Impeding changes to our Health Care system

[TheMercenary]

The only thing controlled in the Bill is percentage differences between the upper and lower tiers. There are no cost controls. The insurance companies were given a gift.

[classicman]

Originally Posted by Happy Monkey

Percentage. Costs can increase, but the percentage of those costs that the employees pay can't. There might be some issue as to what a significant deductible or co-pay increase consists of, but once that's defined the plans will be able to decide whether to follow the new regulations, or raise the co-pay by a bit less.

Got it. ... once that is defined.


I read it this way at first and then changed my mind.

Incorrect. Insurance provider. Not doctor. If your employer moves from Aetna to United Healthcare, they obviously can't call it the same plan. Again, it is your employer changing the plan from the one you like.

... to perhaps a better one or similar one for less cost or a worse one. It doesn't matter. There are too many unknowns. And insurance costs may change from plan A to plan B so that in one case copay for prescription increases while at the same time the co-pay for a doctors visit decreases. How does that work out? No one knows - - - - - yet.

[SamIam]

Originally Posted by classicman

Completely false. Read again for comprehension. That is the main reason why I posted the link.

Hey, Classic, I think you need to look more closely at your own link. It reads:

Plans that increase the percentage of costs patients must pay out of pocket - known as co-insurance - lose their grandfathered status. The same is true for plans that significantly decrease the percentage that employers contribute to premiums or those that significantly increase deductibles or co-payments. An employer that switches health-insurance providers also loses its grandfathered status.

(emphasis my own)

In other words, if an employer wants to increase the amount that employees pay for health care, he can't. What's wrong with that? Do you want to pay even more for health coverage? Most people will be glad that their current plans are grandfathered in.

[TheMercenary]

Sam, do you think that any insurance company can survive by not changing rates in the future? I mean to say that as long as costs go up, every single insurance company in the country will have to eventually change, therefore the idea that "you can keep the plan you have" is based on the false premise that some plans will never have to change over the next 20 years. I don't buy it and I don't believe that those who wrote the bill believed it either.

[Happy Monkey]

Originally Posted by TheMercenary

Sam, do you think that any insurance company can survive by not changing rates in the future? I mean to say that as long as costs go up, every single insurance company in the country will have to eventually change,

Percent.

If costs rise 10%, the insurance company can raise their rates 10%. But not 20%.

[TheMercenary]

Originally Posted by Happy Monkey

Percent.

If costs rise 10%, the insurance company can raise their rates 10%. But not 20%.

How does an insurance company measure that cost?

[Happy Monkey]

I misspoke; raising rates won't lose them their grandfathered status. It is raising the percent of costs that employees still have to pay even after paying those rates.

[TheMercenary]

Originally Posted by Happy Monkey

I misspoke; raising rates won't lose them their grandfathered status. It is raising the percent of costs that employees still have to pay even after paying those rates.

Sounds like co-pay.

[Happy Monkey]

And deductibles. And probably more, for people who actually have to use it.

[SamIam]

Originally Posted by TheMercenary

Sam, do you think that any insurance company can survive by not changing rates in the future? I mean to say that as long as costs go up, every single insurance company in the country will have to eventually change, therefore the idea that "you can keep the plan you have" is based on the false premise that some plans will never have to change over the next 20 years. I don't buy it and I don't believe that those who wrote the bill believed it either.

Well - let's face it - its not as if insurance companies just raise their rates to reflect their increased costs. They have raised their rates because they can get away with it.

Again, from Classic's link:

Plus, it's not as though the employer-based insurance market is reliable and stable in its current form. Most employees don't have any control over the structure of their health insurance. As a result, coverage has been steadily eroding in the past decade, with premium costs for workers increasing 131% from 1999 to 2009, even as the actuarial value of those plans, on average, decreased.

I shed no tears for the insurance companies.

[classicman]

none of us do Sam - that really wasn't the point that at least I was trying to make.
I guess I am not being clear and I'll end up getting frustrated with this.
The claims that were made when this was being sold to the public may not necessarily be true. In some cases it may be BETTER for the consumer and in others not so. We do not know for sure and will not for years.

[classicman]

“Any health care funding plan that is just equitable civilized and humane must, must redistribute wealth from the richer among us to the poorer and the less fortunate. Excellent health care is by definition redistributional.”Donald Berwick

"Senate confirmation of presidential appointees is an essential process prescribed by the Constitution that serves as a check on executive power and protects Montanans and all Americans by ensuring that crucial questions are asked of the nominee — and answered," Max Baucus

On the other hand...

Max Baucus proves, yet again, that he's a major obstacle to any improvement in our nation's health care system. Now he's throwing a hissy fit over Obama's recess appointment of Donald Berwick. Dailykos

Bwahahahah

[Happy Monkey]

What's the "Bwahahahah" about?

[classicman]

The whole thing. The wording, the attitude adn dismay of the comments ... After the Kagan hearings this guy wants to ask "the tough questions" AND have them answered?? That and the ridiculousness of dailykos as a whole. After reading all the comments I couldn't help but laugh.

[classicman]

As the Obama administration begins to enact the new national health care law, the country's biggest insurers are promoting affordable plans with reduced premiums that require participants to use a narrower selection of doctors or hospitals.

The plans, being tested in places like San Diego, New York and Chicago, are likely to appeal especially to small businesses that already provide insurance to their employees, but are concerned about the ever-spiraling cost of coverage.

But large employers, as well, are starting to show some interest, and insurers and consultants expect that, over time, businesses of all sizes will gravitate toward these plans in an effort to cut costs.

The tradeoff, they say, is that more Americans will be asked to pay higher prices for the privilege of choosing or keeping their own doctors if they are outside the new networks. That could come as a surprise to many who remember the repeated assurances from President Obama and other officials that consumers would retain a variety of health-care choices.

But companies may be able to reduce their premiums by as much as 15 percent, the insurers say, by offering the more limited plans.

Bold mine.