Obamacare...(new title): GOP DEATH PLAN: Don-Ryan's Express

[killerbee99]

Jon Stewart ripping CNN a new one. This is beautiful.

and Fox news....so they both ****ed it up....so easy with creaming yourself over the ripping of CNN when both Fox and CNN botched the whole first to report thing

[elkabong82]

Yes,

---------- Post added June-29th-2012 at 12:58 AM ----------

I've been in the restaurant business for most of my life. I've never had anybody offer to pay my insurance. I payed it for a year at $400 a month.

I had a biopsy on my stomach and they covered $100 out of $1,1000. I broke my leg/ankle/foot, they covered $6,000 of $17,000.

Why should I pay into having my own insurance? It's cheaper not to. If I get a major disease, I walk away. Why should I have it?

That's terrible insurance coverage, but now with the mandate they'll have to do better to keep customers.

If you paid $400 a month, that's $4800 a year. So the year you had **** hurt, you would have paid $18,800 without insurance. You paid $12K of what they didn't cover, so 16.8, still less than without.

Still a crappy plan you had, no doubt, but still less than what you would pay without.

Heck, I have $40 co-pays for doctors visits, and my primary doctor sucks down here. Wait an hour just to have her look up symptoms on her computer and guess what's wrong. If she's wrong, which has happened a couple times, oh well come back in a couple weeks while you still deal with what's wrong, pay more money, buy more medicine. It's a joke, but I'm in an area where it seems almost everyone complains about their doctors. The good ones are flooded with patients, and there aren't a lot of good ones because this is not a high income area.

The biggest problem though is cost. Cost of plans, cost of equipment, medicine, services, etc. Private companies were jacking the prices up because they could get away with it. Now they won't have that option, because they'll have to maintain status as the preferable option to the tax. It, along with the patient bill of rights, are good ways to keep things in check. I have my own insurance, so I'm also not worried about paying a tax. However, if the tax means my cost lowers or coverage improves as a method to keep me as a customer rather than risk losing me to the tax alternative, and at the same time millions are now insured, then it's a win in my book.

I prefer private industry be left to do it's thing, but when an industry takes advantage of it's customers to an absurd point like those companies did, then I believe the gov't should step in as a regulator. If the system was good in the first place and accessible to all, instead of being run like a damn scam as it was, then none of this would have even been necessary. The companies took advantage of a needed service, and this is the price being paid.

[Burgold]

Yes,

---------- Post added June-29th-2012 at 12:58 AM ----------

I've been in the restaurant business for most of my life. I've never had anybody offer to pay my insurance. I payed it for a year at $400 a month.

I had a biopsy on my stomach and they covered $100 out of $1,1000. I broke my leg/ankle/foot, they covered $6,000 of $17,000.

Why should I pay into having my own insurance? It's cheaper not to. If I get a major disease, I walk away. Why should I have it?

That's why I wanted true universal health care and not to have it run through private insurance companies. Insurance Companies are grifters. Now, I don't mind us being taxed for uhc, but what I'm worried about is that we might be getting the worst of both worlds. We'll see.

[Major Harris]

I'll be upfront....

this is a great post. sums up my thoughts / feelings but with more knowledge than i could contribute.

[skinsmarydu]

Operation Canadian Bacon is on, watch out you canadian goofy ****s, the republicans are coming to invade... Question, what is Canada's insurance policy? People leaving US might not like it so much, I guess we ll have to let our borders open up to illegal aliens to fill up the jobs left behind :-)

Canada has universal care. That's why we don't worry about them beating our doors down. They've also decriminalized marijuana, and legalized same-sex marriage. Wow, a free country, what a novel idea.

[Thiebear]

Two points:

If i pay 3600$ a year for insurance and now i can pay 99$ year one tax, then up to 2000$ in 2016? (now i can keep Game of Thrones on Hbo)Companies pay 10,000 this year and 10600 next year and they will have to pay a 600-2000$ fine (Corporate tax decrease by quite a lot).

Prediction:

2016: Huge backlogs in the Administration of Healthcare:

"We were staffed to handle 4-12million people and we have 30-50million" HHS secreatry for loss of documents/etc.

Reviewing Canada during the 2009-2010 years on how they fixed a similar but much smaller incident.

Edited June 29, 2012 by Thiebear

[LadySkinsFan]

Canada has universal care. That's why we don't worry about them beating our doors down. They've also decriminalized marijuana, and legalized same-sex marriage. Wow, a free country, what a novel idea.

If there was a "Like" button, I'd click on it.

I don't have health insurance, but I pay for my health care. At 60 with pre-existing conditons (which the ins. companies can no longer use as an excuse to deny but they can skyrocket rates), I can't afford a policy, but I can save the same amount of money I'd be paying or else get on a payment plan like I did when I had my appendectomy. No one paid for it but me, and I paid every penny. It took me a year, but I did it.

I'll pay the penalty, no problem for me, because I will not be forced to buy something I don't want. The mandate was bad when the Republicans thought of it and it's bad now.

I would get on board with paying into a public option, non-profit, sliding scale and not dependent upon employers. And to the person who replied to my post about "quantity" what do you think group plans are about anyway, but lumping people into a group for a "discount"? Think of the public option as a big old group with millions in it.

[MattFancy]

Canada has universal care. That's why we don't worry about them beating our doors down. They've also decriminalized marijuana, and legalized same-sex marriage. Wow, a free country, what a novel idea.

But, but all the people that are unhappy with Obama want to flee to Canada!!!

[Thiebear]

LSF: Youve mentioned the public option a good 30x, I am glad we all are getting closer to getting this right though i'd love to see a little Germany and France mixed in with this bill in a much simpler format.

This will probably match Medicaid in its current size though by 2016.

It seems as if we just want Medicaid increased to cover the other 84.1% of the people, (would be a LOT less struggle in increasing staff and working out the details) than from scratch. (especially fraud/waste/abuse section).

Edited June 29, 2012 by Thiebear

[Larry]

It is never decided on quantity. For health insurance providers it's based on group health. Insurance companies don't want to pay for unhealthy individuals. Quantity never > quality of the members of the group. Nice thought though.

I have a great deal of trouble believing that.

I certainly assume that quantity isn't the only factor considered. But to claim that it is never even a factor?

If so, then as near as I can tell, this may be the only item in our entire market system where quantity doesn't get the purchaser huge discounts.

[ixcuincle]

[Larry]

I manage a team that writes 100 appeals regarding lack of authorization or lack of medical necessity every week. Woat is the difference between a government bureacrat or an actuary in an HMO?

When the government bureaucrat denies coverage, the bureaucrat, and every one of his bosses, don't get to divide up the money they "made" between them.

[chipwhich]

I have a great deal of trouble believing that.

I certainly assume that quantity isn't the only factor considered. But to claim that it is never even a factor?

If so, then as near as I can tell, this may be the only item in our entire market system where quantity doesn't get the purchaser huge discounts.

Quantity might get a slight discount, huge is a strong statement. Health Care is the largest benefit cost for employers. I pay $1500 a month per family employee. It's much more complicated an issue because a company like IBM can "self insure" so to speak where IBM can sign up with Blue Cross Blue Shield and IBM can be held liable for medical costs outside of what Blue Cross Blue Shield expects.

It isn't cheap.

My group health costs per employee in the state of MD are more expensive than what my employees individually could get insured for.

[PeterMP]

It is never decided on quantity. For health insurance providers it's based on group health. Insurance companies don't want to pay for unhealthy individuals. Quantity never > quality of the members of the group. Nice thought though.

If you believe that over head costs isn't a major part of healthcare, then you should try doing a little reading.

http://www.google.com/#hl=en&sclient=psy-ab&q=healthcare+costs+overhead&oq=healthcare+costs+overhead&gs_l=hp.3..0i13i30j0i30j0i8i13i30l2.267.4173.0.4408.25.20.0.2.2.2.787.4842.0j8j8j0j2j0j1.19.0...0.0.Tn7FAppHXm4&pbx=1&bav=on.2,or.r_gc.r_pw.r_qf.,cf.osb&fp=5cb1cc2e78940fe1&biw=1150&bih=515

And while the health state of the people makes a big difference in costs quantity does matter.

There is a reason why people of both parties have at various times pushed health care co-ops as a partial solution to the issue of costs.

Just think of it like this, which is easier (and therefore cheaper):

An organization comes to you and says we currently have 2,500 people that have insurance and here's a bunch of data on their demographs and there history of health care usage. Can you draw us up a set of 3 plans and the associated costs and we'll sign a 5 year contract, which essentially guarantees that you will have about 2500 customers with pretty predictable demographics over the next 5 years?

Or to draw up 3 plans and then go out and find individuals that have the same health care demographis as those 2,500 people so the insurance company makes the same amount of money if you only look at health care costs.

The second one is clearly going to require more in terms of advertising to let the general public know about the health care options and then individuals to sign up and manage the individual health care plans, manage those plans, and work on customer retention and just general over head.

If that's the case, then why wouldn't the insurance company pass those savings onto the organization that is coming in with 2,500 members?

Now, they don't HAVE to, but remember, the organization with 2500 people is also going to be asking other insurance companies.

Now, I could get individual health insurance for less than my employer and myself are currently paying, but I wouldn't get nearly the same coverage and my out of pocket costs would baloon, which would off set the savings.

Edited June 29, 2012 by PeterMP

[skinsmarydu]

If there was a "Like" button, I'd click on it.

I don't have health insurance, but I pay for my health care. At 60 with pre-existing conditons (which the ins. companies can no longer use as an excuse to deny but they can skyrocket rates), I can't afford a policy, but I can save the same amount of money I'd be paying or else get on a payment plan like I did when I had my appendectomy. No one paid for it but me, and I paid every penny. It took me a year, but I did it.

I'll pay the penalty, no problem for me, because I will not be forced to buy something I don't want. The mandate was bad when the Republicans thought of it and it's bad now.

I would get on board with paying into a public option, non-profit, sliding scale and not dependent upon employers. And to the person who replied to my post about "quantity" what do you think group plans are about anyway, but lumping people into a group for a "discount"? Think of the public option as a big old group with millions in it.

I don't agree with the mandate, either. I had to pay for all of my healthcare when I was single, and even the short periods here and there that I did have insurance, I always had to pay more for being female, etc. I work for a privately -owned small restaurant, so I have no option there. My husband's plan asked me NO CRAZY QUESTIONS. Nothing. Just followed the law, as was deemed constitutional yesterday. Trust me, we were both shocked at first. But now I'm getting caught up on stuff like, oh, my first mammogram. (Yikes.) Will be scheduling that today. (Yikes.):yikes:

[PeterMP]

My group health costs per employee in the state of MD are more expensive than what my employees individually could get insured for.

Are you claiming your employees as individuals could get comparable coverage for less money as you are getting for a group?

Can you explain the mechanism that could cause that?

Edited June 29, 2012 by PeterMP

[Baylor Alum]

I hear you, but couldn't all taxes be fairly read as a command then?

I suppose some taxes are coercive, like cigarette and alcohol taxes. But even those tax action in an effort to deter action - increasing the price to deter the purchase of harmful goods. I cannot think of any taxes that tax inaction in an effort to compel action. I agree that there are some similarities between the penalty and a tax, but it just feels different somehow.

[greenspandan]

the republican freakout over "IT'S A TAX!" is going to fail because guess what ... it's a tax that only affects people who choose not to buy health insurance even though they can afford it. if you have health insurance, or if you legitimately can't afford it, there is no tax.

[MattFancy]

the republican freakout over "IT'S A TAX!" is going to fail because guess what ... it's a tax that only affects people who choose not to buy health insurance even though they can afford it. if you have health insurance, or if you legitimately can't afford it, there is no tax.

[skinsmarydu]

the republican freakout over "IT'S A TAX!" is going to fail because guess what ... it's a tax that only affects people who choose not to buy health insurance even though they can afford it. if you have health insurance, or if you legitimately can't afford it, there is no tax.

And everyone on TV yesterday said there's no penalty if you don't pay it, so....

[Tulane Skins Fan]

Yes,

---------- Post added June-29th-2012 at 12:58 AM ----------

I've been in the restaurant business for most of my life. I've never had anybody offer to pay my insurance. I payed it for a year at $400 a month.

I had a biopsy on my stomach and they covered $100 out of $1,1000. I broke my leg/ankle/foot, they covered $6,000 of $17,000.

Why should I pay into having my own insurance? It's cheaper not to. If I get a major disease, I walk away. Why should I have it?

Yes, the old insurance system worked perfectly for you, huh?

[chipwhich]

Are you claiming your employees as individuals could get comparable coverage for less money as you are getting for a group?

Can you explain the mechanism that could cause that?

Well in my case, I am part of a Maryland "group" which is a composite of Maryland businesses that had an average size under 50 employees. This "group" rating based on the health of the group isn't on the healthiest of groups. But in Maryland, I have to participate in this group, you know the group that is supposed to afford me better rates, until I am over 50 employees.

My friend who is self employed with a daughter who has type 1 diabetes pays a family rate of $750 a month. She isn't in a group.

[JMS]

I've been in the restaurant business for most of my life. I've never had anybody offer to pay my insurance. I payed it for a year at $400 a month.

I had a biopsy on my stomach and they covered $100 out of $1,1000. I broke my leg/ankle/foot, they covered $6,000 of $17,000.

Why should I pay into having my own insurance? It's cheaper not to. If I get a major disease, I walk away. Why should I have it?

What you are describing is a byproduct of US laws designed to tie insurance to employers. Designed to favor larger companies who can commit a full time human resource person or two to interface with insurance companies. You see if you are IBM or the federal government and one of their employees were getting the shaft like you are, the HR person would call up the insurance comany and tell them to do a better job or risk loosing the account entirely... And the insurance company would do a better job too because if they didn't their profits would be hit.. You don't have that option so basically you get what they will give you or you will do without and they are fine with that. Ultimately what it means is you don't have the option to really get insurance, because what is being offered to you would not help you if you actually needed it. It is why medical expenses are the #1 cause cited in personal bankrupcies, including for people who have "insurance". Because the "insurance" is fundimentally broken.

Frankly what you are describing is the fact that insurance offered at an affordable rate to individuals ($400 / month) sucks. It doesn't cover much, and what it does cover it doesn't pay much. And yes, many informed people left with the decision to buy terrible insurance which covers little or nothing, opt for no insurance. This is part of what Obamacare is designed to address...

(1) There are new minimums which insurance policies must cover.. so no more of that covering 6k on a 17k bill.

(2) There are no preexisting conditions anymore so gone are insurance companies ability to charge folkls who use their insurance more than healthy folks who have not yet begun to use their insurance.

(3) There are caps in overhead costs... so the profit incentive for insurance companies to screw you are gone. 80% of all their revenue must go towards claims. so now profits, salaries, advertising, etc all have to come out of overhead costs and can not amount to more than 20% of total revenue...

(4) There are also new guidelines in how to list benifits so it will be easier to compare costs from one insurer to another. Also each state is required to stand up a web portal to break down comparisons for consumers.

(5) The little guy buying insurance for his family has had the ground levelled significantly so his rates cant be raised, his policy can't be canceled, and his insurance has to meet certain standards.

So the affordable care act is designed to address some of the problems people like yourelf who were non standard 30-40 years ago, but who really have become the norm for many American healthcare consumers today. Insurance will become more effective, but the trade off is you will have to own insurance.

Edited June 29, 2012 by JMS

[PeterMP]

Well in my case, I am part of a Maryland "group" which is a composite of Maryland businesses that had an average size under 50 employees. This "group" rating based on the health of the group isn't on the healthiest of groups. But in Maryland, I have to participate in this group, you know the group that is supposed to afford me better rates, until I am over 50 employees.

My friend who is self employed with a daughter who has type 1 diabetes pays a family rate of $750 a month. She isn't in a group.

Why do you have to part of the group? Is this a new law?

My dad owned a business in MD and never offered any health insurance.

1. If the group has a pretty large variation in health states, then the more healthy people are likely over paying?

2. I'm dubious of "forced" groups because they seem like an invitation for corruption. If you don't have choice to join the group, then the leaders of the group don't have much incentive to deliver good service.

3. You can't just look at what he's paying for insurance. You have to look at his true total health care costs.

Edited June 29, 2012 by PeterMP

[chipwhich]

Why do you have to part of the group? Is this a new law?

My dad owned a business in MD and never offered any health insurance.

1. If the group has a pretty large variation in health states, then the more healthy people are likely over paying?

2. I'm dubious of "forced" groups because they seem like an invitation for corruption. If you don't have choice to join the group, then the leaders of the group don't have much incentive to deliver good service.

3. You can't just look at what he's paying for insurance. You have to look at his true total health care costs.

In MD you have to be part of the group until you are greater than 50 employees. At my renewal time, I was at 56 employees. Blue Cross Blue Shield required me to be at 50 employees for 7 months, which I was not. So I am stuck in the group for another year. Next year I should get more favorable rates.

I have to offer health insurance, or my company would have no employees but myself. My competition offers it, so I must offer it.