Impeding changes to our Health Care system

Originally Posted by TheMercenary

Nothing in either Bill prevents them from raising premiums and co-pays, decreasing coverage and passing through the cost to those with insurance. And nothing you have posted to date disputes that.

If you have something post it. I have read the Bill.

I think I have provided it 4-5 times in the last few months...and you deny it every time.

The bills set minimum coverage requirements and limit out-of-pocket expenses (which includes co-pays and deductibles)...and provide for no co-pays ($0) for all preventive care, including colonoscopies or mammograms.

And requires caps on premiums (set in premiums/admin costs ratios) for small group/ individual premiums (one rate) and large group premiums (different rate) or provide consumers with a rebate.

Its all there in black and white....but your mind is closed to anything that contradicts your opinion....so perhaps when you read, your brain just cant process it.

[TheMercenary]

Employer Responsibility to Provide Coverage:

Provisio: A meaningful contribution toward coverage.

House: Employers are required to contribute 72.5/65% single/family of employees premium costs for coverage purchased inside or outside the exchange. 5 year grace period for some plans (Unions).

Senate: Employers are not required to provide coverage but either pay penalty if no coverage or insufficient coverage. Permanately grandfathers existing plans with any level of coverage.

Or they can provide subsidy to insurance exchanges: House and Senate version only differ by penalty.

Nothing in these provisions control costs of the premiums.

Originally Posted by TheMercenary

Employer Responsibility to Provide Coverage:

Provisio: A meaningful contribution toward coverage.

House: Employers are required to contribute 72.5/65% single/family of employees premium costs for coverage purchased inside or outside the exchange. 5 year grace period for some plans (Unions).

Senate: Employers are not required to provide coverage but either pay penalty if no coverage or insufficient coverage. Permanately grandfathers existing plans with any level of coverage.

Or they can provide subsidy to insurance exchanges: House and Senate version only differ by penalty.

Nothing in these provisions control costs of the premiums.

You are intentionally or ignorantly attempting to confuse the issue.

That provision sets levels of employer contributions.

Premiums are controlled through different provisions. For large group plans (current employer-based), 85 percent of large group premiums dollars are required to be spent on direct health benefits to consumers...they cant jack the price and simply add it to their profits or even claim it as additional administrative costs......and all "extraordinary" (to be defined in regulations) premium increases require approval by the Sec of HHS.

[TheMercenary]

Originally Posted by Redux

You are intentionally or ignorantly attempting to confuse the issue.

That provision sets levels of employer contributions.

Premiums are controlled through different provisions. For large group plans (current employer-based), 85 percent of large group premiums dollars are required to be spent on direct health benefits to consumers...they cant jack the price and simply add it to their profits or even claim it as additonal administrative costs

Certainly they can, there are no limits set except by income.

......and all "extraordinary" (to be defined in regulations) premium increases require approval by the Sec of HHS.

So you consider that a price control??!?! Please. A Sec of HHS appointed by a President who made back door deals with the Insurance industry and a Senate who basically let a insurance insider write the Bill!??? Are you delusional?

[TheMercenary]

Subsidies*to*Purchase*Coverage*and*Affordability

Ensure Employer Based Plans have similar protections:

House: IF premiums exceed 12% of income then employees can move to insurance exchanges.

Senate: ... if premiums exceed 9.8% of income. More limits if in "small group Markets"

So if your income is $200,000 that means that you premiums can be as high as $24,000 under the house plan and $19,600 under the Senate plan.

Damn dude...you just dont get or wont get it.

This has nothing to do with subsidies.....the bill sets a CAP on percent of premiums (15% for existing large group plans ) that can be claimed as administrative costs (or profits)....or the reverse.. 85% must be applied directly to patient care.

They cant raise premiums and claim more for administrative expenses or profits.

You only see what you want to see.

[TheMercenary]

Originally Posted by Redux

Damn dude...you just dont get or wont get it.

This has nothing to do with subsidies.....it is a CAP on percent of premiums that can be claimed as administrative costs (or profits).

I am quoting the Bill. Why are you ignoring the facts. A person making up to 200k can pay premiums as high as 24k without an opportunity to move to the exchanges.

[TheMercenary]

Originally Posted by Redux

Damn dude...you just dont get or wont get it.

This has nothing to do with subsidies.....the bill sets a CAP on percent of premiums (15% for existing large group plans ) that can be claimed as administrative costs (or profits)....or the reverse.. 85% must be applied directly to patient care.

They cant raise premiums and claim more for administrative expenses or profits.

You only see what you want to see.

No, what it says is that it Requires*that*insurance*companies*rebate*to*policy‐holders*any*spending*in*excess*15% FOR admin costs. Who says what those can be? You are trusting the insurance companies to acurately report the numbers? The same companies that have been screwing us for how long? Fox is incharge of the Hen House. Those rules are so vague that it screams for a scam.

85 percent of large group premiums dollars are required to be spent on direct health benefits to consumers...they cant jack the price and simply add it to their profits or even claim it as additional administrative costs

Are you really that dense?

Carry on.

[TheMercenary]

Originally Posted by Redux

85 percent of large group premiums dollars are required to be spent on direct health benefits to consumers...they cant jack the price and simply add it to their profits or even claim it as additional administrative costs

Are you really that dense?

Carry on.

Are you so dense that you can't see that percentages are easily manipulated by these companies? Those are not cost controls. Why are you ignoring what I posted. It depends on which version comes out in the final Bill as to how much you are going to be screwed.

[TheMercenary]

Insurance Regulations

House

Insurers would no longer be able to deny coverage or charge higher premiums based on pre-existing conditions or gender.

Premiums could vary by age, but premiums for the oldest customers could not cost more than twice premiums for the youngest.Not a cost control

Children would be able to stay on their parents' insurance until age 27, beginning in 2010.

The bill would end the antitrust exemption for the health insurance industry.

Senate

Insurers would no longer be able to deny coverage or charge higher premiums based on pre-existing conditions or gender. For children, this new regulation would go into effect immediately. For adults, it would go into effect with the rest of the legislation in 2014.

Premiums could vary by age, but premiums for the oldest customers could not cost more than three times premiums for the youngest.Not a cost control

Children would be able to stay on their parents' insurance until age 26, beginning in 2010.

Insurers would be required to spend at least 80 cents of every dollar received in premiums on providing health care.

http://www.pbs.org/newshour/updates/...son_12-21.html

[TheMercenary]

On exchanges:

But while House and Senate lawmakers envision the exchanges performing similar functions, there are some key differences.

For example, not everyone will be able to use the exchanges. In both bills, at least at first, only individuals who don't have access to insurance at work and small businesses could buy coverage through the exchanges. But while the House bill might open up the exchanges to more people and larger firms later on, the Senate bill would not.

Another very big difference is that in the House bill, the exchange would be national, set up and run by the federal government. In the Senate bill, each state will have to set up its own exchange, complete with its own state law on the subject.

Liberals tend to support the House's national approach; moderates, the insurance industry and the state insurance commissioners prefer the Senate approach that gives each state responsibility for its own exchange.

Jost worries about the Senate's approach: "It seems to me to be a much more complicated process that has a lot more room for failure and, frankly, I think a lot less accountability," he says. "Because if the state fails to do it, then the federal government is supposed to step in, but I think it's going to be difficult.

http://www.npr.org/templates/story/s...ryId=122476051

As I said elsewhere:

He's your typical internet bully....but laughable, because he is so transparent and predictable...and so easy to expose his "facts" and occasionally poke until he has a meltdown.

Here's the sequence that is so easy to expose:

First, you issue a blanket pronouncement of "failed" for any post that challenges your opinion.

When exposed with facts, first you deny the facts....then claim the poster and post still fail because those acts are just partisan talking points.

When it is demonstrated those facts are written into the bill....its time for your dodge and weave...first, but, biut there are loopholes because the Dems are scumbags in the pocket of the lobbyists

Followed by a new post of yours to deflect from the facts because you no longer can defend your position.

When it is pointed out that your latest post does not address the issue, either the name calling starts or a new post with new deflections.

And, finally, your conclusion it is all propaganda.

You are the only here who can predict the future and know for certain that the program as envisioned in the bills are failures.

And you are simply unwilling or unable to acknowledge that other opinions are valid and factually based. I certainly have never asserted the bill is perfect or there is guaranteed success (as opposed to your assertion of guaranteed failure) but IMO, it is clear from the facts in the bills that they address the significant cost and coverage/access issues in meaningful ways. Perfect? Nope.

But then you are the only one here who takes the extreme position that if a solution proposed by the Democrats...whether it is health reform, economic stimulus, etc. ..is not 100% perfect, it is a failure. I hope, for your sake, you dont judge your own life actions by those extremes.

Just look back over the last two pages and you are true to form.

[TheMercenary]

Originally Posted by Redux

As I said elsewhere:

He's your typical internet bully....but laughable, because he is so transparent and predictable...and so easy to expose his "facts" and occasionally poke until he has a meltdown.

Here's the sequence that is so easy to expose:

First, you issue a blanket pronouncement of "failed" for any post that challenges your opinion.

When exposed with facts, first you deny the facts....then claim the poster and post still fail because those acts are just partisan talking points.

When it is demonstrated those facts are written into the bill....its time for your dodge and weave...first, but, biut there are loopholes because the Dems are scumbags in the pocket of the lobbyists

Followed by a new post of yours to deflect from the facts because you no longer can defend your position.

When it is pointed out that your latest post does not address the issue, either the name calling starts or a new post with new deflections.

And, finally, your conclusion it is all propaganda.

You are the only here who can predict the future and know for certain that the program as envisioned in the bills are failures.

And you are simply unwilling or unable to acknowledge that other opinions are valid and factually based. I certainly have never asserted the bill is perfect or there is guaranteed success (as opposed to your assertion of guaranteed failure) but IMO, it is clear from the facts in the bills that they address the significant cost and coverage/access issues in meaningful ways. Perfect? Nope.

But then you are the only one here who takes the extreme position that if a solution proposed by the Democrats...whether it is health reform, economic stimulus, etc. ..is not 100% perfect, it is a failure. I hope, for your sake, you dont judge your own life actions by those extremes.

Just look back over the last two pages and you are true to form.

No, what I have said repeatedly is that the Bills before Congress will not fix the problems in healthcare, they will not control costs, they will not prevent the astronomical increases in co-pays and premiums, and the Insurance companies have all been in on co-opting this "reform" to their benifit. All things you have ignored to address or brushed aside with blanket statements which are false. If the Bill does not fix the problems with Healthcare then yes, it is a failure, just like the Stimulus, which was suppose to provide millions of jobs, and it has not. Even Demoncratic members of Congress are beginning to question it's success. Time will tell.

[tw]

Originally Posted by TheMercenary

No, what I have said repeatedly is that the Bills before Congress will not fix the problems in healthcare, they will not control costs,

The healthcare bill is not a solution to all that. Does not even claim to be. It addresses only some reasons for sky high costs.

But it does address a serious problem. So many Americans without any healthcare. Something approaching 40% of Americans have none. Many are playing games with "it will not happen to me" or "I always pay my bills" myths. If you have a serious illness and no health insurance, you will never pay those bills. Your credit rating destroyed for life.

In children hospitals, I am told the number without health insurance is closer to 60%. Making the kids victims.

Other programs are also necessary to address rising costs. This healthcare bill is only step one.

Now, where are costing rising? Insurance companies have somewhere around a 2% profit margin. Suppliers of medical equipment and big Pharma have double digit profit margins. That George Jr Medicaid plan did not help by keeping drug prices in America 40% higher. Making it a felony for Americans to buy the exact same drug in Canada or Mexico.

To address rising health costs means going after those with extreme profit margins and executives that are some of America's highest paid. We know a direct relationship exists between higher paid executives and less productive companies. This healthcare bill is not intended to address those problems.

Step one - first we must have what Massachusetts has - a health insurance system that is actually working. Step two comes later. Go after the reasons for escalating costs. With intentional political gridlock - we want Obama to fail - we cannot even do step one.