Industry insider (sort of) information on health insurance reform

[SnyderShrugged]

Good morning, As some of you know, I work for a large insurance company. In my work, I focus on cost reduction and overall quality improvement efforts. Pretty much mostly Lean and Six Sigma project work.

Yesterday, I was presenting some project results to the executive committee. One of the attendees was a friend who works in our Government relations division.

She related a few things that she claims are almost certain to transpire within the next 3 months.

1. There definitely will be some form of reform passed by year's end. That was her most certain statement.

2. There will definitely be a facet called "Guaranteed issue" which means that applicants cannot be turned down for coverage based on their health status. Most job-based group health plans offer coverage on a guaranteed issue basis. Also, a handful of states require insurers to offer guaranteed issue individual policies.

It is important to remember that applicants for guaranteed issue plans can be turned down or have their coverage discontinued for other reasons, such as fraud or non-payment of premiums.

3. There will almost definitely be "community rating" rather than "experience rating mandates. community rating is where everyone pays the same premium. An insurer using community rating to set insurance premiums ignores any differences in expected costs among insured groups or people. New York State implemented the same one-price-fits-all regime, with dismaying results.

In the first year of community rating 25-year-old males were hit with premium hikes of over $500, while 55-year-olds paid about $415 less than under the risk-rated system. Not surprisingly many young people decided to drop their coverage. With fewer young, healthy policyholders available to subsidize older ones, insurance premiums skyrocketed again this year. Even older policyholders--who, in theory, should pay less under community rating--are paying slightly more.

3. There will definitely be madates to cover pre-existing conditions.

4. It's a 50/50 chance that insurance purchase mandates will go into place. While I personally am against the mandates (where everyone is required to purchase insurance or pay a fine). Without them, these new costs without an offsetting ability to pay and spread the risk across more policy holders, will likely close down or at least severely mitigate health insurers. In short, I'll likely lose my job, along with at least 20 thousand others in my company alone.

5. The public option is still a possibility, but less likely due to an inability to pay for it responsibly. This is also the case for co-ops, but co-ops have a better chance to pass because much of the burden of paying for them will fall to the states. States are fighting this hard.

6. There will be drastic cuts to medicare reimbursment rates, but medicare as a whole will likely be expanded to cover more people. This means that Dr's will likely stop taking as many medicare patients since they wont get reimbursed for their services as well. Medicare advantage may actually stay in play, which is a surprise to many of us in the industry. This is the one small light for many of us.

7. Here is one of the more surprising parts that she told me. It's something that we havent heard discussed much yet. HMO's are coming back into prominance. (I believe that HMO mandates from the 70's are one of the primary root causes of the rapid increases in medical costs today, there is certainly correlation, and possibly causation). HMOs and PPOs differ in two main ways: cost and access.

With an HMO plan, your costs tend to be much lower. HMO plans often have no deductible, and co-payments are low when you visit a doctor or hospital. This means your out-of-pocket expenses are kept at a minimum.

The tradeoff for these low costs is that your HMO plan comes with restrictions on when you can receive care — and who you can receive it from. To receive coverage, you must get care from a doctor on the plan’s pre-approved list of healthcare providers. And if you need specialist care, you’ll need a referral from your doctor. For some kinds of specialist care, you’ll need approval from the plan’s management.

PPO plans can be more expensive, but have fewer restrictions. Many PPO plans have a deductible between $500 – $2,000. And your PPO plan will have higher monthly premiums.

But with a PPO, you’ll be able to see almost any doctor you choose. PPO plans also have pre-approved lists of healthcare providers — but they also provide coverage when you see provides who aren’t on that list. When you see a pre-approved doctor, you’ll save more money — but you won’t be stuck without coverage if you choose to see an “out-of-network” provider.

So this is what I've been told, and by someone who I honestly feel would know the temperature in DC.

[chipwhich]

So this is what I've been told, and by someone who I honestly feel would know the temperature in DC.

Meh...

At this point its all opinion, and biased towards either side.

I once had it on expert "authority" that a new health plan was definitely coming in the Clinton admin.

It's such a political hotspot, anything could hapeen between now and 3 months.

[SnyderShrugged]

Meh...

At this point its all opinion, and biased towards either side.

I once had it on expert "authority" that a new health plan was definitely coming in the Clinton admin.

It's such a political hotspot, anything could hapeen between now and 3 months.

Very true, and thats why I advised any who read this thread of my source. That said, The things she mentioned do seem to be reality. But still, please dont take it as gospel and with a grain of salt.

[Larry]

But death panels. What did she say ahout death panels?

(Just joking.)

I certainly agree with the reasoning that if you mandate coverage for pre-existing conditions, then you also have to mandate that people buy insurance when they don't think they need it. Otherwise, nobody would buy insurance until after they need it.

(One version of what I think of as "pre-existing coverage, light" I've been wondering about. That would be a mandate that pre-existing conditions must be covered if someone is changing insurance. IMO, this would eliminate the "I'll wait till I need it, then buy it" effect, but it would also prevent consumers from becoming "locked in" to their existing coverage. IMO, this would increase competition. A lot.)

I liked the analysis about the effects of going to a "one price fits all" system. (Which I hadn't even heard a mention of, before. Didn't know anybody was considering it.) The analysis of what happens makes sense to me, too.

(Wonder what the effects of "one price fits all" combined with mandatory purchase of insurance would be.)

[SnyderShrugged]

But death panels. What did she say ahout death panels?

(Just joking.)

I certainly agree with the reasoning that if you mandate coverage for pre-existing conditions, then you also have to mandate that people buy insurance when they don't think they need it. Otherwise, nobody would buy insurance until after they need it.

(One version of what I think of as "pre-existing coverage, light" I've been wondering about. That would be a mandate that pre-existing conditions must be covered if someone is changing insurance. IMO, this would eliminate the "I'll wait till I need it, then buy it" effect, but it would also prevent consumers from becoming "locked in" to their existing coverage. IMO, this would increase competition. A lot.)

I liked the analysis about the effects of going to a "one price fits all" system. (Which I hadn't even heard a mention of, before. Didn't know anybody was considering it.) The analysis of what happens makes sense to me, too.

(Wonder what the effects of "one price fits all" combined with mandatory purchase of insurance would be.)

Good thoughts Larry! AS much as the libertarian in me cant stand it, mandatory purchase would certainly offset the costs. (and would probably keep me employed. LOL) I just dont like anything as mandatory!

[SnyderShrugged]

what makes a lot of this tough for me is the inner battle I have in terms of my personal values vs. my job security.

edit: funny, Congressman Paul just expressed similar thoughts on mandates just today.

Like I said, I have mixed feelings. On one hand, the reforms without the mandates may put me out of work. On the other hand, my belief system rejects mandates. UGGGGH!

from the good Dr...

Health Care Reform Is More Corporate Welfare

By Ron Paul

Published 09/19/09

Printer-friendly version

Last Wednesday the nation was riveted to the President's speech on healthcare reform before Congress. While the President's concern for the uninsured is no doubt sincere, his plan amounts to a magnanimous gift to the health insurance industry, despite any implications to the contrary.

For decades the insurance industry has been lobbying for mandated coverage for everyone. Imagine if the cell phone industry or the cable TV industry received such a gift from government? If government were to fine individuals simply for not buying a corporation's product, it would be an incredible and completely unfair boon to that industry, at the expense of freedom and the free market. Yet this is what the current healthcare reform plans intend to do for the very powerful health insurance industry.

The stipulation that pre-existing conditions would have to be covered seems a small price to pay for increasing their client pool to 100 of the American people. A big red flag, however, is that they would also have immunity from lawsuits, should they fail to actually cover what they are supposedly required to cover, so these requirements on them are probably meaningless. Mandates on all citizens to be customers of theirs, however, are enforceable with fines and taxes.

Insurance providers seem to have successfully equated health insurance with health care but this is a relatively new concept. There were doctors and medicine long before there was health insurance. Health insurance is not a bad thing, but it is not the only conceivable way to get health care. Instead, we seem to still rely on the creativity and competence of politicians to solve problems, which always somehow seem to be tied in with which lobby is the strongest in Washington.

It is sad to think of the many creative, free market solutions that government prohibits with all its interference. What if instead of joining a health insurance plan, you could buy a membership directly from a hospital or doctor? What if a doctor wanted to have a cash-only practice, or make house calls, or determine his or her own patient load, or otherwise practice medicine outside the constraints of the current bureaucratic system? Alternative healthcare delivery models will be at an even stronger competitive disadvantage if families are forced to buy into the insurance model. And yet, the reforms are sold to us as increasing competition.

What if just once Washington got out of the way and allowed the ingenuity of the American people to come up with a whole spectrum of alternatives to our broken system? Then the free market, not lobbyists and politicians, would decide which models work and which did not.

Unfortunately, the most broken aspect of our system is that Washington sees the need to act on every problem in society, rather than staying out of the way, or getting out of the way. The only tools the government has are force and favors. These are tools that many unscrupulous and lazy corporations would like to wield to their own advantage, rather than simply providing a better product that people will willingly buy. It seems the health insurance industry will get more of those advantages very soon.

http://www.campaignforliberty.com/article.php?view=218

[twa]

Good thoughts Larry! AS much as the libertarian in me cant stand it, mandatory purchase would certainly offset the costs. (and would probably keep me employed. LOL) I just dont like anything as mandatory!

Read the top line in the sig please:silly:

[SnyderShrugged]

Read the top line in the sig please:silly:

You know I agree!

[ThinSkin]

• SEPTEMBER 18, 2009
  

Mandatory Insurance Is Unconstitutional

Why an individual mandate could be struck down by the courts.

By DAVID B. RIVKIN JR. AND LEE A. CASEY

Federal legislation requiring that every American have health insurance is part of all the major health-care reform plans now being considered in Washington. Such a mandate, however, would expand the federal government’s authority over individual Americans to an unprecedented degree. It is also profoundly unconstitutional.

An individual mandate has been a hardy perennial of health-care reform proposals since HillaryCare in the early 1990s. President Barack Obama defended its merits before Congress last week, claiming that uninsured people still use medical services and impose the costs on everyone else. But the reality is far different. Certainly some uninsured use emergency rooms in lieu of primary care physicians, but the majority are young people who forgo insurance precisely because they do not expect to need much medical care. When they do, these uninsured pay full freight, often at premium rates, thereby actually subsidizing insured Americans.

The mandate's real justifications are far more cynical and political. Making healthy young adults pay billions of dollars in premiums into the national health-care market is the only way to fund universal coverage without raising substantial new taxes. In effect, this mandate would be one more giant, cross-generational subsidy—imposed on generations who are already stuck with the bill for the federal government's prior spending sprees.

View Full Image

Chad Crowe

Politically, of course, the mandate is essential to winning insurance industry support for the legislation and acceptance of heavy federal regulations. Millions of new customers will be driven into insurance-company arms. Moreover, without the mandate, the entire thrust of the new regulatory scheme—requiring insurance companies to cover pre-existing conditions and to accept standardized premiums—would produce dysfunctional consequences. It would make little sense for anyone, young or old, to buy insurance before he actually got sick. Such a socialization of costs also happens to be an essential step toward the single payer, national health system, still stridently supported by large parts of the president's base.

The elephant in the room is the Constitution. As every civics class once taught, the federal government is a government of limited, enumerated powers, with the states retaining broad regulatory authority. As James Madison explained in the Federalist Papers: "n the first place it is to be remembered that the general government is not to be charged with the whole power of making and administering laws. Its jurisdiction is limited to certain enumerated objects." Congress, in other words, cannot regulate simply because it sees a problem to be fixed. Federal law must be grounded in one of the specific grants of authority found in the Constitution.

These are mostly found in Article I, Section 8, which among other things gives Congress the power to tax, borrow and spend money, raise and support armies, declare war, establish post offices and regulate commerce. It is the authority to regulate foreign and interstate commerce that—in one way or another—supports most of the elaborate federal regulatory system. If the federal government has any right to reform, revise or remake the American health-care system, it must be found in this all-important provision. This is especially true of any mandate that every American obtain health-care insurance or face a penalty.

The Supreme Court construes the commerce power broadly. In the most recent Commerce Clause case, Gonzales v. Raich (2005) , the court ruled that Congress can even regulate the cultivation of marijuana for personal use so long as there is a rational basis to believe that such "activities, taken in the aggregate, substantially affect interstate commerce."

But there are important limits. In United States v. Lopez (1995), for example, the Court invalidated the Gun Free School Zones Act because that law made it a crime simply to possess a gun near a school. It did not "regulate any economic activity and did not contain any requirement that the possession of a gun have any connection to past interstate activity or a predictable impact on future commercial activity." Of course, a health-care mandate would not regulate any "activity," such as employment or growing pot in the bathroom, at all. Simply being an American would trigger it.

Health-care backers understand this and—like Lewis Carroll's Red Queen insisting that some hills are valleys—have framed the mandate as a "tax" rather than a regulation. Under Sen. Max Baucus's (D., Mont.) most recent plan, people who do not maintain health insurance for themselves and their families would be forced to pay an "excise tax" of up to $1,500 per year—roughly comparable to the cost of insurance coverage under the new plan.

But Congress cannot so simply avoid the constitutional limits on its power. Taxation can favor one industry or course of action over another, but a "tax" that falls exclusively on anyone who is uninsured is a penalty beyond Congress's authority. If the rule were otherwise, Congress could evade all constitutional limits by "taxing" anyone who doesn't follow an order of any kind—whether to obtain health-care insurance, or to join a health club, or exercise regularly, or even eat your vegetables.

This type of congressional trickery is bad for our democracy and has implications far beyond the health-care debate. The Constitution's Framers divided power between the federal government and states—just as they did among the three federal branches of government—for a reason. They viewed these structural limitations on governmental power as the most reliable means of protecting individual liberty—more important even than the Bill of Rights.

Yet if that imperative is insufficient to prompt reconsideration of the mandate (and the approach to reform it supports), then the inevitable judicial challenges should. Since the 1930s, the Supreme Court has been reluctant to invalidate "regulatory" taxes. However, a tax that is so clearly a penalty for failing to comply with requirements otherwise beyond Congress's constitutional power will present the question whether there are any limits on Congress's power to regulate individual Americans. The Supreme Court has never accepted such a proposition, and it is unlikely to accept it now, even in an area as important as health care.

Messrs. Rivkin and Casey, Washington D.C.-based attorneys, served in the Department of Justice during the Ronald Reagan and George H.W. Bush administrations.

Printed in The Wall Street Journal, page A23

http://online.wsj.com/article/SB10001424052970204518504574416623109362480.html

[SnyderShrugged]

The HMO avenue worries me, more as a consumer than anything else.

here is an article from India on HMO dangers.

http://www.issuesinmedicalethics.org/094co128.html

some very interesting and troubling thoughts in terms of access, physician requirements (patient quotas) and payment concerns

[SnyderShrugged]

^^ That pretty much covers my thoughts on mandates too Thinskin.

[SnyderShrugged]

How would you all feel if these items were the only reforms put into place?

Anything you would add/subtract?

[Hooper]

Such a complicated issue. I love my country, but we can and have to do better.The richest and most powerful nation in the world should not be the only one in the advanced world that has never made a commitment to provide medical care to everyone who needs it.

[JimboDaMan]

• SEPTEMBER 18, 2009
  

Mandatory Insurance Is Unconstitutional

Why an individual mandate could be struck down by the courts.

By DAVID B. RIVKIN JR. AND LEE A. CASEY

Federal legislation requiring that every American have health insurance is part of all the major health-care reform plans now being considered in Washington. Such a mandate, however, would expand the federal government’s authority over individual Americans to an unprecedented degree. It is also profoundly unconstitutional.

An individual mandate has been a hardy perennial of health-care reform proposals since HillaryCare

Got that far and then quit.

There might actually be something worthwhile in the rest of the article. But the minute the namecalling starts, credibility becomes so questionable that its not worth continuing. Why bother, when you already know the source is biased? If you really want truth, as opposed to somebody who agrees with you, why go to a source who displays their untrustworthiness (if that's a word) right up front?

[Larry]

Such a complicated issue. I love my country, but we can and have to do better.The richest and most powerful nation in the world should not be the only one in the advanced world that has never made a commitment to provide medical care to everyone who needs it.

Y'know, that's one of the slogans in this debate that sets my teeth on edge. (There are lots of others, like "death panels", "rationing", and "socialized".)

There comes a time in every life when it's time to not provide medical care.

To me, "provide medical care to everyone who needs it" is like, say, "provide our troops with everything they need". It's an impossible goal. No matter what gear you provide the troops, there will always be something newer, or better, or that the manufacturer claims is better. Or something which is better, but the troops simply can't carry the bloody thing unless they get rid of something else.

We're at the point where I think we could keep someone "alive" for 200 years. If you were willing to spend enough on it. Heck, Terry Schiavo demonstrates that we can keep someone alive who isn't just "brain dead", but who more than half of her brain simply isn't even there any more.

(It's the same problem I have with transitioning from a "life begins at birth" standard to one where life begins at "viability". A fertilized egg is viable. All you need is a boatload of money and a volunteer "mother". A sperm is viable, if you have those ingredients and an unfertilized egg. Dolly the Sheep says that a skin cell is viable.)

Somebody has to decide when it's time to quit.

And, either that person also has to be the person who's paying the bill, or else you're in a situation where somebody is demanding "everything", and demanding that somebody else pay for it.

I know that "It's time to quit sending Grandma to the Doctors, cause she's costing too much money" is a rotten way to make quality of life decisions. But, should cost be ignored as a factor in the decision making?

(Course, IMO, the best way to make these decisions is for the patient to make an informed decision, in advance of the need. Problem with that is that whole "Difficult to see, the future is." thingie.)

[/rant]

[Duncan]

Good morning, As some of you know, I work for a large insurance company. In my work, I focus on cost reduction and overall quality improvement efforts. Pretty much mostly Lean and Six Sigma project work.

Yesterday, I was presenting some project results to the executive committee. One of the attendees was a friend who works in our Government relations division.

She related a few things that she claims are almost certain to transpire within the next 3 months.

1. There definitely will be some form of reform passed by year's end. That was her most certain statement.

2. There will definitely be a facet called "Guaranteed issue" which means that applicants cannot be turned down for coverage based on their health status. Most job-based group health plans offer coverage on a guaranteed issue basis. Also, a handful of states require insurers to offer guaranteed issue individual policies.

It is important to remember that applicants for guaranteed issue plans can be turned down or have their coverage discontinued for other reasons, such as fraud or non-payment of premiums.

3. There will almost definitely be "community rating" rather than "experience rating mandates. community rating is where everyone pays the same premium. An insurer using community rating to set insurance premiums ignores any differences in expected costs among insured groups or people. New York State implemented the same one-price-fits-all regime, with dismaying results.

In the first year of community rating 25-year-old males were hit with premium hikes of over $500, while 55-year-olds paid about $415 less than under the risk-rated system. Not surprisingly many young people decided to drop their coverage. With fewer young, healthy policyholders available to subsidize older ones, insurance premiums skyrocketed again this year. Even older policyholders--who, in theory, should pay less under community rating--are paying slightly more.

3. There will definitely be madates to cover pre-existing conditions.

4. It's a 50/50 chance that insurance purchase mandates will go into place. While I personally am against the mandates (where everyone is required to purchase insurance or pay a fine). Without them, these new costs without an offsetting ability to pay and spread the risk across more policy holders, will likely close down or at least severely mitigate health insurers. In short, I'll likely lose my job, along with at least 20 thousand others in my company alone.

5. The public option is still a possibility, but less likely due to an inability to pay for it responsibly. This is also the case for co-ops, but co-ops have a better chance to pass because much of the burden of paying for them will fall to the states. States are fighting this hard.

6. There will be drastic cuts to medicare reimbursment rates, but medicare as a whole will likely be expanded to cover more people. This means that Dr's will likely stop taking as many medicare patients since they wont get reimbursed for their services as well. Medicare advantage may actually stay in play, which is a surprise to many of us in the industry. This is the one small light for many of us.

7. Here is one of the more surprising parts that she told me. It's something that we havent heard discussed much yet. HMO's are coming back into prominance. (I believe that HMO mandates from the 70's are one of the primary root causes of the rapid increases in medical costs today, there is certainly correlation, and possibly causation). HMOs and PPOs differ in two main ways: cost and access.

With an HMO plan, your costs tend to be much lower. HMO plans often have no deductible, and co-payments are low when you visit a doctor or hospital. This means your out-of-pocket expenses are kept at a minimum.

The tradeoff for these low costs is that your HMO plan comes with restrictions on when you can receive care — and who you can receive it from. To receive coverage, you must get care from a doctor on the plan’s pre-approved list of healthcare providers. And if you need specialist care, you’ll need a referral from your doctor. For some kinds of specialist care, you’ll need approval from the plan’s management.

PPO plans can be more expensive, but have fewer restrictions. Many PPO plans have a deductible between $500 – $2,000. And your PPO plan will have higher monthly premiums.

But with a PPO, you’ll be able to see almost any doctor you choose. PPO plans also have pre-approved lists of healthcare providers — but they also provide coverage when you see provides who aren’t on that list. When you see a pre-approved doctor, you’ll save more money — but you won’t be stuck without coverage if you choose to see an “out-of-network” provider.

So this is what I've been told, and by someone who I honestly feel would know the temperature in DC.

Did she mention anything about HSAs?

[mardi gras skin]

Did she mention anything about HSAs?

Yeah, I have the same question. I've got an HSA and its a powerful little tool. It was a bear to set up but I like it a lot. I've heard there's a chance those of us with HSA's might be steamrolled somehow.

[Ellis]

Yeah, I have the same question. I've got an HSA and its a powerful little tool. It was a bear to set up but I like it a lot. I've heard there's a chance those of us with HSA's might be steamrolled somehow.

can you elaborate on what an HSA is?

this is the first I've heard of it.

[twa]

HSA is a tax free savings account that you can pay healthcare costs out of(pre tax)that is coupled with a high ded heath plan

Under the proposed heath ex change it would not qualify as a approved plan,thus be unavailable if it is dropped/changed

http://en.wikipedia.org/wiki/Health_savings_account

[Larry]

Possible way to resolve that:

Permit people who have money in an HSA to roll it into a Roth?

[twa]

Possible way to resolve that:

Permit people who have money in an HSA to roll it into a Roth?

You are still screwing us over,just not stealing from us:)

[Larry]

You are still screwing us over,just not stealing from us:)

With such gracious responses, you're obviously doing it to yourself.

Please consider this your invitation to do so again.

[hkHog]

3. There will almost definitely be "community rating" rather than "experience rating mandates. community rating is where everyone pays the same premium. An insurer using community rating to set insurance premiums ignores any differences in expected costs among insured groups or people. New York State implemented the same one-price-fits-all regime, with dismaying results.

My god, this is exactly the kind of BS I was afraid of! Seriously, this would be an absolute disaster. Once again, the responsible (those people who take care of their health, always maintain insurance regardless of age, don't smoke or drink excessively, etc..., etc...) will be screwed at the expense of the irresponsible, short-sighted, and stupid people out there.

This is exactly like the Cash for Clunkers (I wish I could buy a new car, too bad I bought a used car that GOT GOOD GAS MILEAGE and wasn't eligible, instead I must subsidize all the other retards out there), foreclosure programs (I only bought as much house as i could afford and pay my mortgage every month, now I must pay for many of the idiots who didn't), bailouts (come on, how is any business going to learn not to take stupid risks if there is no fear of failure), etc..., etc..., etc...

Honestly, I really am beginning to wonder why I should live like I do, always buying insurance, investing for the future, going to work every day, living within my means, trying to be a responsible person, living a healthy lifestyle when at every turn I am being penalized for these choices and others are being rewarded for their bad behavior. I am not a rich person, I do not make much money, but I live responsibly and have worked hard for everything I have and these days I really wonder why.

It is quite depressing, I feel like if I had not put in so much work I would be getting "rewarded" in today's society. Even more depressing is the fact that I used to think of myself as a friendly generous person (and probably everyone I meet would tell you the same thing) but recently I have started to feel a sort of seething hatred to many of my fellow Americans. I used to think that Americans were independent and responsible but I just don't think so any more. Americans of all classes and economic status are turning to **** and it is ruining the society. There is nobody too big or small to fail. There is no such thing as freedom without personal responsibility. There is no such thing as capitalism without failure. IMO, all these bailouts and programs are destroying the very fabric of our society. Rather than the government being a massive safety net for everyone who does stupid **** we should be promoting individual responsibility but his is not happening.

Sorry, kind of a crazy tangential rant bt this is really getting out of hand.

BTW, I hate you all!

[Baculus]

what makes a lot of this tough for me is the inner battle I have in terms of my personal values vs. my job security.

edit: funny, Congressman Paul just expressed similar thoughts on mandates just today.

Like I said, I have mixed feelings. On one hand, the reforms without the mandates may put me out of work. On the other hand, my belief system rejects mandates. UGGGGH!

http://www.campaignforliberty.com/article.php?view=218

Thank you for posting that article. Rep. Paul made some noteworthy points, and, if you noticed, he was able to do so by interjecting some rational debate as opposed to resorting to fear mongering.

I'm also worried that health care reform will simply be a boom to the health industry (which is ironic, considering the claims coming from the right-wing), that costs will not slow down while, that people will still be uninsured, and that problems in the health insurance industry (such as refusal to cover treatment) will persist.

I think all alternatives should be explored. Debate about this is good, but we are sometimes too wrapped up in the muck to actually get the talking starting.

[twist]

There will almost definitely be "community rating" rather than "experience rating mandates. community rating is where everyone pays the same premium. An insurer using community rating to set insurance premiums ignores any differences in expected costs among insured groups or people. New York State implemented the same one-price-fits-all regime, with dismaying results.

In the first year of community rating 25-year-old males were hit with premium hikes of over $500, while 55-year-olds paid about $415 less than under the risk-rated system. Not surprisingly many young people decided to drop their coverage. With fewer young, healthy policyholders available to subsidize older ones, insurance premiums skyrocketed again this year. Even older policyholders--who, in theory, should pay less under community rating--are paying slightly more.

4. It's a 50/50 chance that insurance purchase mandates will go into place. While I personally am against the mandates (where everyone is required to purchase insurance or pay a fine). Without them, these new costs without an offsetting ability to pay and spread the risk across more policy holders, will likely close down or at least severely mitigate health insurers. In short, I'll likely lose my job, along with at least 20 thousand others in my company alone.

I'm 28 and incredibly healthy.

So, I get to pay a lot more and get forced to do so?

I'll never vote for another democrat if they try this. And I'm freaking young and healthy they can count on me sticking around for a while.