Impeding changes to our Health Care system

[TheMercenary]

Originally Posted by Redux

Certainly, by any measure, not as much as you whine about Democrats in nearly every post.

Ummmm yea, last time I checked they hold all the power and are responsible for everything that happens or does not happen in government at the current time.

It is not an issued of the letter after the name....it is the talking points in most of your daily opinion pieces that have an agenda....an agenda that makes them partisan.

Yea. Most of what they are doing is not all that great, no matter how you want to spin it. But they get the responsiblity with the authority.

But enough of this bullshit.....your opinion is no more valid than mine...but you wont accept that.

Maybe, but opinions of known subject matter experts trump those of a no named poster without the same known credentials of 90% of my 'cut and paste' on a bad day.

[classicman]

Redux, thanks for the input. I still don't see anything that addresses the cost issues for any of this. All it says is "eligible" "affordable" or refers to some ambiguous "out of pocket limits." I still don't see what the premiums are going to be for people with pre-existing conditions relative to those without.

Originally Posted by classicman

Redux, thanks for the input. I still don't see anything that addresses the cost issues for any of this. All it says is "eligible" "affordable" or refers to some ambiguous "out of pocket limits." I still don't see what the premiums are going to be for people with pre-existing conditions relative to those without.

I dont think it is ambiguous at all.

The bill prohibits rate discrimination based on pre-existing conditions or gender (to the benefit of women who have historically faced rate discrimination). The only allowable rate differentials under the bill are age and smoking.

SO if you are on a group plan at work, the bill would require the insurance company to immediately (or within 90 days) cover a child with a pre-existing condition at the same cost as the healthy child of a co-worker. In 2014, group plans would be required to cover adults with pre-existing conditions at the same rate as healthy co-workers.

If you are talking about an uninsured adult with a pre-existing condition, the temporary pool sets rate limits indexed to the IRS rates for health saving accounts. I dont know the rates off of the top of my head, but I would guess a maximum out of pocket cost of $3-4,000 for an individual.

But dont take my word for it or dont buy into Merc's "smoke and mirrors" complaints....call or e-mail your Senator and have his/her policy person respond to your questions and concerns.

[classicman]

Originally Posted by Redux

The bill prohibits rate discrimination based on pre-existing conditions or gender. The only allowable rate differentials under the bill are age and smoking.

At what cost? that was my question.

SO if you are on a group plan at work, the bill would require the insurance company to immediately (or within 90 days) cover a child with a pre-existing condition at the same cost as the healthy child of a co-worker.

Where did it say that? I was specifically looking for that! And I thought it said after 6 months not 3.

If you are talking about an uninsured adult with a pre-existing condition, the temporary pool sets rate limits indexed to the IRS rates for health saving accounts.

What the hell is that?

I dont know the rates off of the top of my head, but I would guess a maximum out of pocket cost of $3-4,000 for an individual.

Out of pocket is not what I was referring to. I believe that was actually $5,000. I was talking about the cost of the plan.

call or e-mail your Senator and have his/her policy person respond to your questions and concerns.

Been there done that - He was less than helpful. I think my limited knowledge was more than his. Really sad when you consider he voted on it. I'm not done with him yet and he promised to get back to me... I'll hold my breath - NOT.

[SamIam]

Originally Posted by jinx

Fail.

Well, actually, I mostly agree with Redux. I just wish that certain posters would stop with the name calling already. A stance of "I'm right and you're stupid" really doesn't do much for the discussion.

Originally Posted by classicman

At what cost? that was my question.

Where did it say that? I was specifically looking for that! And I thought it said after 6 months not 3.

My mistake...6 months to cover children with pre-existing conditions on a group plan (3 months for the temp pool for uninsured). Prohibiting rate discrimination means providing coverage at the same rate currently applied to other co-workers (and families)

What the hell is that?

Out of pocket is not what I was referring to. I believe that was actually $5,000. I was talking about the cost of the plan.

The IRS sets annual rates for maximum deductables and out-of-pocket for the purpose of deducting HSA expenses for persons who currently purchase insurance on the open market (rather than through a group plan at work). These same rates will be applied to the temporary pool for adults with pre-existing conditions.

I've offered my best understanding of what all this means. I dont have anything else to add.

Been there done that - He was less than helpful. I think my limited knowledge was more than his. Really sad when you consider he voted on it. I'm ot done with him yet and he promised to get back to me... I'll hold my breath - NOT.

Keep trying...and your Congressperson as well.

[Shawnee123]

Well, actually, I mostly agree with Redux. I just wish that certain posters would stop with the name calling already. A stance of "I'm right and you're stupid" really doesn't do much for the discussion.

Well, they started it!

(I'm not feigning innocence; I get tired of the crap, which is why I chimed in when I have no horse in this race...Redux has tried and tried to have discussions based on facts. He (or she) has been put into the position everyone else who has ever tried to have a discussion with those guys has been put into...so, fuck 'em. You CANNOT have reasonable discussions with those two on any matter. If I said brown hair is better they'd post article after article by some blogger who begs to differ, then say I'm stupid and didn't read the piece of shit article. God, aren't you tired of it yet? Give it a couple more years. You will be. My Chicken Little also says the sky if falling...and it's raining asshats.)

Originally Posted by Shawnee123

Redux has tried and tried to have discussions based on facts. He (or she)...

He

Me receiving an award from former mayor of DC for work several years ago on citizen's social services commission.

Contrary to the opinion of some, I do know a little about social services issues and policy (including health care).

[Shawnee123]

Oh HAI Redux! Nice to see you!

:can't find the stupid wave smilie:

[SamIam]

Originally Posted by classicman

At what cost? that was my question.

The following is a rather long cut and paste. Please note that the study was done in 2004 so dollar amounts are probably higher now. I do think it is worth taking note of because it addresses many of the points we have been discussing here.

Kaiser Commission on uninsured and Medicaid.

It has been estimated that the number of excess deaths among uninsured adults age 25-64 is in the range of 18,000 a year. (So, we already have what amounts to a “death panel” – no insurance you are more likely to die.)

Total medical care expenditures among all of the uninsured in 2004 (including both those without coverage for all or part of the year) are almost $125 billion.

Most uncompensated care dollars are incurred by hospitals, where services are most costly. In 2001 hospitals accounted for over 60% of uncompensated care dollars; office-based physicians’ share and that of direct care programs/clinics accounted for just under 20% each.

Health services research has consistently documented an insurance disparity in access to and use of medical services. Compared to persons who have health insurance, the uninsured:

• receive less preventive care,
• are diagnosed at more advanced disease states,
• and once diagnosed, tend to receive less therapeutic care and have higher mortality rates.

Total spending for those who would gain coverage under a universal expansion would increase by $48 billion. Added to the current spending level of almost $125 billion (which includes all uncompensated care, out-of-pocket payments, and insurance payments for those covered for part of the year) the new dollars would bring the total to $173 billion if coverage were similar to the average low to middle income person with health insurance.

http://www.kff.org/uninsured/upload/...l-Spending.pdf

[Spexxvet]

Originally Posted by classicman

At what cost? that was my question.
...

How much is your health worth? Your life? The health and lives of your loved ones?

[Spexxvet]

Originally Posted by Redux

[i]..I know it, you know it, Shawnee and Sam and anyone viewing this thread know it....

Succeed.

[TheMercenary]

Sam, I think those are all valid points. But there are some things that must be considered when looking at those raw numbers. The whole story is not there.

Health services research has consistently documented an insurance disparity in access to and use of medical services.

They:
receive less preventive care,
• are diagnosed at more advanced disease states,
• and once diagnosed, tend to receive less therapeutic care and have higher mortality rates.

It has been my experience that many people in this group also fails to seek care until the last minute, over uses care that they know they don't have to pay for, and is often less compliant with their care when they do receive it. I think the reason that they may receive less theraputic care because the hospitals know they are not reimbursed for much of it, so they get just what they need when the hospital has to eat all the costs. The other reason for the disparity is that healthcare is a business. It has been that way for over 20 years. Insurance companies get to cut deals to bring in the numbers (just like the Dems have done with the mandatory insurance issue) and those who end up paying cash don't get the deal and have to pay the higher costs. Those who don't pay and can't pay still will not. One of the biggest failures in this new plan is that very little has been written into the bill which controls what the insurance companies can charge those who are already insured in the matter of deductables and co-pays. The trade off for them in the advantage of dropping the pre-existing condition clauses is that they get the numbers, millions of new payers. You only need to look at the state of Mass and see how their experiment in healthcare reform to see many of the same failures in this new plan. There is absolutely no promise that people are going to go out and get insurance, mandatory or not. That is exactly what happened in Mass. People still waited to the last minute to seek care, they still did not go out and get the mandatory insurance, and the costs were shifted to the state and individually insured to pay the bills. It is breaking their bank.

[classicman]

Originally Posted by Spexxvet

How much is your health worth? Your life? The health and lives of your loved ones?

Idiotic question. Wanna think about that & try again. Perhaps what you are asking and what I am reading aren't the same thing.

[Spexxvet]

Originally Posted by classicman

Idiotic question. Wanna think about that & try again. Perhaps what you are asking and what I am reading aren't the same thing.

This is exactly what Shawnee is talking about. Or are you really just too stupid to see the connection between your question and my answer?