine undergarments. What I did is a standard, and often humorous, practice in these parts. /hugs?

To get to the point though, the Health Exchange is not a list of "approved" companies -- it is a selection of plans that conform to minimal standards.

What are those standards? Oh yeah, they're TBD.

AFAIC, "list of approved companies" is the same damn thing as "selection of plans that conform to minimal standards..."

Carriers are not obligated to participate in the Exchange and participating does not restrict them from offering other plans for employers.

I think you're wrong; but, even if what you're saying is true, I believe that businesses that choose to go outside of the HIE(s) will be hit with the 8% fine.

Let me re-read the sections related to the fines, and I'll get back to you...

As noted in the article linked in my other post, there are all sorts of Insurance Exchanges, both government and non-government sponsored, already in operation.

If I'm not mistaken, all of which would become superseded, or nullified altogether, by the new Federal HIE(s).

I'll do some more research on that and get back to you.

Good catch on the multiple HIE's btw. I may be wrong about there being only one in the proposal. I still need to look into that some more as well.

 

[seemingly random]

Originally posted by: spidey07

Originally posted by: Marlin1975


Yea and 10 years farther back then that it probable be cheaper. That just proves the point that we have to do something as medical cost are just going through the roof. The only ones that are really happy are drug makers and insruance companies. There is a reason insurance compnaies are spending over a million dollars EVERYDAY to keep things the way they are.

The only ones that are really happy are Americans, 80 percent of whom say they are happy with their healthcare and insurance.

-edit-
WOW! Go to anthem and see what kind of plans you can get for 150 bucks. 1000 deductible and that's the OOPM

I had the anthem < $150 lie, also. Within four years, it was up to almost $500. It's cheap until you start to use it...

 

[blackangst1]

Originally posted by: Athena

Originally posted by: TheSkinsFan (as a deliberate misquoting of Athena's words to reflect his own views....)
I don't seem to understand what the Exchange is; it is a Federal Government listing of approved private insurers. Companies are "listed" using To-be-determined standards. The Insurance Exchange (singular) is completely relevant to what employers offer.

It is unethical to change someone else's words and present them as a quote.

To get to the point though, the Health Exchange is not a list of "approved" companies -- it is a selection of plans that conform to minimal standards. Carriers are not obligated to participate in the Exchange and participating does not restrict them from offering other plans for employers.
As noted in the article linked in my other post, there are all sorts of Insurance Exchanges, both government and non-government sponsored, already in operation.

Unless I am misunderstanding, you are wrong. After 5 years (the whole "you can keep your plan (*cough* for 5 years), employers may only offer "approved" plans, thus must be part of the exchange. You can purchase your own "non-exhange" plans on your own however.

 

[Athena]

Originally posted by: blackangst1
Unless I am misunderstanding, you are wrong. After 5 years (the whole "you can keep your plan (*cough* for 5 years), employers may only offer "approved" plans, thus must be part of the exchange.

No, that's not what the bill says about employer plans.

Insurance companies offer an infinite number of plans to companies today. Most large company plans are negotiated and unique to a particular company. Two companies in the same city with the same carrier can have very different plans; varying in what is covered, deductibles, and co-pays..and of course rates. There is nothing in the bill to change that -- carriers can offer as many different conforming employer plans as they like. The plans that are in force today may have to be revamped in some minor ways to be in line with the standards but the companies have a 5 year grace period to get that done.

Exchange plans are for individuals and optional for small businesses. Carriers are not required to participate in that market at all; they can focus 100% on employer-paid plans if they like (just as many do today). A carrier that contracts with the commissioner to participate in the Exchange must offer at least a basic plan. If they so choose, they can also offer other plans with some extras. In some ways, that is similar to the Swiss system where every insurance company is required to offer a basic, low priced plan and every resident must carry insurance.

About the 5 year grace period: The number of companies in this country whose plans are configured exactly as they were 5 years ago is miniscule -- and even fewer are likely to remain static for the next five years. Obama's promise that people can keep what they have really opens him up to blame for something that is not under his control because whether or not employees are satisfied with what they have, employers are not. A recent survey of 439 large companies found that only 62% of them are confident they will be able to offer coverage 10 years from now and only 46% are supportive of the status quo. Companies have been tweaking the edges for a decade and they just don't have any more wiggle room.

There may be reasons to oppose the bills under discussion but health care reform itself is long overdue. Those who think that reform is just about providing coverage for the uninsured that will be so costly that they might loose some of their own coverage program are mistaken. The biggest threat to maintaining the level of benefits in company plans is not the prospect of covering the uninsured; it is in fact the status quo.

 

[blackangst1]

Originally posted by: Athena

Originally posted by: blackangst1
Unless I am misunderstanding, you are wrong. After 5 years (the whole "you can keep your plan (*cough* for 5 years), employers may only offer "approved" plans, thus must be part of the exchange.

No, that's not what the bill says about employer plans.

My apologies I should have qualified my statement. It is true for ERISA employers. After 5 years they may only offer "approved" plans.

 

[shira]

Originally posted by: Marlin1975

Originally posted by: blackangst1

Oh you mean their skyrocket profit margin in 2008 of 1.5%? That one you mean?

Profit is after they take all their cuts. There is a reason their "overhead" is 20%. That means every dollar they take in only 80cents goes to medical cost. The rest stays with them for the previlage to allow them to pay your doctor. Hell the Fed Gov has less then 5% overhead and trolls like you complian they are bloated, but 20% overhead is just fine?

5% overhead by the government is waste and abuse. 20% overhead by the insurance companies is free enterprise.

Just ask any Republican.

 

[shira]

Originally posted by: spidey07

Originally posted by: Pens1566


I didn't have a maximum. I have coverage through my employer thats about as bullet proof as you can get. But I'm lucky. Most people don't, and I don't care what you say, it's not easy to just wave your hands and get that kind of coverage. Your attitude that anyone can get it is dishonest at best, at worst its a "let them eat cake" complex.

Are you missing where I already looked up a plan that you can go out and get on right now?

How is it dishonest? Want better insurance? Want less out of pocket maximum? Want higher or unlimited maximum? Then go out and buy it! Stop spreading lies and go out and get better insurance if one needs it or wants it. Even just quickly pricing plans right now you can generally increase lifetime maximum if you want to.

I'm reporting you and this thread to flag@whitehouse.gov.

Most people can't "just get" any plan they want. I personally can't get private insurance, neither can my sister. This is TYPICAL. At least 40% of those who apply get rejected for "preexisting conditions," and can't get normal coverage at ANY price. If they're lucky, their state has an insurance pool. Even then, there are waiting lists and high out-of-pocket expenses.

Group plans through employment typically have lifetime maximums. Mine, for example, is $1.5 million.

Naturally, you'll just ignore this post, and keep right on spouting your lies.

 

[blackangst1]

Originally posted by: shira

Originally posted by: spidey07

Originally posted by: Pens1566


I didn't have a maximum. I have coverage through my employer thats about as bullet proof as you can get. But I'm lucky. Most people don't, and I don't care what you say, it's not easy to just wave your hands and get that kind of coverage. Your attitude that anyone can get it is dishonest at best, at worst its a "let them eat cake" complex.

Are you missing where I already looked up a plan that you can go out and get on right now?

How is it dishonest? Want better insurance? Want less out of pocket maximum? Want higher or unlimited maximum? Then go out and buy it! Stop spreading lies and go out and get better insurance if one needs it or wants it. Even just quickly pricing plans right now you can generally increase lifetime maximum if you want to.

I'm reporting you and this thread to flag@whitehouse.gov.

Most people can't "just get" any plan they want. I personally can't get private insurance, neither can my sister. This is TYPICAL. At least 40% of those who apply get rejected for "preexisting conditions," and can't get normal coverage at ANY price. If they're lucky, their state has an insurance pool. Even then, there are waiting lists and high out-of-pocket expenses.

Group plans through employment typically have lifetime maximums. Mine, for example, is $1.5 million.

Naturally, you'll just ignore this post, and keep right on spouting your lies.

Where do you live?

 

[spidey07]

Originally posted by: shira

Originally posted by: spidey07

Originally posted by: Pens1566


I didn't have a maximum. I have coverage through my employer thats about as bullet proof as you can get. But I'm lucky. Most people don't, and I don't care what you say, it's not easy to just wave your hands and get that kind of coverage. Your attitude that anyone can get it is dishonest at best, at worst its a "let them eat cake" complex.

Are you missing where I already looked up a plan that you can go out and get on right now?

How is it dishonest? Want better insurance? Want less out of pocket maximum? Want higher or unlimited maximum? Then go out and buy it! Stop spreading lies and go out and get better insurance if one needs it or wants it. Even just quickly pricing plans right now you can generally increase lifetime maximum if you want to.

I'm reporting you and this thread to flag@whitehouse.gov.

Most people can't "just get" any plan they want. I personally can't get private insurance, neither can my sister. This is TYPICAL. At least 40% of those who apply get rejected for "preexisting conditions," and can't get normal coverage at ANY price. If they're lucky, their state has an insurance pool. Even then, there are waiting lists and high out-of-pocket expenses.

Group plans through employment typically have lifetime maximums. Mine, for example, is $1.5 million.

Naturally, you'll just ignore this post, and keep right on spouting your lies.

I don't believe that for one second. I'm a smoker with high blood pressure. NEVER been denied for insurance and neither has ANYBODY I know, including two cancer survivors (skin). What did an insurance broker tell you when you went and asked them to find a plan for you?

 

[WhipperSnapper]

Originally posted by: spidey07
Again, I am in control of my own destiny. I WILL NOT ALLOW a government agency dictate my health and health insurance.

In that case, you're going to love it when an health insurance death panel dictates how much, if any, medical care you will receive. Instead of an evil excrement-grubbing Karl Marx-loving socialist government agency you can have your health care dictated to you by a money hungry insurance company that would happily gouge out infants' eyeballs with rusty spoons if they thought they could earn a profit at it.